Gateway Pediatric Therapy
nefits Acknowledgment Form for New Hires
Welcome to Gateway! We want your new hire onboarding experience to be as seamless as possible. We know
benefits are important to you, so we’ve prepared the following information to help you understand the actions
you need to take to complete your benefits enrollment.
Benefit Enrollment Notices and Deadline to Enroll
• Your benefits will be effective the first day of the month following 60 days of service.
• You’ll receive an enrollment notice within 7-10 business days from when you are entered into the system
and will have 30 days to enroll.
• It’s important to watch your mail and contact Benefit Service Center if you have not received your
enrollment packet. It’s your responsibility to enroll timely.
Benefits Enrollment and Confirmation
• Enrollment is through BrightSpring’s online enrollment system at www.BrightSrpringBenefits.com or you
may contact the Benefits Service Center at (844) 896-0169 from 9 a.m. to 7 p.m EST.
• You’ll have 30 days to complete your benefit enrollment. If you do not enroll during your enrollment
window, you will not have another opportunity to enroll until the next annual enrollment for benefits
effective January 1, unless you experience a mid-year qualifying event.
• After you submit your benefit elections, you’ll receive a benefit confirmation. We encourage you to print
your confirmation statement and retain it for your records.
• Please allow 10-14 days from completion of your enrollment for your coverage to reflect active with our
insurance carriers. If you need immediate care, you can pay for services out-of-pocket and submit for
• In some instances, back deductions may be necessary due to the timing of your enrollment and our
payroll processing schedules.
• If you miss a deduction due to low or no hours or because you’re on an unpaid leave of absence, you’ll be
responsible for submitting payment to maintain active coverage. You’ll receive a notification from
BrightSpring of your amount due.
• Once you enroll in coverage, you will not be able to drop or make changes to your coverage throughout
the year unless you experience a mid-year qualifying event. Contact the Benefits Service Center for
additional information regarding qualifying events.
Keep BrightSpring Informed of Your Contact Information
It’s your responsibility to keep BrightSpring informed of your personal contact information. You can update your
contact information anytime using Employee Self Service.
By signing this Benefits Acknowledgment Form, you acknowledge that you have fully read and understand the
timelines and action required to enroll in BrightSpring benefits.
Employee Name: ________________________ Signature: _____________________________ Date: _________