FMLA Basics

Question 1

What is FMLA?

Answer 1

FMLA stands for Family Federal Medical Leave Act. It provides legal job protection by the Federal Government.

Question 2

What are the 3 eligibility requirements for FMLA?

Answer 2

1250 hrs wrked in rolling year, 1 YOS, Approved WL (work location)

Question 3

What reasons can an EE use FMLA?

Answer 3

OSHC, COFM, Bonding, Military Exigency, Adoption/Foster Process

Question 4

EE adv is adoption of new child is becoming official today. EE adv needs to file a claim to spend time with their new child.

What is the reason and relationship?

Answer 4

Bonding: Adopted Child

Question 5

EE adv both of his parents are getting older and he needs to frequently miss work to take them to appointments. EE adv they have the same doctor and since it is just for driving parents to appointments he asks if he can just use one claim for both parents. How many claims would EE need to file in this situation?

Answer 5

Two. A claim can only be used for 1 reason or 1 relationship

Question 6

EE adv he is brand new his company but has to miss work for surgery. EE asks does he really need to file a claim is it is just going to be denied since he is not eligible for FMLA. What do you adv?

Answer 6

Hard Hold should be used to review ABS Summary to see if EE has DSB, if there are any state or company leaves that may apply. If yes CSP would adv EE we will start claim and review to see if any other leaves may apply. Additionally, you ER wants us to track your ABS even if you won’t be eligible

Question 7

Where can you find how long an ER allows for original MC to be completed?

Answer 7

Version

Question 8

Where can you find whether or not an ER allows Intermittent Bonding?

Answer 8

Pg 2

Question 9

For NY PFL how long does EE have to get MC or supporting documents submitted from date of intake?

Answer 9

30 days

Question 10

When adding a new WS where can you find that date that the new WS becomes effective?

Answer 10

Work Schedule Effective Start Date, upper right hand corner. This will auto populate based on FDO

Question 11

When does EE get their FMLA time back on a Calendar Year calendar basis?

Answer 11

All 12 wks on Jan 1

Question 12

If EE and EE wrks M-F 8-5 what else do you need to ask before adding a new WS?

Answer 12

If WS is the same every week, if they have paid or unpaid lunch, if that is 8A-5P or 8P-5A

Question 13

What is the primary difference between FMLA Mil Ex and USERRA?

Answer 13

USERRA can only be used by military member. FMLA Mil Ex can only be used by family members

Question 14

Where can you find all leaves available to a specific EE?

Answer 14

ABS Summary

Question 15

EE (not NY WS) just filed a claim for Bonding and asks what happens next. You adv….

Answer 15

We will send a packet out by mailing requesting POB or Proof of Pregnancy with a due dates on it. That packet will be available on MyBenefits starting tomorrow. EE can text in POB.

Question 16

Where would you look to see if late certs are allowed?

Answer 16

DBA shows if late certs are allowed. Pg 2 will explain late cert process

Question 17

Where can you find how often an EE will need to recert for Intermittent ABS OSHC?

Answer 17

Version

Question 18

Do we manage USERRA for control # 70184

Answer 18

Yes

Question 19

I say: “The start of ABS is always…”

You say:

Answer 19

“first day out of work”

Question 20

I say: “Bonding starts when”

You say:

Answer 20

“disability ends”

Question 21

Does EE need to be meeting 1250 hrs in last yr requirement for each time an ABS is added to be approved?

Answer 21

No, once eligibility is approved EE remains eligible for 1 yr from date of first ABS on that specific claim

Question 22

If EE already has an approved claim for migraines and now needs to miss work for PT can EE just report the PT ABS on the migraines claim?

Answer 22

No. A new claim is needed for each medical condition. An exception to this is if EE is already OOW on a continuous ABS is reporting now has another condition that would be documented for DCM

Question 23

Name 3 differences between Bonding and COFM: bio child claims

Answer 23

1. Bonding only need POB or Prook of Pregnancy while COFM requires a MC by AP
2. COFM: family member must have a medical condition
3. While Intermittent Bonding is not always allowed. COFM does always allow Intermittent ABS (as long as medically supported)

Question 24

Can FMLA denial be appeal?

Answer 24

No

Question 25

Name 3 reason why a specific ABS could be denied

Answer 25

Late Reporting, Late Cert, No FMLA time available, Not meeting leave requirements (NY PFL only full days) or (Bonding over 1 yr since birth or placement), Not a covered relationship

Question 26

True or False: If there is a leave listed on the DBA then it will also appear on the ABS Summary screen

Answer 26

False, DBA shows what we manage for the company, ABS Summary shows all leaves available to an EE, Pg 2 shows all Company Leaves managed by Pru but may not apply to every EE that works there.

Question 27

Which Calendar Basis gives EE 12 wks of FMLA time Jan 1 every yr?

Answer 27

Calendar Year

Question 28

Which Calendar Basis gives EE 12 wk of FMLA 1 yr from their first ABS?

Answer 28

Rolling Forward

Question 29

Which Calendar Basis gives EE FMLA time back 365 days after it was used?

Answer 29

Rolling Backward

Question 30

True or False:

EE only has 1 yr from the DOB or placement to use bonding time

Answer 30

True

Question 31

True or False:

Pregnancy claims can have up to 5 events all under 1 claim

Answer 31

True

Question 32

Name the five events that can be on a pregnancy claim

Answer 32

Pre Natal Comps, Pre Natal Well Care, Pregnancy, Post Natal Comps, Bonding