Fillable Userra Return To Duty Technician Checklist (Page 2 of 3) in pdf

IV. EARNED LEAVE

You will resume earning leave as normal effective on you RTD date.

Cached Leave

All earned leave (Annual, Compensatory, paid M ilitary Leave, Sick, and T ime Off Awards) which were cached during your Non-Pay status will

resume effective on your RTD date unless leave was forfeited or requires restoration.

Forfeiture of Leave

1) Compensatory Time and Time Off Awards which were not used within 1 year of earning them may have been forfeited and cannot be restored.

2) M ilitary Leave which e xceeded t he maximum amount of 240 hours may have been forfeited cannot be restored.

Restore Leave

Accrued Annual Leave which exceeded the maximum amount of 240 hours may have been forfeited, but can be restored upon request depending on

the time it was lost. Reference Technician Personnel Regulation Chapter 630, Leave and Absences for details on how to request leave restoration(s).

Initials

I understand my earned leave conditions and requirements and will take the necessary steps as appropriate.

V. TECHNICIAN PAY

All allotments, deductions, and garnishments such as normal employment benefits or investments (Health Benefits, Life Insurance, Thrift Savings

Plan, and Loans) established on your technician pay will resume effective on your RTD date.

It is your responsibility to review, coordinate, and/or reestablish any obligated or any additional allotments, deductions, and/or garnishments.

To manage your pay information (i.e. Address, Direct Deposit, LES delivery, and Allotment information) you will need to access the DFAS MyPay

Web Site at https://mypay.dfas.mil/mypay.aspx.

Initials

I understand my Technician Pay conditions and requirements and will take the necessary steps as appropriate.

VI. FEDERAL EMPLOYEE’S G ROUP L IFE I NS URANCE ( FEGLI)

FEGLI coverage, whether terminated or not, will resume effective on your RTD date. If FEGLI coverage has been terminated the

FEGLI coverage in place when your non-pay status began will be reinstated automatically upon your Return to Duty.

Initials

Select and Initial ONLY ONE:

I DO NOT H AVE F EGL I COVERAGE.

I understand my FEGLI coverage becomes active upon my RTD.

VII. FEDERAL EMPLOYEE’S HEALTH B ENEFITS (FEHB)

FEHB coverage will resume effective on your RTD date. If your FEHB was previously cancelled per your request, was automatically terminated

after having exceeded the 24 month or simply did not have FEHB prior to you entering military service, you may elect to waive, reinstate or enroll

in FEHB.

Reinstatement/Enrollment

You have 60 days after returning to duty to reinitiate or enroll in FEHB. Your HRO office will complete and submit a Standard Form 2810 or 2809 .

Waiver

Upon returning to duty, you may waive FEHB reinstatement or enrollment due to military TRICARE coverage so lon g as y ou complete the Waiver

of Immediate Reinstatement of FEHB form.

Initials

Select and Initial:

I understand my FEHB options and elect ONE o f the following:

Initials

Select and Initial ONLY ONE:

I ELECT TO CONTINUE my current FEHB coverage.

I EL ECT TO EN ROLL/REINSTATE FEHB coverage HRO will submit a SF 2809 or SF 2810 with this

checklist.

I EL ECT TO WAIVE FEHB coverage at this time and understand I must complete the Waiver of Immediate

Reinstatement of FEHB fo rm.

Page 2 of 3

USERRA RTD Technician Checklist

Userra Return To Duty Technician Checklist Page 2

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