Create Eligibility and Rights & Responsibilities Notice
Create Eligibility and Rights & Responsibilities Notice
From the employee’s EFI Profile page:
• Complete the Eligibility Notice by clicking on the “Not Done – Create” button next to “Eligibility Notice."
A summary page will appear with an overview of the Eligibility Notice (EN).
Scroll down and click Continue” to proceed to the EN form.
• Section I: Notice of Eligibility (is usually already completed)
If Employee is Eligible for FMLA: Section I of the Eligibility Notice will be fully completed if the employee meets the FMLA eligibility criteria for FMLA leave. If so, simply scroll to the bottom of the page and select “Continue” to proceed to Section II.
If Employee is Not Eligible for FMLA: If the employee does not meet the eligibility criteria for FMLA leave, enter either the approximate number of weeks the employee has worked (or will have worked) for your organization and/or the approximate number of hours the employee has worked (or will have worked) for your organization during the 12-month period preceding the scheduled leave start date.
Note: If the employee does not meet the eligibility criteria for FMLA leave, the Rights &
Responsibilities portion of the notice will not appear because it is not applicable. In those situations, indicate in the textbox what options the employee has for taking leave, if any.
• Section II: Additional Information Needed (usually a Medical Certification)
Certification of Health Care Provider for Employees Serious Health Condition
Section II is defaulted to require additional information from the employee in the form of a
certification or other documentation. Enter the Date that the Certification is due.
If you do not need additional information, change the defaulted selection to the top option (informing the employee that you “do not need any additional information”) and click “Continue” at the bottom of the page to proceed to Section III.
Note: The type of certification an employee needs to submit will be automatically selected based on the reason for the requested FMLA leave. The selection “is enclosed” also will be preselected. There is no default selection if the reason for the leave is birth of a child or placement of a child for adoption/foster care. In the case of birth of a child, the applicable medical certification could be (a) the employee’s own serious health condition (for the birth mother), family member’s serious health condition (if the spouse has requested leave to care for the birth mother during pregnancy or recovery from childbirth), or (c) neither (if the birth mother’s spouse or non-spouse parent is requesting leave to care for/bond with a newborn child). Select the applicable certification form if (a) or (b) applies, or change the selection to the top option (informing the employee that you “do not need any additional information”) if (c) applies or if your organization does not require a medical certification form from an employee who is expecting a child.
In the case of placement of a child for adoption or foster care, no certification can be required.
• Section III: Rights and Responsibilities
Certain checkboxes in Section III will be preselected based on the Eligibility Notice template
selections in your Account Profile Menu. Modify as needed by checking or unchecking an checkboxes as applicable to a particular employee.
• After completing the Notice, click “Finish” at the bottom of the page. If no changes need to be made, click “Return to Profile” at the bottom of the page.
You can go back to the Employee Profile to create additional forms or Send the Forms to the Employee
Notify the Employee Via Email:
Send the notices by clicking on the Email Employee Forms/Files button at the bottom of the page.
Indicate Which Forms are to be sent on the next page.
Select other options on the page, scroll to bottom and click send.
