The Family Medical Leave Act (FMLA) entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.

• the birth of a child and to care for the newborn child within one year of birth;

• the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;

• to care for the employee’s spouse, child, or parent who has a serious health condition;

a serious health condition that makes the employee unable to perform the essential functions of his or her job;

• any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter or parent is a covered military member on “covered active duty” or 26 workweeks of leave during a single 12-month period to care for a covered service member with a serious injury or illness if the eligible employee is the service member’s spouse, son, daughter, parent or next of kin (military caregiver leave).

• FMLA Information Packet 

• KCPS Personnel Procedure 300-4 Family and Medical Leave Act (FMLA)

• Department of Labor – FMLA Guide

 

To request leave from Kent County Public Schools under the FMLA, the following forms will need to be completed and returned to the Office of Human Resources for processing:

• FMLA Request Form 

• FMLA Supervisor Form 

• FMLA Benefit Contribution Form 

• Certification of Healthcare Provider for Employee’s Serious Health Condition

 

• FMLA Request Form

• FMLA Supervisor Form

• FMLA Benefit Contribution Form 

• Certification of Health Care Provider for Family Member’s Serious Health Condition

 

Information:

• FMLA Information Packet for Expectant Parents

• Spouses Working for the Same Employer     

Forms:

• FMLA Request Form 

• FMLA Supervisor Form 

• FMLA Benefit Contribution Form 

• Certification of Healthcare Provider for Employee’s Serious Health Condition 

• CareFirst Member Application

Following the birth of a child, new parents should submit the following to Human Resources:

1. Verification of birth or call/email with full name and date of birth.

2. Completed CareFirst membership application to add baby to the plan within 30 days of birth.

3. Copy of the birth certificate, once received

4. The baby’s social security number, which may take 6 to 8 weeks but is very important for HR to have on record.

It is the responsibility of the employee to make the necessary arrangements to cover the cost of all benefits outlined in the FMLA Benefit Contribution Form (above) as well as informing Maryland State Retirement and Pension System of a period of leave without pay.   

 

• FMLA Return to Work Certification

• MSRA Form 26 Request to Purchase Previous Service