ERISA Benefits Law Model Paid Sick Leave and Expanded FMLA Leave Policies, Leave Request and Leave Determination Forms Available

ERISA Benefits Law’s model Paid Sick Leave and Expanded FMLA leave Policies, Leave Request and Leave Determination forms are now available. These documents include:

  • An Emergency Paid Sick Leave And Expanded Family and Medical Leave (EPSL/EFML) Policy setting forth model company policies and procedures governing
    • Employee requests for paid Emergency Paid Sick Leave (EPSL) and Expanded Family and Medical Leave (EFML) pursuant the Families First Coronavirus Response Act (the “Act”);
    • Payment of paid EPSL and EFML and coordination of the two types of leave
    • The limited circumstances under which EPSL and EFML leave can be taken intermittently
    • Coordination of EPSL/EFML with regular FMLA leave (for those employers subject to FMLA)
    • Leave determinations
    • Leave extensions
    • Termination of leave
  • A model EPSL/EFML Leave Request Form for employees to use to request the leave, including the information and documentation they need to provide in support of their request under each category of qualified leave
  • A model EPSL/EFML Leave Determination Form for the employer to use to review and make determinations on employee leave requests, including approving a given number of hours, days or weeks of leave; requesting additional information to make a determination; or deny a leave request

These model policies and forms are designed help employers with fewer than 500 employees make the necessary good faith efforts to implement the Act, and to gather the information and documentation necessary to support the company’s claims for tax credits under the Acts. We also include:

  • a link to the DOL’s Employee Rights: Paid Sick Leave and Expanded Family and Medical Leave under The Families First Coronavirus Response Act notice;
  • instructions for distributing the DOL notice, the Policy and the Leave Request Form to employees; and
  • links to the latest guidance from the DOL and IRS regarding the Acts 

There is a modest fee of $295 to create your company’s individualized version of the Policy and these forms, including designating the company official to whom leave requests should be submitted and the timing of leave requests. 

Note: The model policies and procedures will not be provided under an engagement to provide legal services, and you will not be entering into an attorney-client relationship with me or ERISA Benefits Law when you purchase them.

To create your company’s version of these model documents, enter the information requested in the form below.

Fill out my online form.

When you submit the information, you will be taken to our secure payment page operated by LawPay to pay the $295 fee. Enter your company name in the “Case Name” box and submit your echeck or credit/debit card payment through that site.

You will receive your company EPSL/EFML Policy, Leave Request Form and Leave Determination Form by email sent to the email address you provide within 12 hours.

Author: Erwin Kratz

Erwin Kratz practices exclusively in the areas of ERISA and employee benefits law, focusing on tax and regulatory matters relating to qualified and nonqualified deferred compensation and welfare benefits.