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Sample Fair Labor Standards Act FLSA Compliance

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Sample_Documents

DISCLAIMER: This is a sample template provided for informational purposes only. It does not constitute legal, tax, or financial advice. Organizations should consult their own legal and tax advisors and tailor this document to reflect their specific business needs, geographies, and applicable laws.

Document Header

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Document Type Fair Labor Standards Act (FLSA) Compliance
Category Compliance & Governance
Company <Company Name>
Title FLSA Compliance Policy and Implementation Guide
Version <Version Number> (e.g., 1.0)
Effective Date <Effective Date> (e.g., <Date>)
Next Scheduled Review <Date> (e.g., 12 months after Effective Date)
Document Owner <Title/Department> (e.g., Total Rewards)
Policy Contact <Name>, <Title>, <Email>
Approved By <Approver Name>, <Title>, on <Date>
Geographic Applicability United States and U.S. territories; interplay with state and local wage and hour laws

Purpose and Objectives

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  • Provide a clear, standardized framework for FLSA compliance at <Company Name> that protects employees and the organization
  • Define roles, responsibilities, and governance across HR, Payroll, Legal, Finance, and People Managers
  • Establish consistent classification, timekeeping, pay practices, and recordkeeping standards
  • Outline implementation steps, controls, and audit routines to sustain compliance
  • Equip Total Rewards and HR teams with reference material, examples, and decision criteria to resolve complex scenarios
  • Provide employees and managers with an accessible, plain-language overview of rights and responsibilities

Scope and Applicability

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In Scope

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  • All employees of <Company Name> employed in the United States and U.S. territories subject to FLSA
  • All employment arrangements including full-time, part-time, temporary, seasonal, and interns, unless expressly excluded by law
  • Timekeeping, overtime, minimum wage, exemptions, deductions, premium pay, on-call, travel, training time, remote work, and recordkeeping practices
  • All People Managers and Supervisors responsible for scheduling, approving time, and overseeing work
  • Third-party vendors who perform payroll, timekeeping, or HRIS services for <Company Name>

Out of Scope (addressed in separate policies)

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  • Non-U.S. wage and hour compliance under <Country> laws
  • Independent contractor classification under IRS/DOL tests
  • Collective bargaining agreement provisions that supersede policy terms
  • Leave of absence policy details (beyond FLSA docking rules interaction with unpaid leave)
  • Pay equity, incentive plan design, and executive compensation (addressed in Total Rewards policies)

Applicability Notes

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  • Where state or local law provides greater employee protections than federal law (e.g., daily overtime, higher minimum wage, meal/rest rules), <Company Name> applies the more protective standard
  • If a collective bargaining agreement applies, those terms govern where they provide greater rights or specifically modify work rules
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  • The FLSA is enforced by the U.S. Department of Labor, Wage and Hour Division
  • This policy references federal standards and requires alignment with state/local rules including but not limited to <State> and <City/County> wage orders
  • Minimum salary levels and highly compensated thresholds are subject to periodic updates by the DOL. Insert current thresholds based on official guidance as of <Date>: <Weekly Salary Threshold> and <HCE Annual Threshold>
  • Official resources:

Policy Statement

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  • <Company Name> complies with the FLSA and applicable state/local wage and hour laws
  • Working time is recorded accurately and paid timely. No off-the-clock work is permitted
  • Overtime for nonexempt employees is paid at no less than one and one-half times the regular rate for hours worked over 40 in a defined workweek, except where state rules differ and are more protective
  • Exempt status is determined by job duties and salary basis/level tests and is not based on job title alone
  • Improper deductions from exempt salaries are prohibited. A safe harbor complaint process is provided below
  • Retaliation against employees who raise wage and hour concerns is strictly prohibited

Definitions and Key Concepts

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  • Workweek: A fixed and recurring period of seven consecutive 24-hour periods established by <Company Name> as <Day> 12:00 a.m. through <Day> 11:59 p.m.
  • Regular Rate of Pay: All remuneration for employment (subject to statutory exclusions) divided by total hours worked in the workweek, used to compute overtime premiums
  • Exempt Employee: Employee exempt from overtime under a white-collar exemption (executive, administrative, professional, computer, outside sales, or highly compensated) based on duties and salary requirements
  • Nonexempt Employee: Employee entitled to minimum wage and overtime protections
  • Salary Basis: Predetermined amount not subject to reduction based on variations in quality or quantity of work, paid in each pay period in which any work is performed
  • Nondiscretionary Bonus: Bonus announced in advance or promised based on set criteria; included in the regular rate
  • Discretionary Bonus: Bonus at sole discretion, not promised in advance; typically excluded from the regular rate
  • On-Call Time: Time spent waiting to work subject to restrictions that determine compensability
  • De Minimis Time: Insubstantial periods of time that cannot practically be recorded; <Company Name> limits reliance and follows applicable law

Job Classification Standards

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Classification Principles

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  • Job titles do not determine exempt status; duties and salary tests govern
  • Exemptions are narrowly construed. When in doubt, classify as nonexempt
  • Reviews occur at job creation, significant duty change, reorganization, market review, or as laws change
  • The workweek and hourly recordkeeping rules apply to all nonexempt employees, regardless of pay frequency

Exemption Categories and Key Tests (summarized)

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  • Executive Exemption
    • Primary duty is management of the enterprise or a customarily recognized department
    • Customarily and regularly directs at least two full-time equivalent employees
    • Has genuine authority to hire or fire, or recommendations carry particular weight
    • Paid at or above <Weekly Salary Threshold> on a salary basis
  • Administrative Exemption
    • Primary duty is office or non-manual work directly related to management or general business operations of <Company Name> or customers
    • Exercises discretion and independent judgment on matters of significance
    • Paid at or above <Weekly Salary Threshold> on a salary basis
  • Learned Professional Exemption
    • Primary duty requires advanced knowledge in a field of science or learning customarily acquired by prolonged specialized instruction
    • Paid at or above <Weekly Salary Threshold> on a salary basis
  • Creative Professional Exemption
    • Primary duty is work requiring invention, imagination, originality, or talent in a recognized artistic or creative field
    • Paid at or above <Weekly Salary Threshold> on a salary basis
  • Computer Employee Exemption
    • Primary duty includes systems analysis, programming, or software engineering work
    • Paid on a salary basis at or above <Weekly Salary Threshold> or hourly at not less than <Computer Hourly Rate> per hour
  • Outside Sales Exemption
    • Primary duty is making sales or obtaining orders/contracts
    • Customarily and regularly engaged away from <Company Name>’s place of business
    • No salary minimum is required, but this exemption is not applicable to inside sales
  • Highly Compensated Employee (HCE)
    • Total annual compensation at or above <HCE Annual Threshold> including at least <Weekly Salary Threshold> paid on a salary basis
    • Performs at least one of the exempt duties of the executive, administrative, or professional exemptions

Exemption Evaluation Procedure

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  1. Total Rewards drafts a preliminary classification using a duties questionnaire and job description
  2. Manager validates actual day-to-day duties and staffing authority
  3. Legal reviews borderline cases and state overlays
  4. Final classification is approved by <Approver Title> and recorded in HRIS
  5. Employee is notified in writing and provided an acknowledgement
  6. Classification is revalidated during annual job architecture review or upon material duty change

Classification Documentation Record (Sample Fields)

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Field Description
Job Code <Job Code>
Job Title <Job Title>
FLSA Status Exempt or Nonexempt
Exemption Category Executive, Administrative, Professional, Computer, Outside Sales, HCE
Salary Basis Salary, Hourly, Piece-Rate, Commission
Salary Level <Amount> per week; verify vs <Weekly Salary Threshold>
Duties Summary <Summary of primary duties>
State/Local Overlays <State> daily OT, meal/rest, wage orders
Reviewer <Name>, <Title>, <Date>
Final Approver <Name>, <Title>, <Date>

Workweek, Scheduling, and Timekeeping

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Workweek Definition

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  • The standard workweek is fixed as <Day of Week> 12:00 a.m. to <Day of Week> 11:59 p.m. across all U.S. locations
  • Changes to the workweek require approval by <Approver Title> and must be prospective

Scheduling Rules

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  • Managers schedule hours to meet business needs while minimizing unplanned overtime
  • Nonexempt employees must obtain prior approval for overtime; however, all overtime worked must be paid whether approved or not, and failure to obtain approval may be addressed through coaching

Timekeeping Standards

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  • <Company Name> uses <Timekeeping System Name> administered by <Department> for all nonexempt employees
  • Employees record all time worked daily, including start, end, and meal periods
  • No off-the-clock work is permitted. Work includes tasks such as emails, calls, systems checks, and pre- or post-shift duties
  • Time edits must be requested by the employee and approved by the manager with documentation retained

Rounding and Grace Periods

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  • If rounding is used, it must be neutral and not result in underpayment over time (e.g., to the nearest <Increment> minutes)
  • Grace periods may not be used to avoid paying for actual work time. If work occurs during a grace period, it must be recorded and paid

Meal and Rest Periods

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  • Federal law does not mandate meal or rest breaks; however, state laws may. <Company Name> applies <State> rules where more protective
  • Bona fide meal periods of 30 minutes or more where the employee is fully relieved of duty are unpaid; rest breaks of short duration (typically 5 to 20 minutes) are compensable

Determining Hours Worked

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Preliminary and Postliminary Activities

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  • Activities integral and indispensable to the principal job are compensable (e.g., required donning/doffing of protective gear)
  • Preliminary/postliminary activities that are not integral and indispensable may be non-compensable, subject to state law

On-Call and Waiting Time

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  • On-call time is compensable when constraints are so restrictive that employees cannot use the time effectively for their own purposes
  • Waiting time is compensable when employees are engaged to wait; if waiting to be engaged and free to use time for their own purposes, time may be non-compensable

Travel Time

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  • Home-to-work commuting is generally non-compensable
  • Same-day, out-of-town travel is compensable minus normal commute
  • Overnight travel during normal working hours is compensable, even if on non-working days, excluding bona fide sleep time per applicable standards

Training, Meetings, and Lectures

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  • Time is generally compensable unless all of the following are met:
    • Attendance is outside regular working hours
    • Attendance is voluntary
    • Event is not directly related to the job
    • No productive work is performed

Remote and After-Hours Work

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  • Nonexempt employees must record all remote work, including emails or calls outside scheduled hours
  • Tools or devices should be configured to minimize after-hours notifications for nonexempt employees unless approved and scheduled

Overtime and Premium Pay

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Overtime Eligibility and Rate

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  • Nonexempt employees earn overtime at 1.5 times the regular rate for hours worked over 40 in a workweek, or per more protective state rule (e.g., <State> daily overtime after <Hours> hours)
  • Overtime must be calculated based on the regular rate of pay, which includes most nondiscretionary compensation

Regular Rate Components

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  • Included:
    • Hourly wages or salary converted to hourly equivalent for nonexempt salaried employees
    • Shift differentials, hazard pay, on-call pay, and geographically indexed premiums
    • Nondiscretionary bonuses tied to production, attendance, or quality
    • Commissions and piece-rate earnings
  • Excluded:
    • Discretionary bonuses (at sole discretion, not promised in advance)
    • Gifts or payments on special occasions not tied to hours worked or production
    • Reimbursed expenses at or below accountable plan thresholds
    • Vacation, holiday, and sick pay when not worked

Regular Rate Example (Illustrative)

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  • Example week for nonexempt employee:
    • Hourly base rate: <Amount> per hour
    • Hours worked: 46
    • Shift differential: <Percentage>% of base for 20 hours
    • Nondiscretionary bonus for week: <Amount>
  • Calculation:
    • Straight-time earnings: 46 x <Amount> = <Amount>
    • Shift differential: 20 x (<Amount> x <Percentage>%) = <Amount>
    • Add nondiscretionary bonus: <Amount>
    • Regular rate = (Total includable earnings) ÷ 46 = <Amount>
    • Overtime premium due = 0.5 x Regular rate x 6 overtime hours = <Amount>

Salaried Nonexempt Overtime

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  • Convert weekly salary to hourly by dividing by agreed hours (typically 40) and include other includable compensation in regular rate
  • For fluctuating workweek arrangements, consult Legal. Use is restricted and must meet strict criteria including a clear mutual understanding and fixed salary for straight time

Multiple Rates and Weighted Average

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  • When an employee works at two or more rates in a workweek, compute the regular rate as the weighted average of rates and hours unless a lawful alternative agreement applies

State and Local Premiums

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  • Some jurisdictions require daily overtime, seventh day premiums, or meal/rest premiums. Apply the most protective standard and ensure system configuration reflects <State> rules

Pay Practices for Exempt Employees

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Salary Basis and Level

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  • Exempt employees must be paid on a salary basis at or above <Weekly Salary Threshold> per week, exclusive of board, lodging, or other facilities
  • Partial-day deductions are generally prohibited, except where permitted by law (e.g., FMLA intermittent leave under certain conditions)

Permissible Deductions

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  • Full-day absences for personal reasons other than sickness or disability
  • Full-day sickness or disability absences under a bona fide plan, policy, or practice once benefits are exhausted or before eligibility
  • Unpaid disciplinary suspensions of one or more full days for workplace conduct rule violations
  • First and last week of employment when salary is proportionate to hours/days worked
  • Offset amounts received for jury fees, witness fees, or military pay

Improper Deductions and Safe Harbor

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  • <Company Name> prohibits improper salary deductions
  • Employees should report suspected improper deductions to <Reporting Contact> or <Hotline>
  • If an improper deduction is confirmed, <Company Name> will reimburse the employee and take corrective action to prevent recurrence

Minimum Wage, Tipped, and Child Labor Compliance

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  • <Company Name> pays at least the higher of federal, state, or local minimum wage
  • Tipped employees and tip credits are permitted only where lawful and operationally approved by <Approver Title> with specialized procedures for tip pooling and notice
  • Youth employment must comply with federal and state restrictions on hours and occupations for employees under 18

Deductions, Offsets, and Reimbursements

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  • Lawful deductions may include taxes, benefit premiums, and voluntary deductions authorized in writing
  • Deductions must never reduce nonexempt pay below minimum wage or cut into overtime pay where prohibited
  • Tool, uniform, or cash shortage deductions require Legal review and must comply with <State> law
  • Business expenses must be timely reimbursed to avoid minimum wage erosion for required expenses

Recordkeeping Standards

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  • Retain payroll, time, and related records for at least <Retention Period> years, or longer where required by <State> law or litigation hold
  • Maintain the following data for each employee:
    • Full name and identifying number
    • Address and date of birth (if under 19)
    • Sex and occupation
    • Time and day of week when the employee’s workweek begins
    • Hours worked each day and total hours worked each workweek
    • Basis on which wages are paid and regular hourly rate
    • Total daily or weekly straight-time earnings
    • Total overtime earnings for the workweek
    • Additions to or deductions from wages
    • Total wages paid each pay period and date of payment and pay period covered

Systems, Data, and Controls

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System Configuration Principles

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  • HRIS of record: <HRIS Name>
  • Timekeeping: <Timekeeping System Name> integrated via <Integration Method>
  • Payroll: <Payroll System Name> calculates regular rate and overtime using configuration tables reflecting <State> rules

Required Data Elements

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  • Employee master: FLSA status, workweek day, home location for jurisdictional rules, pay rates, schedule, cost center
  • Job master: Exemption category, salary basis, salary level, union status
  • Premium codes: Shift differential, on-call, hazard pay, meal/rest premiums
  • Bonus attributes: Nondiscretionary vs discretionary, covered period, eligibility

Controls and Monitoring

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  • Preventive controls:
    • User access controls limiting time edits and pay code changes by role
    • System validations for below-minimum wage rates and missing FLSA attributes
    • Overtime calculation unit tests maintained by <Owner>
  • Detective controls:
    • Weekly exception reports for long shifts, missed meals, unapproved OT, and off-cycle edits
    • Quarterly audits of exempt deductions and reclassification changes
    • Annual reconciliation of bonus inclusions in regular rate

Roles and Responsibilities

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Total Rewards (Policy Owner)

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  • Maintain policy, interpret standards, and lead classification reviews
  • Update thresholds and state overlays as of <Date> with Legal
  • Design system pay codes and regular rate inclusion rules

HR Business Partners

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  • Advise managers on scheduling and classification impacts
  • Facilitate employee acknowledgements and training

Managers and Supervisors

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  • Schedule work, approve time daily or per shift, and prohibit off-the-clock work
  • Pre-approve overtime when feasible and document business need
  • Ensure meal and rest compliance per <State>

Payroll

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  • Configure and validate overtime and regular rate calculations
  • Process corrective payments promptly and maintain payroll records

Legal/Compliance

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  • Advise on complex classification and multi-jurisdiction issues
  • Oversee investigations of complaints and regulator inquiries

Internal Audit/Finance Controls

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  • Test design and operating effectiveness of FLSA controls
  • Report findings to <Governance Committee Name>

Employees

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  • Accurately record all time worked and promptly report discrepancies
  • Comply with scheduling, meal/rest, and timekeeping procedures

Implementation Guidelines

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Phase 1: Assessment and Planning

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  1. Conduct a current-state risk assessment of classification, timekeeping, deductions, and bonus inclusion practices
  2. Inventory all pay codes and map to regular rate inclusion/exclusion with Legal sign-off
  3. Define workweek, schedules, and jurisdictional configurations

Phase 2: Job Classification Review

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  1. Prioritize roles with ambiguous duties or salary levels within <Percentage>% of thresholds
  2. Administer duties questionnaires and job shadowing as needed
  3. Document decisions and effective dates; communicate changes with at least <Number> days notice

Phase 3: System Configuration and Testing

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  1. Configure timekeeping rules: workweek, rounding, meal/rest, and overtime rules, including <State> overlays
  2. Configure payroll: regular rate formulae for bonuses, differentials, commissions, and multiple rates
  3. Execute test cases covering edge scenarios:
    1. Daily overtime and seventh day premiums
    2. Bonus allocation across covered period
    3. Travel, training, and on-call pay codes
    4. Exempt deductions under permitted scenarios

Phase 4: Change Management and Training

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  1. Develop role-based training materials for managers, employees, and HR/Payroll staff
  2. Publish quick reference guides and FAQs
  3. Require training completion and track acknowledgements

Phase 5: Go-Live and Hypercare

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  1. Run first payroll in parallel for <Number> cycles to validate results
  2. Monitor exception reports daily during first <Number> weeks
  3. Hold weekly stand-ups with HR, Payroll, and Legal to resolve issues

Ongoing Review, Audits, and Monitoring

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  • Quarterly:
    • Spot-audit timecards for missed meals, excessive rounding impact, and off-cycle edits
    • Review high-overtime roles and staffing plans
  • Semiannual:
    • Validate regular rate configurations against current pay codes
    • Reconcile nondiscretionary bonuses allocated to correct periods
  • Annual:
    • Comprehensive classification audit of at least <Percentage>% of exempt roles
    • Update thresholds and state overlays as of <Date>
    • Conduct policy refresher training

Exceptions and Escalations

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  • Requests for exceptions must be submitted in writing to <Approver Title> with business rationale and defined end date
  • Exceptions are time-bound and reviewed every <Number> days
  • Escalation path for unresolved classification or pay disputes:
  1. Manager and HR Business Partner
  2. Total Rewards
  3. Legal/Compliance
  4. <Executive Committee or Governance Body>

Safe Harbor Reporting and Non-Retaliation

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  • Employees who believe improper pay practices occurred should promptly report to <HR Contact>, <Payroll Contact>, or <Hotline>
  • <Company Name> will investigate in good faith, reimburse any underpayments, and correct processes
  • Retaliation is prohibited. Any retaliation will result in discipline up to and including termination

State and Local Law Addenda

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  • <State> Addendum:
    • Daily overtime after <Hours> hours in a day
    • Meal period by end of the <Hour>th hour with <Minutes>-minute duration
    • Rest breaks of <Minutes> minutes every <Hours> hours
  • <City/County> Addendum:
    • Minimum wage of <Amount> effective <Date>
    • Predictive scheduling requirements where applicable
  • Maintain a repository of current addenda reviewed by Legal each <Frequency>

Metrics and Reporting

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  • Key performance indicators:
    • Percentage of timecards approved on time: target <Percentage>%
    • Overtime as a percentage of total hours: target ≤ <Percentage>%
    • Exception rate on regular rate calculations: target 0 with corrective turnaround ≤ <Number> days
    • Training completion rates for managers: target <Percentage>%
    • Audit findings closed within SLA: <Percentage>% within <Number> days

Review and Approval Process

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Step Responsible Description Target Timeline
Draft Update Total Rewards Incorporate legal changes and operational feedback Within <Number> days of law change or by <Date> annually
Legal Review Legal/Compliance Validate against federal, state, and local requirements +<Number> days
Stakeholder Review HRBP, Payroll, Operations Verify feasibility and system support +<Number> days
Approval <Approver Title> Formal sign-off and effective date confirmation +<Number> days
Publication HR Operations Post to policy portal and notify impacted audiences Within <Number> days of approval

Change Log

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Version Date Summary of Changes Author Approver
1.0 <Date> Initial release <Name> <Name>

Examples and Decision Aids

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Example 1: Nondiscretionary Bonus Allocation

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  • Scenario: Monthly production bonus of <Amount> covering 4 weeks; employee worked 45, 38, 42, 35 hours
  • Allocation:
    • Allocate bonus proportionally by hours worked each week
    • Recalculate regular rate each week with allocated portion and pay additional overtime premium due

Example 2: Multiple Rates in a Week

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  • Scenario: 20 hours at <Amount>/hr as Warehouse Associate, 25 hours at <Amount>/hr as Forklift Operator
  • Weighted average regular rate = ((20 x <Amount>) + (25 x <Amount>)) ÷ 45
  • Overtime premium = 0.5 x weighted average x 5 hours

Example 3: Exempt Safe Harbor Correction

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  • Scenario: Unlawful partial-day deduction for exempt employee attending a 2-hour appointment
  • Action: Reimburse deduction, re-train manager, log incident, and test for pattern

Communication to Employees and Managers

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Purpose of This Section

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  • This section is written for employees and managers. It summarizes what you need to know and do day-to-day. If anything here conflicts with law or the full policy, the law and full policy apply.

Your Pay and Time: What You Can Expect

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  • You will be paid fairly, on time, and in line with federal, state, and local wage and hour laws. We do not allow off-the-clock work. If you work, you will be paid for it.

Recording Your Time (Nonexempt Employees)

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  • Please clock in when you start work and clock out when you finish. Record your meal breaks. If you forget, tell your manager right away so your time can be corrected
  • If you need to work overtime, get approval in advance when possible. If you do work overtime, it will be paid. We may follow up if it wasn’t approved, but you will not be asked to work unpaid
  • Short rest breaks are paid. Meal breaks are unpaid only if you are fully off duty

Remote Work and After-Hours Messages

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  • If you are nonexempt and you read or respond to work messages after hours, that counts as work time. Please record it. Talk to your manager about how to handle urgent messages so your time is tracked

Travel and Training

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  • Everyday commuting isn’t paid. Some travel and training time is paid depending on the situation. When in doubt, ask your manager or HR before the event so we can confirm what should be recorded

Exempt Employees and Salary Basis

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  • If you are classified as exempt, you receive a salary that doesn’t change based on hours or day-to-day work. We do not make improper deductions. If you think a deduction was wrong, tell <HR Contact> or use <Hotline>. We will fix errors

Questions or Concerns

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  • If you see a time or pay issue, please speak up. You can contact your manager, HR, Payroll, or <Hotline>. You will not be retaliated against for raising a concern in good faith

Acknowledgement

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  • By following these guidelines, you help us pay everyone correctly and on time. Thank you for recording your time accurately and for asking when you’re unsure

Glossary

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  • Basic Rate vs Regular Rate: The basic rate is the base wage; the regular rate includes most additional pay for overtime calculations
  • Compensable Time: Time that must be paid under applicable law
  • De Minimis: Small amounts of time that are hard to track; limited reliance per law and policy
  • Discretionary Bonus: A bonus given at the employer’s sole discretion without prior promise; typically excluded from the regular rate
  • Exempt: Not eligible for overtime under a specific exemption
  • Highly Compensated Employee (HCE): An employee meeting a total annual compensation threshold with certain duties
  • Nonexempt: Eligible for minimum wage and overtime protections
  • Nondiscretionary Bonus: A bonus promised in advance or based on set criteria; included in the regular rate
  • Regular Rate: The hourly rate used for overtime, including most compensation
  • Salary Basis: A fixed salary not reduced for variations in work quality or quantity
  • Workweek: A fixed seven-day period used to measure hours for overtime
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  • DOL Wage and Hour Division: https://www.dol.gov/agencies/whd
  • State Wage and Hour Resources: <Link to State Agency>
  • <Company Name> Policies:
    • Time and Attendance Policy
    • Remote Work Policy
    • Travel and Expense Policy
    • Code of Conduct and Non-Retaliation Policy

Appendices

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Appendix A: Manager’s Daily Checklist

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  1. Review yesterday’s time entries and approve or correct with comments
  2. Confirm meal/rest compliance exceptions are addressed
  3. Forecast staffing to minimize unplanned overtime
  4. Communicate schedule changes in writing
  5. Remind employees to record any after-hours work

Appendix B: Regular Rate Inclusion Matrix (Template)

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Pay Code Description Include in Regular Rate Notes
Base Hourly Base wage Yes N/A
Shift Differential <Percentage>% premium for <Shift> Yes Rate-based
Nondiscretionary Bonus Production/attendance bonus Yes Allocate over covered period
Discretionary Bonus Management discretion award No Must meet discretionary criteria
On-Call Stipend Flat amount per day Yes If tied to availability
Expense Reimbursement Business expense No Within accountable plan

Appendix C: Acknowledgement Language (Template)

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  • I acknowledge that I have received and read the <Company Name> FLSA Compliance Policy. I understand my responsibilities and know whom to contact with questions. Signature: <Name> Date: <Date>

Administrative Information

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  • Owner: <Owner Title>
  • Backup Owner: <Backup Owner Title>
  • Distribution: All U.S. employees and managers; HR, Payroll, Legal, and Audit
  • Storage: <Repository/URL>

Final Notes

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  • Laws change. <Company Name> updates this policy as needed. For current salary thresholds and state overlays, consult Legal as of <Date> and update configurations accordingly
  • This template includes placeholders such as <Company Name>, <Date>, <Amount>, and <Percentage>. Replace with organization-specific details during implementation

Document Information:

  • Document Type: Fair Labor Standards Act (FLSA) Compliance
  • Category: Compliance & Governance
  • Generated: August 28, 2025
  • Status: Sample Template
  • Next Review: <Insert Review Date>

Usage Instructions:

  1. Replace all text in angle brackets < > with your company-specific information
  2. Review all sections for applicability to your organization
  3. Customize content to reflect your company's policies and local regulations
  4. Have legal and HR leadership review before implementation
  5. Update document header with your company's version control information
  6. At bottom of the document you find a short example on how the content could be communicated to end-users, for instance employees.

This sample document is provided for reference only and should be customized to meet your organization's specific needs and local legal requirements.