FMLA
Family Medical Leave Act
When a major life event changes your world—for better or worse—the safety of your job is the last thing you should have to worry about. That’s why Family Medical Leave is here.
Central Peninsula Hospital complies with the Family Medical Leave Act (FMLA) of 1993. The FMLA entitles eligible employees 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. Eligible employees are entitled to:
Twelve workweeks of leave in a 12-month period for:
- the birth and subsequent care of a baby 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 Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember’s spouse, son, daughter, parent, or next of kin (military caregiver leave).
* A serious health condition is defined as: “an illness, injury, impairment, or physical or mental condition that involves either an overnight stay in a medical care facility, or continuing treatment by a health care provider for a condition that either prevents the employee from performing the functions of the employee’s job, or prevents the qualified family member from participating in school or other daily activities.”
Eligible employees must have one year of total service and have worked 1250 hours in the previous 12 months when the leave will begin. For more information on FLMA, please visit
Eligible spouses working for the same department or administrative unit are both entitled to receive up to 12 weeks of family medical leave, which they can take concurrently or consecutively.
Overview: How to Apply for Family Medical Leave
As a Central Peninsula Hospital employee, you must request family medical leave through the Human Resources office.
Step 1: Contact Human Resources to begin the process. You may call 907-714-4773 or email hrinquiry@cpgh.org
Step 2: Human Resources will provide you with a Notice of Eligibility and Rights and Responsibilities, a Health Care Certification Form and an FMLA checklist within five business days (absent extenuating circumstances). This will include details about your eligibility for family medical leave and the specific expectations and obligations for you and your department, which explain any consequences of a failure to meet these obligations. If you are ineligible, Human Resources will provide you a reason. Once your request has been approved, please continue to step 3.
Step 3: In conjunction with your doctor, complete the appropriate forms and disclosure statements to provide proof that you are experiencing a life event that qualifies for family medical leave.
Step 4: Submit your completed forms to the Human Resources office within 15 days. (Forms my be dropped off or faxed to 907-262-9128)
Step 5: Before you return from leave,obtain medical approval to return to work, which you must submit to Human Resources by the specified deadline.
