Page 21 - GXO 2022 OE Guide-Active

6 Health Savings Account (HSA) eligibility Indicate whether you’re eligible for an HSA.
Not ready to finish yet?
No problem. You can click Save and Finish Later to save your progress and return later. Remember
to come back and finish before the deadline, because your elections won’t be submitted until you complete the process.
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Choose your benefits
Review each benefit section and decide what you want to enroll in or waive. Indicate who you want to cover under each benefit you’re enrolling in for 2022.
Review your beneficiary information
Open Enrollment is a good time to review your beneficiary designations and update them if necessary. If you elect Life Insurance, you must name a beneficiary.
9 Review and confirm your elections
After reviewing your elections, click the blue Complete Enrollment button to confirm them.
Print your confirmation statement and review the reminders about next steps, if applicable.
If you don’t complete the process by clicking Complete Enrollment before the end of the enrollment
period, your elections won’t be saved. See What Happens if I Don’t Enroll? on page 18. 10 Provideverification
If you add a dependent or elect any life insurance benefits that require Evidence of Insurability or other documentation, you’ll see a verification page that shows you what’s required. You can upload required documentation directly to the secure website.
Where can I find coverage costs?
You’ll find medical, dental and vision costs on page 21. Visit https://myGXO.GXO.com and click on Your Benefits to find complete cost information. Keep in mind that you’ll pay more if the tobacco or spousal surcharge applies to you.
Tobacco Surcharge
If you’re a tobacco user, you must pay a tobacco surcharge of $100 per month in addition to the medical plan cost. If you complete the FREE tobacco cessation program through Anthem, you can have this surcharge removed for the remainder of the year.
Spousal Surcharge
If your spouse has coverage available through his or her employer and you still choose to cover your spouse under your GXO medical plan, you must pay a spousal surcharge of $151.66 per month.
How to enroll I 19