Offer health benefits to your team

Gusto currently supports benefits in all 50 U.S. states and D.C.

Supported benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Employer-paid life insurance
• Short-term disability insurance
• Long-term disability insurance
• Health Flexible Spending Account (FSA)
• Dependent care Flexible Spending Account (DCFSA)
• Health Savings Account (HSA)
• Commuter benefits

Admins can add new lines of coverage anytime in Gusto. If you want to offer dental, vision, life, or disability insurance, or a tax-advantaged account (HSA, FSA, DCFSA, or commuter benefits), you must first offer Gusto-brokered medical coverage.

Follow the steps below to see quotes and choose the plans you'd like to offer your team. Once you choose plans and sign forms, we'll set up open enrollment. Eligible employees will receive emails when it's time to choose or waive coverage in Gusto.

Step 1: Get started 

Follow the steps below to see quotes right from Gusto. You can choose from medical, dental, vision, life, or disability insurance, as well as tax-advantaged accounts (HSA, FSA, DCFSA, or commuter benefits).

1. Sign in to your Gusto admin account.
2. Go to the Benefits section.
   • If you don't see this, make sure you're in your admin account and have benefits permissions. 
3. Click Health Benefits.  
4. Choose No, we want to offer new benefits, then click Next.
   • If you already offer benefits, click Yes — we currently offer this benefit. You’ll be able to integrate your current benefits with Gusto on the following page. 
5. Under "Explore Plans," click See Price Quotes.
   • To speak with a licensed benefits advisor, click Schedule a Call. 

Step 2: Build your benefits package

Start by selecting your medical plans. After you choose medical plans, you can view quotes for dental, vision, life, and disability coverage. We partner with multiple nationwide carriers and our licensed benefits advisors are available to help you select the best options for your team. You'll also have the option to offer tax-advantaged benefits like a Health Savings Account, Flexible Spending Account, and commuter benefits. 

1. Review your company information, including employee count, contribution, coverage start date, and company location. We’ll use these factors to determine which insurance carriers you are eligible for.
   • To help you predict costs, under "Eligible employees" you can add the number of eligible employees, business owners, and dependents that your team might have.
   • To adjust the company contribution, click Edit.
   • Your “Coverage start date” is the earliest start date available based on the carriers’ application deadlines.
2. Click Get more personalized plans to fill out a brief survey. This helps Gusto select plans based on your preferences. After completing your survey, your recommended plans will be shown at the top. Scroll to “All insurance plans” to see more. In this section, you can filter by carrier, premium cost, plan type, and more. 
3. Review the plan options and premiums to choose your base plan. 
   • Click View full details to review the Summary of Benefits and Coverage (SBC) of each plan. Check out our guide to reading an SBC.
4. When you’ve found a base plan you like, click Add plan. 
5. Decide if you want to offer more metal tiers to your team. Click Remove plan or Add this plan to make changes.
   • Having a base plan means your company costs will stay the same regardless of which plans your employees enroll in. For example: you chose the Silver tier for your base plan and set the company contribution as 75%. If an employee enrolls in the higher-cost Gold plan, the company will only pay 75% of what their Silver premium would be, and the employee will pay the difference. If an employee enrolls in a Bronze plan, the company contribution of 75% of their Silver premium will go further toward the lower-cost Bronze premium. 
6. Click Save & continue.
   • On the next page, scroll to Download employee cost breakdown for a PDF with employee and company costs for each plan you chose. 
7. To see quotes for other benefits, click Add Plan for the coverage you're interested in.
8. When you're finished selecting plans, click Save & continue.

Note that 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. 

Step 3: Tell us about your team

In order to generate quotes, let us know who will be eligible for benefits.

1. Decide whether you're offering benefits to all full time employees, or to all full time and part time employees. The ACA defines a full time employee as anyone working 30+ hours/week, though state rules may vary.
   
   • If you want to offer benefits to all part time employees: Toggle to Full-time and part-time employees in the employee coverage section. 
2. Confirm which employees are eligible for benefits, including any owners who may need benefits but are not on payroll.
3. In each row, review the employees’ average hours worked (full-time/part-time/variable/seasonal) and their ownership status (owner/spouse of owner/non-owner).
   • Use the “Select all” checkbox to make changes to multiple employees at once.
4. Next, tell us about any missing owners. If there are owners or officers in your company who are not on payroll but may want to enroll in benefits, click Add an owner. We'll create an employee account for them so they can participate in open enrollment.
5. Click Save & continue. 

Step 4: Add company info

Next, you'll choose a waiting period and provide some more company information for your application. 

1. Select the waiting period for new hires. 
   • The drop-down includes every option that your carrier offers.
2. Choose if you want to waive the waiting period for this open enrollment period.
   • Selecting "Yes" means that if there are any recent hires, they can enroll in the new coverage at the same time as the rest of your team. 
3. Indicate if you have worker’s compensation insurance. If you don’t, click here to start one. 
4. Identify whether your company files taxes as an S-Corporation. 
   • If yes, select if you want to enable 100% company contributions for the premiums of 2%+ shareholders and their dependents. This setting is available because there are tax implications for S-Corp shareholders' benefit premiums. Contact your accountant for advice. 
5. Let us know the status of your company under your state’s Secretary of State.
6. Select the date that your business was established.
7. Click Save & continue. 

Step 5: Review and sign forms

1. Review your entire benefits package to make sure you’ve selected the right offering for your team.
2. Scroll down to the "Sign required documents" header. Click Sign Form beside each document listed.
3. Check the acknowledgment box for the Terms of Service and Compensation and Fee Disclosure.
4. Click Submit Application.

Our team will review your application and contact you with next steps. An open enrollment specialist will email you to confirm open enrollment timing. Then, your team will receive emails when it's time to sign in to Gusto and choose or waive coverage.

Any tasks you need to complete are listed in the application checklist, found in the Benefits section of your admin account. Tasks can include answering survey questions and uploading documents. Please complete these tasks as soon as possible to prevent delays in coverage. 

Note: There's no guarantee the insurance carriers will approve your application, but we’ll keep you posted 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.

View the application checklist

Here's where to view outstanding tasks:

1. Sign in to your Gusto admin account.
2. Go to the Benefits section.
3. Under "Your new benefits application," click Complete tasks.
4. Items that require action from you are listed under "Application checklist." Click the name of any task to start it.

Complete tasks on the checklist

Here are tasks the checklist may include and how to handle them.

Provide info for [carrier name]

If this task on your checklist, your insurance carrier needs some more information to process your application. This could include details about employee absences or your workers’ comp policy.

For a "Provide info" task, click Start next to the task and 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. Here's how to submit a document:

1. On the checklist, click the Upload documents task.
2. Click Upload document.
3. Click Select File to choose the document, or drag and drop your file.
   • You can upload a .jpeg, .jpg, or .png up to a maximum file size of 20 MB.
4. Click Upload.
5. 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 taking a look to make sure the document meets the carrier’s requirements.
   • Accepted: The document is good to go.
   • Rejected: The document does not meet the carrier’s requirements. Take a look at the notes and re-submit.

Once you set up benefits with Gusto, here are a few things to know about your benefits management 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. Head here for other options to find 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). Gusto does 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. 

Gusto handles all of your enrollments and deductions

All you need to do is keep your teams' employment details up to date in Gusto. Whenever you make changes (such as hiring and dismissing employees, or changing them from part-time to full-time), Gusto automatically takes care of their benefits and payroll deduction changes. What to expect:

• New hires: After their new hire waiting period is complete, Gusto emails 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 changes, be sure to update their employment status. If they're newly eligible for benefits (e.g. if you change their status from part-time to full-time), they're invited to enroll in coverage after their benefits waiting period is complete. If the change makes them ineligible for benefits (ex. they went from full time to part-time), Gusto lets the carrier know to remove them from coverage. Read more on eligibility here.
• Class changes: If you offer different company contributions to different types of employees, and an employee changes classes, update their class in Gusto:
  • Click the People section.
  • 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 next steps to make any plan changes, if desired.
    • If their class changes from a benefits-eligible class to a benefits-ineligible class, their coverage will be canceled.
    • If they're newly benefits eligible with this change, we'll email them inviting 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, head 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), Gusto will reach out to you to understand how the plans worked for you and help you choose your benefits package for the next year. Then we'll run a new open enrollment for your team.