Family Medical Leave Act
What Is the Family Medical Leave Act - or FMLA?
FMLA is a federally mandated leave policy that provides 12 weeks of unpaid, job protected leave in a 12 month period. For Complete Details, Please Review the Booklet Below.
Leave of Absence Portal
The Benefits Service Center’s leave of absence portal offers employee access. Through the portal, you will have access to all your leave of absence information. You can view your absences, any claims created in the last year, forms, request a leave and upload documents. You must have an email, either business or personal, listed in Employee Central. The portal is user-friendly and works on mobile devices, tablets and computers.
To get started, review the Employee User Guide here on how to set up your account, review your information or request a leave. Visit https://bsc.force.com/eep to access the portal. First time users much click Activate Login to access the system.
If you have any questions, please contact the BSC at 866-481-4922.
To Request A Leave, Contact The Benefits Service Center at 1-866-481-4922
Representatives are available from 8:00 am - 6:00 pm EST, Monday - Thursday and 8:00 am - 5:00 pm Friday EST. Please make your request 30 days prior to the start of your leave (or as soon as practical under your circumstances). You will also need to advise your supervisor of any request being made for a leave. Leaves must be requested within 15 days of the initial date of absence, or the leave may be denied.
Submitting the FMLA Certification Form
The law requires that the Company allow employees up to 15 days to return their FMLA paperwork to the Benefits Service Center (BSC) from the date the paperwork is mailed.
After the initial 15 days have expired, the BSC will attempt to follow up with the employee and remind them that their paperwork is overdue and allow an additional 10 days to satisfy the paperwork requirement. If the completed FMLA paperwork has not been received by the end of the 10-day grace period, the leave will be denied.
Please contact the Benefits Service Center's Leave Department at (866) 481-4922 for further details.
Intermittent Leaves
An Intermittent Leave is where your time off will occur sporadically - a day here and there or a partial work day. A completed, signed certification form is required and must include a frequency and duration for the estimated time you expect to be out of work.
Intermittent Leave time must be reported to the BSC at 866-481-4922 and to your supervisor. When possible, intermittent leave time should be reported in advance. In the instance where this is not possible, any intermittent time off should be reported to the BSC within 5 business days of the absence.
State Paid Family Leave (PFL): States of CA, CO, CT, MA, NJ, NY, OR, RI, WA, D.C.,
To file a claim, please call Mohawk’s Benefits Service Center to file a claim and then contact your corresponding state entity.
Mohawk’s Benefits Service Center: 1-866-481-4922
State Paid Family Leave Customer Service:
California
Phone: English (877) 238-4373 or Spanish (877) 379-3819
Website: https://www.edd.ca.gov/disability/sdi_online.htm
Colorado
Phone: 1-866-CO-FAMLI (1-866-263-2654)
Website:https://famli.colorado.gov/
Email Address:
Connecticut
Phone: (877) 499-8606
Website: https://ctpaidleave.org/s/employee-landing-page?language=en_US
Email Address:
Massachusetts
Phone: (833) 344-7365
Website: https://www.mass.gov/orgs/department-of-family-and-medical-leave
New Jersey
Phone: English/Spanish (609) 292-7060
Website: https://myleavebenefits.nj.gov/
New York
Phone: Hartford (866) 945-4558
Oregon
Phone: 833-854-0166
Website: https://paidleave.oregon.gov/Pages/default.aspx
Email Address:
Rhode Island
Phone: (401) 462-8420
Website: https://dlt.ri.gov/tdi/
Email Address:
Washington, D.C.
Phone: (202) 899-3700
Website: https://dcpaidfamilyleave.dc.gov/
E-mail Address:
Washington State
Phone: (833) 717-2273
Website: https://paidleave.wa.gov
E-mail Address: https://paidleave.wa.gov
General program information and instructions on how you can file a claim are listed below by state:
California Paid Family Leave (PFL)
Paid Family Leave (PFL) provides benefits to individuals who need to take time off work to care for a seriously ill child, parent, parent-in-law, grandparent, grandchild, sibling, spouse, or registered domestic partner. Benefits are also available to new parents who need time to bond with a new child entering their life either by birth, adoption, or foster care placement.
How to File a Claim
Complete and submit your claim form no earlier than the first day your family leave begins, but no later than 41 days after your family leave begins or you may lose benefits.
To apply for benefits, visit the State of California’s website at
https://www.edd.ca.gov/disability/sdi_online.htm Paper applications are available by calling Customer Service at English (877) 238-4373 or Spanish (877) 379-3819.
Questions?
If you have questions about the program or need help with an application or claim, contact the State of California:
Customer Service: English (877) 238-4373 or Spanish (877) 379-3819
Website: https://www.edd.ca.gov/disability/sdi_online.htm
Colorado Paid Family Leave (PFL)
Paid Family Leave allows employees who work in the State of Colorado to take paid time off to manage the health and care of a family member.
Paid leave benefits are available to care for a themselves or a family member with a serious health condition; to bond with a new child after birth, adoption, or foster-case placement; to manage qualifying military exigency or military caregiver needs; and to victims of family violence.
Family members include spouse, son or daughter, parent/parent-in-law, sibling, grandparent, grandchild, or an individual related to the employee by blood or affinity, and whose close association with the employee shows to be the equivalent of those family relations.
How to File a Claim
Effective January 1, 2024, applicants can start filing claims.
Questions?
If you have questions about the program, contact the State of Colorado at
Customer Service: 1-866-CO-FAMLI (1-866-263-2654)
Email:
Connecticut Paid Family Leave (PFL)
Paid Family Leave allows employees who work in the State of Connecticut to take paid time off to manage the health and care of a family member.
Paid leave benefits are available to care for a family member with a serious health condition; to bond with a new child after birth, adoption, or foster-case placement; to manage qualifying military exigency or military caregiver needs; and to victims of family violence.
Family members include spouse, son or daughter, parent/parent-in-law, sibling, grandparent, grandchild, or an individual related to the employee by blood or affinity, and whose close association with the employee shows to be the equivalent of those family relations.
How to File a Claim
Effective December 1, 2021, applicants can start filing claims.
Online: Accessing the portal is the fastest way to apply for Paid Leave benefits https://ctpaidleave.org/s/for-claims?language=en_US
Telephonic: Call an Aflac Customer Care Advocate at (877) 499-8606 to file a new claim or ask questions about paid leave benefits.
Email: Email request for Paid Leave claims to
Fax: Fax request for Paid Leave claims to (888) 485-0973. Supporting documentation for an existing claim can also be faxed at any time.
Mail: Mail completed documents to request leave to the following address:
Administrative Office
PO Box 84077
Columbus, GA 31908-4077
Questions?
If you have questions about the program or need help with an application or claim, contact the State of Connecticut’s Paid Leave Claims Administrator: Aflac.
Customer Service: (877) 499-8606
Email:
Online Customer Support: https://ctpaidleave.org/s/contactus?language=en_US
Massachusetts Paid Family Leave (PFL)
Employees who work in the state of Massachusetts are eligible for Paid Family Leave (PFL). Paid Family Leave is designed to provide resources to manage the health and care of a family member.
Paid leave benefits are available to bond with a child newly born, adopted, or placed in foster care; help eligible workers manage family affairs that take place immediately after a family member is deployed in a foreign country or has been notified of an upcoming deployment in a foreign country, and to care for a family member with a serious health condition who is a covered Service Member.
Paid family leave benefits to care for a non-Service family member with a serious health condition are now available to you. Family members include spouse, domestic partner, child, parent, grandchild, grandparent or sibling; the parent of a spouse or domestic partner; and guardians who legally acted as a parent when you were a minor.
How to File a Claim
You may begin the application process for paid leave up to sixty (60) calendar days in advance of the anticipated start date. The State will not accept applications with a start date more than sixty (60) calendar days in the future.
To apply for benefits, visit the State of Massachusetts website at https://www.mass.gov/how-to/how-to-apply-for-paid-family-and-medical-leave-pfml.Questions?
If you have questions about the program or need help with an application or claim contact the State of Massachusetts:
Customer Service: (833) 344-7365
Website: https://www.mass.gov/orgs/department-of-family-and-medical-leave
New Jersey Family Leave Insurance (FLI)
Family Leave Insurance provides New Jersey workers benefits to bond with a newborn, newly adopted, newly placed foster child, or to provide care for a seriously ill or injured family member.
Family Members covered under New Jersey Family Leave Insurance include parents, spouse, domestic partner, children of any age, parent-in-law, siblings, grandparents, grandchildren, any other individuals related by blood or any other individuals with whom you consider to be family.
How to File a Claim
To file a claim or download a claim form go to https://myleavebenefits.nj.gov/
Questions?
If you have questions about the program or need help with an application or claim contact the State of New Jersey:
Customer Service: English/Spanish (609) 292-7060
Website: https://myleavebenefits.nj.gov/
New York Paid Family Leave (PFL)
Employees who work in the State of New York are eligible for New York Paid Family Leave (NY PFL).
New York Paid Family Leave mandates job protected paid leave for employees who work in the State of New York for the following leave reasons: bond with a newborn, adopted or foster case child during the first 12 months; care for a seriously ill family member; address important needs related to a family member’s* military service (*does not include grandparent/grandchild for military).
Family members covered under New York Paid Family Leave include: Spouse or domestic partner; Child (biological, adopted, foster, stepchild, legal ward, child of a domestic partner, or the child to whom the employee stands in loco parentis); Parent, parent-in-law (biological, foster, adoptive, stepparent, or in loco parentis);Grandparent or grandchild; Sibling (biological or adopted sibling, a half-sibling or step sibling).
How to File a Claim
If you work in the state of New York, to initiate a Paid Family Leave claim, you will need to do the following:
- Call Mohawk’s BSC at 866-481-4922 to request a Leave of Absence
AND - Call Hartford at 866-945-4558 to initiate claim for NY Paid Family Leave
- Hartford will determine eligibility for PFL and mail you an acknowledgement letter, a claim form, and the physician’s certification form.
- You will have 30 days to submit completed paperwork to Hartford.
- If paperwork is not received within 30 days, the claim is closed.
Benefit
Questions?
If you have questions on NY PFL, please contact Hartford at 866-945-4558.
Oregon Paid Family Leave (PFL)
Paid Family Leave allows employees who work in the State of Oregon to take paid time off to manage the health and care of a family member.
Paid leave benefits are available to care for a family member with a serious health condition; to bond with a new child after birth, adoption, or foster-case placement; and to victims of family violence, sexual assault, harassment or stalking. Family members include spouses and domestic partners, children, parents, siblings or stepsiblings, grandparents, grandchildren, and any individual related by blood or affinity, whose relationship is equivalent to family.
How to File a Claim
Effective September 3, 2023, applicants can start filing claims through the State of Oregon’s online filing system: https://www.oregon.gov/employ/frances/Pages/default.aspx/
Questions?
If you have questions about the program contact the State of Oregon.
Customer Service: 833-854-0166
E-mail Address:
Rhode Island Temporary Caregiver Insurance (TCI)
Under the TCI program, an individual can receive benefits to care for a child, parent, spouse, domestic partner, seriously ill parent-in-law or grandparent or to bond with a newborn child, an adoptive child or a foster child (available only during the first 12 months of parenting).
How to File A Claim
You must apply for TCI benefits during the first 30 days after the first day of leave is taken for bond or caregiver reasons.
To file a TCI claim, go to https://dlt.ri.gov/tdi/
Questions?
If you have questions about the program or need help with an application or claim contact the State of Rhode Island:
Customer Service: 401-462-8420
E-mail Address:
Washington, D.C. Paid Family Leave (PFL)
Paid Family Leave family leave benefits allows you to be with your family in difficult times and to provide needed care and companionship to your loved ones when they need it the most. You can only receive family leave benefits if you will be providing care or companionship to your family member with a serious health condition.
You can also receive parental leave benefits for bonding with a newborn, adoption, foster care, or custody of a child.
How to File a Claim
To file a claim go to https://dcpaidfamilyleave.dc.gov/how-to-apply-for-benefits/
Questions?
If you have questions about the program or need help with an application or claim contact the District of Columbia:
Website: https://dcpaidfamilyleave.dc.gov/
Customer Service: 202-899-3700
E-mail:
Washington State Paid Family Leave (PFL)
Family leave is here for when you need to take time off to care for a family member. If the family member has a serious health condition that would qualify them for medical leave, or if you are welcoming a new baby or child into your family, that’s when you can take family leave. Family leave can be taken for spouses and domestic partner, children (biological, adopted, foster or stepchild), parents and legal guardians (or spouse’s parents), siblings, grandchildren and grandparents (or spouse’s grandparents).
Estimate your pay: https://paidleave.wa.gov/estimate-your-weekly-pay/
How to File a Claim
To file a claim go to https://paidleave.wa.gov/get-ready-to-apply/.
Questions?
If you have questions about the program or need help with an application or claim contact the State of Washington:
Customer Service: 833-717-2273
E-mail:
Website: https://paidleave.wa.gov
Additional Information
FMLA Rights and Responsibilities Document
Military FAQ's - Qualifying Exigency
For Additional Information, Contact The Benefits Service Center at 1-866-481-4922
Note that this website is for educational purposes only and is not intended to replace the Mohawk Benefits Plan Documentation. Where this information conflicts with the Plan Documentation, the Plan Documentation will prevail. The contained content is for informational purposes only. The terms and conditions are in accordance with each individual state policy and are subject to change.