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  • Ct Aflac Ctpl-0006 2022

Get Ct Aflac Ctpl-0006 2022-2025

An send it by email CTPFL Aflac.com or fax to (888) 485-0973. Section 1: Applicant s Leave Information (to be completed by the Applicant or the Employer) First Name: Last Name: Date of Birth: Last 4 Digits of SSN: Beginning Date of Leave: End Date of Leave: Leave Type: Continuous Intermittent Reduced schedule Case Number: Reason for Leave: Employee s own serious health condition Caregiver leave Bonding leave Military caregiver leave Qualifying exig.

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How to fill out the CT Aflac CTPL-0006 online

This guide offers clear instructions on how to complete the Connecticut Paid Leave CTPL-0006 form online. Whether you are an applicant or an employer, following these steps will help ensure accurate and timely submission.

Follow the steps to complete the CTPL-0006 form effectively.

  1. Click ‘Get Form’ button to access the CT Aflac CTPL-0006 form and open it in your preferred online editor.
  2. In Section 1, as the applicant or employer, fill in the applicant’s first and last name, date of birth, and the last four digits of the Social Security Number. Specify the beginning and end dates of the leave and choose the leave type: continuous, intermittent, or reduced schedule. Provide a case number and the reason for leave by checking the applicable box.
  3. Proceed to Section 2 and complete the employer information including the employer's name, address, city, state, zip code, and contact details. If applicable, indicate the relevant category by checking the correct box before returning the form to Aflac.
  4. In Section 3, input the employee’s rate of pay, hire date, and date of separation if applicable. Select the days the employee typically works. If their workweek varies, provide details for the hours worked over the previous 12 weeks, including any overtime.
  5. In Section 4, the employer must list any company holidays or scheduled closures during which the employee would not be expected to work if they were not on leave.
  6. Move to Section 5, where the employer checks if the employee has applied for Worker’s Compensation. If yes, indicate whether it has been approved and provide the corresponding dates. State the income-replacement benefits the employee will receive while on leave.
  7. Complete Section 6 if additional employer approval is required for certain leaves. Indicate approval for intermittent leave or qualifying exigency leave and provide a description of the leave's timing, frequency, and duration.
  8. Finally, in Section 7, the employer must sign and date the form, certifying that the information provided is true and complete. Print their name and title before submitting the form.
  9. Once all sections are finished, review the form for accuracy, then save the changes, download it, print, or share the form as necessary.

Complete your CT Aflac CTPL-0006 form online today to ensure timely processing of your leave request.

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Generally, leave under the federal and Connecticut FMLA — and Connecticut Paid Leave benefits from the CT Paid Leave Authority — are limited to 12 weeks in a 12-month period, with the possibility of 2 additional weeks of leave for incapacity during pregnancy.

Major Diagnostic Exams Aflac will pay $150 when a covered person requires one of the following exams for a covered sickness: • CT scan • MRI (magnetic resonance imaging) • EEG (electroencephalogram) • Thallium stress test • Myelogram • Angiogram • Arteriogram These exams must be performed in a hospital, doctor's office ...

Aflac manages your Connecticut Paid Leave on behalf of the Connecticut Paid Leave Authority and this is a general guide on how to use our website to find information on your claim for benefits.

Under FMLA, a resident/fellow who has worked for at least 12 months and for at least 1,250 hours during the preceding 12-month period may take up to 12 weeks of unpaid leave in a 12-month period, except that an eligible resident/fellow may take up to 26 weeks of leave to care for a covered service member, as explained ...

No, the Connecticut Paid Leave (CTPL) program is not dollar for dollar wage replacement. If an employee's wages are less than or equal to the Connecticut minimum wage multiplied by 40, the weekly benefit rate under CTPL will be 95% of the employee's average weekly wage.

The paid leave program is funded through employee payroll contributions. Employers do not make contributions to the program, but they are required to deduct and withhold a mandatory tax of 0.5 percent from all employee paychecks and remit these contributions quarterly to the CT Paid Leave Authority.

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Fill CT Aflac CTPL-0006

CTPL-0006 (02-2022) o. Com or fax to . This form is intended to verify wages when wage data is unavailable from CT Department of Labor. Section 1: Applicant's Information CTPL-0006 (08-2023). The CTPL provides income replacement benefits to eligible employees who are unable to work for the same leave reasons. The difference between CT Paid Leave and CT FMLA. • Qualifying Reasons for Leave. Please submit the completed Connecticut Paid Leave Employment Verification form to Aflac within 10 calendar days of receipt. Connecticut's Family and Medical Leave law gives employees access to unpaid, jobprotected leave for various qualifying life events.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232