Related Pages:
US based benefits are arranged through Willis Towers Watson and managed on the PlanSource platform. The benefits decision discussions are held by Total Rewards, the CFO, and the CEO to elect the next year's benefits by the carrier's deadlines. Total Rewards will notify the team of open enrollment as soon as details become available.
Please see additional information on the 2022 US Benefit Plans:
Review the 2022 US Benefits Guide for full plan details and updated plan rates.
Watch the 2022 US Benefits Open Enrollment Video for a full review of the Benefit Plans.
Please review the full summary plan description of all related health benefits and a the most recent Summary of Material Modifications from Jan 1, 2022. Please review the 2022 Annual Rights and Notices.
GitLab offers Mental Wellnesss Services through Modern Health. In addition to these services, team members that enroll in the Cigna and Kaiser plans have access to their network of Mental Health Programs and Resources
Transparency in Coverage Starting July 1, 2022, this link leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data
Illinois Team Members: In accordance to the Illinois Consumer Coverage Disclosure Act, please find the 2022 Coverage Summary for the essential health benefits available to you. See the HDHP, PPO, and EPO Summary Plan Descriptions for reference.
Team Members can find information on the 2021 Calendar Year benefit plans, details, and open enrollment archived here.
877-409-9288 or GitLab@willistowerswatson.comtotal-rewards@ gitlabtotal-rewards@ gitlabPhysical carrier ID cards for medical and vision are normally received within 3 weeks of submitting your benefit elections. If you or your medical providers are in need of immediate confirmation of your coverage, please contact the carrier directly. Please note there are no physical ID cards for dental coverage.
Please allow up to two weeks for ID cards to generate after completing your enrollment.
If you have existing coverage when joining GitLab (e.g. coverage for an additional month from your prior employer), you have the option of enrolling in GitLab's coverage after your prior coverage terminates. If you wish to do this, you should register with PlanSource during onboarding and waive all coverages. Once your previous coverage is terminated, you should sign up for coverage through PlanSource on or within 30 days of the termination date by initiating a Qualifying Life Event and providing proof of coverage termination.
GitLab covers 100% of team member contributions and 66% for spouse, dependents, and/or domestic partner of premiums for medical, dental, and vision coverage. Plan rates are locked through December 31, 2020.
More information on the processed deductions in payroll from PlanSource can be found on the Accounting and Reporting page.
For questions on benefits, please see the following PlanSource Video Library.
Effective 16 June 2022, You can log into PlanSource through your Workday profile. There is an integration built between Workday and Plansource that allows for single sign on.
View All Apps link. Click Personal Information appExternal Links, select US Benefits Enrollment - PlanSourceReview the PlanSource Login & Enrollment Guide for additional details on logging in and electing benefits.
GitLab offers plans from Cigna, as well as additional Kaiser options for residents of California, and Colorado. Hawaii residents are offered Kaiser options for medical plan enrollment.
Deductibles are for plan year of 2022-01-01 to 2022-12-31.
If you already have current group medical coverage, you may choose to waive or opt out of group health benefits. If you choose to waive health coverage, you will receive a $300.00 monthly benefit allowance and will still be able to enroll in dental, vision, optional plans, and flexible spending accounts. In order to receive the monthly benefit allowance you must log on to PlanSource and actively waive medical cover.
If you do not enroll in a plan within your benefits election period, you will automatically be enrolled in the High Deductible Health Plan (HDHP).
GitLab has confirmed that our medical plans are CREDITABLE. Please see the attached 2021 notice and page 7 of the 2022 Annual Notice. If you or your dependents are Medicare eligible or are approaching Medicare eligibility, you will need this notice to confirm your status when enrolling for Medicare Part D. For more information about Medicare prescription drug coverage:
Any active, regular, full-time team member working a minimum of 30 hours per week are eligible for all benefits. Benefits are effective on your date of hire. Others eligible for benefits include:
Note: If you and an eligible dependent (as defined above) are both employed by GitLab, you may only be covered by GitLab’s coverage once. This also applies to enrolling in either your own supplemental life insurance or supplemental spouse/dependent life insurance through your dependent who is employed by GitLab, but not both.
Due to IRS guidelines, you cannot make changes to your health insurance benefits outside of GitLab's annual open enrollment period unless you experience a Qualifying Life Event.
A QLE is a change in your situation — like getting married, having a baby, etc that can make you eligible for a special enrollment period. You have 30 days from the date of your qualifying event to submit your requested change to PlanSource.
Update your current Benefits.Add Dependent and add their information. (For Birth Event: If you are still pending the SSN for your newborn, you may continue the request without this information and can add later when received.)Select Benefits and the system will lead you to the Benefit plans you can update.
View or Change Plan. On the next page, select the specific plan you want to enroll in (if you wish to continue on your current plan, select that plan). On the specific plan page, add your new dependent by checking their name. Click Update Cart.View or Change Plan. On the next page, select the specific plan you want to enroll in without your dependent (if you wish to continue on your current plan, select that plan). On the specific plan page, remove your dependent by unchecking their name. Click Update Cart.View or Change Plan button next to the plan name. Click Update Cart after you've made your desired changes.Review and CheckoutIf your Qualifying Life Event requires documentation the steps below will follow your QLE request
Coverages:
Cigna plans are available to team members located in all US states, with the exception of Hawaii. The Cigna 2022 plan details include the following enhancements: inclusion of acupuncture, chiropractic care, and hearing aid benefits.
In Network:
| Plan Details | 2022 Cigna HDHP- HSA | 2022 Cigna EPO (PPO $0)** | 2022 Cigna PPO 500*** |
|---|---|---|---|
| Deductible (Single/Family) | $2,000 / $2,800 | $0 / $0 | $500 / $1,000 |
| Out of Pocket Max (Single/Family) | $4,000 / $8,000 | $2,500 / $5,000 | $3,000 / $6,000 |
| Primary Care Visit | 20% | $20 per visit | $20 per visit |
| Specialist Visit | 20% | $20 per visit | $20 per visit |
| Urgent Care | 20% | $50 per visit | $50 per visit |
| Emergency Room | 20% | $100 per visit | $100 per visit |
| Hospital Inpatient | 20% | $250 per admission | 10% |
| Hospital Outpatient | 20% | 0% | 10% |
| Generic | $10 | $10 | $10 |
| Brand - Preferred | $30 | $30 | $30 |
| Brand - Non-Preferred | $50 | $50 | $50 |
| Rx Plan^ | Standard 3-tier | Standard 3-tier | Standard 3-tier |
| Summary Plan Descriptions | HDHP | EPO | PPO |
** In order for the EPO plan to be compliant in all states, it has been set up as a PPO plan with bad out-of-networks benefits including a deductible of $10k/$20k, an Out of Pocket Max of $20k/$40k, and a coinsurance of 50%. Please do not enroll in this plan if you are intending to use the out-of-networks benefits and instead review the Cigna PPO 500 or Cigna HSA plans.
*** Cigna will provide an extended network PPO Plan for Utah team members which will include the Intermountain Healthcare System.
^ The linked Prescription Drug List is subject to change. When making a change mid-year, Cigna states that they will send out the following communication to impacted members: centralized notification 60 days prior, 2 letters before the change, and 1 letter after the change.
Accredo is Cigna's specialty pharmacy. For more information on managing your speciality medication please review the Accredo Customer Flyer.
Team Member Costs:
2022 Rates: The following costs are monthly rates which would be deducted from your paycheck.
| Tier | HDHP-HSA | EPO | PPO |
|---|---|---|---|
| Team Member Only | $0 | $0 | $0 |
| Team Member + Spouse | $0 | $248 | $242 |
| Team Member + Child(ren) | $0 | $188 | $184 |
| Family | $0 | $426 | $416 |
Note: For the HSA, GitLab will contribute $100 per month. For residents of California, Alabama, and New Jersey this additional contribution is taxable on the state level.
Enrolled Cigna members can find in-network mental health providers by logging in to their mycigna.com account, selecting "connect now" under "My Health Team". For more information on virtual support please see the the Emotional Well-Being Virtual Support flyer.
Infertility services will be included in both the PPO 500 plan and HSA plan. This includes a $15,000 lifetime infertility benefit for each covered member.
Coverage will be provided for the following services:
See the HDHP, PPO, and EPO Summary Plan Descriptions for more details.
Cigna has advised they will provide WPATH compliant coverage for all plans. For more information on their coverage, please see the coverage policy document. For Cigna to provide coverage, medical necessity must be proven. It is highly recommended to go through the prior authorization process when seeking treatment.
Please reach out to the Total Rewards team and WTW with any questions or if you need help while seeking authorization for a treatment.
Potential joiners who do not have a myCigna account yet can search for providers on the Cigna Website. When selecting a plan everyone at GitLab (PPO, EPO, and HDHP members) will use the OPEN ACCESS PLUS selection, except for Utah members, who will use the PPO option.
IMPORTANT NOTE:
As an additional measure to confirm “Contracted Providers” (i.e. In-Network), it’s always a good idea to follow up with Providers directly (phone, email or otherwise) to additionally confirm if a Provider is contracted with Cigna or not and if the type of service is covered. In some instances, the same provider may be covered In-Network for certain types of services, but may be Out-Network for other services. Provider contracts change and sometimes the contracts change faster than the website maintenance teams for the insurance carriers. It's better to spend time researching and confirming rather than assuming and being stuck with balance billing from Out of Network providers. Balance billing is if the Out of Network provider's charge is $100 and the carrier’s maximum allowed reimbursement (MAR) amount is $70, the provider is within rights to bill you for the remaining $30. A “Cigna Contracted Provider” cannot balance bill Cigna members.
Virtual visits for Cigna members can be accessed by visiting myCigna, selecting "Find Care & Costs" and scrolling down to the bottom of the page.
Benefits for services and supplies received outside the Service Area are covered only for medical emergencies and other urgent situations where treatment could not have been reasonably delayed until the insured person was able to return to the United States
The following Kaiser options are availble for Hawaii residents. Residents in California and Colorado have the Kaiser options below, in addition to the Cigna plan options.
Coverages:
The Kaiser 2022 plan details will include the following enhancements: inclusion of acupuncture, chiropractic care, and hearing aid benefits. Review the Kaiser Permanente Chiropractic and Acupuncture Benefits flyer for more information on these plans.
| Plan Details | 2022 HMO NorCal | 2022 HMO 20 SoCal | 2022 HMO 20 CO | 2022 HMO 20 HI (TBD) |
|---|---|---|---|---|
| Deductible (Single/Family) | $0 / $0 | $0 / $0 | $0 / $0 | $0 / $0 |
| Out Of Pocket Max (Single/Family) | $1,500 / $3,000 | $1,500 / $3,000 | $2,000 / $4,000 | $2,500 / $7,500 |
| PCP/Specialist Copay | $20 / $35 | $20 / $35 | $20 / $35 | $15 / $15 |
| Emergency Room | $100 | $100 | $250 | $100 |
| Urgent Care | $20 | $20 | $50 | $15 |
| Hospital Inpatient | $250/admit | $250/admit | $300/admit | 10% |
| Hospital Outpatient | $35/procedure | $35/procedure | $100/procedure | 10% |
| Rx - Deductible | ||||
| Generic | $10 | $10 | $10 | See SBC (tier 1), $3 (tier 1a), $15 (tier 1b) |
| Brand - Preferred | $35 | $35 | $30 | $50 |
| Brand - Non-Preferred | $35 | $35 | $50 | $50 |
| Specialty Drugs | 20% up to $150 | 20% up to $150 | 20% up to $250 | $200 |
Please see the 2022 Kaiser Colorado Enrollment Guide for more information on the Kaiser Colorado plan.
Team Member Costs:
The following costs are monthly rates which would be deducted from your paycheck.
2022 Rates: The following costs are monthly rates which would be deducted from your paycheck.
| Tier | HMO CA North | HMO CA South | HMO CO | HMO HI |
|---|---|---|---|---|
| Team Member Only | $0 | $0 | $0 | $0 |
| Team Member + Spouse | $244 | $244 | $340 | $178 |
| Team Member + Child(ren) | $194 | $194 | $284 | $144 |
| Family | $378 | $378 | $566 | $356 |
Virtual visits for Kaiser members can be accessed by logging into Kaiser's online portal. Please consult the online portal and your plan details for your copay amount.
Kaiser provides or arranges for Services or supplies directly to you and your Family Dependents through an integrated medical care system. You must receive your health care from KP providers and in KP facilities within the Kaiser Service Area except for these services:
Written and authorized referrals (by a KP provider and/or our Authorizations and Referrals department)
Outside the Service Area Your benefits outside the Service Area are limited to:
For in-network services: N/A.
For out-of-network services: 365 days from Date of Service.
Kaiser California and Colorado Members are covered for infertility services at 50% co-insurance. Coverage includes services for diagnosis and treatment of infertility. Coverage does not include conception by artificial means (IVF/GIFT/ZIFT/etc). Please check with the WTW Benefits Helpline 877-409-9288 or GitLab@willistowerswatson.com for more information.
Kaiser Hawaii Plan members are covered for an infertility consultation and certain In Vitro Fertilization (IVF) procedures. More information on the Infertility services for Hawaii Kaiser members can be found on the 2021 Hawaii Health Plan.
With medical plans, GitLab offers pregnancy and maternity care. Depending on the plan you selected, your coverages may differ for in-network vs out-of-network, visits, and inpatient care. Please contact the Total Rewards team or WTW with any questions about your plan. To learn more about Parental Leave, please refer to our Parental Leave policy. Once your child has arrived, please follow the steps outlined above in regard to this Qualifying Life Event.
You may need a reasonable accommodation during your pregnancy. For more information regarding GitLab's Pregnancy Accommodation policy, please also refer to our Individuals with Disabilities policy.
Dental is provided by Cigna, plan: DPPO.
Dental does not come with individualized insurance cards from Cigna, although you can download them by setting up a Cigna account through the Cigna website. Cigna's site and app will house individualized ID cards team members can access at any time. For the most part, dental providers do not request or require ID cards as they look up insurance through your social security number. If you need additional information for a claim please let the Total Rewards team or WTW know. Cigna'a mailing address is PO Box 188037 Chattanooga, TN, 37422 and the direct phone number is 800-244-6224.
When submitting a claim, you can mail it to Cigna Dental PO Box 188037 Chattanooga, TN, 37422 or fax it to 859-550-2662.
Coverages:
| Plan Details | DDPO 2022 |
|---|---|
| Deductible (Single/Family) | $50 / $150 |
| Maximum Benefit | $2,000 |
| Preventive Care CoInsurance (in/out) | 0% / 0% |
| Basic Care Coinsurance (in/out) | 20% / 20% |
| Major Care Coinsurance (in/out) | 50% / 50% |
| Out of Network Reimbursement | 90th R&C |
| Orthodontia | |
| Orthodontic Coinsurance (in/out) | 50% / 50% |
| Orthodontic Max Benefits | $1,500 |
Team Member Costs:
The following costs are monthly rates which would be deducted from your paycheck.
2022 Rates: The following costs are monthly rates which would be deducted from your paycheck.
| Tier | DPPO |
|---|---|
| Team Member Only | $0 |
| Team Member + Spouse | $14 |
| Team Member + Child(ren) | $20 |
| Family | $36 |
For in-network services: N/A.
For out-of-network services: 365 days from Date of Service.
Vision is provided by Cigna.
When submitting a claim, you can mail it to Cigna Vision PO Box 385018 Birmingham, AL 35238 or submit it online using the following instructions:
Coverages:
The 2022 Vision plan details will include the following enhancements: increase frame allowance to up to $150.
| Plan Details | Vision 2022 |
|---|---|
| Frequency of Services | 12 months |
| Copay Exam | $20 |
| Copay Materials | - |
| Single Vision | $0 |
| Bifocal | $0 |
| Trifocal | $0 |
| Frame Allowance | up to $130 |
| Elective Lenses Contact Allowance | up to $130 |
The Frame allowance has increase to up to $150 for the Vision 2022 Calendar Year Plan.
Team Member Costs:
The following costs are monthly rates which would be deducted from your paycheck.
2022 Rates_: The following costs are monthly rates which would be deducted from your paycheck.
| Tier | Vision |
|---|---|
| Team Member Only | $0 |
| Team Member + Spouse | $2.40 |
| Team Member + Child(ren) | $1.80 |
| Family | $4.80 |
For in-network services: 365 days from Date of Service.
For out-of-network services: 365 days from Date of Service.
GitLab offers company paid basic life and accidental death and dismemberment (AD&D) plans through Cigna which is a subsidiary of New York Life. The Company pays for basic life insurance coverage valued at two times annual base salary with a maximum benefit of $500,000, which includes an equal amount of AD&D coverage. Please find addtional details, limitations, and exclusions on the summary of benefits.
Under the New York Life Group Benefit, US Team Members also have access to the New York Life Employee Assistance Program. The Program includes:
For more information and how to access these benefits, please see the EAP flyer
GitLab provides, at no cost to our Inc and Federal team members, a disability policy through New York Life (administered by Cigna) that may replace up to 66.7% of your base salary, for qualifying disabilities. For short-term disability there is a weekly maximum benefit of $2,500; for long-term disability there is a monthly benefit maximum of $12,500.
Short-term disability insurance has a 7-calendar day waiting period before payments begin. Benefits coverage (medical, dental, vision, etc.) and vesting will continue for the time the team member is receiving short-term disability pay.
GitLab Process for Disability Claim
Short-Term Disability Claim Process via Cigna
dallasfco.intake2@cigna.comand TeamArakeliansMailbox@Cigna.com.GitLab team members in the United States are eligible for a complementary Employee Assistance program as a result of enrollment in the long-term disability plan through Cigna, dependents who are enrolled in a Cigna coverage are also eligible. More information can be found online on myCigna for the following topics: Emotional Health and Family Support, Home Life Referrals, Financial and Legal Assistance, Job and Career Support, and other topics.
The company offers a 401k plan in which you may make voluntary pre-tax contributions toward your retirement.
support@betterment.com. There is also a Help section on the Betterment site.total-rewards@gitlab.com. Total Rewards is not able to advise you on your financial decisions.GitLab offers matching 50% of contributions on the first 6% of allocated gross earnings per pay period with a yearly cap of $1,500 USD. If a hypothetical team members salary is $50,000 USD, their gross pay per period is $50,000 / 24 = $2083.33. This is then matched at a rate of $2083.33 * 6% * 50% = $62.50.
As you are eligible to participate in GitLab's 401k as of your hire date, you are also eligible for GitLab matching contributions as of your hire date.
All employer contributions are pre-tax contributions. Team members can still make Roth 401(k) team member contributions and receive pre-tax employer contributions to your Traditional 401(k) account.
Administration of the 401(k) Match:
If you leave GitLab and would like to rollover your 401(k) account, contact Betterment directly to get more information about this process. If you are needed to locate your account number, you can find it by clicking Settings and then Accounts. You can reach Betterment, by Chat in the app, by phone at 855-906-5281, and by email at support@betterment.com. They also have a Rollovers section on their site going into detail.
The 401(k) Committee meets on a regular cadence with Betterment to review how the plan is doing as well as updates from the Betterment investment team. The Committee Members are:
Chief People Officer Principal Accounting Officer Director, Total Rewards Director, Treasurer Note: Chief Legal Officer will serve as an committee observer.
If you are enrolled in a Health Savings Account (HSA), Flexible Spending Account (FSA), Dependent Care Flexible Spending Account (DCFSA) or commuter benefits, the funds are held through WEX (Discovery Benefits). After your benefit enrollment effective start date, create an account with WEX (Discovery) to manage your funds. You will only receive one debit card upon enrollment. To obtain a second card (for a dependent, etc.) you will need to login to your account on WEX (Discovery) or call and they will send one to your home of record.
GitLab contributes $100 per month for those enrolled in the HSA.
If you would like to transfer your HSA from a previous account, please contact WEX (Discovery) and request a HSA Transfer funds form. On the form you will put your old HSA provider’s account number and any other required personal information. You will then submit the form to WEX (Discovery), and they will get in contact with your old HSA provider and process the transfer of funds. You can reach WEX (Discovery) at 866.451.3399 or customerservice@discoverybenefits.com.
If you would like to adjust your HSA contributions please log into [PlanSource](https://benefits.plansource.com/.
HSAs roll over completely year-to-year and are 'owned' by the team member. If you leave GitLab and would like to keep your HSA account, GitLab will no longer be responsible for the administration fee. The account holder will become responsible for the $2.50 per month admin fee.
Domestic Partner Reimbursements: If the team member is not legally married to their domestic partner, the domestic partner's expenses are not eligible for disbursement from the HSA. However, if the domestic partner is covered under the family HDHP through the team member, the domestic partner can open their own HSA and contribute up to the full family contribution maximum. The team member may also contribute up to the full family contribution maximum to their own HSA.
FSAs help you pay for eligible out-of-pocket health care and dependent day care expenses on a pretax basis. You determine your projected expenses for the Plan Year and then elect to set aside a portion of each paycheck into your FSA. FSA contributions can only be updated during open enrollment or through a qualifying life event (QLE).
FSAs typically have a $550 rollover each calendar year. This is subject to change as dictated by the IRS. Due to COVID legislation, the IRS is allowing for unlimited carryover of FSA funds from 2021 to 2022. Starting in 2022 the IRS increased the FSA rollover amount to $570.
FSAs are employer-owned accounts. If you leave GitLab, your FSA account will be terminated on your date of termination unless you continue this through COBRA. You are able to use your full FSA amounts up to and on your last day, but not afterwards unless you enroll into COBRA. WEX (Discovery) asks that all claims be submitted up to 90 days after termination date. You can enroll into COBRA FSA if you have spent less out of your account than you have contributed to it. If you decide to enroll, you will be required to continue making your monthly contributions on a post-tax status. For additional information, please reach out to WEX (Discovery) at 866.451.3399 or customerservice@discoverybenefits.com.
FSAs (and Dependent Care FSAs) are subject to annual testing by the Internal Revenue Code guidelines to ensure the pre-tax benefits do not disproportionately benefit highly compensated employees. At the end of each plan year, GitLab will work with WTW to conduct the nondiscrimination testing. If a test returns that highly compensated employees benefit, you may not be able to pre-tax the full amount of your election. This can vary each year and is based upon the dollar amount of non-highly compensated employees’ elections.
Up to 90 days after the plan year has concluded (also known as the runout period).
Due to the Consolidated Appropriations Act, the IRS is allowing for unlimited carryover of FSA funds from 2021 to 2022 and an extended grace period of 12 months to utilize Dependent Care FSA funds from 2021 on expenses incurred in 2022. GitLab has opted into this with our vendor, WEX, to allow team members to take advantage of this and no action is required from team members.
GitLab offers commuter benefits which are administered through WEX (Discovery Benefits). The contribution limits from the IRS for 2021 are $270/month for parking and $270/month for transit. Starting in 2022 the contribution limits will increase to $280/month for parking and $280 per month of transit. These contributions rollover month to month.
For active employees: Up to 180 days after plan year has concluded (also known as the runout period).
For terminated employees: Up to 90 days after the termination date.
Effective 2022-10-01, GitLab offers a TravelHealth Reimbursement Arrangement (HRA) benefit to reimburse eligible team members and their dependents for transportation and lodging expenses related to travel while obtaining medical care not offered within 100 miles of the location the member resides.
To be eligible for the Travel HRA benefit, team members and their dependents must be enrolled in one of the Cigna Medical Plans. Navia Benefit Solutions administers the HRA benefit.
The HRA Benefit is split into a pre-tax account, in which team members can receive reimbursement of up to $2,100 USD for eligible pre-tax travel expenses, and a post-tax account of $900 USD for eligible travel expenses that exceed the pre-tax travel limits.
Please see the HRA Summary of Benefits and Coverage document for information on coverage and the Navia Navigation Guide for information on claim eligibility and how to submit claims. Additional details can be found in our Health Reimbursement Arrangement (HRA) FAQ
To access the benefit, eligible team members can create an account on the Navia Portal, first time users will click the Register button in the top right corner of the page.
To register for online account access you will be requested to provide the following information:
Reminder! review and accept the Terms and Conditions. After clicking Submit for online access, you will receive an email confirmation with a temporary link to set your password to complete your registration.
If you are a newly hired GitLab Team Member, please allow 1 month following your start date to access the portal. Should you require access to the portal earlier, please contact Total-Rewards@gitlab.com. Once you have access to the portal you can submit a claim directly with Navia, and view plan documents.
Team members who wish to elect additional life insurance above what is provided by GitLab through the Basic Life Insurance or elect life insurance for their dependents, can elect Voluntary Life Insurance through Cigna.
If you elect supplemental life insurance greater than the guaranteed issue of voluntary life insurance for yourself or dependent, you or your dependent may be required to complete an evidence of insurability (EOI). If required, you will be prompted and provided with the form during the enrollment process and can also access it here.
Please complete this form to the best of your ability, but if you're unsure for any field, please leave it blank. No information needs to be filled out for the ID # field and for security, you may also leave the Social Security Number field blank.
Once complete, please send the form to total-rewards@ gitlab. The Total Rewards team will then help fill in any missing information, if applicable, and will forward to the carrier for review. Total Rewards will confirm receipt of the EOI with the carrier, track its status, and the team or the carrier will reach out to the team member with any issues that need to be addressed in order for the EOI to be approved.
If you leave GitLab, all supplemental life insurance is not included in COBRA and will terminate on your last day at GitLab unless you choose to continue your or your spouse/children's life insurance directly with the carrier. Please contact the carrier (Cigna) for more information on premiums and setting this up.
US team members have access to a discount platform offered through ADP. This platform provides discounts for national and local brands and services.
To access LifeMart through ADP:
The Family Medical Leave Act FMLA provides eligible U.S team members up to 12-weeks, or up to 26- workweeks (in one 12 month period to care for an injured service member), unpaid time away from work for their own serious health condition, to care for a family member with a serious health condition, or to bond with a newborn or newly adopted child. FMLA eligible leave time can be taken in continuous segments or intermittently as certified by a physician. If FMLA is used to bond with a child, or newly adopted child, all eligible time must be used prior to the child’s first birthday or date of adoption. For more information please see Employee Rights Under the Family Medical Leave Act.
Team members must have 12 months of continuous service and 1250 hours worked in the year immediately before the start of their leave to be eligible for FMLA leave. Working hours are calculated as actual hours worked and does not include PTO or vacation time. GitLab calculates FMLA eligibility as a “rolling” 12-month period measured backward from the date of any FMLA leave usage. (Each time a team member takes FMLA leave, the remaining leave is the balance of the 12 weeks not used during the 12 months immediately before the FMLA leave is to start.)
All FMLA entitled leave will run concurrently with any State specific leave or pay program (if applicable), GitLab's PTO and sick leave policies (including COVID leave), and/or Short-Term disability benefits. GitLab’s extended 25-day “don’t ask, must tell” PTO policy can not be used to delay, extend, or in lieu of FMLA.
Any medical related absence (for yourself or a family member) requiring you to be away from work for 5 or more calendar days (either continuously or non-continuous but related to the same condition) must be reported to leaves@gitlab.com. You will be contacted within 24-48 business hours (whenever possible) and provided with information regarding your request. If approved, please submit your time away via PTO by Roots request utilizing the Out Sick option.
The Absence Management team will review the team members eligibility for Short-Term Disability benefits, State pay benefits, and/or GitLab's Sick Time policy, and will communicate how the team member can expect to receive their pay while on leave.
Initial Leave Request:
FMLA Certification Received:
If Approved:
Out Sick in PTO by Roots.If Denied:
FMLA Certification NOT Received:
Parental Leave option at least 30 days in advance.Non-Birthing Parent Pay Non-Birthing parents are not eligible to receive Short-Term Disability pay during Parental Leave, so if the team member is not eligible for State Paid Family Leave, they will receive 100% of their regular salary from GitLab following our normal bi-monthly pay cycle.
If a non-birthing parent is eligible for State paid benefits, the Absence Management team will calculate their pay minus these benefits on the Top Up Pay tab, and report those wages via the Pay Changes report at least 7 days before payday.
Birthing Parent Pay Unless a Birthing Parents is eligible for State paid disability benefits and/or State paid family leave beneits, they will continue to receive 100% of their regular salary from GitLab following our normal bi-monthly pay cycle.
If a birthing parent is eligible for State paid benefits, the Absence Management team will calculate their pay minus these benefits on the Top Up Pay tab, and report those wages via the Pay Changes report at least 7 days before payday.
To learn more about State-specific leave laws, please visit the US Leaves of Absence page/
If you are enrolled in medical, dental, and/or vision when you terminate from GitLab (either voluntarily or involuntarily), you may be eligible to continue your coverage through COBRA.
total-rewards@ gitlab at least a week after your termination date and we can send an electronic copy of your COBRA enrollment packet to you if it has been generated.If you are currently employed and have any general COBRA questions, feel free to contact the Compensation & Benefits team. If you have terminated already or have specific questions on the administration of COBRA, feel free to contact WEX (Discovery) Benefits directly: (866) 451-3399.
Medical
2022
| Tier | Cigna EPO | Cigna HDPHP HSA | Cigna PPO | Kaiser HMO NorCal | Kaiser HMO SoCal | Kaiser HMO CO | Kaiser HMO HI |
|---|---|---|---|---|---|---|---|
| Team Member Only | $617.15 | $461.04 | $602.85 | $545.89 | $545.89 | $829.45 | $523.05 |
| Team Member + Domestic Partner | $1,345.49 | $1,003.65 | $1.314.21 | $1,260.63 | $1,260.63 | $1,824.79 | $1,046.11 |
| Team Member + Spouse | $1,345.49 | $1,003.65 | $1,314.21 | $1,260.63 | $1,260.63 | $1,824.79 | $1,046.11 |
| Team Member + Child(ren) | $1,167.99 | $871.43 | $1,134.03 | $1,113.62 | $1,113.62 | $1,658.90 | $941.50 |
| Family | $1,865.77 | $1,391.22 | $1,822.35 | $1,653.67 | $1,653.67 | $2,488.36 | $1,569.16 |
Dental
2022
| Tier | Cigna DPPO |
|---|---|
| Team Member Only | $41.13 |
| Team Member + Domestic Partner | $81.74 |
| Team Member + Spouse | $81.74 |
| Team Member + Child(ren) | $94.55 |
| Family | $145.05 |
Vision
| Tier | Cigna VPPO |
|---|---|
| Team Member Only | $7.66 |
| Team Member + Domestic Partner | $15.35 |
| Team Member + Spouse | $15.35 |
| Team Member + Child(ren) | $12.99 |
| Family | $21.43 |