Paid Time Off Policies Questionnaire 2014

Please Keep This Sheet Attached to the Questionnaire
Indicate any changes to name and address below.
2014 Paid Time Off Policies Survey – AZ, CO & WY 10887
To complete this survey online go to

http://surveys.msec.org/controller.aspx
You will need to contact surveys@msec.org Final Acceptance Date:

for your personal access code to complete the Friday, November 7, 2014
survey online.
UNDERSTANDING OF CONFIDENTIALITY
This survey questionnaire should be completed with the understanding that:

♦ Organization identity and compensation or benefit information will remain
confidential and will not be released without advanced approval by the organization.
♦ The contents and the resulting survey report will not be used in collective bargaining
sessions or in grievance proceedings by either MSEC or the organization.
♦ The resulting survey will be used solely to assist in guiding the effective
management of compensation or benefit programs.
1799 Pennsylvania Street ■ P.O. Box 539

Denver, Colorado 80201-0539
303 839 5177 (main) ■ 303 861 0135 (fax)
surveys@msec.org (email)
Directions and Definitions
This questionnaire is designed for collecting information on benefits as they affect the majority of full-time
employees. If a question requests information specifically for exempt/nonexempt employees, use the definitions
below.
EXEMPT Defined as full-time employees exempt by Federal Wage-Hour Law.
NONEXEMPT Defined as full-time employees, nonexempt under Federal Wage-Hour Law.

Employees receiving a fixed compensation paid regularly for services. Includes nonexempt as
SALARIED well as exempt (as defined by Federal Wage-Hour Law). Excludes outside sales and top level
executives.
Employees paid on an hourly basis for hours worked. Typically includes cleaning and
maintenance, factory production and warehousing/material handling (including truck drivers).
HOURLY
Also includes culinary workers, laundry workers and related categories. These employees are
all classified as nonexempt under the Federal Wage-Hour Law.
♦ Check only one option unless the question
specifically states “Multiple Responses
♦ Use a check ( ) to indicate your answer in the
Permitted.” Check the box or boxes which best
appropriate box.
describe the policy used for the majority of
employees.
♦ If you are reporting for more than one location and
the benefits are the same, only one completed ♦ If none of the multiple choice options provided
questionnaire is necessary. If practices differ seem appropriate, please explain your benefit in
between locations for certain questions, please the margin, or in the space marked “Other.”
note differences in the margins.
♦ Report the policies and practices applying to the ♦ All questions pertain to full-time employees
majority of your employees and which are covered (employees working at least 35 hours per week)
by a single, well-defined program or policy. unless otherwise specified.
♦ If your policy matches an option which indicates

that a “Specify” is required, please check the box ♦ Answer each question based on benefits in effect
under the appropriate category and also fill in the on September 1, 2014.
blank provided next to the “Specify.”
EXAMPLE FOR COMPLETION
11.00) Carry over of unused vacation to the next vacation year?
1.0 Require employee to use during vacation year 1.0 _____

2.0 Employee paid for unused time 2.0 _____
3.0 May carry over all accrued, unused time 3.0 _____
4.0 May carry over only a certain amount 4.0 X__
40
(Specify maximum carry over hours per year) _______ hours
5.0 No established policy 5.0 _____
6.0 Other (Specify)_________________________ 6.0 _____
If you have questions or need assistance as you complete this questionnaire,

please call the MSEC Surveys Department at 303.839.5177.
Return your completed questionnaire by Friday, November 7, 2014.
MSEC – 10887 Paid Time Off Policies – AZ, CO & WY 9/2014

General Information Questionnaire
Full Organization Name:
Name of Person Completing Questionnaire:
Street Address and Zip Code (if different than on cover):
Phone Number: FAX Number: Email Address:
Location and Employment Size: If you are reporting for more than one location, complete the following
information for each site. However, only one completed questionnaire is necessary if practices and plans are the
same. If policies/plans differ between locations, please note differences in the margins.
Enter current employment size on the line below.

COLORADO GEOGRAPHIC AREAS:
Metro Denver (includes the counties of Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson,
and Gilpin)
Total Number of Employees in Reporting Area:
Colorado Springs (includes the counties of El Paso, Elbert and Teller)
Pueblo (includes the counties of Pueblo, Fremont, Huerfano, Rio Grande, Otero, Alamosa, and Las Animas)
Northern Colorado (includes the counties of Weld, Larimer, Logan and Morgan)
Colorado Western Slope (includes the counties of Delta, Mesa, Montrose, Archuleta, San Miguel, Ouray, Dolores, an
Juan, Montezuma, Moffat, Rio Blanco, and La Plata)
Resort Areas (includes the counties of Pitkin, Grand, Park, Lake, Chaffee, Garfield, Summit, Clear Creek, Eagle,
Gunnison, and Routt)
WYOMING GEOGRAPHIC AREA:
Wyoming
ARIZONA GEOGRAPHIC AREAS:
Metro Phoenix, Arizona (includes Maricopa County)
Tucson, Arizona
Flagstaff, Arizona
Other Arizona
MSEC – 10887 Paid Time Off Policies – AZ, CO & WY 9/2014

Holidays 2.00
1.00 Do you grant paid holidays as an employee benefit?

1.00 No -- Skip to Vacation section
2.00 Yes -- Please Continue
3.00 Paid Time Off* bank of days (PTO) includes holidays (i.e. no separate holiday pay) --
Skip to Vacation section
* A formal plan providing a bank of days to be used by each employee as desired (i.e. holidays, vacation, sick leave).
2.00 Total number of paid holiday hours per employee in 2015? (Exclude election days; include floaters.)______
MSEC 2014 Paid Time Off Policies Survey - AZ, CO & WY Page 1 of 34
Holidays 2.00
3.00 Indicate which of the following holidays will be observed as paid holidays by your organization?
1.00 Monday, December 29, 2014
2.00 Tuesday, December 30, 2014
3.00 Wednesday, December 31, 2014
4.00 New Year's Day - Thursday, January 1, 2015
5.00 Friday, January 2, 2015
6.00 Martin Luther King Day - Monday, January 19, 2015
7.00 Presidents' Day - Monday, February 16, 2015
8.00 Good Friday Half Day - Friday, April 3, 2015
9.00 Good Friday Full Day - Friday, April 3, 2015
10.00 Easter Monday - Monday, April 6, 2015
11.00 Memorial Day - Monday, May 25, 2015
12.00 Independence Day Observance - Friday, July 3, 2015
13.00 Labor Day - Monday, September 7, 2015
14.00 Columbus Day - Monday, October 12, 2015
15.00 Veterans' Day - Wednesday, November 11, 2015
16.00 Thanksgiving - Thursday, November 26, 2015
17.00 Friday after Thanksgiving - November 27, 2015
21.00 Half Day - Thursday, December 24, 2015
22.00 Full Day - Thursday, December 24, 2015
23.00 Christmas Day - Friday, December 25, 2015
27.00 Thursday, December 31, 2015
28.00 New Year's Day - Friday, January 1, 2016
Holidays 2.00
4.00 Indicate which of the additional paid days off are granted to employees? (Multiple responses permitted.)
0.10 No additional paid days
1.00 Employee's Birthday
2.00 Employment Anniversary Date
3.00 Floater(s) holidays (Specify number of days)____
4.00 Other (Specify)_______________________
5.00 Religious Holy Day observance policy (e.g., Ash Wednesday, Rosh Hashanah) when not designated as a company
holiday?
1.00 Time off without pay unless employee elects to use earned vacation, floating holiday,
and/or personal time
2.00 Time off with pay (not charged to vacation, floating holiday or personal time)
3.00 No established policy
4.00 Other (Specify)_______________________
6.00 Holiday observance when holiday falls on Saturday, and Saturday is not a normal workday?
0.10 Saturday is a normal workday
1.00 Holiday observed on preceding workday
2.00 Holiday observed on following workday
3.00 Grant another day off
4.00 Grant a day's pay instead of holiday
5.00 Lose day as a paid holiday
7.00 Holiday observance when holiday falls on Sunday, and Sunday is not a normal workday?
0.10 Sunday is a normal workday
1.00 Holiday observed on preceding workday
2.00 Holiday observed on following workday
3.00 Grant another day off
4.00 Grant a day's pay instead of holiday
5.00 Lose day as a paid holiday
Holidays 2.00
8.00 To receive holiday pay, is employee required to be present the workday before and after the holiday unless formally
excused by management?
Office/ Production/
Clerical Maintenance
0.10 No employees in category 0.10
1.00 No 1.00
2.00 Yes 2.00
3.00 No established policy 3.00
9.00 At what rate is employee paid for hours worked on a holiday (total compensation paid)? NON-EXEMPT ONLY
0.10 No holidays worked. Company closed
1.00 Straight-time unless hours exceed normal workweek, then 1 1/2x regular rate
2.00 1 1/2x regular rate regardless of hours worked in workweek
3.00 2x regular rate regardless of hours worked in workweek
4.00 2 1/2x regular rate regardless of hours worked in workweek
5.00 3x regular rate regardless of hours worked in workweek
7.00 Other (Specify)_______________________
10.00 What adjustments are made for a paid holiday falling within an employee's vacation period?
1.00 Holiday is granted instead of vacation day used
2.00 Extra day's pay given
3.00 Extra day or pay, management's option
4.00 Extra day or pay, employee's option
5.00 Holiday is forfeited
11.00 Minimum service requirement (from date of hire) to be eligible for holiday pay for an unworked holiday?
1.00 Eligible immediately
2.00 Specific number of days (Specify)______
3.00 Other (Specify)_______________________
12.00 Is the service requirement for eligibility for holiday pay the same for exempt and nonexempt employees?
1.00 Yes
2.00 No
Vacation 3.00
1.00 Do you grant paid vacations as an employee benefit?

1.00 No -- Skip to Personal Time Off section
2.00 Yes, vacation is earned annually
3.00 Yes, hours accrued monthly, each pay period, etc.
4.00 Paid Time Off* bank of days (PTO) includes vacation (i.e. no traditional vacation) --
Skip to Personal Time Off section
* A formal plan providing a bank of days to be used by each employee as desired (i.e. holidays, vacation, sick leave).
2.00 Maximum hours of paid vacation accrued/given within a single year? (Exclude accumulation of unused time from a
previous year.)
1.00 40 hours (1 week)
2.00 80 hours (2 weeks)
4.10 161 - 199 hours
7.00 More than 240 hours
8.00 Other (Specify)_______________________
If your paid vacation is earned annually, skip to question 5.00.
3.00 For organizations with accrual, specify the amount of accrual for full-time employees after 1 year, 5 years, and 10
years of service.
1 Year 5 Years 10 Years
1.00 Weekly (Specify hours/week) 1.00
___________ ___________ ___________
2.00 Biweekly (Specify hours/biweek) 2.00
___________ ___________ ___________
3.00 Semi-monthly (Specify hours/semi-month) 3.00
___________ ___________ ___________
4.00 Monthly (Specify hours/month) 4.00
___________ ___________ ___________
5.00 Other (Specify)_______________________ 5.00
Vacation 3.00
4.00 For a new hire, when does vacation accrual begin?

1.00 Accrual begins immediately
2.00 Accrual begins immediately, but time cannot be used until a specified number of days
from date of hire (Specify # of days)_______
3.00 Accrual begins after a specified number of days (Specify # of days)_______
4.00 Other (Specify)_______________________
5.00 Are the maximum weeks of paid vacation the same for exempt and nonexempt employees?
1.00 Yes
2.00 No
6.00 How many days of vacation does an employee receive immediately upon hire?
1.00 No vacation days are immediately given to an employee upon hire
2.00 Specific number of days (Specify)_______
7.00 Maximum days of paid vacation accrued/given after 6 months of service?

0.10 No vacation days accrued/given after 6 months of service
2.00 Other (Specify)_______________________
8.00 Maximum days of paid vacation accrued/given after one year of service?
2.00 Other (Specify)_______________________
9.00 Maximum days of paid vacation accrued/given within a single year after five years of service? (Exclude accumulation
of unused time from a previous year.)
2.00 Other (Specify)_______________________
10.00 Maximum days of paid vacation accrued/given within a single year after ten years of service? (Exclude accumulation
of unused time from a previous year.)
2.00 Other (Specify)_______________________
11.00 Maximum days of paid vacation accrued/given within a single year after fifteen years of service? (Exclude
accumulation of unused time from a previous year.)
2.00 Other (Specify)_______________________
Vacation 3.00
12.00 Maximum days of paid vacation accrued/given within a single year after twenty years of service? (Exclude
2.00 Other (Specify)_______________________
13.00 Maximum days of paid vacation accrued/given within a single year aftter twenty-five years of service? (Exclude
2.00 Other (Specify)_______________________
14.00 Carry-over of unused vacation to the next vacation year?

1.00 No carry-over of unused vacation to the next year -- Skip to question 16.00
2.00 Employee paid for unused time
3.00 May carry-over all accrued, unused time
4.00 May carry-over only a certain amount (Specify maximum carry-over hours per
year)_______
6.00 Other (Specify)_______________________
15.00 Maximum accumulation (current plus carry-over) of vacation allowed?

Maximum hours of paid vacation in a single year plus allowed carry-over. Example: 160 hours of paid vacation in a
single year plus 40 hours allowed carry-over equals 200 hours maximum accumulation.
1.00 No established limits
2.00 Established limits (Specify maximum hours)_______
3.00 Other (Specify)_______________________
16.00 Sickness during vacation?

1.00 Charged to sick leave instead of vacation
2.00 Charged to sick leave only with doctor certification
3.00 Charged to sick leave only if hospitalized
4.00 Vacation continues with no adjustment
17.00 Which method do you use for structuring your vacation plan?
1.00 Calendar/fiscal year basis
2.00 Employee anniversary date basis
3.00 Employee anniversary date for first year, then calendar year basis
4.00 Other (Specify)_______________________
Vacation 3.00
18.00 Which of the following are part of your vacation policy? (Multiple responses permitted.)
1.00 Allow single day vacations
2.00 Allow employee to take pay in lieu of vacation time
3.00 Formal written "buy"/"sell" vacation plan*
4.00 Allow employee to borrow against future vacation time
5.00 Allow employee to take in one hour increments
6.00 Minimum allowed is a 1/2 day
7.00 Have annual vacation shutdown during holiday season
8.00 Have annual vacation shutdown during Independence Day week
9.00 None of the above
* An established policy that allows the buying and selling of vacation with administrative guidelines.
19.00 Do you have an established program that allows employees to give vacation/sick time to employees in need?
1.00 Yes, both vacation and sick can be donated
2.00 Yes, vacation ONLY can be donated
3.00 Yes, sick time ONLY can be donated
4.00 Case-by-case basis
5.00 Had a policy but discontinued
Personal Time Off 4.00
1.00 Do you have a formal written personal time off policy allowing employees to take paid time off for personal business,
e.g. house closing?*
Non-Exempt Exempt
1.00 No -- Skip to Sick Leave section 1.00
2.00 Yes -- Please Continue 2.00
3.00 Yes, as part of sick leave plan -- Skip to Sick Leave section 3.00
4.00 Based on management discretion -- Skip to Sick Leave section 4.00
5.00 Paid Time Off bank of days (PTO) includes personal time off 5.00
(i.e. no separate personal time off) -- Skip to Sick Leave section
* This is separate from a formal personal leave of absence.
2.00 Maximum amount of time granted per year under paid personal time off policy?
Non-Exempt Exempt
1.00 Specific number of hours (Specify) 1.00
___________ ___________
3.00 Cash-out options permitted for unused paid personal time? (Multiple responses permitted.)
Non-Exempt Exempt
1.00 No cash-out for unused personal time 1.00
2.00 At year end (Specify % paid) 2.00
___________ ___________
3.00 At retirement (Specify % paid) 3.00
___________ ___________
4.00 At termination (Specify % paid) 4.00
___________ ___________
6.00 None of the above 6.00
4.00 Maximum carry-over of unused paid personal time from one year to the next?
Non-Exempt Exempt
1.00 No carry-over allowed 1.00
2.00 Carry-over 100% of unused time 2.00
3.00 Carry-over less than 100% of unused time 3.00
Formal Uninsured Sick Leave 5.00
1.00 Do you have a paid sick leave benefit?*

Non-Exempt Exempt
1.00 No paid sick leave benefit -- Skip to Bereavement Leave 1.00

section
2.00 Yes - formal written policy* (not insured by a third party) -- 2.00
Please Continue
3.00 Yes - formal written policy* (not insured by a third party) AND 3.00
short term disability insurance -- Please Continue
4.00 Yes - short term disability insurance only-- Skip to 4.00
Bereavement Leave section
5.00 Yes - informal policy based on management discretion-- Skip to 5.00
Bereavement Leave section
6.00 Salary continues - no loss of pay-- Skip to Bereavement Leave 6.00
section
7.00 Paid Time Off bank of days (PTO) includes sick leave (i.e. no 7.00
separate sick leave plan) -- Skip to Bereavement Leave section
* Referred to in the following questions as uninsured sick leave. Do not include PTO extended illness bank in this section.
2.00 Permitted uses of uninsured sick leave? (Multiple responses permitted.)

Non-Exempt Exempt
1.00 ONLY for employee's injury/illness 1.00
2.00 100% of days can be used for illness in family 2.00
3.00 A portion of days can be used for illness in family 3.00
4.00 Death in family 4.00
5.00 Doctor appointments 5.00
6.00 Dentist appointments 6.00
7.00 Personal emergency/business 7.00
8.00 Legal matters (e.g. house closing) 8.00
9.00 Additional vacation time 9.00
10.00 Snow days 10.00
11.00 Other (Specify)_______________________ 11.00
3.00 Minimum service required from date of hire to receive paid uninsured sick leave?
Non-Exempt Exempt
1.00 Eligible immediately 1.00
2.00 Specific number of days (Specify) 2.00
___________ ___________
4.00 Maximum number of 100% paid uninsured sick days available to an employee after the first year of service (without
accumulation)?
Non-Exempt Exempt
1.00 Sick days paid at a rate of less than 100% 1.00
___________ ___________
3.00 No established maximum 3.00
4.00 Other (Specify)_______________________ 4.00
5.00 Provisions for unused sick leave at YEAR END?

Non-Exempt Exempt
1.00 Forfeit unused time -- Skip to question 9.00 1.00
2.00 Carry-over all/part of unused time 2.00
3.00 Cash-out all/part of unused time -- Skip to question 9.00 3.00
4.00 Employee's choice, cash-out or carry-over unused time 4.00
5.00 Convert to extra vacation -- Skip to question 9.00 5.00
6.00 Other (Specify)_______________________ 6.00
6.00 Maximum carry-over of unused sick leave from YEAR-TO-YEAR?

Non-Exempt Exempt
1.00 Carry-over 100% of unused time 1.00
2.00 Carry-over less than 100% of unused time 2.00
3.00 Other (Specify)_________________________________ 3.00
7.00 Maximum accumulation of 100% paid uninsured sick leave days? (Total days available, not just maximum that can
be carried forward each year.)
Non-Exempt Exempt
___________ ___________
2.00 No limit on accumulation 2.00
8.00 Policy when sick leave is accumulated beyond maximum permitted?

Non-Exempt Exempt
0.10 No limit on accumulation 0.10
1.00 Forfeit unused time beyond established maximum 1.00
2.00 Paid in full for time beyond established maximum 2.00
3.00 May use as extra vacation 3.00
4.00 Paid in part or converted in part to vacation 4.00
6.00 Other (Specify)_______________________ 6.00
9.00 When is unused sick leave cashed-out in full or in part? (Multiple responses permitted.)
Non-Exempt Exempt
1.00 No cash-out for unused sick leave 1.00
2.00 Annually 2.00
3.00 Termination of employment 3.00
4.00 Retirement 4.00
5.00 Death 5.00
6.00 Temporary layoff 6.00
7.00 After accrual of specified number of sick days 7.00
8.00 Other (Specify)_______________________ 8.00
10.00 MAXIMUM cash-out of unused sick leave?

Non-Exempt Exempt
0.10 No cash-out 0.10
1.00 Cash-out 100% of unused time at 100% of salary 1.00
2.00 Cash-out 100% of unused time at less than 100% of salary 2.00
3.00 Cash-out less than 100% of unused time 3.00
4.00 Other (Specify)_______________________ 4.00
Bereavement Leave 6.00
1.00 Do you grant a paid bereavement leave benefit?

1.00 No -- Skip to Paid Time Off / Consolidated Annual Leave section
3.00 Based on management discretion -- Please Continue
4.00 Paid Time Off bank of days (PTO) includes bereavement leave -- Skip to Paid Time
Off / Consolidated Annual Leave section
2.00 Maximum days normally permitted off with pay for immediate family?
1.00 Specific number of days (Specify)_____
3.00 Does the number of days granted depend on location of funeral (e.g. in-state, out-of-state)?
1.00 Yes
2.00 No
4.00 Does the number of paid days granted depend on the family member?
1.00 Yes
2.00 No
Bereavement Leave 6.00
5.00 Indicate who falls within the definition of immediate family in your bereavement leave policy. (Multiple responses
permitted.)
0.10 Family members not specified
1.00 Spouse
2.00 Parent
3.00 Step-parents
4.00 Child
5.00 Step-child
6.00 Sister/Brother
7.00 Parents-in-law
8.00 Son/Daughter-in-law
9.00 Sister/Brother-in-law
10.00 Aunt/Uncle
11.00 Niece/Nephew
12.00 Grandchild
13.00 Grandparents
14.00 Grandparents-in-law
15.00 Legal guardian/ward
16.00 Domestic partner
17.00 Either friend and/or dependent living in same household
18.00 Other (Specify)_______________________
Paid Time Off / Consolidated Annual Leave 7.00
Answer THIS SECTION ONLY if you have a consolidated paid days off plan.
A formal plan providing a bank of days to be used by each employee as desired
(i.e. holidays, vacation, sick leave).
1.00 Are your paid time off days combined into one bank of days (i.e. a consolidated annual leave plan)?
1.00 No, have traditional vacation, sick leave, etc. policies -- Skip to Workers'
Compensation section
2.00 Do the number of Paid Time Off days vary depending on job classification (i.e. management, salaried, hourly)?
1.00 No
2.00 Yes (Specify)_______________________
3.00 What is covered under Paid Time Off (PTO) Plan? (Multiple responses permitted.)
1.00 Holidays
2.00 Vacations
3.00 Sick leave
4.00 Personal time
5.00 Bereavement leave
6.00 Other (Specify)_______________________
4.00 For a new hire, when does accrual begin in Paid Time Off Plan?
1.00 Accrual begins immediately
2.00 Accrual begins immediately, but time cannot be used until a specified number of days
from date of hire (Specify # of days)_______
3.00 Accrual begins after a specified number of days (Specify # of days)_______
4.00 Other (Specify)_______________________
5.00 During the first year of service, what is the accrual rate? Specify number of hours/month_____
6.00 How many paid time off days are granted after completing one (1) year of service? (Exclude carry-over.)_____
7.00 How many paid time off days are granted after completing five (5) years of service? (Exclude carry-over.)_____
8.00 How many paid time off days are granted after completing ten (10) years of service? (Exclude carry-over.)_____
9.00 How many paid time off days are granted after completing fifteen (15) years of service? (Exclude carry-over.)_____
10.00 How many paid time off days are granted after completing twenty (20) years of service? (Exclude carry-over.)_____
11.00 How many paid time off days are granted after completing twenty-five (25) years of service? (Exclude
carry-over.)_____
12.00 Carry-over of unused paid time off hours to the next year?
1.00 No carry-over allowed -- Skip to question 15.00
2.00 May carry-over all accrued, unused time
3.00 May carry-over only a certain amount (Specify maximum carry-over hours)______
5.00 Other (Specify)_______________________
13.00 What is the MAXIMUM accumulation permitted in your Paid Time Off Plan?
2.00 No maximum limit
14.00 Policy when paid time off is accumulated beyond maximum permitted?
1.00 No maximum accumulation
2.00 Forfeit unused time beyond established maximum
3.00 Paid in full for time beyond established maximum
5.00 Other (Specify)_______________________
15.00 Cash-out options for accumulated leave at TERMINATION?

1.00 No cash-out for Consolidated Annual Leave at termination
2.00 100% of unused paid days off is paid
3.00 A specified number of days will be paid
4.00 Length of service determines the cash-out amount
5.00 A specified percentage is based on the total accumulation
7.00 Other (Specify)_______________________
16.00 Cash-out/conversion options during employment?

1.00 No cash-out except at termination
2.00 Employee can elect to cash-out a specified number of days per year
3.00 Employee can cash-out or convert time to the extended illness bank contingent to
specified policy conditions
5.00 Other (Specify)_______________________
17.00 Maximum accumulation in the extended illness bank?

1.00 No extended illness bank
3.00 No established maximum
18.00 Which of the following are part of your Paid Time Off Plan? (Multiple responses permitted.)
1.00 Formal written "buy"/"sell" Paid Time Off plan
2.00 Allow employee to borrow against future paid time off
3.00 Other (Specify)_________________________________
* An established policy that allows the buying and selling of vacation with administrative guidelines.
Workers' Compensation 8.00
1.00 Company policy for payment of 1st three days (Arizona - 1st seven days) of a workers' compensation injury when it is
not covered by Workers' Compensation insurance?*
1.00 Employee may use sick leave/paid time off
2.00 Company pays - does not deduct from sick leave accrual
3.00 Company does not pay
5.00 Other (Specify)_______________________
* Colorado and Wyoming Workers' Compensation insurance does not pay until day four of an injury; Arizona does not pay until
day eight. In Colorado and Arizona, after fourteen days of disability, payment is retroactive to first day (Wyoming, after eight
days).
2.00 Do you pay for the time injured workers spend going to medical appointments?
0.10 Unknown
1.00 No, we do not pay our employees for this time but turn the lost time into the
insurance company
2.00 Yes, we pay sick leave, vacation pay or other accrued paid time off
3.00 Yes, we pay regular wages
3.00 Do you have a return to work policy for injured workers?

1.00 No
2.00 Yes, we have a formal written return to work policy
3.00 Yes, we have an informal return to work policy
4.00 Other (Specify)_______________________
4.00 What types of return to work options do you have available? (Multiple responses permitted.)
1.00 No return to work options
2.00 Return to modified regular job
3.00 Return to designated light duty position
4.00 Return to outsourced light duty position
5.00 Do you designate FMLA leave time when the injured worker is off as a result of his/her injury if the injury qualifies as a
serious health condition under the FMLA?
0.10 Not covered by FMLA - Skip to Jury Duty Leave section
1.00 Yes
2.00 No
Workers' Compensation 8.00
6.00 Do you terminate injured workers when they have exhausted FMLA leave and are unable to return to work as a result
of an on-the-job injury, absent ADA considerations?
1.00 Yes
2.00 No
Jury Duty Leave 9.00
1.00 Pay for jury duty? *

0.10 Not Applicable (no requirement in Wyoming and Arizona)
0.50 ONLY pay up to $50/day for first three days
1.00 Pay up to $50/day for first three days of jury service and time off with pay from the
employer thereafter
2.00 Pay regular pay for first three days of jury service and regular wages to a specified
maximum # of days thereafter
3.00 Pay regular wages for length of jury service with no maximum number of days
4.00 Pay regular wages for first three days; nothing thereafter
5.00 Other (Specify)_______________________
* The State of Colorado pays jurors $50 per day after the first three days of jury duty in the state, district or county courts.
Employers are required to pay regular wages up to $50 per day for the first three days of jury duty.
2.00 Maximum length of paid jury duty including initial three days?
0.10 Only pay initial three days
1.00 No specified maximum number of paid days
Parental Leave (Maternity/Paternity) 10.00
1.00 Does your organization offer paid parental leave (maternity/paternity) that is separate from other leave policies such
as vacation, PTO, FMLA, etc.?
1.00 Yes (Specify maximum number of paid days)_____
2.00 No
Family and Medical Leave Act 11.00
For employers COVERED under FMLA (This section covers standard FMLA Leave and not Military
Caregiver Leave)
1.00 In determining the 12-month period in which the 12 weeks of the leave entitlement occurs, which method is used?
0.10 Less than 50 employees, no FMLA - Skip to Personal Leave section
1.00 The calendar year
2.00 Any fixed 12-month leave year*
3.00 The 12-month period measured forward from the date any employee's first FMLA
leave begins
4.00 A "rolling" 12-month period measured backward from the date an employee is
requesting any FMLA leave
* For example -- a fiscal year, a year required by state law, or a year starting on employee's anniversary
2.00 Benefits offered during unpaid FMLA leave? (Exclude required health/vision/dental.) (Multiple responses permitted.)
0.10 Only health/vision/dental benefits offered
1.00 Consolidated Paid Time Off Plan**
2.00 Life insurance
3.00 Insured short term disability
4.00 Vacation accrual
5.00 Sick leave accrual
6.00 Long Term Disability
7.00 Other (Specify)_______________________
** A formal plan providing a bank of days to be used by each employee as desired, i.e. holidays, vacation, sick leave.
3.00 Are you requiring any of the following paid time off to be used as part of the MEDICAL* leave? (Multiple responses
permitted.)
1.00 Vacation
2.00 Sick leave
3.00 Personal days/personal leave (includes Consolidated Paid Time Off Plans)
* MEDICAL - Time off for employees' serious health condition or pregnancy.
4.00 Are you requiring any of the following paid time off to be used as part of the FAMILY* leave? (Multiple responses
permitted.)
1.00 Vacation
2.00 Sick leave
3.00 Personal days/personal leave (includes Consolidated Paid Time Off Plans)
* FAMILY - Time off for serious health condition of a child, parent or spouse. Also includes child care following birth, adoption or
foster care.
5.00 If additional leave is granted for FAMILY* beyond FMLA 12-week requirement, (no guarantee implied), what is the
maximum FAMILY leave?
0.10 No family leave granted beyond 12 weeks - Skip to question 7.00
1.00 Specific number of months (Specify)_____
2.00 Based on length of service
3.00 Based on job classification
5.00 Other (Specify)_______________________
foster care.
6.00 If additional leave is granted for FAMILY* beyond FMLA 12-week requirement, is the job guarantee (for same or like
position) for the same amount of time?
1.00 No job guarantee
2.00 Yes
3.00 No, leave may be longer than the actual job guarantee
foster care.
7.00 Continuation of the employer contribution for HEALTH INSURANCE for employee on MEDICAL* leave (paid or
unpaid) over 12 weeks?
0.10 No medical leave granted beyond 12 weeks
1.00 Duration of leave
4.00 Company doesn't continue contribution; coverage continues if employee pays
(exclude COBRA)
5.00 Company only pays as long as the employee is on a "paid status"
7.00 Other (Specify)_______________________
8.00 Continuation of the employer contribution for HEALTH INSURANCE for employee on FAMILY* leave (paid or unpaid)
over 12 weeks?
0.10 No family leave granted beyond 12 weeks
(exclude COBRA)
5.00 Company only pays as long as the employee is on "paid" status
7.00 Other (Specify)_______________________
foster care.
9.00 Eligibility of site locations with less than 50 employees (legally covered employer with no eligible employees at that
location)?
0.10 No multiple sites
1.00 Provide FMLA benefits to all locations (even though not legally required)
2.00 Provide FMLA benefits only to locations where legally required
10.00 Do you provide MEDICAL* leave for employees prior to their FMLA eligibility?
1.00 No
2.00 Yes, eligible immediately
3.00 Yes (Specify the number of days after hire)______
11.00 Do you provide FAMILY* leave for employees prior to their FMLA eligibility?
1.00 No
2.00 Yes, eligible immediately
3.00 Yes (Specify number of days after hire)______
foster care.
12.00 How is FMLA tracking done?

1.00 Automated (Specify software used)_______________________
2.00 Manual process
3.00 Other (Specify)_______________________
13.00 Does your organization outsource your FMLA administration?

1.00 Yes (Specify vendor used)_________________________________
2.00 No
3.00 Unsure
14.00 What is the minimum increment of FMLA that is tracked?

1.00 No minimum increment
2.00 15 minutes
3.00 30 minutes
4.00 45 minutes
5.00 60 minutes (1 hour)
6.00 4 hours
7.00 8 hours
8.00 Other (Specify)_______________________
15.00 What is your call-in procedure for an employee to use FMLA?

1.00 No call-in procedure
2.00 Must call by specific time
3.00 Must call specific individual
4.00 Must call by specific time and call specific individual
5.00 Other (Specify)_______________________
16.00 What percentage of your workforce is currently using FMLA block leave?
1.00 0-5%
2.00 6-10%
3.00 11-15%
4.00 16-20%
5.00 21-25%
6.00 More than 25%
7.00 Unsure
17.00 What percentage of you workforce is currently using FMLA intermittent leave?
1.00 0-5%
2.00 6-10%
3.00 11-15%
4.00 16-20%
5.00 21-25%
6.00 More than 25%
7.00 Unsure
18.00 For which of the following reasons will you approve PERSONAL leaves of absence* of 30+ days? (Multiple responses
permitted.)
1.00 Extended vacation
2.00 Political service
3.00 Community service
4.00 Education
5.00 Personal reasons
6.00 Sabbatical
7.00 Union business
8.00 No established policy/no personal leave of absence of 30+ days
9.00 Other (Specify)_______________________
* The following types of leaves are excluded from PERSONAL leave: Time off for employees' serious health condition or
pregnancy and time off for serious health condition of a child, parent or spouse. Also excludes child care following birth,
adoption or foster care.
Personal Leave of Absence / Paid or Unpaid 12.00
Answer the following questions based on the personal leave absence policy used by the
MAJORITY of your employees.
For employers NOT covered under FMLA
1.00 Do you grant personal leaves of absence of 30+ days?
1.00 No -- Skip to Medical Leave section
3.00 Based on management discretion - Skip to Medical Leave section
2.00 Do you guarantee employment upon return?

1.00 Yes
2.00 No
3.00 Maximum duration of personal leave of absence?

4.00 For which of the following reasons will you approve leaves of absence of 30+ days? (Multiple responses permitted.)
1.00 Adoption of child
2.00 Child care following the birth of a child
3.00 Extended vacation
4.00 Political service
5.00 Community service
6.00 Education
7.00 Family illness
8.00 Personal reasons
9.00 Sabbatical
10.00 Union business
12.00 Other (Specify)_______________________
5.00 Pay policy for personal leaves of absence?

1.00 No organization pay
2.00 Organization pays 100%
3.00 Paid only if vacation or other time off benefits are used
5.00 Other (Specify)_______________________
Personal Leave of Absence / Paid or Unpaid 12.00
6.00 Continuation of company contribution for health insurance for employees on approved personal leave of absence?
(paid or unpaid leave)
2.00 Set number of days (Specify)_____
(exclude COBRA)
4.00 Company only pays as long as the employee is on a "paid" status
5.00 Other (Specify)_______________________
Medical Leave of Absence / Paid or Unpaid 13.00
Answer the following questions based on the medical leave of absence policy used by the
MAJORITY of your employees.
For employers NOT covered under FMLA
1.00 Does your company have a medical (disability) leave of absence policy? *
1.00 No medical leave of absence granted - Skip to Military Leave section
2.00 Yes, formal written policy with established guidelines - Please Continue
3.00 Based on management discretion - Skip to Military Leave section
* Time off allowed (paid or unpaid - with or without benefits) for a medical disability which exceeds typical sick time off.
2.00 Minimum service for eligibility for a medical leave?

1.00 Eligible immediately
3.00 Maximum duration permitted for medical leave?

1.00 No specified time limit
4.00 Based on job classification
4.00 Pay policy for medical leave of absence?

1.00 100% company paid
2.00 Less than 100% company paid
3.00 Sick leave/other paid time off may be used first, short or long term disability if
available, then unpaid
6.00 Other (Specify)_______________________
5.00 When an employee is granted a medical leave of absence is the job guarantee (for same or like position) for the same
amount of time?
1.00 No job guarantee - Skip to question 7.00
2.00 Yes
3.00 No, leave may be longer than the actual job guarantee
Medical Leave of Absence / Paid or Unpaid 13.00
6.00 When an employee is on medical leave, how long will you guarantee his/her return to the same or a like position?
1.00 For the maximum duration of medical leave
2.00 Specific number of weeks (Specify)_____
4.00 Other (Specify)_______________________
7.00 Continuation of company contribution for health insurance for employees on approved medical leave of absence? (paid
or unpaid leave)
2.00 Set number of days (Specify)_____
(exclude COBRA)
4.00 Company only pays as long as the employee is on a "paid" status
5.00 Other (Specify)_______________________
8.00 Continuation of the company's benefit accrual while on approved medical leave of absence? (Multiple responses
permitted.)
2.00 Benefit accruals DO NOT continue
3.00 Seniority accrual continues
4.00 Vacation accrual continues
5.00 Consolidated Paid Time Off Plan** accrual continues
6.00 Sick leave accrual continues
7.00 Other (Specify)_______________________
** A formal plan providing a bank of days to be used by each employee as desired, i.e. holidays, vacation, sick leave.
Military Leave 14.00
1.00 Basis of payment for an employee on a military leave of absence? PRIVATE EMPLOYERS ONLY
1.00 Company continues full pay
2.00 Company pays full pay for a specific number of days (Specify)______
3.00 Company pays difference between military pay and salary
4.00 Company does not pay, unless employee chooses to take vacation
6.00 Other (Specify)_______________________
Inclement Weather 15.00
1.00 For NONEXEMPT employees, what is the pay policy when a "Snow Day" or inclement weather occurs? (Multiple
responses permitted.)
2.00 Full pay WITHOUT charging to accrued paid time off (e.g. vacation, personal days)
3.00 Pay if charged against accrued time
4.00 Not paid unless actually worked
5.00 Pay if management determines to close the office
6.00 Pay if city where business is located prohibits travel
7.00 Pay if city where employee lives prohibits travel
8.00 Other (Specify)_______________________
Part-Time Employees 16.00
1.00 For paid time off benefits, what are the MINIMUM number of hours defining regular part-time employees?
0.10 No part-time employees -- Skip to Miscellaneous section
0.20 No paid time off benefits offered to regular part-time employees -- Skip to question
6.00
1.00 Specific number of hours/week (Specify)_____
2.00 No minimum - paid time off benefits pro-rated based on hours worked
3.00 Other (Specify)_______________________
2.00 What paid time off benefits are offered to regular part-time employees? (Multiple responses permitted.)
1.00 Vacation
2.00 Holidays
3.00 Sick leave
4.00 Personal time
5.00 Bereavement leave
3.00 Regular part-time employees eligible for holiday pay?

0.10 Part of Paid Time Off plan
0.20 No holiday pay for unworked holiday
1.00 Pro-rated on basis of hours worked
2.00 Full day's pay for scheduled holiday - same as full-time employees
3.00 4 hours pay per holiday
4.00 Paid only for hours employee would have worked
5.00 Other (Specify)_______________________
4.00 Paid vacation for regular part-time employees?

0.10 Part of Paid Time Off Plan
0.20 No paid vacation
1.00 Pro-rated vacation based on hours worked
2.00 Vacation at 1/2 full-time rate
4.00 Other (Specify)_______________________
Part-Time Employees 16.00
5.00 Paid sick leave for regular part-time employees?

0.10 Part of Paid Time Off plan
0.20 No paid sick leave
1.00 Pro-rated sick leave based on hours worked
2.00 Sick leave at 1/2 full-time rate
4.00 Other (Specify)_______________________
6.00 When establishing benefit levels, does a part-time employee who converts to full-time status receive credit for their
part-time service?
1.00 Yes, full credit
2.00 Yes, partial credit (Specify)_______________________
3.00 No
Miscellaneous 17.00
1.00 In a REHIRE situation does the employee receive credit for previous service for vacation eligibility?
0.10 No paid vacation granted
1.00 No credit given
2.00 Yes, partial credit
3.00 Yes, full credit immediately upon rehire
4.00 Yes, full credit after completion of designated length of service
5.00 Yes, full credit if rehired within a designated length of time
6.00 Yes, full credit if rehired within a designated length of time AND after completion of
designated length of service
7.00 Yes, full credit dependent on reason for termination (i.e. layoff)
9.00 Other (Specify)_______________________
2.00 Does a NEW employee receive service credit from employment with other employers when establishing vacation
eligibility?
3.00 If retained, does a TEMPORARY employee receive service credit for time worked?
0.10 No temporary employees
5.00 Other (Specify)_______________________

Paid Time Off Policies Questionnaire 2014

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Paid Time Off Policies Questionnaire 2014

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Please Keep This Sheet Attached to the Questionnaire

Indicate any changes to name and address below.

2014 Paid Time Off Policies Survey – AZ, CO & WY 10887

To complete this survey online go to

You will need to contact surveys@msec.org Final Acceptance Date:

This survey questionnaire should be completed with the understanding that:

1799 Pennsylvania Street ■ P.O. Box 539

EXEMPT Defined as full-time employees exempt by Federal Wage-Hour Law.

NONEXEMPT Defined as full-time employees, nonexempt under Federal Wage-Hour Law.

♦ If your policy matches an option which indicates

EXAMPLE FOR COMPLETION

11.00) Carry over of unused vacation to the next vacation year?

1.0 Require employee to use during vacation year 1.0 _____

If you have questions or need assistance as you complete this questionnaire,

Return your completed questionnaire by Friday, November 7, 2014.

MSEC – 10887 Paid Time Off Policies – AZ, CO & WY 9/2014

Full Organization Name:

Name of Person Completing Questionnaire:

Street Address and Zip Code (if different than on cover):

Phone Number: FAX Number: Email Address:

Enter current employment size on the line below.

MSEC – 10887 Paid Time Off Policies – AZ, CO & WY 9/2014

1.00 Do you grant paid holidays as an employee benefit?

0.10 No employees in category 0.10

2.00 Yes 2.00

3.00 No established policy 3.00

1.00 Do you grant paid vacations as an employee benefit?

If your paid vacation is earned annually, skip to question 5.00.

1.00 Weekly (Specify hours/week) 1.00

___________ ___________ ___________

2.00 Biweekly (Specify hours/biweek) 2.00

___________ ___________ ___________

3.00 Semi-monthly (Specify hours/semi-month) 3.00

___________ ___________ ___________

4.00 Monthly (Specify hours/month) 4.00

___________ ___________ ___________

5.00 Other (Specify)_______________________ 5.00

4.00 For a new hire, when does vacation accrual begin?

7.00 Maximum days of paid vacation accrued/given after 6 months of service?

14.00 Carry-over of unused vacation to the next vacation year?

15.00 Maximum accumulation (current plus carry-over) of vacation allowed?

16.00 Sickness during vacation?

1.00 No -- Skip to Sick Leave section 1.00

2.00 Yes -- Please Continue 2.00

4.00 Based on management discretion -- Skip to Sick Leave section 4.00

1.00 Specific number of hours (Specify) 1.00

1.00 No cash-out for unused personal time 1.00

2.00 At year end (Specify % paid) 2.00

3.00 At retirement (Specify % paid) 3.00

4.00 At termination (Specify % paid) 4.00

5.00 No established policy 5.00

6.00 None of the above 6.00

1.00 No carry-over allowed 1.00

2.00 Carry-over 100% of unused time 2.00

3.00 Carry-over less than 100% of unused time 3.00

1.00 Do you have a paid sick leave benefit?*

1.00 No paid sick leave benefit -- Skip to Bereavement Leave 1.00

2.00 Permitted uses of uninsured sick leave? (Multiple responses permitted.)

1.00 ONLY for employee's injury/illness 1.00

2.00 100% of days can be used for illness in family 2.00

3.00 A portion of days can be used for illness in family 3.00

4.00 Death in family 4.00

5.00 Doctor appointments 5.00

_____ _ _______

_____ _ _______

_____ _ _______

_____ _ _______