Family and Medical Leave Act (FMLA) Forms
Leave of Absence
In the event an employee is out of work due to an approved leave of absence, the employee may continue to have benefit coverage based on the type of leave taken.
When Should I Apply for a Leave of Absence?
The MCSD leave process requires employees to apply for a leave of absence if the employee will be out of work more than 5 consecutive days. Any time an employee is in an unpaid status, applying for a leave of absence may preserve their benefits. Employees are required to notify their supervisor/worksite of the absence. Failure to notify the supervisor/worksite could lead to employment concerns including job abandonment processing.
How to Apply for a Leave of Absence Electronically
Submitting an Extended Leave of Absence request is done through your Skyward homepage. Please click here to review instructions on how to submit a Leave of Absence request. All other aspects of submitting your extended leave of absence request remains the same such as providing supporting documentation and entering your leave dates in Time Off
Other leave processes are electronic as well. You must be logged into your SBMC Google account to access the tutorials below:
Application to use donated sick time click here
Donating sick time form click here
Return to Work from Medical Leave
Please download and have the appropriate form completed by your physician; forward the completed document to the Human Resource Department, Attention Janine McColley, so that your return to work date may be approved/denied.
MCEA, Professional Technical and Administrative Employees complete Form #1302
AFSCME complete Form #1301
Employee on an Approved FMLA Leave
If employee is approved for FMLA leave, MCSD will continue to provide employer contributions towards benefits. Employee is required to continue to pay employee's share of benefit elections while on leave. Payments to continue benefits must be paid on the first of the month following the first missed payroll deduction. For further information on how to make payments, please contact the Risk & Employee Benefits Department.
If employee has not returned to active duty when FMLA leave ends, benefits will terminate at the end of the month. Employee may continue coverage for eligible insurance benefits by paying the total premium amount under COBRA. Upon expiration of benefits, a COBRA notice will be mailed to the employee's home address on record to provide them an opportunity to elect coverage. The Human Resources Department determines eligibility for FMLA.
Employee on an Approved Non-FMLA Leave
MCSD does not contribute towards the employee's insurance premiums while out on non-FMLA leave. Coverage ends at the end of the month the employee's leave starts. For example, if employee's leave begins on September 3rd, employee benefit will end on September 30th. Employee may continue employee eligible insurance benefit by paying the total premium amount under COBRA. Upon the expiration of benefit a COBRA notice will be mailed to the employee's home address on record to provide an opportunity to elect coverage.
When the benefit eligible employee returns from a non-FMLA leave, the employee must re-enroll and elect coverage for any plan(s) in which they would like to enroll. If employee does not re-enroll and elect new benefits, benefit-eligible employees will be auto-enrolled in EAP and Life Insurance only. Any supplemental coverages and tax-free account(s) must also be re-elected. After the effective date of coverage, no changes, additions or cancellations of employee's insurance coverage can be made unless the employee experiences a qualifying event (See Qualifying Events and IRS Code Section 125).
Workers' Compensation Leave
If employee is out of work on Workers’ Compensation Leave, MCSD will continue to provide employer contributions for up to six (6) months towards benefits. Employee is required to continue to pay employee share of benefit elections while on leave. For information on how to make payment arrangements, please contact the Risk & Employee Benefits Department.
At the expiration of benefits, an employee may continue employee insurance coverages by paying the total premium amount under COBRA. Upon the expiration of benefits, a COBRA notice will be mailed to the employee's home address on record to provide an opportunity to elect coverage.
Click HERE to view the current Leave Toolkit.
If you have questions please contact Janine McColley at ext. 30246 or via email at firstname.lastname@example.org