Leave Request

If you are planning a leave from work (FMLA or personal leave due to illness, injury, pregnancy, to provide care for a family member, or other), access the Leave Request Process to review the process for filing a leave request and/or short-term disability claim through UNUM.com.

FMLA Definition of Serious Illness or Injury

If the reason for the leave is your own health, Short and long-term disability insurance may apply.  These are Foth-paid benefits available to eligible members, effective on their hire date. When requesting disability paid time-off, a member must notify their RCM or Benefits Specialist of their absence from work and submit a claim by calling UNUM at 866-779-1054, OR access www.unum.com  and follow the claim submission instructions (new users will need to register a new account). Some states offer their own disability policy, so refer to your state instructions.

Visit www.unum.com and log in to view the status of your FMLA and/or disability claim.  You’ll be able to see open claims, submit FMLA time, submit documentation and check the status of disability payments.

Disability Insurance

Short Term Disability (STD) Summary

Short Term Disability (STD) insurance provides you with an important source of income should you become disabled and unable to work for a short period of time. All Regular Full- and Part-time members are eligible for STD benefits, after a 14 calendar day elimination period, that equal 60% of weekly gross earnings up to a maximum weekly benefit of $2,500. Payments for STD begin on the 15th calendar day of disability resulting from an accident or illness and are payable for up to 11 weeks.  For pregnancy, STD typically applies for 6 weeks for a normal delivery and 8 weeks for Cesarean section (which includes the elimination period).

Refer to the Summary Plan Description for additional information

Long Term Disability (LTD) Summary

Long Term Disability (LTD) insurance provides you with an important source of income should you become disabled and unable to work for an extended period of time. All Regular Full- and Part-time members are eligible for LTD benefits that equals 60% of monthly gross earnings up to a maximum monthly benefit of $5,000. This policy pays as long as you are disabled from doing your own occupation.  Payments for LTD begin on the 91st day of continuous disability and follow STD.

Refer to the Summary Plan Description for additional information

 Long Term Disability – Buy Up Coverage

Depending on your situation, a gap could exist between your income and the amount the Foth Long Term Disability (LTD) policy will pay out in the event of a disability.  If 60% of your monthly income exceeds the monthly benefit limit, or if you receive bonuses, you may potentially have a gap between your current income and the income you would receive if disabled.  If interested in evaluating LTD buy up options, contact Jeff Bartosic with USI (Foth’s benefits consultants) at 920-481-2079 or jeffry.bartosic@usi.com to find a policy.  He will research multiple carriers to find a policy to best fit your needs.  Medical underwriting may include a physical exam.

Bereavement Leave

In the event of the death of an immediate family member, regular full-time and part-time exempt and non-exempt members receive up to three work days with an equivalent of eight hours pay per day. The three work days do not need to be consecutive but they must be taken within one month of the death.  An immediate family member is defined as a member’s spouse, parent, sibling, child, grandparent, or grandchild. (This includes in-law, step- and domestic partner relationships.) Bereavement leave, including the duration of the leave, must be approved by the member’s RCM.  An assignment will be provided by Human Resources after RCM approval.

Jury Duty Leave

Receive up to 10 days paid leave for eligible jury duty events for regular full-time and regular part-time members (time past 10 days is unpaid). Members are to notify their RCM upon receiving summons for duty. Prior to reporting for jury duty, members must furnish a copy of the court order as proof of required absence to HR. Once jury duty payment is received, a copy of the check must be submitted to HR, along with a check to Foth for the per diem portion only.

Military Duty Leave

All regular full-time members and regular part-time members who belong to Federally-recognized uniform services, such as, National Guard, Naval Reserve, or Officers Reserve, etc., who present official orders for training or active duty will be granted a military leave of absence, not to exceed five years for such activity. Advance notice of military service is required, unless military necessity prevents such notice or it is otherwise impossible or unreasonable. Each case presented will be handled as necessary. You’ll need to inform your RCM and Human Resources and present documentation.

 Leave Sharing

In the event your unpaid medical leave results in your PTO balance going below 40 hours you may request Leave Sharing if needed, (donated PTO by caring Foth members) by opening and completing the form located within the Leave Sharing Account Program handbook*.
*Internal document, must be logged into the Foth network to access