This article is for admins who want to offer health benefits like medical, dental, vision, disability, or life insurance through Gusto.
Note: To offer other benefits like dental, vision, life, disability, and tax-advantaged accounts through Gusto, you need to first offer medical coverage through Gusto. That coverage must stay active. Depending on the carrier, an active policy typically needs at least one enrolled employee.
You can also set up tax-advantaged accounts, including a Health Savings Account (HSA), flexible spending account (FSA), dependent care flexible spending account (DCFSA), and commuter benefits.
As your insurance broker, we'll help you build a benefits package, run open enrollment for your team every year, automate your payroll deductions, and manage your team's benefit enrollments and terminations.
If you already offer benefits through another broker and you'd like Gusto to automate your payroll deductions and manage your team's enrollments, you can transfer your broker of record. You can also set up manual payroll deductions for benefits you offer outside of Gusto.
We currently support benefits in all 50 US states and Washington, D.C.
Supported benefits
Medical insurance
Dental insurance
Vision insurance
Employer-paid life insurance
Employer-paid short-term disability insurance
Employer-paid long-term disability insurance
Health flexible spending account (FSA)
Dependent care flexible spending account (DCFSA)
Health Savings Account (HSA)
Commuter benefits
Follow the steps below to view quotes and choose the plans you'd like to offer your team. After you choose medical plans, you can view quotes for dental, vision, life, and disability coverage, or choose from tax-advantaged benefits like a Health Savings Account, flexible spending account, dependent care account, or commuter benefits.
Once you choose plans and sign forms, we'll set up open enrollment. Eligible employees will get emails when it's time to choose or waive coverage in Gusto.
Follow the steps below to view quotes right from Gusto.
To start viewing quotes:
Go to Benefits.
If you cannot find this, make sure you're in your admin account and have benefits permissions.
Click Health Benefits.
Choose Explore new plans.
If you already offer benefits, click I already have benefits and click here for next steps.
Under Explore Plans, click See Price Quotes.
To speak with a licensed benefits advisor, click Schedule a Call.
We partner with multiple nationwide carriers. Our licensed benefits advisors can help you select the best options for your team.
Review your company information
Start by reviewing what's below Your company information. Here's each item and what it means:
Eligible employees: This is how many people we'll include in quotes and estimates of your company's costs. Click Edit to change whether part-time employees are included in the quotes.
Business owners: If any owners or officers of your company are not on payroll but may want to enroll in coverage, click Edit and enter their information. We'll create a Gusto profile for them so they can participate in open enrollment.
Dependents: Click Edit to add or remove any dependents from the quotes.
Company contribution: The percentage of employee or dependent premiums your company will pay for. Click Edit to change this percentage.
Coverage start date: The date your benefits will begin. Click Edit to view other start dates that may be available based on the carriers' application deadlines.
Main company location: The main company address determines which carriers your company may be eligible for.
Browse and personalize health benefit plans
You can personalize your plan recommendations or browse all available plans.
To view recommended plans:
Click Personalize plans.
Complete the brief survey.
Click See recommendations. Based on your preferences, we'll add recommended plans to the top of the page.
To change your survey responses, click Edit plan preferences.
To browse all plans:
Scroll to All Insurance plans to view more options.
Filter by carrier, premium cost, plan type, and more.
Click View full details to review a plan's Summary of Benefits and Coverage (SBC). Check out our guide to reading an SBC.
Understand the base plan for health benefits
The first plan you add becomes the base plan. If you offer more than one medical plan, we use the base plan to determine the company's contribution toward employee health insurance.
For example, if you choose a Silver plan as the base, set your contribution at 75%, and also offer Bronze and Gold plans, here's what happens: If an employee picks a more expensive Gold plan, the company still only pays 75% of the Silver plan. The employee pays the rest. If they pick a cheaper Bronze plan, the company's 75% of the Silver cost might cover most of it.
Add health benefit plans
Once you review your options and understand how the base plan works, you can start adding plans.
To add plans:
When you find a base plan you like, click Add plan.
If you get an error message when adding more plans, your chosen carrier may have a limit on the number of plans you can offer.
If you want to change the base plan, remove each plan you added. Find the plan you'd like to set as the base and add it first. Then, add the other plans.
Once you add the plans you want to offer at open enrollment, click Save and continue.
If you click Leave and finish later, your progress saves.
To view a PDF of the company and employee costs for the plans you added so far, scroll to the bottom of the page and click Download employee cost breakdown.
Add quotes for other types of benefits
After you add your medical plans, you can view quotes for other types of coverage.
To add other types of benefits:
Find the type of coverage you're interested in, then click Add plan.
When you finish choosing plans for each type of coverage you'd like to offer, click Save and continue.
Clicking Exit and continue later saves your progress.
Note: These quotes are estimates until you confirm employee eligibility details. The estimated costs represent the maximum you would pay if all employees on payroll enroll. You can edit enrollee details in the next step to get a more accurate quote before submitting your benefits application.
Let us know who will be eligible for benefits.
To confirm employee eligibility:
Under Employee coverage, choose whether you're offering benefits to all full-time employees or to all full-time and part-time employees.
The Affordable Care Act (ACA) defines a full-time employee as anyone working 30 or more hours per week, though state rules may vary.
In the Enrollee eligibility information section, choose each employee's average number of hours worked and ownership status.
To update multiple employees at once: Click the checkbox next to either Select all or the names of each person you'd like to edit. Click Actions. Choose either Edit avg. hours worked or Edit ownership status. Choose the status that applies and click Save.
If any owners or officers who may want to enroll in benefits are not listed here: Click Add an owner. Fill out their name, email, date of birth, and work location, then click Save. This creates a Gusto profile for them so they can participate in open enrollment.
Click Save and continue.
Clicking Exit and continue later saves your progress.
Next, you'll choose a waiting period and provide more company information for your application.
To enter your company info:
Select the waiting period for newly eligible employees.
The dropdown includes all the options your carrier offers.
Choose whether you want to waive the waiting period for this open enrollment period.
Selecting Yes means that any newly eligible employees can enroll in the new coverage at the same time as the rest of your team.
Identify whether your company files taxes as an S-Corporation.
If yes, choose whether to turn on 100% company contributions for the premiums of 2% or more shareholders and their dependents. This setting is available because there are tax implications for S-Corp shareholders' benefit premiums. Contact your accountant for advice.
Let us know the status of your company under your state's Secretary of State.
Select the date your business was established.
Click Save and continue.
Clicking Exit and continue later saves your progress.
Review your plan selections and company contribution for each line of coverage you selected.
To review and submit:
If you'd like to add any other types of benefits, scroll down to the Add additional lines of coverage section. Find the benefit you'd like to view quotes for and click the link in the tile.
If you add a new benefit type, we may ask you to provide more information about your company to better support your business.
Scroll down to the Sign required documents header. Click Sign form beside each listed document.
Check the acknowledgment checkbox for the Terms of Service and Compensation and Fee Disclosure.
Click Submit application.
Clicking Exit and continue later saves your progress.
We'll review your application and contact you with the next steps and the timing of open enrollment. Check your email for next steps and any tasks to complete on the application checklist. Once it's time for your team to sign in to Gusto and choose or waive coverage, we'll email all eligible employees.
Note: There's no guarantee the insurance carriers will approve your application. We'll send updates throughout the process.
The insurance carriers may request more documents or information to process your application. If so, we'll email you and add the task to your application checklist in Gusto.
To view outstanding tasks:
Go to Benefits.
Under Your new benefits application, click Complete tasks.
Items that require your action appear under Application checklist. Click the name of any task to start it.
Your checklist may include different types of tasks depending on what the carrier needs. Here are the tasks you may come across and how to handle them.
Provide info for [carrier name]
If this task is on your checklist, your insurance carrier needs more information to process your application. This could include details about employee absences or your workers' comp policy.
To complete this task, click Start next to the task, then follow the prompts to submit information.
Upload documents
If this task is on your checklist, your insurance carrier needs one or more documents to process your application.
To submit a document:
On the checklist, click the Upload documents task.
Click Upload document.
Click Select File to choose the document, or drag and drop your file.
You can upload a .jpeg, .jpg, or .png up to 20 MB.
Click Upload.
The Status column shows whether the document has been uploaded or accepted:
Requested: We're waiting on you to upload the document.
Pending review: We're verifying that the document meets the carrier's requirements.
Accepted: The document is good to go.
Rejected: The document does not meet the carrier's requirements. Check the notes and resubmit.
Once you set up benefits with Gusto, here are a few things to know about managing them going forward.
Check your mailbox for your ID card
The insurance carriers send ID cards directly to each enrolled person. They typically arrive 7-10 business days after the benefits start date, though some carriers take longer. Learn how to find your ID numbers and what to do if you need to go to the doctor before your card arrives.
Pay your carriers on time
Pay your invoice directly to your insurance carrier(s). We do not make invoice payments on your behalf. Read about how the funds move with payroll deductions and check out our carrier-specific steps to pay your carrier.
How we handle your enrollments and deductions
All you need to do is keep your teams' employment details up to date in Gusto. Whenever you make changes, like hiring and dismissing employees or changing them from part-time to full-time, we automatically handle their benefits and payroll deduction changes.
Here's what to expect:
New hires: After their new hire waiting period is complete, we email eligible new hires when it's time to sign in to their account and enroll in benefits. You can estimate your new hire's benefits cost even before their coverage starts.
Employment changes: If someone's employment status changes, make sure to update it. If they're newly eligible for benefits (for example, if you change their status from part-time to full-time), we invite them to enroll in coverage after their benefits waiting period is complete. If the change makes them ineligible for benefits (for example, they went from full-time to part-time), we let the carrier know to remove them from coverage. Read more on eligibility.
Class changes: If you offer different company contributions to different types of employees, and an employee changes classes, update their class in Gusto:
Go to People.
Choose the employee.
Then, go to their Job tab.
Under Employment status, click Edit to set or change their class.
If this changes the company contribution they can receive, we'll email them with the next steps to make any plan changes if desired.
If their class changes from benefits-eligible to benefits-ineligible, their coverage will be canceled.
If they're newly benefits-eligible with this change, we'll email them and invite them to enroll if desired.
Dismissals: When you dismiss an employee, their benefits are terminated, and we'll send them COBRA information. Here's more info on termination payrolls and how final deductions work.
Qualifying life events: If an employee experiences a life event that qualifies them to change their coverage, they can submit enrollment changes in Gusto. They must submit their request within 30 days of the event.
Find benefit information
To find details about your company benefits package, download a Summary of Benefits, add new lines of coverage, or view deductions, contributions, enrollment, and more, go to the Benefits section of your admin account.
For questions about claims and coverage, contact your carrier directly.
When to expect renewal and open enrollment
When your company benefits are up for renewal (a year after they begin), we'll reach out to you to understand how the plans worked for your team and help you choose your benefits package for the next year. Then we'll run a new open enrollment for your team.