INSURANCE 101: Family and Medical Leave Act (FMLA)

Enacted in 1993, the Family and Medical Leave Act, also referred to as the FMLA, provides ‘eligible’ employees with the ability to take an unpaid leave of absence of up to twelve (12) workweeks during any 12-month period for certain qualified medical, family and military reasons.  An employee becomes eligible for FMLA protection upon being employed by the same employer for at least one (1) year and has worked for 1,250 hours over the previous 12 months.

Under this Act, employers are required to maintain the employee’s health coverage under the employer’s group health plan as well as any other employment benefits in the absence of the employee.  In addition, an employer must accept an employee back to the company after a qualified FMLA period of absence for the same or an equivalent job position as before taking such leave of absence.

The Department of Labor provides 12 weeks of unpaid, job-protected coverage under FMLA for the following reasons:

• The incapacity of the employee due to pregnancy, prenatal medical care or child birth as well as to care for the employee’s child after birth, or adoption
• A serious health condition that makes the employee unable to perform the essential functions of his or her job
• To care for the employee’s spouse, child or parent who has a serious health condition

As defined under the FMLA, a ‘serious health condition’ is an illness, injury, impairment or physical or mental condition that involves either an overnight stay in a medical care facility, or continuing treatment by a health care provider for a condition that either prevents the employee from performing the functions of the employee’s job, or prevents the qualified family member from participating in school or other daily activities.

Enforced by the Department of Labor, all State and Federal agencies and employers, as well as private employers with 50 or more employees within 75 miles of the employer must provide such employment protection.  Eligible employees are responsible for providing sufficient information and documentation pertaining to a need for a leave of absence and should provide advance notice, when possible, of 30 days before needing to take such leave from employment.