FMLA Basics
What are the 3 eligibility requirements for FMLA?
1 year LOS
1250 HW
Eligible Work Location
Which state paid leaves allow for intermittent bonding no matter the ER's election?
NY PFL, CO PFL, OR PFL
What is the initial certification period?
How long a claimant has to return the MC after filing the claim.
Which DCMS screen has the certified F&D for an intermittent ABS claim?
Medical Screen - Med Cert tab
Where can the timely reporting window be found?
Version
How do you report time as Not Taken?
Complete the P360 template and leave a PMR intervention.
Does FMLA have an appeal process?
No (but some situations allow for a denial to be overturned)
MA PFML, 7 calendar days
Where can the due date for an MC on a pending claim be confirmed?
Preliminary Packet/letter
What is the review TAT to review new ABS time (Both paid and unpaid leaves)?
5 Business Days
Where can specifics about an ERs MA PFML handling be found?
Page2
How many ABS event could a maternity claim have?
5
Explain when an EE gains time back on a rolling backward calendar basis?
EE will regain ABS time 1 year from the date they originally used it.
Which state offers an unpaid leave to use specifically for pregnancy related ABS reasons?
CA (CA PDL)
Name 2 reasons an updated Med Cert would be needed on and intermittent ABS claim.
1. Certification has expired
2. EE exceeded the certified frequency and duration
Should you add a PMR to the call document if you only report new intermittent ABS time?
No (A follow is automatically created by DCMS when new ABS time is reported)
Where can the scheduled benefit amount for a paid leave be found in DCMS?
PL Coverage screen
What does EOL stand for?
Extension of Leave - When additional ABS time is reported beyond the cert expiry date.
How is the definition of intermittent bonding different from the definition of intermittent ABS?
Intermittent Bonding occurs if EE RTW for any length of time then goes back out again to take additional bonding time whereas Intermittent ABS is defined as being OOW for 3 or less consecutive days
Which state paid leaves have their own forms?
NY PFL (COFM, Bonding Cert, Exigency)
CO PFML (Bonding Cert, Safe Leave Attestation)
Name 3 common reasons why an MC may be deemed incomplete?
Missing Medical Facts
Missing/incomplete F&D or ABS duration
Missing certification start/end date
Which QR status still allows for ABS time to be reported?
Both QR pending and QR error
Where do you go to confirm company level leave information?
CLWS
When can CSPs add STD to an ABS only claim and what should they do before adding it?
Yes, check ABS Summary/ERS to confirm EE has coverage
Yes (check the JA!)
What is the de-implementation process for SPL after an ER terminates with PRU?
If the FDO occurred when the policy was active with PRU, PRU will continue to handle the SPL until a new claim is needed/claim is run out.
What must be true to be able to offer a 1x7day extension?
ER must allow extensions (check DBA)
Due date is in the future
An extension is not already on file for the cert period
An incomplete cert letter has not been sent for the cert period
What 5 things should you do when you add new ABS time?
1. Confirm the ABS reason/relationship
2. Obtain and update the date and time/s of the ABS
3. Review the WS to confirm the ABS time falls within it.
4. Confirm the certification expiry date
5. Check the Med Cert tab in the Medical Screen to confirm the ABS time falls within the current certified F&D/ABS duration
How can you determine if PRU can speak to payment information for a Company Leave?
CPL code on the CLWS
Purple branch in PDR
CL willow show on the PL tab in DCMS
For COFM - Adult Child, what additional information is needed on the Med Cert?
Confirmation that the adult child is unable to perform 3 or more ADLs