Receive your Auto ID cards via email, US Postal Mail or Fax from The Hartford with your account or policy number. Suite 402 Last 4 digits of Social Security #: Relation to Employee: Child Parent Employee #: Relation to Employee: Spouse Age: Enter the range of numbers between 13 and 25 to indicate the age of the family member. Suite 1416 1-866-4-USWAGE White Plains, NY 10601, 914-682-6348 Federal government websites often end in .gov or .mil. Wage and Hour Division English: 1-877-238-4373 for Paid Family Leave Claim and General Information. Wage and Hour Division Life insurance policies: It is possible coverage will expire when either no premiums are paid following the initial premium, or subsequent premiums are insufficient to continue coverage. Federal Employees Compensation Act (FECA) 202-693-0040 If you do not have internet access or need assistance filing an appeal, please contact the CTDOL Appeals Division at 38 Wolcott Hill Road, Wethersfield, CT 06109. Contact us Problems? Drop us a line. 1-866-4-USWAGE 1-866-4-USWAGE Here are some useful steps you can take to get started: For more than 200 years businesses have trusted The Hartford. Employees who believe their employer is not following the CT Family and Medical Leave law may file a complaint. If the employee requests leave for a different qualifying reason in the same leave year and the employees eligibility status has changed, the employer must notify the employee of the change in eligibility status within five business days. The purpose of this position is to support the Agency's needs by applying Generally Accepted Accounting Principles, its conventions and definitions in Payroll, Budgeting . The employee must have worked for their covered employer for at least one year to be eligible to apply for FMLA. Workers who have been denied paid leave may file anappeal, regular Wage and Hour Division (1-866-487-9243), U.S. Department of Labor 510 Shotgun Road (1-866-487-9243), U.S. Department of Labor . Grand Rapids, MI 49503-1451, (616) 456-2004 Ontario, CA 91789-4884, 909-204-3773 Wage and Hour Division 1-866-4-USWAGE 620 SW Main St Wage and Hour Division Wage and Hour Division Before sharing sensitive information, make sure youre on a federal government site. Failure to follow the notice requirements may constitute an interference with, restraint, or denial of the exercise of an employees FMLA rights. Springfield, Illinois 62704, (217) 793-5028 Suite 575 Room 101 Wage and Hour Division Under the law, American employees are entitled to certain protections after a major life event or illness affecting them or their immediate family members. #views-exposed-form-manual-cloud-search-manual-cloud-search-results .form-actions{display:block;flex:1;} #tfa-entry-form .form-actions {justify-content:flex-start;} #node-agency-pages-layout-builder-form .form-actions {display:block;} #tfa-entry-form input {height:55px;} 9 Princess Road, Suites G/H The candidate (s) offered this position will be required to submit . You can apply online or call the toll-free application line at (877) 499-8606. If you work in the Western half of Missouri, see Kansas City District Office. 1-866-4-USWAGE 3161 W. White Oaks Drive Albany, NY 12207, 518-431-6460 Wage and Hour Division If you are unable to find the information you need on this page, you can contact the CTDOL Legal Division atDOL.CTFMLA@ct.gov. Contact HR Service Center; 704-631-1500, choose Option 3. Empowering performance. Computershare All covered employers must display a general notice about the FMLA (an FMLA poster). The Hartford's Absence Management solutions offer your employees digital tools and on-call advocates to manage Leave and Disability claims with care and helpful resources. Suite 110 Hours: 8 a.m. to 9 p.m. (1-866-487-9243), U.S. Department of Labor And, as youll see below, there are complicated cases where the administrative burden becomes heavy indeed. If you are applying for military-related paid family leave benefits, or if you are currently unemployed, please call the Department's Contact Center at (833) 344-7365 to begin your application. The .gov means its official. Suite 1130 If you work in the Virgin Islands, please see the Caribbean District Office. 1-866-4-USWAGE Wage and Hour Division U.S. Department of Labor Serving San Francisco, San Mateo, Napa, Del Norte, Humboldt, Mendocino, Alameda and Contra Costa county: U.S. Department of Labor Charlotte, NC 28273, (704) 749-3360 .usa-footer .container {max-width:1440px!important;} The employee may request only one Family and Medical Leave for a child or adult dependent. 1-866-4-USWAGE U.S. Department of Labor San Diego, CA 92101, 619-557-5110 #views-exposed-form-manual-cloud-search-manual-cloud-search-results .form-actions{display:block;flex:1;} #tfa-entry-form .form-actions {justify-content:flex-start;} #node-agency-pages-layout-builder-form .form-actions {display:block;} #tfa-entry-form input {height:55px;} 700 E. San Antonio Street Note: All requests for Family and Medical Leave for a child or for adult dependents must be made within three (3) years of leaving the employee's employment. Federal Contract Compliance Assistance. (1-866-487-9243), U.S. Department of Labor Benefits and Costs of the Family and Medical Leave Act PDF, The Equal Employment Opportunity Commission (EEOC), Find out more information about third party resources, Fortunately, the learning curve for FMLA basics is not steep. Our technology enables our colleagues to do their best work and binds us together . Room W-1836 .usa-footer .grid-container {padding-left: 30px!important;} ol{list-style-type: decimal;} */. You can watch ourInformational webinarand review ourPowerPointslideshow for more detailed information about the Connecticut Family & Medical Leave Act. Oklahoma City, OK 73102, 405-231-4158 Donations to Hartford HealthCare are managed by the Hartford Hospital Department of Philanthropy, a Connecticut tax-exempt organization under section 501(c)(3) of the IRS code (E.I.N. Choose how you want to receive or enter your security code. In addition, youll need to plan for the impact on your budget and the rest of your workforce. Suite 618 Employee's name: Note: If the employee provided the employee name on a previous FMLA certification form, the employee's name is required to be included on this request when the employee requests Family and Medical Leave for this purpose. Another time-sensitive letter dated 3/11/2022 not received until 3/29/2022. Find the right form for you and fill it out: No results. of Labor 1-866-4-USWAGE 1-866-4-USWAGE Somerset Bank Building CTDOL Leave complaints are filed below after January 15th. #block-googletagmanagerheader .field { padding-bottom:0 !important; } U.S. Department of Labor Wage and Hour Division Suite 373M Westbury, NY 11590-5119, 516-338-1890 .manual-search ul.usa-list li {max-width:100%;} 401 North Market Street Room 9.102B If you work in Calhoun, Jersey, Madison, Monroe, Randolph, and St. Clair counties, see St. Louis District Office. You are about to be logged out due to inactivity. Wage and Hour Division Family and Medical Leave Act (FMLA) Eligibility Employees with at least 12 months with the state, who have worked at least 1,250 hours in the last 12 months (1-866-487-9243), U.S. Department of Labor Suite 250 Wage and Hour Division 1000 Liberty Ave .manual-search ul.usa-list li {max-width:100%;} #block-googletagmanagerheader .field { padding-bottom:0 !important; } Room 318 Pay for this position is: $55,000-$65,000 plus commission. Manchester, NH 03101, (603) 666-7716 1-866-4-USWAGE Medical, Dental, Vision Phone Number 1 (800) 244-6224 24 hours a day, 365 days a year Medical Claims Cigna PO Box 182223 Chattanooga, TN 37422-7223 Dental Claims Cigna Employees are eligible for up to 12 workweeks of unpaid FMLA leave each 12-month period for the following reasons: Medical Leave - for a serious health condition that makes the employee unable to perform his/her job. 1-866-4-USWAGE Infographics, articles and more helpful information for individuals and employees. FMLA Poster If you have difficulty in obtaining the Paid Family Leave forms or need help in completing these forms, please contact the PFL Helpline at (844)-337-6303. Wage and Hour Division Wage and Hour Division Orange, CA 92868-4954, 714-621-1650 Hartford will provide employees with any paperwork required and confirm the next steps. 725 10127 Morocco St If your employer denies the privileges guaranteed to you under the Family and Medical Leave Act (FMLA), you may be able to file a claim for . Interested parties may communicate with The Hartford's non-management directors through our third party service provider, EthicsPoint. Wage and Hour Division Room 310 .cd-main-content p, blockquote {margin-bottom:1em;} Employers also may be required to provide notices in languages other than English where a significant portion of the employers workforce is not literate in English. Learn more. Our integrated model helps keep the Claims process simple and efficient while giving your employees the resources they need to recover swiftly and safely: An Employee Assistance Program that provides professional counseling for employees and their immediate family for financial, legal and emotional work-life challenges.