School Administrative Unit #9

Family and Medical Leave Act (FMLA)

Family and Medical Leave Act (FMLA)
FMLA Employee Notice of Rights & Responsibilities 

FMLA Informational Brochure

 What is FMLA?

FMLA provides unpaid, job-protected leave for up to 12 weeks per 12 month period for qualified employees, with the continuation of health insurance coverage by the district. This means that for eligible employees under FMLA, the district will continue to pay its portion of any health care coverage (employee is still responsible for their portion) and guarantees the employee will return to the same or similar position when they come back.

Who is required to complete FMLA Paperwork?

When an employee is out (or is planning to be out) for more than 5 consecutive days and/or they will be out intermittently for more than 5 days for the same condition, they must fill out FMLA paperwork. Where your need for FMLA leave is foreseeable, employees must provide notice of their need for leave to the SAU office not less than thirty (30) days before the leave is scheduled to begin. If the need for FMLA is not foreseeable (for example, where a need for medical treatment requires leave to begin in less than thirty (30) days), you must provide notice as soon as practicable.

Reasons for Taking Leave: If you are an eligible employee you are entitled to FMLA leave for any of the following reasons:
a) To care for a newborn, an adopted child, or a foster child within a year of the child’s arrival;
b) To care for a spouse, child, or parent who has a serious health condition *see collective bargaining agreement or personnel policies for exclusions;
c) For a serious health condition that makes you unable to perform the functions of your job;
d) For qualifying exigencies related to the foreign deployment of a military member who is the employee's spouse, child, or parent.

How do I know if I qualify for FMLA?
To be eligible for FMLA an employee must have been employed by the district for at least 12 months and worked the required amount of hours per federal and state law in the past 12 months, not including any paid or unpaid leaves they have taken (aka sick or vacation days). To make sure you are eligible, contact the SAU office. *Again, please see collective bargaining agreement or personnel policies for exclusions.

Is FMLA considered sick time?
NO, FMLA is unpaid leave. FMLA runs concurrently with any accrued sick time the employee is using *our policy requires that an employee use all accrued sick, personal and vacation time while on FMLA (see personnel policies for exclusions). The use of any accrued sick time, in addition to FMLA coverage, will be monitored by the SAU #9 Payroll Manager.
FMLA Paperwork:
Request for Family and Medical Leave form
WH-380-E (Employee) *Section # 3 must be completed and signed by attending physician
WH-380-F (Family member) *Section # 3 must be completed and signed by attending physician
WH-385 (Military)
WH-384 (Military Family Member)
*Please see your personnel policy for additional FMLA information.
FMLA forms can be faxed to Siiri Chase at 603-447-8497.

District FMLA Policies:

Contact Siiri Chase at 603-447-8368 x1019.
FMLA forms can be faxed to Siiri Chase at 603-447-8497
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