US based benefits are arranged through Lumity. 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.
The 2020 Open Enrollment will begin October 19, 2020 and will end on October 30, 2020. Your plan will renew January 1, 2021. This will be an active enrollment, you must elect benefits in Lumity during the Open Enrollment window to have benefits in 2021. Please review the information added on the plans for 2021 below and the digital benefits guide is also available to review.
Please review the full summary plan description of all related health benefits.
If you have any questions regarding benefits please reach out to Total Rewards directly. If you have any questions with the Lumity platform, feel free to reach out to their support personnel at support@lumity.com or 1-844-258-6489.
Carrier ID cards are normally received within 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. ID cards are also available within the Lumity mobile app: IOS or Android or available to be printed through the carrier website, myCigna, for Cigna participants. Please see the pamphlet for how to use the Lumity mobile app.
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 Lumity during onboarding and waive all coverages. Once your previous coverage is terminated, you should sign up for coverage through Lumity 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 Lumity can be found on the Accounting and Reporting page.
GitLab offers plans from Cigna for all states within the US as well as additional Kaiser options for residents of California, Hawaii, and Colorado. Deductibles for a plan year of 2021-01-01 to 2021-12-31.
For additional information on how Benefits or HSAs operate, please check out the documentation on the Google Drive or Lumity's resources.
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.
If you do not enroll in a plan within your benefits election period, you will automatically receive the medical waiver allowance.
GitLab has confirmed that our medical plans are CREDITABLE. Please see the attached 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.
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 Lumity. You will be asked to include supporting documents (see Required Documents), and list the date the change occurred.
You can start the process by logging into Lumity, selecting Benefits from the panel on the left, and selecting Update Benefits in the upper right. Lumity support can be contacted directly with any questions.
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.
Effective January 1, 2021, GitLab will be transitioning from UHC to Cigna as the primary national carrier.
Coverages:
In Network:
| Plan Details | Cigna - HSA | Cigna EPO (PPO $0)** | Cigna PPO 500*** |
|---|---|---|---|
| Deductible (Single/Family) | $2,000 / $2,800 | $0 / $0 | $500 / $1,000 |
| OOP 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 |
** 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 OOPM 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.
Team Member Costs:
The following costs are monthly rates which would be deducted from your paycheck.
| Tier | HSA | EPO | PPO |
|---|---|---|---|
| Team Member Only | $0 | $0 | $0 |
| Team Member + Spouse | $0 | $234 | $222 |
| Team Member + Child(ren) | $0 | $180 | $168 |
| Family | $0 | $402 | $378 |
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. More details will be included in the SBCs once available.
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 Lumity with any questions or if you need help while seeking authorization for a treatment.
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. 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.
Coverages:
| Plan Details | HMO 20 NorCal | HMO 20 SoCal | HMO 20 CO | HMO 20 HI |
|---|---|---|---|---|
| Deductible (Single/Family) | $0 / $0 | $0 / $0 | $0 / $0 | $0 / $0 |
| OOP 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 |
Team Member Costs:
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 | $240 | $240 | $276 | $174 |
| Team Member + Child(ren) | $192 | $192 | $228 | $138 |
| Family | $366 | $366 | $456 | $342 |
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.
For in-network services: N/A.
For out-of-network services: 365 days from Date of Service.
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 Lumity or Total Rewards with any questions about your plan. Once your child has arrived, please follow the steps outlined above in regard to this Qualifying Life Event.
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. Lumity's site 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 People Ops 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 | DPPO |
|---|---|
| Deductible | $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.
| Tier | DPPO |
|---|---|
| Team Member Only | $0 |
| Team Member + Spouse | $12 |
| Team Member + Child(ren) | $18 |
| 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:
| Plan Details | Vision |
|---|---|
| Frequency of Services | 12 / 12 / 12 |
| Copay Exam | $20 |
| Copay Materials | - |
| Single Vision | $0 |
| Bifocal | $0 |
| Trifocal | $0 |
| Frame Allowance | up to $130 |
| Elective Lenses Contact Allowance | up to $130 |
Team Member Costs:
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. The Company pays for basic life insurance coverage valued at two times annual base salary with a maximum benefit of $250,000, which includes an equal amount of AD&D coverage.
GitLab provides a policy through 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.
Process for Disability Claim
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@domain. Total Rewards is not able to advise you on your financial decisions.GitLab offers matching 50% of contributions on the first 6% of allocated earnings with a yearly cap of 1,500 USD. 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 team member contributions and receive pre-tax employer contributions.
Vesting:
Employer contributions vest according to the following schedule:
| Years of Vesting Service | Vesting Percentage |
|---|---|
| Less than One Year | 0% |
| One Year but less than Two Years | 25% |
| Two Years but less than Three Years | 50% |
| Three Years but less than Four Years | 75% |
| Four or More Years | 100% |
Employee contributions are the assets of those team members and are not applicable to this vesting schedule.
Vesting example
To help you understand the math, here is a hypothetical vesting chart showing how much the employeed would get if they left the company.
In this example the employee's salary is $50,000 USD and they max out their match every year. 50,000 * 6% = 3000. 3000 * 50% = 1500 match.
Year 1: Put in 3K, GitLab matches 1500. Leave the company get 3K (none vested) Year 2: Put in 3K, GitLab matches 1500. Leave the company get 6K own money + $750 USD vested contribution. (3K * 0.25) Year 3: Put in 3K, GitLab matches 1500. Leave the company get 9K own money + $2250 USD vested contribution. (4500 * 0.50) Year 4: Put in 3K, GitLab matches 1500. Leave the company get 12K own money + $4500 USD vested contribution. (6000 * 0.75) Year 5: Put in 3K, GitLab matches 1500. Leave the company get 15K own money + $7500 USD (fully vested)
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. 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 will meet quarterly with Betterment to review how the plan is doing as well as updates from the Betterment investment team.
Committee Members: Chair: Principal Accounting Officer (PAO) Other Members:
Gitlab's 401(k) Committee Responsibilities:
Betterment's Responsibilities (co-fiduciary):
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 Discovery Benefits. After your benefit enrollment effective start date, create an account with 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 Discovery or call and they will send one to your home of record.
If you would like to transfer your HSA from a previous account, please contact Discovery Benefits 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 Discovery, and they will get in contact with your old HSA provider and process the transfer of funds. You can reach Discovery Benefits at 866.451.3399. If you would like to adjust your HSA contributions please log into Lumity. HSAs roll over completely year-to-year, and FSAs have a $550 rollover each calendar year.
FSAs are employer-owned accounts. If you leave GitLab, you cannot take FSA accounts with you. You are able to use your full FSA amounts up to and on your last day, but not afterwards. Your FSA benefits stop on your termination date. Discovery Benefits asks that all claims be submitted up to 90 days after termination date. For additional information, please reach out to Discovery Benefits at 866.451.3399.
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 Lumity 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.
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.
Up to 90 days after the plan year has concluded (also known as the runout period).
GitLab offers commuter benefits which are administered through Discovery Benefits. The contribution limits from the IRS for 2020 are $270/month for parking and $270/month for 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.
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 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.
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@ domain and support@lumity.com. Lumity and the Total Rewards team will then help fill in any missing information, if applicable, and Lumity will forward to the carrier for review. Lumity will confirm receipt of the EOI with the carrier, track its status, and reach out to the team member with any issues that need to be addressed in order for the EOI to be approved.
US team members have access to two discount platforms offered through ADP and Lumity. These platforms provide discounts for national and local brands and services.
To access LifeMart through ADP:
To access PerkSpot through Lumity:
The Total Rewards Analyst will review and initiate payment for all monthly health bills in the United States.
ap@gitlab.com for accounting purposes.Based on the Family and Medical Leave Act, or FMLA, US team members are "eligible to take job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the team member had not taken leave." For more information on what defines an eligible team member and medical reason please visit the Electronic Code of Federal Regulation for the most up to date data.
This section will be populated once we have the form from Cigna.
This section will be populated once we have the form from Cigna.
Paternity Leave Paternity Leave is not covered under Short Term Disability, so if the team member is eligible for 100% of pay, payroll would enter 100% of the pay period hours under "Leave with Pay."
Maternity Leave For maternity leave, GitLab will verify 100% of the wages are paid for eligible team members through payroll and Short-term Disability (STD).
Note: Also, ensure the disability is not capped out at the current maximum or that will also need to be supplemented in each pay cycle.
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.
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 Discovery Benefits directly: (866) 451-3399.
Medical
| Tier | UHC HSA | UHC EPO (A/B) | UHC PPO | Kaiser HMO NorCal | Kaiser HMO SoCal | Kaiser HMO CO | Kaiser HMO HI |
|---|---|---|---|---|---|---|---|
| Team Member Only | $371.52 | $497.25 | $496.12 | $502.20 | $502.20 | $625.78 | $481.83 |
| Team Member + Domestic Partner | $813.61 | $1,088.96 | $1,086.49 | $1,159.72 | $1,159.72 | $1,376.71 | $963.66 |
| Team Member + Spouse | $813.61 | $1,088.96 | $1,086.49 | $1,159.72 | $1,159.72 | $1,376.71 | $963.66 |
| Team Member + Child(ren) | $705.88 | $944.76 | $942.61 | $1,024.48 | $1,024.48 | $1,251.56 | $867.29 |
| Family | $1,129.41 | $1,511.63 | $1,508.19 | $1,521.31 | $1,521.31 | $1,877.34 | $1,445.49 |
| Spouse Only | $371.52 | $497.25 | $496.12 | $502.20 | $502.20 | $625.78 | $481.83 |
| Spouse + Child(ren) | $705.88 | $944.76 | $942.61 | $1,024.48 | $1,024.48 | $1,251.56 | $867.29 |
| Child Only | $371.52 | $497.25 | $496.12 | $502.20 | $502.20 | $625.78 | $481.83 |
Dental
| Tier | Cigna DPPO |
|---|---|
| Team Member Only | $38.99 |
| Team Member + Domestic Partner | $77.48 |
| Team Member + Spouse | $77.48 |
| Team Member + Child(ren) | $89.62 |
| Family | $137.49 |
| Spouse Only | $38.99 |
| Spouse + Child(ren) | $89.62 |
| Child Only | $38.99 |
Vision
| Tier | Cigna VPPO |
|---|---|
| Team Member Only | $7.51 |
| Team Member + Domestic Partner | $15.05 |
| Team Member + Spouse | $15.05 |
| Team Member + Child(ren) | $12.74 |
| Family | $21.01 |
| Spouse Only | $7.51 |
| Spouse + Child(ren) | $12.74 |
| Child Only | $7.51 |
This quarterly audit is conducted to ensure the funding of our account used for FSA, DCFSA, and commuter benefit plans according to Accounts Payable matches the amount of claims incurred in Discovery's system.
Ongoing Discovery Audit spreadsheet, add new entries in the report provided by Accounts Payable to the bottom of the table in the "Discovery Payments History" tab.Ongoing Discovery Audit spreadsheet as new tabs.=sumif('March 2020 Funding Detail'!A:A,"Manual Employer Transaction and Adjustment",'March 2020 Funding Detail'!H:H) and you are working on the row for April 2020, change the formula to say =sumif('April 2020 Funding Detail'!A:A,"Manual Employer Transaction and Adjustment",'April 2020 Funding Detail'!H:H).TODO
This quarterly audit is conducted to identify any differences in enrollment between the carrier records and what a team member has elected in Lumity.
TODO
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