Procedure For Requesting Family
Notify the Human Resources Department of your intention to take
a leave using FMLA. This can be done by calling or emailing Carrie Southwick at 413-387-1104, email@example.com.
Complete the paperwork required to use FMLA. This includes a
Request for FMLA and a Certification of Health Care Provider (These forms will be mailed directly to you). These forms need to be turned in to the HR
Department in in order for the FMLA to be approved.
Once the FMLA request is approved:
The HR Department will notify the Payroll Department of the employee’s
change in status;
The HR Department will complete and submit biweekly
timesheets for the employee. Credited leave time (Sick,
Vacation, and Personal Leave) will be used until it is
exhausted*. Any biweekly deductions (such as for health,
dental or voluntary life insurance, union dues, and 403(b)
plan) will continue to be deducted.
When all an employee’s leave time is
exhausted, any remaining FMLA leave time will be coded as
If this occurs and the employee is
currently enrolled in ServiceNet’s health, dental or
voluntary life insurance plans, the employee will be
required to pay the employee’s share of any premiums in
order to maintain coverage. (Checks
should be made payable to ServiceNet and mailed to or
dropped off at the HR Department by the 1st
of each month.)
If the employee is currently enrolled in ServiceNet’s 403(b)
plan, contributions will stop during unpaid FMLA leave and
no employer match will be made.
The employee must notify the HR Department regarding any changes
in the employee’s expected return date or medical condition.
This can be done via phone or email, or the health care provider
can fax in any medical condition updates. In order to accurately
track benefit time, the HR Department must be aware of the exact
The employee must notify the HR Department on the day the
employee returns to work.
The HR Department will complete a
ServiceNet Employee Action Form and notify the Payroll
Department of the employee’s change in status;
Please contact the HR
Department with any questions regarding the FMLA.
*Employees who are members of the
UAW may retain up to 12.50 days of leave time by
taking unpaid FMLA leave. A UAW member choosing to do this must
notify the HR Department at the beginning of the employee’s FMLA