Enroll in or waive benefits
This article is for employees who need to enroll in or waive their company benefits in Gusto.
If you’re eligible for benefits that your company offers through Gusto, you can view and manage your health plans on the Benefits page of your account. This includes plans for broker integrations.
If you’re a new hire or your company is in open enrollment, we email all eligible employees when it’s time to enroll in benefits or waive them. Each employee must complete their own enrollment or waiver in Gusto. Admins cannot submit enrollments for you.
Opting out of coverage is also known as waiving. If you do not want your company’s coverage, you need to sign a waiver in Gusto. Insurance carriers track why people waive coverage. They call these waiver reasons. Waiver reasons affect your company’s eligibility for coverage.
Choose carefully. You can only change your coverage if you’re newly eligible, during open enrollment, or when you have a qualifying life event.
If you’re a benefits-eligible employee, here's how much time you have to choose plans in Gusto, depending on your enrollment window.
New hire enrollment
After your company admin finalizes your Gusto account, you can start choosing plans on or after your start date.
You have until 20 days after the coverage effective date to enroll.
Example: If you were hired on January 3 and your company's new hire waiting period is “First of the month following hire,” your benefits would start on February 1. You’d have until February 20 to enroll.
Open enrollment
Open enrollment starts around your company’s annual renewal date.
You’ll typically have about a week to choose your coverage.
If you need to change your enrollment selections, you can do so in your Gusto account through the last day of open enrollment.
Qualifying life event
Outside of new hire or open enrollment, you can only change your coverage if you have a qualifying life event (such as the birth of a child or getting married).
You must submit your qualifying life event within 30 days of the event.
Change an enrollment or waiver you’ve recently submitted
Contact us if you need to make changes to an enrollment or waiver you’ve already submitted within 30 days of your coverage effective date. To contact us, sign in to your Gusto account and click the help icon 
in the top-right corner of the page. We’ll determine if you can change your plan or dependent enrollment.
If it’s been more than 30 days since your coverage started, your next chance to make changes is during your company’s next open enrollment or if you have a qualifying life event.
If you’re eligible for benefits and want to enroll, complete the enrollment process in Gusto.
To enroll in benefits coverage:
Step 1: Get started
Go to Benefits.
If you’re an admin, make sure you’re in your employee profile.
If you do not see this in your left menu, your company may not offer benefits through Gusto, or you may not be eligible for benefits. Contact your employer for next steps.
In the tile at the top of your Benefits page, check your selection deadline, then click either Enroll or Waive.
If you do not see this tile: Your enrollment deadline may have passed. Check the Benefits enrollment deadlines section of the article or ask your company admin to find out if you’re eligible.
Click Get Started!.
You may be asked what matters most to you in a health plan and who you'd like to cover. We'll use this to recommend plans.
Step 2: Verify your information
Verify your info for the insurance carrier’s records and enter your dependents’ information. If you’re waiving coverage, you’ll do so on the next page.
Verify your personal info.
If anything is incorrect, reach out to your employer to make changes.
To review your dependents, scroll to Your dependents.
You’ll see all dependents here, whether or not you’re enrolling them. You’ll enroll or remove them from benefits on the next page.
If any dependents have aged out of eligibility for coverage, you’ll see them under a section called Ineligible for coverage.
To add a dependent to the Your dependents list:
Find the Add a new dependent tile and click Add dependent.
Enter their personal information and click Save.
To add more dependents, click Add dependent again.
To remove a dependent from your list of dependents:
Click Edit.
Click Remove. (If this does not work, go to the next page, where you can remove the dependent from coverage.)
Click Save & continue.
The next page lists each type of benefit that your company offers. When you click Enroll or Waive, you’ll see the plan options and pricing for each benefit.
Step 3: Choose or waive medical coverage
On the Medical tile, click either Enroll or Waive.
If you do not want to enroll, scroll to Waive Medical Coverage and click Waive.
Select the dependents you’re enrolling in this plan.
Check the box next to each dependent you’re enrolling.
Click the box again to uncheck it and exclude that dependent from this plan.
Review all the plans and consider which benefits and premiums fit your needs for the next year.
Need help choosing? Watch this video about plan types and insurance terms.
Cost: “Your cost” shows how much comes out of each paycheck. Hover over the i icon to see the total monthly premium and your company’s contribution.
Coverage: Click View full plan details to review each plan’s Summary of Benefits (SBC). This shows what you’d pay for common services.. For info, check out the SBC guide or call the carrier.
Click Select on the plan you decide on.
Click Save & continue.
Step 4: Choose or waive the remaining lines of coverage
If your employer offers other types of benefits, click Enroll or Waive and repeat the above steps for each.
Short-term disability, long-term disability, and life insurance: The insurance carrier automatically enrolls you in these plans because your company pays 100% of the premiums. Dependents are not eligible to enroll.
Step 5: Review your selections and understand the cost summary
Once you’ve enrolled in or waived each line of coverage, check that each line of coverage reflects your choices.
Click View Enrollees for each benefit to see who you’re enrolling in the plan.
Review the cost summary.
Total Cost of Benefits: The total premiums per pay period for each line of coverage you selected and each dependent you enrolled (if any).
Employer’s Contribution: The portion of the total cost that your company is paying for you each pay period.
Your total cost: The amount that comes out of each of your paychecks. Hover over this number to see your company’s pay period schedule.
Click Save & continue.
Step 6: Add waiver reasons and extra info
If you’re waiving coverage: The insurance carrier asks for the reason to make sure your company meets their participation rules. Check out the Waive benefits coverage section of the article for more info.
Answer the questions on the Add Extra Information page.
Click Save & continue.
Step 7: Review and confirm your selections
Review each line of coverage. Make sure your plan choices and dependent enrollments are correct.
To make changes, scroll to the bottom of the page and click Back.
Scroll to Forms you need to sign.
Click Sign form beside each form.
To review a form, click on its name to open it in a new tab.
Draw your name in the signature field and check the box where it says “I agree to electronically sign this form.”
Click Sign.
Once you’ve signed each form, click Confirm selections.
What comes next
Submission to the carrier:
If Gusto's your broker, we’ll prepare your paperwork and send your selections to the health insurance carrier.
If your company uses the broker integration, we’ll let your broker know to submit your selections to the health insurance carrier.
Enrollment status: You can view the status of your enrollment from the sticky note on your Benefits page.
Member ID and accessing care: Once the carrier processes your coverage, they’ll mail you your member ID card. If you need to go to the doctor before your ID card arrives, check out this article.
Follow these steps if your company is currently in open enrollment with Gusto and you want to opt out of coverage. You need to sign your waiver in Gusto because insurance carriers track why people opt out (also known as waiver reasons). Waiver reasons affect your company’s eligibility for coverage.
If your company is not in open enrollment, but you have a qualifying life event, follow these steps to cancel coverage.
Health insurance carriers require a certain percentage of employees to enroll in a company’s health coverage. If someone declines coverage for a valid waiver reason, it does not affect the participation requirement.
Most carriers accept these valid waiver reasons:
Other group coverage through a different employer
Other group coverage through a spouse or parent
Enrolling as a dependent in your employer’s group health plan
Coverage through Medicare
Coverage through Medi-Cal
Coverage through Tricare
Note: Most carriers do not consider having individual health insurance a valid waiver reason.
How carriers calculate participation
Health insurance carriers require a minimum percentage of all eligible employees to enroll in the employer-sponsored health benefit plan. If an employee declines coverage for a valid waiver reason, the carrier excludes them from the total employee count and does not count them against the participation requirement.
You can waive coverage as a new hire, during open enrollment, or after a qualifying life event.
To waive benefits coverage:
If you’re an admin, make sure you’re in your employee profile.
Go to Benefits.
If you do not see this in your left menu, your company may not offer benefits through Gusto. Contact your employer for next steps.
In the tile at the top of your Benefits page, take a look at your selection deadline, then click Enroll or Waive.
The next page lists the benefits that your company offers and the date coverage would begin. Click Get Started!.
Verify that your personal info is correct. If it’s incorrect, reach out to your company admin to make changes before continuing.
To view pricing for dependents before waiving: Click Add dependent and enter their personal info. You can still waive coverage in the next steps.
Click Save & Continue.
The next page lists each benefit that’s available to you. Click Enroll or Waive for the first benefit you’re waiving.
If your company offers life or disability coverage, the carrier automatically enrolls all employees because the company covers 100% of your premium for this benefit.
Scroll to the bottom of the Benefits page and click Waive.
Click Save & continue.
Once you’ve waived each benefit, click Save & Continue.
Provide a reason for waiving coverage.
The carrier needs your reason to verify that your company meets their participation requirements.
If you have existing coverage outside of your employer’s options, you may be asked to provide the name of the insurance provider and your member or subscriber ID. You can find this on your insurance card. Contact your insurance provider online or by phone if you cannot find your ID information.
Answer the questions on the Add Extra Information page.
Click Save & Continue.
Review each line of coverage to make sure your selections are correct.
To change any enrollments, scroll to the bottom of the page and click Back.
Scroll to Forms you need to sign and click Sign form beside each form.
To review the form, click its name to open it in a new tab.
Draw your name in the signature field and check the box where it says, “I agree to electronically sign this form.”
Click Sign.
Once you’ve signed each form, click Confirm selections.