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Designation Notice <br /> 1. Once it has been determined that that the employee's requested leave <br /> qualifies as FMLA leave, the City will provide the employee with a written <br /> Designation Notice within no more than five business days, absent <br /> extenuating circumstances. Such notice shall include, as appropriate: <br /> a. that the leave will be counted against the employee's annual family <br /> medical leave entitlement; <br /> b. any requirements for the employee to furnish medical certification of <br /> a serious health condition and the consequences of failing to do so; <br /> c. the employee's rights to substitute paid leave and the conditions <br /> related to such substitution; <br /> d. any requirement for the employee to make any premium payments <br /> to maintain benefits and the arrangements for making such <br /> payments; <br /> e. any requirement for the employee to submit to a fitness for duty <br /> physical examination to be restored to employment; <br /> f. his/her status as a "key employee" and the potential consequence <br /> that restoration may be denied following family medical leave, <br /> explaining the conditions required for such denial; <br /> g. the employee's rights to restoration to the same or an equivalent job <br /> upon return from leave; <br /> h. the employee's potential liability for payment of health insurance <br /> premiums paid by the City during the employee's unpaid family <br /> medical leave if the employee fails to return to work after taking <br /> family medical leave. <br /> 2. Such designation notice may also include: whether the City will require <br /> periodic reports of the employee's status and intent to return to work or <br /> recertification relating to a serious health condition. <br /> 3. If the leave does not qualify as FMLA leave, the City will notify the <br /> employee in writing that the leave is not FMLA-protected. <br /> 704:2 FMLA Page 16 of 19 <br /> 127 <br />