Brains On Fire, Inc.

Size of Company: 11-49 employees

Length of Policy: 7-10 weeks

1 Parental Leave Policy Brains on Fire, Inc. October 9, 2017 PARENTAL LEAVE POLICY Parental leave is intended to equip employees with paid time off to bond with their newly-arrived child due to birth or adoption. BOF has two categories of Parental Leave: primary caregiver and non-primary caregiver. Employees who take parental leave will be reinstated to their regular position upon their return. Failure to return to work at the end of the parental leave (without an approved extension) shall be considered a resignation. Parental Leave is inclusive of any holidays that occur during the leave period. Vacation time is not included in parental leave and can be used to extend parental leave time. ELIGIBILITY Paid parental leave is available after successful completion of 12 months of full-time employment. Unpaid parental leave is available once the employee has been employed for at least three months. Employees must request parental leave associated with the birth or adoption of a child. Providing advanced notice and indicating intent to return is required by completing and signing BOF Request for Parental Leave form. BOF recommends a 4-month notification whenever possible. CAREGIVER STATUS A "primary caregiver" is defined as someone who has primary responsibility for the care of a child immediately following birth/adoption. This definition thus applies to both births and adoptions. To exercise the primary caregiver benefit, an employee must complete an Affidavit of Parental Leave stating that he or she is the primary person responsible for the child. This policy depends on, and assumes, the good faith of its participants. Determining which parent is the primary caregiver of a child focuses on how parents have divided the key responsibilities for their child: § Purchasing clothes and laundry responsibilities § Health care arrangements § Fostering participation in extracurricular activities § Teaching of reading, writing, and math skills; helping with homework § Conferencing with teachers; attending open houses § Planning and participating with leisure activities with the child § Bathing, grooming, and dressing § Meal planning and preparation It is generally assumed that if one parent stays home to care for the child and does not work, he/she is the primary caregiver. The other parent would then be the non-primary caregiver. 2 PRIMARY CAREGIVER If you are the primary caregiver and the birth parent, your six-week leave must be concurrent with the Short-Term Disability period, and used consecutively within the first six months after the birth/placement of your child. If you gave birth to child, short-term disability will pay for 60% of your salary up to $500 per week for 6-12 weeks per doctor’s orders for leave of absence. The 60% will be paid under Mutual of Omaha (MOH) Disability Insurance plan and MOH will issue you a check. Short-Term Disability must be used immediately after childbirth. BOF will pay the remaining percentage under regular salary to ensure you have a full six weeks of paid parental leave. If your Short-Term Disability is extended due to doctor orders (for example, to 8 weeks), BOF parental leave (for remaining 40%) will only continue for 6 weeks. As a result, the remaining two weeks will only receive Short Term Disability compensation. If child is adopted, BOF will pay full six weeks of salary as normal under regular payroll processing. Once you start your primary caregiver Parental Leave, you must take the entire six-week period continuously, and must be completed within six months of the birth or placement of the child. NON-PRIMARY CAREGIVER If you’re the non-primary caregiver, you can take your two weeks within the first year of the birth/ placement of your child and does not need to be concurrent. Parental Leave for non-primary caregivers will be paid under BOF payroll processing as normal for two weeks. ADOPTION CLAUSE You are eligible for parental leave once children have been placed in your home for permanent placement and court documents are in place for removal of birth parents’ parental rights. You are not eligible for parental leave for normal foster care placements that are temporary in nature. FAMILY & MEDICAL LEAVE ACT (FMLA) FMLA is a labor law requiring larger employers (50+ employees) to provide employees unpaid leave for serious health conditions, to care for a sick family member, or to care for a newborn or adopted child. BOF does not fall under FMLA rules and regulations; BOF voluntarily provides this policy above and beyond the legal minimum to support and value its team members during the addition of children to their family. 3 EMPLOYEE REQUEST FOR PARENTAL LEAVE Brains on Fire, Inc. October 9, 2017 Please complete the sections below and return to Human Resources at least four months prior to your anticipated delivery/placement date. All forms must be submitted to receive Benefits Eligible Leave. To be eligible for this paid leave, you must have successfully completed your introductory period of 1 year. APPLICATION FOR PAID PARENTAL LEAVE ___ As the primary caregiver, I request a 6-week paid leave, per the BOF Parental Leave policy. ___ As the non-primary caregiver, I request a 2-week paid leave, per the BOF Parental Leave policy. Anticipated Leave Start Date: ________________ Anticipated Leave End Date: ________________ *Birth Mothers will be provided with additional Short-Term Disability paperwork. PARENTAL LEAVE PRIMARY CAREGIVER AFFIDAVIT I, ____________________________________ (employee name), certify that I have primary responsibility for the care of my newborn/newly adopted child in accordance with the following criteria and am, therefore, eligible for benefits under BOF’s Parental Leave Program. 1. I am the parent of this newborn/newly adopted child. 2. I will be the primary adult caregiver of the child during the time I am absent from work on paid parental leave. I understand as the primary caregiver I am caring for the newborn/newly adopted child, the majority of the time as the primary caregiver. 3. I will return to work at the expiration of my parental leave. Acknowledgements: I understand that the qualified period of paid Primary Caregiver Parental Leave is (6) weeks immediately following the birth/adoption. I affirm that the assertions in this affidavit are true. ____________________________________ Date: __________________ Employee Signature ____________________________________ Date: __________________ HR Signature