Salt Lake City

Human Resources

Phone: (801) 535-7900

FMLA

FMLA family and medical leave act and stethoscope.

What is the FMLA?

Salt Lake City Corporation fully complies with the Family and Medical Leave Act of 1993 (FMLA). This leave provides up to 12 work weeks of job protected leave per 12–month period and requires that group health benefits be maintained during the leave as if the employee continued to work instead of taking leave.

Salt Lake City Corporation uses the 12-month period measured forward method for establishing the employee’s 12-month period. We measure 12 months forward from the first date an employee takes FMLA leave. The next 12-month period would begin the first time leave is taken after completion of the prior 12-month period.

For example, if Lucia’s FMLA leave beings on November 6, 2018, then her 12-month period is November 6, 2018 through November 5, 2019.

Employees are also entitled to return to their same or an equivalent job at the end of their FMLA leave.

The following are FMLA qualifying events:

  • The birth of a child, the placement of a child for adoption or foster care.
  • The employee’s serious health condition.
  • To care for a covered family member with a serious health condition.

The FMLA also provides certain military family leave entitlements. Eligible employees may take FMLA leave for specified reasons related to certain military deployments of their family members. Additionally, they may take up to 26 weeks of FMLA leave in a single 12-month period to care for a covered service member with a serious injury or illness.

  • Qualifying exigency while the employee’s family member is on covered active military duty or call to covered active military duty status.
  • To care for a covered service member with a serious injury or illness (military caregiver leave).

How to Request Leave under the FMLA?

To request leave, please fill out the appropriate forms and submit them to the Leave Coordination Team as soon as possible. Click here to contact the Leave Coordination Team.

Employee Responsibilities

The employee is required to notify the City if the leave is for a potential qualifying FMLA event. If the leave is foreseeable, the employee must provide at least 30 days notice. If leave is not foreseeable, the employee or employee’s spokesperson shall give notice as soon as practicable.

Employees are responsible for ensuring that their FMLA forms are complete and turned into the HR Leave Coordination Team within the Department of Labor’s specified time-frame of 15 days.

While on continuous FMLA leave, employee must contact their supervisor at least every 30 days.

FMLA Forms

FMLA Care for Family Member Form

  • Use this form if you need to take leave to care for a family member (child, spouse, parent, etc.)

FMLA For Employee Form

  • Use this form if you need to take leave to care for yourself due to your own illness and short-term disability does not apply.

FMLA & SDI Packet

  • Use this form if you need to take leave for your own serious health condition and short-term disability applies.

FMLA SDI AD&D Packet

  • Use this form if you need to take leave for your own serious health condition and both short-term disability & AD&D apply.

Informational FMLA Law Poster

CLICK HERE to access all other leave forms. Contact the Leave Coordination Team at 801-535-7121 if you have any questions about which form(s) you need to fill out for your situation.