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Family Medical Leave Act (FMLA)



The Family Medical Leave Act (FMLA) entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Eligible employees are entitled to:

  • Twelve workweeks of leave in a 12-month period for:

o    the birth of a child and to care for the newborn child within one year of birth;

o    the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;

o    to care for the employee’s spouse, child, or parent who has a serious health condition;

o    a serious health condition that makes the employee unable to perform the essential functions of his or her job;

o    any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or

  • Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the service member’s spouse, son, daughter, parent, or next of kin (military caregiver leave).

Please contact the Human Resources Department for more information concerning eligibility requirements.



Procedure For Requesting Family Medical Leave

      1.       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,

2.    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.

3.       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 “Unpaid FMLA.”  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.

4.       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 return date.


5.       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 leave.