FMLA and Medical Absences at NNPS
NNPS Benefits manages Family and Medical Leave (FMLA), Medical Leave of Absence (MLOA), and related leave programs. Use the options below to get started.
Eligibility
Employees who have been employed by NNPS for at least 12 months and have worked at least 1,250 hours during the previous 12-month period may be eligible for Family and Medical Leave (FMLA).
Eligible employees may receive up to 12 weeks of unpaid, job-protected leave for qualifying reasons, including:
- Their own serious health condition (including pregnancy)
- The birth of a child and care for a newborn child
- The placement of a child through adoption or foster care
- Caring for a qualifying family member with a serious health condition
- Certain qualifying military family needs
Eligible employees may also receive up to 26 weeks of unpaid, job-protected leave during a single 12-month period to care for a covered servicemember with a serious injury or illness incurred in the line of duty.
Leave Forms & Supporting Documents
Access leave forms and medical certification documents below.
- Employee Rights and Responsibilities under FMLA
- Certification of Health Care Provider for Employee's Serious Health Condition
- Certification of Health Care Provider for Family Member's Serious Health Condition
- Certification of Qualifying Exigency For Military Family Leave
- Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave
- Leave of Absence Application
- Leave of Absence Physician Statement
Not sure what forms you need?
Visit the Request Leave section below to get started.
Request Leave
Click the link below to complete the Leave Request Intake Form. The questionnaire will help identify your leave needs and guide you to the appropriate forms and resources.
OR
Scan the QR code to access the form from your mobile device.
Submitting this form does not automatically approve leave. Employees must continue to follow normal call-out and attendance procedures while your request is being reviewed. Supporting medical documentation is required to support the leave request.
Report Approved Intermittent FMLA Time
This form is only for employees who have an approved Intermittent FMLA certification on file with NNPS Benefits.
Use this form to report time missed from work due to your approved Intermittent FMLA condition, including:
- Full-day FMLA absences
- Partial-day FMLA absences
- Late arrivals
- Early departures
Click the link below to access the Intermittent FMLA Reporting Form.
OR
Scan the QR code to access the form from your mobile device.
Intermittent FMLA Absence Guidelines
Review the Intermittent FMLA Absence Guidelines for information regarding reporting absences, employee responsibilities, and call-out procedures.
Important: Employees must continue to notify their supervisor and follow normal departmental call-out procedures when absent from work.
FMLA Information & Guidelines
Find out answers to common questions about eligibility, leave entitlement, required documentation, benefits continuation, and employee responsibilities.
FMLA Frequently Asked Questions
FMLA Rights and Responsibilities
Need Help?
Questions about leave eligibility, required documentation, medical certification requirements, or reporting approved Intermittent FMLA time?
M’Kayla Brown
Benefits Coordinator
FMLA & Medical Leave Administration
Jo Ann Armstrong
Supervisor
Compensation & Benefits
We are here to help answer your questions and guide you through the leave process.
