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 November 2, 2020. Your plan will renew January 1, 2021.
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.
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 platform or through the Lumity mobile app: IOS or Android.
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 United Health Care 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 2020-01-01 to 2020-12-31.
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 selecting the "Qualifying Events" tile on the Lumity Dashboard. 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.
To determine your specific plan name, log in to the Lumity system and click "My Benefits" - View Button > Plan Name (e.g. GitLab UHC HSA 2000 + Infertility). The benefits summary that comes up has the network name IN the plan name (for example: Select Plus PPO HDHP / California - Select Plus / HSA - Plan AXEX).
When reviewing the UHC Find a Doctor site, you will get to the Network selection page and select the appropriate network - Select Plus or Select, based on plan enrollment.
Coverages:
In Network:
| Plan Details | UHC - HSA | UHC - EPO** | UHC - PPO |
|---|---|---|---|
| Deductible (Single/Family) | $2,000 / $2,800 | $0 / $0 | $500 / $1,000 |
| OOP Max (Single/Family) | $4,000 / $4,000 | $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 |
| Specialty Drugs | $50 | 20% up to $250 | 20% up to $250 |
| Rx Plan | C2-HSA*** | Rx Plan: 464*** | Rx Plan: 464*** |
** At this time, coverage by the EPO is not available in all states. Where an EPO is not available, an additional PPO plan that is an in-network copayment is available for selection.
*** Due to COVID-19, the following changes have been made to the linked Prescription Drug List:
Please contact UHC for any questions on the above.
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 | $214 | $204 |
| Team Member + Child(ren) | $0 | $164 | $156 |
| Family | $0 | $365 | $348 |
Note: For the team member only HSA, GitLab will contribute $100 per month. For residents of California, Alabama, and New Jersey this additional contribution is taxable on the state level. If you are 55 or older and would like to contribute an additional amount for the HSA catch up, please reach out to support@lumity.com and People Ops at GitLab.
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.
Telehealth services for UHC members can be accessed by signing into MyUHC and selecting "Connect with a Doctor Online." Estimated out-of-pocket cost is disclosed on the virtual visit platform. Beginning October 1, 2020, telehealth visits not related to COVID-19 will be covered according to your plan benefits. COVID-19 visits have a cost-share of $0 with network providers until the end of the National Public Health Emergency.
Sanvello is an app for managing and treating stress, anxiety, and depression. They are owned by the UnitedHealth Group. Any enrollee into a UHC medical plan can access the premium version of the Sanvello app for free.
Instructions for registering:
For in-network services: 90 days from Date of Service.
For out-of-network services: 365 days from Date of Service.
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 | $50 | $100 | $250 | $100 |
| Urgent Care | $20 | $50 | $15 | |
| Hospital Inpatient | $250/admit | $250/visit | $300/admit | 10% |
| Hospital Outpatient | $35/procedure | $35/procedure | $100/procedure | 10% |
| Rx - Deductible | ||||
| Generic | $10 | $10 | $10 | $0 |
| Brand - Preferred | $35 | $35 | $30 | $0 |
| Brand - Non-Preferred | $35 | $35 | $50 | $0 |
| Specialty Drugs | 20% up to $150 | $35 | 20% up to $150 | $0 |
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 | $228 | $228 | $264 | $168 |
| Team Member + Child(ren) | $180 | $180 | $216 | $132 |
| Family | $348 | $348 | $432 | $324 |
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.
Infertility services are provided through the UHC HSA plan. Please consult the legal SBC for more information or reach out to Total Rewards.
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 regards 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.
If you are enrolled in an HSA, FSA, 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.
GitLab offers company paid basic life and accidental death and dismemberment (AD&D) plans through UHC. 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 UHC 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. More information can be found in the UHC Long-Term Disability Welcome brochure and UHC Short-Term Disability Welcome brochure for these benefits.
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 UHC. More information can be found in the UHC brochure for the following benefits: counseling services, help with financial and legal issues, family support, help with relationships, coping and depression.
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):
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.
Currently, many people are experiencing their child care provider having canceled or limited services due to COVID-19 and are unsure how they are going to use the entire amount elected for their DCFSA. Per IRS regulations, this circumstance would permit you to make changes to your DCFSA as the Qualifying Life Event: change in child care or elder care provider, change in cost, or change in coverage.
In order to submit this Qualifying Life Event, you will need documentation such as an email or letter from your child care provider that highlights the canceled or limited services as of a certain date. You can process this by selecting the "Qualifying Events" tile on the Lumity Dashboard and uploading your documentation. Lumity support can be contacted directly with any questions relating to this.
Up to 90 days after the plan year has concluded (also known as the runout period).
If you want extra protection for yourself and your eligible dependents, you have the option to elect supplemental life insurance through UHC:
Certain coverage increases must be approved by the insurance carrier. For more information on completing an Evidence of Insurability, please reference the EOI flier
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.
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.
- General Demographics (page 3): Name, SSN, address, phone number, date of birth, gender and marital status.
- Employment and Claim Information (page 4):
- Date of hire
- Date you first noticed symptoms of illness/injury: When the symptoms of the pregnancy developed
- Date last worked: Due date of birth
- Hours worked that day: 8
- What date do you expect to return to work: Anticipated date of return
- When were you first treated for your injury or illness? First Prenatal appointment
- Have you ever had the same similar condition in the past? Y if you have been pregnant before, N if it is your first pregnancy
- Have you returned to work: n/a
- Your occupation: Your job title
- What parts of your job are you unable to do? n/a
- Please describe the onset and nature of your illness or injury: Pregnancy
- Is your claim a result of illness or accident: N
- Was your injury or illness due to an auto accident? N
- Were you injured at work? N
- Fill out your physician's details and dates of appointments
- Benefits and Earnings Information (page 5): Leave blank
- Tax Information (page 5): Fill out based on your individual tax preferences
- Final Signature and Certification (page 5)
- Review and sign the Disclosure Authorization (page 6)
- Complete the Authorization of Personal Representative section (page 7) if there is someone involved in your care that you would like to be able to contact UHC in relation to your disability claim
- Have your physician complete the Attending Physician's Disability Statement (page 8)
- General Demographics (page 1):
- Employee's Name, SSN, address, phone number, date of birth, gender and marital status
- Employer's name, phone number, employer's address
- Employment and Claim Information (page 2):
- Date of hire
- Last day worked: Estimated last day of work
- Insurance/division: Insurance Class
- Effective date of STD coverage: 2020-01-01 (until policy is renewed)
- Was coverage effective date within the last 12 months? Y
- Occupation: Team member's job title
- List employee's job duties: Add the link to the team member's job responsibilities
- Has employment been terminated? N
- Has employee returned to work? Leave blank
- If yes, return to work date? TBD
- Employee has returned to work in what capacity? Leave blank
- Are you willing to make return-to-work accommodations for the employee if needed? Y
- Was employee injured at work? N
- Benefits and Earning Information
- Does the employee contribute to the STD premium? N
- Is the employee also covered under a LTD or Life Insurance Policy provided by us? Check both LTD and Life
- If yes, do they contribute to the LTD premium? N
- If yes, do they contribute on a PRE or POST tax basis? Leave blank
- How is the employee paid? Add hourly rate if team member is getting paid per hour. If not, add the annual salary next to "Salaried"
- Does the employee eceive other work related income? Add the annual commission amount if team member receives variable pay.
- Is the employee currently receiving or eligible for any other income benefits? Leave blank
- Final Signature and Certification: Stage for signatures via HelloSign
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 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
TODO
TODO
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