DEPARTMENT: Human Resources
PAGE: 1 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
SCOPE: Employees in Company-affiliated facilities.
PURPOSE: Affiliated employers may provide various leaves of absence to employees.
POLICY:
I. TYPES OF LEAVE:
A. EDUCATIONAL LEAVE
Consideration will be given an employee requesting a leave of absence to continue
his/her education if the employee has expressed full intention of returning to
employment.
Eligibility -Full-time regular employees with at least six months of continuous service
who seek to enroll as full-time students in a course of study that would otherwise conflict
with their normal work schedule. Enrollment in part-time, night or weekend courses will
not support eligibility.
Approval - A written request for educational leave should be submitted by the employee
to the supervisor on the appropriate Leave of Absence Request form, setting forth the
dates of the leave requested, the course of study and the educational institution at which
the study will take place. Approval for an educational leave is based on the needs of the
employer and the appropriateness of the course of study to operations.
Duration - The leave should not exceed six (6) months.
B. GENERAL MEDICAL LEAVE
(Including pregnancy leave not covered by Family Medical Leave, the Tennessee
Maternity statutes, other applicable state statutes and on-the-job injuries or illness)
Eligibility - A medical leave of absence may be granted to a full-time employee with at
least six months of continuous service. Any accrued paid benefit time should be run
concurrently with the leave of absence. There is no minimum service requirement for
eligibility for a leave of absence occasioned by a pregnancy-related disability, or for a
disability arising out of an on-the-job injury or illness.
Approval - A written request for this leave should be submitted by the employee to the
supervisor on the appropriate Leave of Absence Request form. A physician’s
certification will be required. The department head may approve a medical leave of
absence based on the circumstances of the request.
Duration - Medical leaves, if granted, are granted for the duration of the period of
disability, not to exceed six (6) months during a rolling calendar year. If family and
6/2002
DEPARTMENT: Human Resources
PAGE: 2 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
medical leave and general medical leave are taken during the same 12-month period, the
total combined leave time may not exceed six (6) months. (See Family and Medical
Leave guideline).
Medical Verification - The Company reserves the right at any time to require proof or
medical verification of an employee's ability or inability to work. Such proof or
verification may include periodic reports from, or consultation with, the employee's
physician or examination of the employee at the employer’s expense by a physician
selected by the employer. Human Resources should be consulted regarding medical
verifications.
C. MILITARY TRAINING LEAVE
Employees who must be absent for active or inactive military training duty (e.g.,
Reserves or National Guard summer camps, annual cruises, weekend drills, attendance at
military schools) will be granted, upon request, a leave of absence without pay. An
employee may use PTO for military training duty obligations upon written request.
Eligibility - All employees who engage in active or inactive military training duty in the
armed forces of the United States, including the National Guard.
Approval - Request for military leave should be made sufficiently in advance of the
projected beginning of the leave to enable the employer to adjust the work schedule
accordingly. The employee should use the appropriate Leave of Absence Request form.
Duration - Leave will be granted for the period of the training.
D. MILITARY ACTIVE DUTY LEAVE
This policy is in compliance with the Uniformed Services Employment and Reemployment Rights Act (USSERA) of 1994. The intent of this policy is to make
employees called to active military duty, other than routine training, “whole” in terms of
missed compensation while on active duty. Employees’ compensation will be offset in
circumstances where normal pay is greater than military pay while on active duty.
Payments will be calculated based on the difference between the employee’s gross
regular pay (including shift differentials) at the time of activation to military service and
his/her gross pay from the military. Therefore, regular gross pay will be based on the
employees’ scheduled hours and shifts at time of activation. Overtime hours are not
included in the calculations; only regular hours, shift differentials, and any applicable
other premium pay such as certification differentials, are to be included.
Eligibility - Regular Full Time and Regular Part Time employees who have been served
6/2002
DEPARTMENT: Human Resources
PAGE: 3 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
with Activation Orders to report to active duty within their component (USA, USMC,
USN, USCG, etc). Temporary and PRN employees are not eligible.
Procedure for Supplemental Military Pay –
Use the link http://www.defenselink.mil/specials/militarypay2002/paychart2002.html to
determine the pay for employees on military leave. Use the employee’s military rank and
years of service with the Military and match it to the pay grade in column one.
Employee’s military years of service should be located on their “JUMPS” (Joint Uniform
Military Pay System) Statement. This table is set up for monthly pay periods, so you
may need to calculate the differential if the employee is on a bi-weekly or hourly pay
schedule.
Once employees are able to provide specific proof of pay received from the military,
adjustments may need to be made. All payments will be subject to taxes and other
applicable withholdings.
1. Determine gross pay employee will be receiving from the Military by looking at the
“Monthly Basic Pay Table”.
2. Convert Military “Monthly Basic Pay Table” to an annual amount (12 months) and
divide by 26 (# of bi-weekly payrolls in a year). If you process payroll weekly, divide
by 52.
3. After you calculate the amount of bi-weekly Gross pay received by the Military
(using step 2 above), subtract the employee’s gross regular pay (including shift
differentials). The difference will be the employee’s new gross payroll.
4. Enter the amount of the new Gross Payroll to earnings code 78 using on-line time
entry for dollars ($$) only. The on-Line time entry screen is accessed through option
11 (SPECIAL PAYROLL ACTIVITIES), then option 7 (TIME ENTRY MENU),
then option 1 (ADD TIME).
5. For questions about this procedure, you may contact IT&S Customer Support –
Payroll at 1-800-265-8422, option 4, 1.
Procedure for Coding the Active Duty Military Leave –
1.
2.
3.
4.
6/2002
Access the Payroll/Benefits/HR System – Main Menu
Select Human Resources Activities – Employee Maintenance Activity 30
Select Activity 18 – LOA
Select Activity 1 – Place On LOA Or Correct Current LOA (see below for a screen
print)
 On this screen, you will enter all appropriate employee data in the required
fields. Please note the following items which must be processed per the
instructions below:
DEPARTMENT: Human Resources
PAGE: 4 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002



POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
This leave should be listed as a paid LOA. The date the paid LOA begins
is the day following their last physical day at work.
LOA Reason should be listed as M911.
Change Pay Status should remain as an A.
SSN:
- -
NAME:
PAY STATUS (LAST PAY PER):
LOA STATUS (PLACE ON LOA):
UNPAID LOA START DATE:
PAID LOA START DATE: - LOA END DATE : - -
- EXPECTED: E
LOA REASON:
M911
LOA REASON EFF DATE: - LOA COMMENTS:
:
NEXT REVIEW DATE: - REVIEW TYPE:
CHANGE PAY STATUS TO: A (' '/'A'/'I')
For questions about this procedure, you may contact IT&S Customer Support at
1-800-265-8422.
Benefits Continuation While on Active Duty Military Leave – (See Attachment A).
E. PERSONAL LEAVE
A personal leave of absence without pay may be approved for a variety of reasons. A
Supervisor may allow an employee personal leave for situations that in management's
view, require it.
Eligibility - An approved personal leave of absence may be granted to regular full-time
employees with at least six (6) months of continuous service.
Approval - A written request for a personal leave of absence should be submitted on the
appropriate Leave of Absence Request form by the employee to the supervisor prior to
the commencement of the leave. Approval will be granted by the department head based
on the circumstances surrounding the request.
Duration - The leave should not exceed six (6) months.
6/2002
DEPARTMENT: Human Resources
PAGE: 5 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
F. LEAVES OF ABSENCE (FAMILY AND MEDICAL LEAVE)
The Family and Medical Leave Act provides that eligible employees are entitled to a total
of twelve (12) weeks of unpaid leave during a backwards-rolling twelve-month period for
any one, or more, of the following reasons:
1) The birth of a son or daughter, and to care for the newborn child;
2) The placement with the employee of a son or daughter for adoption or foster care;
3) To care for the employee's spouse, son, daughter, or parent with a serious health
condition;
4) Because of a serious health condition that makes the employee unable to work.
Leave Entitlement - Leave for birth or placement of child for adoption or foster care must
be taken within 12 months of birth or placement. When both spouses are employed by
the Company they are limited to a combined total of 12 work weeks during a backwards
rolling 12-month period if leave is taken for birth or placement of a child for adoption or
foster care.
Family and medical leave need not always be taken in one continuous leave period.
Leave may be taken "intermittently" or on a "reduced schedule" basis under certain
circumstances. Intermittent leave is leave taken in separate blocks of time due to a single
illness or injury, rather than for one continuous period of time. A reduced schedule leave
is a leave that reduces an employee's number of scheduled working hours per day or per
week.
Intermittent or reduced schedule leave for a birth or placement of a child for adoption or
foster care may be approved by the employee's department head if staffing and workload
permit. Intermittent or reduced schedule leave to care for a qualified sick family member
or for an employee's own serious health condition will be approved if the leave is
medically necessary.
An employee who has a serious health condition and is unable to return to work after 12
weeks of family and medical leave may be placed on a general medical leave. (See
general medical leave guideline). An eligible female employee working in Tennessee
who is taking maternity leave may be entitled to an additional four (4) weeks. (See
maternity leave guidelines). Leave for employees working outside Tennessee will be
governed by applicable state and local law.
Serious Health Condition - An illness, injury, impairment or physical or mental condition
that involves either:
Any period of incapacity or treatment connected with inpatient care (i.e., an overnight
stay) in a hospital, hospice, or residential medical care facility, and any period of
6/2002
DEPARTMENT: Human Resources
PAGE: 6 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
incapacity or subsequent treatment in connection with such inpatient care; or continuing
treatment by a health care provider which includes any period of incapacity (i.e., inability
to work, attend school, or perform other regular daily activities) due to:
1. A health condition (including treatment therefore, or recovery therefrom) lasting
more than three consecutive calendar days, and any subsequent treatment or
period of incapacity relating to the same condition, that also includes:
a) treatment two or more times by or under the supervision of a health care
provider; or
b) one treatment by a health care provider with a continuing regimen of
treatment; or
2. Any period of incapacity due to pregnancy or for prenatal care. A visit to the
health care provider is not necessary for each absence; or
3. A chronic serious health condition which continues over an extended period of
time, requires periodic visits to a health care provider, and may involve
occasional episodes of incapacity (e.g., asthma, diabetes). A visit to a health care
provider is not necessary for each absence; or
4. A permanent long-term condition for which treatment may not be effective (e.g.,
Alzheimer’s, a sever stroke, terminal cancer). Only supervision by a health care
provider is required, rather than active treatment; or
5. Any absences to receive multiple treatments for restorative surgery or for a
condition which would likely result in a period of incapacity for more than three
days if not treated (e.g., chemotherapy or radiation treatments for cancer).
Eligibility - An eligible employee is one who has been employed for at least 12 months,
has at least 1,250 hours of service during the 12-month period immediately preceding the
date of the requested leave, and who expresses an intent to return to work after the leave.
Approval - An employee desiring to take family and medical leave must give at least 30
days advance notice prior to commencement of leave, if the need for leave is foreseeable.
If the need for leave was not foreseeable, and/or 30 days is not possible, the employee
must give as much notice as is possible under the circumstances. The employee should
give at least verbal notification to the employer within one or two business days after the
need for leave becomes known. The employer may delay the taking of FMLA leave until
at least thirty (30) days after the date that notice is provided except in extraordinary
circumstances where such notice is not feasible.
A written request for leave should be submitted by the employee to the Supervisor. The
request should set forth the reasons for the leave, the anticipated start and the duration of
the leave.
6/2002
DEPARTMENT: Human Resources
PAGE: 7 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
When planning medical treatment, the employee should consult with the health care
provider and his/her Supervisor, before scheduling treatment, in order to prevent undue
disruption of department operations.
Medical Certification - A health care provider’s certification will be required to support a
request for leave. Second or third opinions may also be required at the employer’s
expense. It is the employee’s responsibility to return both the health care provider
certification as well as the Leave of Absence Request form to Human Resources within
fifteen (15) days of receipt of the form. A delay in the return of the required documents
and certification may result in the leave being denied or postponed.
Subsequent re-certifications may also be requested of the employee at periodic intervals
which are no more often than every thirty (30) days in order to update the leave record
and justify the continuation of the leave. Failure to comply with the requests for recertification may result in the leave being canceled.
A fitness for duty or physician’s release to return to work will be required when the leave
has been taken due to the serious health condition of the employee. An employee will
not be returned to work without the proper documentation from the health care provider.
Failure to submit a fitness for duty certification may result in the denial of restoration to
employment following FMLA leave.
Reinstatement - An employee should provide the employer with periodic reports
concerning intent to return to work. An employee should give the employer at least two
(2) days notice of intent to return to work earlier than anticipated. An eligible employee
who returns from family and medical leave taken in accordance with this guideline will
be reinstated to his/her former position, or to an equivalent position with equivalent pay,
benefits, and working conditions. Taking of FMLA leave does not entitle the employee
to any lesser or greater right to be restored to his/her position, or an equivalent position
than the right the employee otherwise would have had if FMLA had not been taken (e.g.,
during a reduction in force or organizational redesign).
Key Employee - Reinstatement may not always be possible for certain salaried "key
employees." If the employer determines that reinstatement of a "key employee" would
cause substantial and grievous economic injury to the operations of the employer,
reinstatement may be denied.
An employee requesting leave will generally be notified, at the time of the request, of
his/her status as a "key employee" and the potential consequences with respect to
reinstatement following the leave. If such notice cannot be given immediately, because
of the employer’s need to determine whether the employee is a key employee, notice will
be given as soon as practicable after receipt of the leave request (or the commencement
of leave, if earlier).
6/2002
DEPARTMENT: Human Resources
PAGE: 8 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
If the employer determines, after the leave has begun, that it will not be able to reinstate
the key employee at the end of the leave, it will so notify the employee in writing and
give the employee a reasonable time in which to return to work. If the key employee
elects not to return to work, (if the leave has already begun) after receiving notification of
the employer’s intent to deny reinstatement, the employee's eligibility for reinstatement
will be governed by the guideline for reinstatement from general medical leave.
In such a case, the key employee's insurance coverages continue in effect throughout the
entire family and medical leave in accordance with the Benefits Continuation section of
this guideline.
Benefits Continuation - An employee on an approved family and medical leave may
continue group insurance coverages during the leave. If any portion of the leave is paid,
(i.e., EIB or PTO), the premiums normally paid by the employee, while working, will be
deducted from such pay.
If the leave is unpaid, or paid benefit time is exhausted before completion of the leave,
the medical and dental premiums normally paid by the employee will be paid directly to
LifeTimes Connection during the unpaid leave period. Employees who desire to
continue other coverages (e.g., life insurance and LTD) during an unpaid leave must pay
the full premium amount (company and employee premiums) to LifeTimes Connection
during the unpaid leave period. LTD can only be continued if LOA is due to employee
illness.
Premiums are due on a monthly basis, in advance of the coverage period. An employee's
failure to pay his/her portion of the insurance premiums will result in termination of the
coverages, after proper notice, at the end of the thirty days following commencement of
the leave, or at the end of thirty days following the date premiums became due.
An employee who fails to return to work, following a family and medical leave, for
reasons other than health conditions or some other reason beyond the employee's control,
is required to reimburse the employer for premiums paid by the employer to continue the
employee's insurance coverage during the unpaid portion of the leave.
Employees may choose not to continue insurance coverages during leave. If an employee
elects not to continue coverage his/her coverage will be reinstated, upon the employee's
return from leave, to the same coverage levels that were in effect prior to the leave. The
employee's coverage will be reinstated the first of the following month without any
waiting period, evidence of insurability, or pre-existing condition exclusion.
6/2002
DEPARTMENT: Human Resources
PAGE: 9 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
G. MATERNITY LEAVE- Female employees with twelve (12) months of consecutive
full-time service and who work in the State of Tennessee are eligible for up to sixteen
(16) weeks of unpaid maternity leave for pregnancy, childbirth, and nursing the infant.
This leave is not in addition to the twelve (12) weeks for which the employee may be
eligible under the FMLA. An employee on maternity leave may use sick leave benefits
for any portion of the leave during which she is disabled.
Eligibility - Full-time regular female employees with twelve (12) consecutive months of
service.
Approval - An employee desiring to take maternity leave must give at least three (3)
months’ advance notice of the anticipated date of departure for maternity leave (unless
prevented from doing so by a medical emergency requiring that leave begin earlier), the
length of leave, and her intention to return to full-time employment.
Duration - Up to sixteen (16) weeks during the pregnancy, birth and nursing of the child.
Reinstatement - An eligible employee who returns from maternity leave requested and
taken in accordance with this policy will be reinstated to her former position or a similar
position unless her former position was so unique that the employer, after reasonable
efforts, was unable to fill the position on a temporary basis. In the event that the
employer determines that it must fill the position of an employee who is on maternity
leave, the employer will so notify the employee. In such a case, the employee’s
eligibility for reinstatement will be governed by the guideline for reinstatement from
general medical leave or FMLA, if applicable. An employee who seeks other
employment or works full or part-time for another employer during maternity leave will
not be reinstated.
II. EMPLOYEE BENEFIT PARTICIPATION WHILE ON LEAVE
An employee on an approved leave of absence may continue group insurance coverages
during the leave (not to exceed six months). In order to ensure that benefits are continued
through an unpaid Leave of Absence, the employee and Supervisor should submit a
Personnel Action Request Form (PAR) indicating the date the unpaid leave will begin. The
employee will be notified by LifeTimes Connection regarding premium payments.
III. REINSTATEMENT FOLLOWING LEAVE (OTHER THAN MILITARY AND
FAMILY AND MEDICAL LEAVE)
Notice of Request for Reinstatement - An employee who is absent on medical leave should
notify the employee's Supervisor of availability to return to work immediately upon being
released to return to work by the employee's doctor. An employee who desires to return from
another type of leave of absence prior to the date the leave was due to expire should submit
6/2002
DEPARTMENT: Human Resources
PAGE: 10 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
written notice of the desire to return to work to the Supervisor at least fourteen (14) calendar
days before the desired return date.
Eligibility for Reinstatement - Unless applicable state or local law requires otherwise, an
employee seeking reinstatement from any leave other than military or family and medical
leave or maternity leave pursuant to Tennessee law is not entitled to reinstatement to his/her
former position. The employee may be offered any available position for which the employer
concludes s/he may be qualified, at the rate of pay for the new position. If there are no such
positions available, the employee may be placed on a priority hiring status for ninety (90)
days, and may be considered for the first vacancy for which the employer deems that the
employee may be qualified. If no such position becomes available within ninety (90) days,
the employee will be terminated. In the event an employee declines an offer of reinstatement
to any full or part-time position, the employee will be terminated.
IV. BENEFITS AT REINSTATEMENT (OTHER THAN MILITARY FAMILY
MEDICAL LEAVE OR MATERNITY LEAVE)
Upon return to work with the employer, the employee's accrued service may be adjusted to
reflect the length of absence. If an employees pay rate upon return from a leave of absence is
different from his/her pay rate prior to the leave of absence, any vacation or sick leave
benefits will be paid at the pay rate in effect at the time they are used. Any sick leave
accrued but not used at the end of the leave of absence shall become available to the
employee upon return to work in a classification to which this benefit is applicable.
V. REINSTATEMENT AND BENEFITS FOLLOWING MILITARY LEAVE OR
FAMILY AND MEDICAL LEAVE
Reinstatement from military leave, family and medical leave or maternity leave shall be
granted in accordance with state and federal law.
VI. USE OF ACCRUED BENEFIT TIME DURING LEAVE
An eligible employee is entitled to twelve (12) weeks of FMLA and sixteen (16) weeks of
maternity leave run concurrently, when appropriate, whether or not the employee has accrued
paid benefit time. In those cases where employees have accrued paid benefit time, (i.e., EIB
or PTO), this paid time should be run concurrently with the leave of absence. Paid benefit
time may be used only if the usage is consistent with the employer’s earned benefit time
utilization guidelines or practice, (e.g., An employee who would not otherwise be eligible for
EIB pay may not apply these benefits to their FMLA). See Paid Time Off Policy.
If the leave is due to an employee's own serious medical condition, the employee must use all
available EIB benefits before being placed on unpaid leave status.
However, the entire leave period whether paid or unpaid will be counted toward the 12-week
maximum Family and Medical Leave provided by the employer or, when appropriate, the
sixteen (16)-week Tennessee Maternity Leave period.
6/2002
DEPARTMENT: Human Resources
PAGE: 11 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
VII. ACCRUAL OF BENEFITS WHILE ON LEAVE
Benefits such as PTO and EIB do not continue to accrue during any unpaid portion of a leave
of absence. However, employees retain benefits accrued prior to, but not used during, the
leave. The employee's credit for length of service is protected, but the employee's
anniversary date may be adjusted to reflect the time away from work.
VIII. MEDICAL CERTIFICATION (OTHER THAN FMLA)
The employer requires medical certification of an employee’s condition or, in the case of
leave to care for a qualified, seriously ill family member, that the requested leave is medically
necessary. In addition, an employee may be required to submit periodic medical recertifications to the employer, on a reasonable basis, throughout the leave period. Failure to
provide medical certification may result in the leave not being approved or extended.
The employer may require an employee, at the employer’s expense, to obtain a second
medical opinion. The employer in such cases will designate the health care provider to
furnish the second opinion. If the first and second opinions differ, the employer may require
the employee to obtain a medical opinion from a third health care provider, again at the
employer’s expense. The third healthcare provider will be jointly selected by the employer
and the employee. The third opinion is final and binding.
IX. FITNESS FOR DUTY (OTHER THAN FMLA)
A fitness for duty or physician’s release to return to work will be required when general
medical leave has been taken. An employee will not be returned to work without the proper
documentation from the health care provider. Failure to submit a fitness for duty
certification may result in the denial of restoration to employment following the leave of
absence.
The interpretation of this or any Human Resource policy rests with the Human Resource
Department who reserves the right to modify, change or discontinue the policy at any time.
PROCEDURE:
1. The Supervisor will advise the employee of his/her potential eligibility for a leave of
absence when either the qualifying event becomes known to the Supervisor, the employee
requests a leave of absence or the employee has been off work for greater than 3 consecutive
work days.
2. The Supervisor should contact Employee Relations in order to process the Leave of
Absence Request form.
3. Employee Relations will generate the Leave of Absence Request form upon notification
from the Supervisor or employee.
4. The Supervisor will submit a Personnel Action Request form (PAR) indicating the start date
of the leave.
5. Human Resources will retain all documentation pertinent to the LOA separate from the
6/2002
DEPARTMENT: Human Resources
PAGE: 12 of 12
APPROVED: May 29, 2002
EFFECTIVE DATE: June 30, 2002
6.
7.
8.
9.
POLICY DESCRIPTION: Leaves of Absence
REPLACES POLICY DATED: April 1, 1998
RETIRED:
REFERENCE NUMBER: HR.203
Personnel File including medical certifications.
The Supervisor will ensure that a physician’s release to return to work is received from the
employee before being returned to the job. The medical release should be forwarded to
Human Resources.
The Supervisor will submit a PAR when the leave becomes unpaid indicating the original
date the leave began as well as the date the unpaid portion of the leave began.
Supervisors should consult with Human Resources when an employee is returned to work
with a temporary or permanent restriction that affects their ability to perform the essential
functions of their job.
The Supervisor will submit a PAR when the employee returns to work or fails to return to
work after exhausting the leave benefit indicting the termination date.
REFERENCES:
Family and Medical Leave Act of 1993
Tennessee Family and Medical Leave Act
Americans with Disabilities Act
Uniformed Services Employment and Reemployment Rights Act
6/2002
Active Duty
Military Leave of Absence
Continuation of Benefits
Topic
Comments
Continue
(Y/N)
End Date
Direct Deposit
Salary review date
Continue current arrangement in place, contact local payroll for changes.
Salary adjusted to reflect merit increases employee would have received
if not for the leave.
Employee continues to earn PTO through the period of active military
duty, but not to exceed the plan maximum.
Employee may cash out within the terms of the PTO policy.
 Coverage continues through the end of the month in which the
employee works. Employees have the option to continue benefits
through Direct Bill and Payment to Lifetimes. Premium notices will
be sent to current address on file.
Y
N/A
N/A
N/A
Y
N/A
N/A
Y
N/A
End of month
following last
work day
UNLESS
they opt to
continue
through
Direct Bill
and Payment
Same as
Medical
N/A
PTO accrual
PTO cash out
Medical

Dependents eligible for CHAMPUS; if employer plans are
continued through above process employer plans are primary to
CHAMPUS.
Dental
Same as Medical
Y
Benefit premium
costs
Through LifeTimes Direct Bill and Payment, employees will be billed at
their current “active” rate.
Y
Employee Life
May be continued during first 6 months of military leave at which time
employee may convert to individual policy (if done within 45 days of
loss of coverage).
Will not cover death or disability due to acts of declared/undeclared war
or reserve duty.
May be continued during first 6 months of Active Duty Military Leave,
at which time may convert to individual policy (if done within 45 days
of loss of coverage).
May be continued during first 6 months of Active Duty Military Leave,
at which time may convert to individual policy (if done within 45 days
of loss of coverage).
Coverage is not available to dependents of employees in active military
service.
Y
End of 6
months LOA
N
Last work day
Y
End of 6
months LOA
Y
End of 6
months LOA
N
Will not cover disability due to acts of declared or undeclared war;
coverage ceases while on military leave, no COBRA or conversion
option.
Reinstated upon return to work with no waiting period other than those
expenses as a result of disease, defect or injury caused by war,
declared/undeclared; protected for up to five years.
Deferrals on compensation during leave are not allowed. However,
rollovers into the plan would be allowed. Loan payments will be
suspended until reinstatement. If eligible, employee will be allowed to
take in-service withdrawals including hardship distributions. Employee
will maintain investment discretion over the account. Certain “catch up”
contributions allowed upon reinstatement. Vesting service will be
updated with military service upon reinstatement.
N
Date of active
military
service
Last work day
Employee AD&D
Dependent Life
Dependent AD&D
Dependent Life &
AD&D (deps. in
military service)
LTD
Reinstatement
(Health & Group)
401(K)
N/A
N/A
N*
Last work day
Attachment to HR.203
Active Duty
Military Leave of Absence
Continuation of Benefits
Topic
Money Purchase
Pension Plan
ESPP
Stock Options
Job security
Seniority
Employee
Assistance
Program
Flexible Spending
Accounts**
*
Comments
Continue
(Y/N)
End Date
Annual contribution(s) will be made based on pre-military leave pay.
Contribution(s) based on Active Duty Military Leave rate of pay will be
made after reinstatement. Vesting service will be updated with military
service upon reinstatement.
Contributions on this compensation are not allowed. Contributions
deducted for the current plan period, prior to Active Duty Military
Leave, may be held for purchase or refunded based upon employee
election. Employee may re-enter plan upon reinstatement. No “catch
up” contributions allowed. Employee must fill out election form to
withdraw from plan.
Plan operates as normal, according to plan documents.
Reinstatement to original position if return to work in less than 91 days.
Reinstatement to original or comparable position if return to work in 91
or more days.
No break in service for time spent on active military duty
Available to employee and dependents
N*
Last work day
N
Last work day
Y
Y
N/A
N/A
Y
Y
N/A
N/A


N
Y
**
**
Dependent Care Flexible Spending
Health Care Flexible Spending Account
Special rules for bridging service apply upon reinstatement.
** Flexible Spending Account rules apply:


Dependent Care contributions will not continue, claims may still be reimbursed up to the balance of the
account
Health Care contributions may continue through Direct Bill & Payment
Employee Life Insurance
If the employee is activated to military status, coverage will remain in effect for the amount of time specified under LOA
provisions, but no longer. The employee may convert (or port effective 1/01/2002) coverage at the time coverage ends (also
applies to dependent coverage). Keep in mind that all contract provisions will apply including AD&D exclusions unless
otherwise determined by UnumProvident. It is important to keep in mind that the United States Government will cover a
person who is reactivated by the military for life insurance benefits during that activity.
Dependent Life Insurance
If a dependent is activated to military status, coverage will continue as long as the employee remains actively employed and
covered under the plan. Keep in mind that all contract provisions apply including AD&D exclusions.
Attachment to HR.203