Please note: Effective 12/30/2024, we will be moving to a new platform (Guardian) for requesting a leave of absence. The new request form will be posted on this webpage when it is live.
Leave of Absence Requests
A request for leave of absence should be submitted to the Office of Human Resources when an HCPSS employee meets the following qualifications:
The employee has been absent more than 10 consecutive days of work
The employee is aware of an upcoming qualifying condition* that will require them to be absent for more than 10 consecutive days of work (temporary leave of absence)
The employee wishes to apply for an extended leave of absence
Fill out this form to log your request in our system. You must use your HCPSS account to log in.
Temporary Leaves of Absence:
Each qualifying condition requires a leave of absence request form, Healthcare provider certification form and a benefits billing form. Employees may elect to complete a Maryland State Retirement form.
Extended Leaves of Absence:
Each option for an extended leave of absence require an employee to complete a request for leave of absence including request form, benefits billing form and documentation verifying eligibility for request. Employees may elect to complete a Maryland State Retirement form.
HCPSS Policies & Negotiated Agreements
For information pertaining to HCPSS Policies and Negotiated Agreements, as they pertain to leaves of absence, please see below:
While on a paid leave, your benefits are protected. Once you are on an unpaid leave, you will be responsible for protecting these benefits. It is important to know that Howard County’s leave of absence rules differ from the Maryland State Retirement Agency’s (MSRA) rules.
For both MSRA qualified and unqualified leave
If you retire following a leave of absence, in order to receive health and life insurance benefits as a retiree, you must keep these benefits active through your leave so that coverage is continuous. If your leave is not a FMLA leave or goes beyond your FMLA time, and it is an unpaid leave, you will have to pay the full cost of your health insurance to qualify for that insurance in retirement. If you are totally disabled and your disability began prior to your 60th birthday, a waiver for the life insurance premiums may be available; call a Benefits Specialist at 410-313-1564. (If you are on workers compensation from Sisco or on an unpaid leave following workers’ compensation, procedures may be different; call the claims representative at 410-313-7494).
If you wish to continue your health, dental, vision insurance, etc., you must complete a Benefits Billing Form giving HCPSS authorization to bill you. Your coverage will end if you fail to maintain payments. This form is part of your leave packet
If you want to continue your Basic life insurance, contact the Benefits office at 410-313-1564 to request a conversion form within 30 days of your final paycheck from HCPSS.
If you had Long term disability and would like to continue the LTD while on unpaid leave contact the Benefits office at 410-313-1564 to request a conversion form within 30 days of your final paycheck from HCPSS.
If you move during your leave period, please notify HCPSS as well as the Maryland State Retirement and Pension system.
For MSRA qualified leaves only
MSRA will grant an approved leave of absence for up to two years. Your MSRA leave will begin when your unpaid status begins. To take advantage of the full two years of unpaid leave with MSRA, it is important that your Application to Be Placed on a Qualifying Approved Leave of Absence reflect your unpaid leave time only.
You will be eligible to purchase the unpaid leave (two year maximum) by making up your missed contributions, provided there is a Form 46 on file. You will need to complete a Request to Purchase Previous Service, Form 26. Purchase this as early as possible for your missed contributions will accumulate interest: the longer you wait, the more you will pay.
Questions or concerns:
Contact the Benefits Office at 410-313-6713, 1564 or 6710 for questions regarding life or health insurance. Contact the MSRA at 1-800-492-5909 for questions regarding your MSRA qualified leave and pension benefits.
Contact Us
For more information, send an email to HRLeaveofAbsence@hcpss.org or call one the following telephone numbers: 410-313-6695, 410-313-6612, 410-313-8872.
