A “Sample Letter To Notice To Employee That FMLA” is a written communication. Employers use it to inform employees about their rights and responsibilities under the Family and Medical Leave Act (FMLA). You might need to write this letter when an employee requests leave for a qualifying reason. This ensures legal compliance.
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Sample Letter To Notice To Employee That Fmla
[Your Company Letterhead]
[Date]
[Employee Name]
[Employee Address]
**Subject: Notice of Family and Medical Leave Act (FMLA) Eligibility**
Dear [Employee Name],
This letter is to inform you about your eligibility for leave under the Family and Medical Leave Act (FMLA).
We received your request for leave on [Date of Request]. Based on the information you provided, we are [choose one: “able to confirm your eligibility” OR “unable to confirm your eligibility at this time”].
**If Eligible:**
You are eligible for FMLA leave because you have met the following requirements:
* You have been employed by [Company Name] for at least 12 months.
* You have worked at least 1,250 hours during the 12-month period immediately preceding the start of your leave.
* [If applicable: You work at a worksite where the company employs at least 50 employees within 75 miles.]
Please note:
* Your leave is for [State Reason – e.g., your own serious health condition, to care for a family member with a serious health condition, etc.].
* You are entitled to up to 12 weeks of unpaid leave during a 12-month period.
* During your FMLA leave, we will maintain your group health insurance coverage under the same terms and conditions as if you were actively working.
* You are required to provide [Type of Documentation – e.g., medical certification] by [Date]. Please see the attached form.
* You are required to use [Accrued Paid Leave Type – e.g., vacation, sick leave] concurrently with your FMLA leave.
* Upon your return from FMLA leave, you will be restored to your original job or to an equivalent job with equivalent pay, benefits, and other terms and conditions of employment.
**If Not Eligible:**
You are not eligible for FMLA leave at this time because [State Reason – e.g., you have not worked enough hours, you have not been employed for long enough, etc.].
[Optional: You may be eligible for leave under [State Leave Law or Company Policy]. Please contact HR for more information.]
**Regardless of Eligibility:**
Please review the attached FMLA policy for more detailed information about your rights and responsibilities.
If you have any questions, please contact [HR Contact Name] at [HR Contact Phone Number] or [HR Contact Email Address].
Sincerely,
[Your Name]
[Your Title]
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How to Write a Letter to Notify an Employee About FMLA
1. Crafting the Subject Line: Precision is Paramount
The subject line is your initial communiqué. Be forthright and succinct. Avoid ambiguity; instead, opt for language that explicitly indicates the letter’s purpose.
- Example: “FMLA Leave Notification” or “Regarding Your Request for FMLA Leave”
- Ensure it’s easily identifiable amongst a deluge of emails.
2. The Salutation: Initiate with Professionalism
Begin with a respectful salutation. Even in these digital epochs, formality still holds sway.
- Use “Dear Mr./Ms./Mx. [Employee’s Last Name]” unless you have a rapport that warrants a more casual approach.
- If unsure of the employee’s preference, “Dear [Employee’s Full Name]” is a safe harbor.
3. Acknowledge the Request: Validate Their Initiative
Immediately acknowledge the employee’s request for FMLA leave. This demonstrates attentiveness and validates their action.
- “This letter acknowledges your request for leave under the Family and Medical Leave Act (FMLA), received on [Date].”
- Briefly reiterate the reason for their request, if appropriate, to ensure mutual understanding.
4. Eligibility Determination: Laying Down the Ground Rules
Clearly state whether the employee is eligible for FMLA leave. This is pivotal. If ineligible, provide a lucid explanation.
- If eligible: “We have determined that you are eligible for FMLA leave based on your employment history and the information provided.”
- If ineligible: “Unfortunately, based on our initial assessment, you do not meet the eligibility requirements for FMLA leave. [Provide specific reason, e.g., insufficient tenure, lack of qualifying event].”
5. Detailing Leave Entitlements: The Nitty-Gritty
If eligible, meticulously detail the employee’s leave entitlements, including the duration and any relevant stipulations.
- “You are entitled to up to 12 weeks of unpaid leave within a 12-month period.”
- Specify the commencement date and potential end date of the leave.
- Mention any requirements for medical certification or recertification.
- Describe the employee’s obligations during leave, such as periodic updates.
6. Benefits and Obligations: A Two-Way Street
Outline the maintenance of health benefits during FMLA leave and the employee’s obligations regarding premium payments.
- “During your FMLA leave, your health benefits will be maintained under the same conditions as if you were actively employed. You will be responsible for paying your portion of the premium.”
- Clearly state the payment schedule and methods for premium remittance.
- Address any other relevant benefits, such as life insurance or disability coverage.
- Reiterate the employee’s right to reinstatement upon return from leave.
7. The Closing: Conclude With Clarity and Cordiality
End the letter with a professional closing, inviting the employee to seek clarification or pose questions.
- “If you have any questions or require further clarification regarding your FMLA leave, please do not hesitate to contact [HR contact person] at [phone number] or [email address].”
- Use a formal closing, such as “Sincerely” or “Respectfully.”
- Include your name and title.
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Frequently Asked Questions: FMLA Notice to Employee
This section addresses common inquiries related to providing proper notice to employees regarding their rights and responsibilities under the Family and Medical Leave Act (FMLA).
It is essential to ensure compliance with all FMLA regulations when an employee requests or takes leave.
What information must be included in the FMLA eligibility notice?
The eligibility notice must inform the employee whether they are eligible for FMLA leave, the reasons for ineligibility (if applicable), and any additional information required from the employee.
What is the timeframe for providing an FMLA designation notice?
Employers must provide the designation notice within five business days of determining whether the leave qualifies as FMLA-protected, absent extenuating circumstances.
What should I do if I need more information to determine FMLA eligibility?
If more information is needed, the employer must notify the employee, specifying what information is required and providing a reasonable timeframe for submission.
Can I request medical certification from the employee?
Yes, employers can request medical certification to support the need for FMLA leave related to the employee’s or a family member’s serious health condition.
What happens if the employee fails to provide the required information or certification?
Failure to provide requested information or certification within the specified timeframe may result in denial of FMLA leave.