Claim Basics
This claim type does not require any initial support documentation for adjudication to begin.
What is safe leave?
This icon allows for the editing of fields on a saved ticket in Salesforce.
What is the pencil icon?
In order to qualify for FAMLI job protection, a claimant must have been employed for at least this long at their current job.
What is 180 days?
This is how I know who to contact when I need to speak with the employer.
What is checking the Related Contacts?
I look at this page when there’s a question about a benefits payment.
What is Payment History?
What is 30 days?
Information of this type cannot be included with a ticket description in Salesforce.
What is Personally Identifiable Information (PII) (E.g. SSN, dates of birth, personal addresses, etc.)?
FAMLI Job Protection and Anti-Retaliation rules do not apply to this group of participants.
Who are Employees of Opted-Out Local Governments (EOOLGs)?
When I know the employer called into the call center, I always look for this.
What is the ticket record of the call?
I always check this when I’m reviewing medical or care leave claims.
What is the Serious Health Condition Form (SHCF)?
When claimant is not satisfied with a claim determination outcome, they may complete this first step in the appeals process via their claim in the My FAMLI+ portal.
What is a Request for Reconsideration?
This field connects an older ticket to a newer one.
What is Parent Ticket? (Also acceptable: What is Related Tickets?)
Employers must continue to provide this to employees while they are out on FAMLI leave.
What is the continuation of health insurance coverage?
This is where I would confirm the private plan start date.
What is the Plans section on the employer account?
The Serious Health Condition Form (SHCF) can be found here, along with any other required uploads.
What is the Documents section of the claim details page?
A claimant can update or cancel their claim from this My FAMLI+ portal page.
What is Edit Claim, (link found on the claim details page)?
This link on a saved ticket in Salesforce will allow for it to be assigned to a different person or queue.
What is the Change Owner icon or Change Ticket Owner screen?
All complaints received by the Job Protection & Retaliation Unit are ____, but may not be ____.
What is reviewed, but may not be investigated?
This feature lets me verify whether an employer reported wages for a specific individual. I can search quarter-by-quarter.
What is the Internal Wage Reporting tab in Salesforce?
If I need to know how many hours of leave the claimant reported last month, this is what I do.
What is check the claim’s Leave Details section?
These are the two determinations made on every properly filed FAMLI claim.
What are Event Eligibility and Coverage & Wage Replacement?
The three subtypes available for Job Protection and Retaliation tickets in Salesforce.
What are interference, job protection, & retaliation?
These are the two ways a claimant can report a job protection or retaliation issue.
What is by calling into the OCC or filling out the complaint form online? (https://famli.colorado.gov/individuals-and-families/get-help-from-famli/job-protection-and-retaliation)
This action will help me find all tickets related to a specific claimant.
What is searching for the claimant account ID in Salesforce?
This shows all the changes made to a particular claim.
What is the Event Log?