LOA One Page TEAM MEMBER

Leave of Absence Toolkit TEAM MEMBER
Si necesita ayuda en Espanol por favor hable al departamento de Beneficios al 844-216-9320.

The Company recognizes that Team Members may need to take leaves of absence for reasons noted below. It is the
Company’s intention to comply with federal and state leave of absence laws. When you initiate a Leave of Absence,
there are actions you must take to ensure your leave is properly qualified, you are paid correctly, and that the leave
will go smoothly for you and your location/department.

Types of Leaves
Family Care/
Find the type of leave you are taking, Medical Leave Family care and/or medical leave for up to 12
and read down the list to see what Military weeks in a rolling calendar year in accordance
actions you need to take and what to Caregiver Leave with the federal Family and Medical Leave Act
expect from the leave process. Workers Comp (FMLA) and any applicable state/local laws.
Leave
Military Leave Americans with Disabilities Act (ADA) Medical
Personal Leave
Intermittent Leave to reasonably accommodate leave of
Leave

♦ ♦ ♦ ♦ ♦ ♦pInrfioorrmtoytohuersmtaarntaogfeyroaunrdle/aovreHoRrRasepsooofnyoasurpnoesseidblfeor leave 30 days absence request for Team Members with a
qualified disability/medical or workplace illness/

♦ ♦ ♦ ♦ ♦Complete and submit the Request Leave of Absence form in Dayforce. injury.

aCovanislaidbeler sPuTbOm/VitaticnagtiaonTifmoreuAnwpaayidredqauyesswt ihnilDeaoyuftoorcneletoavbee.paid Intermittent leave as permitted by FMLA,

♦ ♦ ♦ ♦ ♦ ♦ Americans with Disabilities Act (ADA), USERRA and
any applicable state law.

♦ ♦ ♦ ♦pCoronvtiadcetrSs’ucnoLnitfaecattin8f3o3r-m8a12ti-o5n17w7hteonfyiloeuycoaullr.claim; have your health ♦ Personal leave usually not to exceed 30 days, is
an unpaid leave that a Team Member may take for
♦ ♦ ♦SalusnoLbiefepwroilvlipdreodvitdoeyfoourrmhsefaolrthyopurotvoidcoemrsp, ilfeateppanlicdarbelteu.rn. Forms will absences other than FMLA or for medical reasons.

aIfnyionucridaebnstenrecpeoisrtbweictahusyeouorf Sanupoenr-vtishoer-.job incident, immediately file ♦ ♦ A Team Member is eligible after one year of
service. This type of leave is considered on a case-
yYoouurminutsetnntottoifryeytuorunrtSouwpeorrvki.sor and Sun Life within three days of ♦ ♦ ♦♦ by-case basis at the manager’s discretion.
Workers Comp Leave is for a Team Member
absence due to an on-the-job injury. This type will

♦ also be eligible for FMLA or ADA as applicable.

rIfelyeoausreletoavreetwuarns ftoorwmoerkditcoalyroeuarsSounps,eyrvoiusomr.ust provide a physician’s ♦ ♦ Military leave is in compliance with the
yIrfeolyuaortuemrtaponhyayogsuiecrripatnoosaditlilsioocwnus.ssytohuetroerqeutiurerndwacitchomremstoridctaitoionns,spalneadsheocwonthtaecyt ♦ ♦ Uniformed Services Employment and
Reemployment Rights Act (USERRA), when
the federal or state government calls a Team
Member to active service or military training.
Military caregiver leave as required under FMLA.

What requires filing for a leave of absence Can I use PTO/Vacation while on a leave? How much does the STD benefit pay?
and/or Short Term Disability (STD)? Team Members may use all available PTO/ The STD benefit pays 70% of the base
Any time a Team Member experiences Vacation for unpaid periods during their rate of pay beginning the 15th day
an unexpected absence of three or more leave. If you are receiving STD benefits, of your 13 week benefit period. Pay
days, they should be placed on a Leave of you may supplement this benefit by using for Team Members who receive only
Absence. If the Leave of Absence is due PTO/Vacation time not to exceed 100% of commissions and piece rate will be based
to your own health condition or that of a base pay. on a calculation averaging their prior 12
qualifying family member, you should also months of earnings, determined annually
file for FMLA/ADA. If the leave of absence is Can I go negative on PTO/Vacation? prior to Open Enrollment.
for your own health condition and expected Team Members on a paid leave of absence
to last more than 14 calendar days, you are allowed to go negative up to 40 hours Are STD benefits taxed?
should also file a claim for STD, if enrolled. on vacation and 8 hours on PTO. Short Term Disability benefits are subject
to the same withholdings and deductions
How do I report a leave of absence claim? Will I receive STD pay? as regular hours worked, including federal,
You need to contact Sun Life at 833-812- If you are enrolled in the STD benefit, state and local taxes, benefit premiums,
5177. Sun Life will qualify the absence for STD pay will be processed on the same child support, garnishments, etc.
eligibility under FMLA, ADA and State/Local schedule as regular hours worked. You
Leave Laws, and STD if applicable. will receive the pay via your chosen How are the benefit premiums paid if I
method in Dayforce. Process may differ don’t have PTO, Vacation, or STD income?
How do I know the Leave has been approved? for state mandated plans. Team Members will be responsible for
Sun Life will notify you (the Team monthly payment of benefits equal to the
Member) and the LOA Administrator of When does the STD benefit start? sum of their usual bi-weekly deductions
any approvals or denials. Dayforce will be The STD benefit is effective on the 15th for that month. You will receive an initial
updated to reflect your leave status. calendar day of the approved leave. premium notice and ongoing monthly
invoices with instructions on where to
send the monthly payments.

Who do I contact if I still have questions? Please contact the Benefits Department at 844-216-9320.

Disclaimer: While every attempt has been made to ensure the accuracy of the notice, the legal documents, policies, certificates pertaining to the various
benefits prevail in the event of any discrepancies. This is noofteamlpelgoaylmdeonctumanednta,raensdubdjoeecst ntootcghuaanrgaen.tee coverage. Policies summarized here are not conditions