Page 6 - 2016 Enrollment
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Eligibility




Eligible Employees
„ Must be a U.S. citizen who works outside of their home country for more
than three months during the year

Eligibility Note „ Must have a valid U.S. Social Security number (SSN)

If you are a U.S. employee and „ Must be paid through the U.S. payroll in order to set up pretax
paid through the U.S. payroll deductions
department: „ Must work more than 30 hours per week


„ Your beneits become Note: Intertek employees who are not U.S. citizens, do not have
effective on the irst day of a valid SSN, and are not paid through the U.S. payroll, will only
the month following your be eligible to enroll in the GeoBlue medical plan. Under U.S.
date of hire regulations, they are not eligible for any other non-medical beneits.

If you are a non-U.S. employee Any beneit deductibles will be paid through the payroll in their home
and are not paid on the U.S. country. However, enrollment forms must be returned to the U.S.
payroll: Intertek Beneits Department to process the enrollment.


„ Your beneits become Enrollment
effective on the irst day of Once you’ve reviewed your choices and conirmed which beneits
the month following your best meet your needs and the needs of your family members, follow
date of hire the instructions below to complete your enrollment process.

„ Please complete the paper 1. Go to www.portal.adp.com.
enrollment form and fax to
the Beneits Department at 2. Click on the Beneits tab and then click on the Enrollment link.

713.543.3799 or via email to 3. Have your beneit decisions and all dependent information
use.beneits@intertek.com including SSNs available.
4. Follow the system prompts to elect the beneits you want (check
Decline Coverage if you do not want a particular beneit).

5. If you want to continue participating in the FSA or HSA program,
be sure to make this election for 2016.

6. Click submit when you are inished. Print your conirmation statement as
proof of your elections for 2016.











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New Hire Enrollment
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