April 3, 2019

NAME

TITLE

ADDRESS OR DEPARTMENT

Subject: Family Medical Leave (FMLA) – Academic Employee - Paternity Leave

Dear NAME:

Please find attached the University of Minnesota’s Family and Medical Leave Act (FMLA): Notice of Eligibility and Health Certification forms. Your current leave may qualify you for coverage under the FMLA.

For FMLA to apply to this leave, please return these documents as soon as possible, but no later than DUE DATE(15 days hence).

If you feel that your current leave may qualify, ask your healthcare provider to complete the enclosed certification form and return it to CONSULTANT:

Mail:ADDRESS

Fax: NUMBER

Below, is a brief overview of how relevant UMN Policy and FMLA work alongside one-another.

  • Further FMLA information is available on the University of Minnesota, Office of Human Resources website:
  • Relevant Parental Leave for Academic Employees policy

FMLA provides:

  1. 12 workweeks (480 hours if intermittent) of leave eachfiscal year.
  2. Job protection (return to same or equivalent position)
  3. Unpaid leave
  4. Maintenance of health plan coverage with the same conditions as if employee had been working during the leave period
  5. During FMLA if you use unpaid time for an entire pay period you will not receive a check and will therefore be billed for your portion of your Healthcare Insurance Premium - your portion only - which is normally deducted from each paycheck.
  6. After FMLA if you enter unpaid time for an entire pay period you will be billed for the full cost of your Healthcare Insurance Premium.

UMN Policy Provides:

  1. Paid Time - Under U of MN policy you are required to use your paid leave concurrent with FMLA
  2. Two (2) weeks parental leave with pay
  3. Four (4) weeks unpaid leave. May use accrued vacation.
  4. Option to use UNPAID time AFTER your paid-leave is exhausted. Additional provisions for unpaid time can be found under a separate policy - Unpaid Personal Leaves at

*If you enter a time under FMLA when you no longer receive a paycheck, you will receive an Invoice for your health plan Premium which is normally deducted from your paycheck.

Payroll & Leave Time

  • Please work with your Supervisor SUPERVISOR and HRIS (Payroll & Leave) CONTACT NAMEto submit your absence request.
  • A separate email with time keeping instructions will follow.

I know this is a lot of information, if you have questions, please don't hesitate to contact me or CONSULTANT.

Best,

SIGNATURE

1