Pay your insurance carrier

There are two ways that health insurance carriers determine premiums. The first method is called member-level rating and uses the employee’s personal details to determine price on an individual basis. The second is called composite rating and determines price using individual information at the time the plan is established, averages the price for all employees, and locks it in for the duration of the plan year.

Member-level rating

Rates are based on the age, zip code, and in some states, the smoker’s status of the employees and their dependents. For small group insurance, these rates are public, so we can tell you exactly what your premium will be before you enroll.

Composite rating

Rates are calculated based on the average of the rates of all participating employees. This means that we cannot determine exactly what your premium will be until all employees in your company complete open enrollment and their applications are submitted. At that time, the carrier calculates the final composite rates. Once that’s done, we will tell you what your premiums will be for the year.

In some states (like Massachusetts), carriers will calculate four composite rates, which will depend on which (if any) of your family members enrolls:

• Employee only rate
• Employee + spouse rate
• Employee + child rate
• Employee + family rate

In other states (like Washington), some insurance carriers will use just two composite rates. The age of an individual determines which one applies to you:

• Over 21 years old rate
• Under 21 years old rate

Questions and answers

Q: How much will the premium cost for a newly hired employee who enrolls in the middle of the plan year?

A: Depending on the carrier, member-level rating premiums will be calculated either by the member’s age and zip code at the time of their start date or the group’s start date.

Composite rates are locked in for the year based on the average demographics at the time the company began their plan year. New hire employees will have those fixed rates apply until the company renews their contract.

Q: When will I find out how much the premiums will cost with composite rating?

A: Once we hear back from the carrier with the final rate, we’ll let you know. This will be after your group has completed open enrollment and before your start date.

The company contribution is the amount of money that an employer contributes to employee premiums. The company contribution is written into your contract with the insurance carrier and can only be changed during the plan's annual renewal. 

You can find your company's contribution scheme in the Benefits section of your Gusto account. 

Contribution requirements

If you offer benefits with Gusto, we'll make sure that your company's benefits package is compliant with all requirements, including minimum contributions. 

• Carrier requirements: your insurance carrier may require a minimum company contribution for employees (and sometimes dependents). 
• Federal requirements: If you have 50+ employees, your company is likely subject to the employer mandate of the Affordable Care Act, including the "Employer Responsibility" provision. Learn more from the IRS.

Once your benefits are effective, your company will receive premium invoices from your carrier(s). Remember to pay these on or before the due date to avoid the carrier terminating your group plan.

Depending on your company's contribution scheme, if you offer benefits through Gusto we'll make the necessary pre-tax deductions from your employees. If you offer benefits through a third party, you can set up manual payroll deductions. Deductions remain in your company bank account so your company can send the company and employee contributions to the carrier in one lump sum. 

Owner's draw and premium deductions

Because owner's draws are pre-tax, you will not see a deduction appear on an owner's draw paystub. The company is paying for the entire cost of health benefits for an owner and no deductions are necessary.

Once you've set up a health insurance policy for your team, you will receive monthly invoices that you need to pay directly to your carrier. Make sure to pay these invoices by their due date so that you don't risk losing coverage.

As a convenience, for carriers that allow it, we may set up automatic payments on your behalf. If you've connected your bank account using Instant bank verification (IBV) we may send your carrier an electronic funds transfer (EFT) form utilizing the tokenized account number (TAN). 

Select your carrier from the list below for instructions to pay your insurance invoices.

If your carrier isn't listed here, contact them directly for payment info. Once your benefits are set up with Gusto, you can find carrier contact info in the Benefits section of your account. 

Aetna

When you sign up for a new Aetna policy, your first payment is called a binder premium and must be paid by ACH. Future payments can be made by the following methods: 

Online and Autopay	Pay with the Aetna employer portal.  If you haven't registered for the portal yet, you can do so here.  We recommend you use the "Manage eBilling" function to set up automatic payments.
Check	Use the P.O. Box listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your Aetna ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.
Phone	Call (866) 350-7644 and press 1. You will be asked for your billing account number and invoice number, located on the top right of your invoice.

 

Anthem Blue Cross of CA

When you sign up for a new policy, your first payment is called a binder premium and must be paid by ACH.

Online and Autopay

Register online. Click Register to register as an employer. Choose a username, fill out the required information, and submit your registration. Anthem will process your account information and send you an email when your username is unlocked. Once you have successfully gained access to your account, we recommend you set up autopay: Sign in to your employer account.  Click on the Billing tab. Click on the hyperlink that has your group number and group name underlined. Click Schedule Payments on the left and set up your auto-payments.

Check

Use the P.O. Box listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your ABC ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date

Anthem Blue Cross Blue Shield CO (BCBS CO)

If you have any questions about online payments, visit the FAQ page on the BCBS CO website. If you have any additional questions, contact Anthem BCBS CO directly.

Online	Use the P.O. Box listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your BCBS CO ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.
Check	Sign in to your employer account. Click Service Your Account. Click Make Payment/View Billing Information.

Blue Cross Blue Shield IL (BCBSIL)

If you have questions about paying your BCBSIL invoice, visit the payment options page of their website for more details and contact information.

Online	Sign in to your Blue Access for Employers account. Look for the Billing and Payments section and click Pay with Debit Card, which will direct you to the payment screen.
Check	Use the P.O. Box or address listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your BCBSIL ID number on the check or money order. For the payment to process on time, make sure the payment is postmarked 5 days before the payment due date.
Phone	Call the OrbiPay payment line at (844) 642-9414 and have your ID number, bank routing number, and bank account number ready.
In person	Bring a copy of your bill to a MoneyGram. To find a location near you, search for one on the MoneyGram website.

Blue Cross Blue Shield of Texas (BCBS TX)

When you sign up for a new BCBS TX policy, you will pay your first month's premiums by check. If you have any questions about paying your BCBS TX invoice, contact them directly at (888) 706-0583.

Check

Use the P.O. Box listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your BCBS TX ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.

Blue Shield of CA (BSCA)

When you sign up for a new BSCA policy, your first payment is called a binder premium and must be paid by ACH.  

Online and Autopay	Register for the employer portal online. Click Register on the right side of the page. Enter your group number and click Verify. Fill in the invoice information to complete the process. Once you have registered for the employer portal, we recommend you set up autopay. Sign in to the BSCA employer portal. Click Go under "Billing." Click Set up autopayment and follow the instructions.
Check	Use the P.O. Box listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your BSCA ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.
Phone	Call (800) 325-5166 and say "billing and payment."  Certify you are the account administrator. Provide your account number, which is located on the top of your invoice.

CalChoice

CalChoice does not have any online or phone billing options. If you have any questions about paying your CalChoice invoice, contact the CalChoice Customer Service Center at (800) 558-8003 Monday–Friday 8am–5pm, or email them at [email protected].

CoPower

When you sign up for a new CoPower policy, you must remit your first payment by check. If you have any questions about paying your CoPower invoice, contact the CoPower Group Service department at (888) 920-2322.

Autopay	Fill out this authorization form.  Email the form and a voided check to [email protected].
Check	Your payment is due on the first of the month. Make the check out to “CoPower” and include your CoPower ID number. Mail the payment to: CoPower Dept. 34604 P.O. Box 39000 San Francisco, CA 94139

Covered California (SHOP)

If you have any questions about paying your SHOP invoice, call the SHOP Customer Service Center at (877) 453-9198 Monday–Friday 8am–6pm, and 8am–5pm on Sundays.

Check

To pay your SHOP invoice, remit the payment via check before the due date and make your check payable to "Covered California for Small Business." You have two mailing options: U.S. mail: Covered California for Small Business P.O. Box 740167 Los Angeles, CA 90074-0167 Overnight delivery: Bank of America Lockbox Services Lockbox LAC-740167 2706 Media Center Drive Los Angeles, CA 90065

Empire BCBS NY

Online	Visit the Employer Online Billing website for step-by-step instructions and a guide to the Employer Resource Center.
Check	Use the P.O. Box or address listed on your invoice and mail a check directly. Remember to include your group number on the check and make it payable to Empire.

Guardian

If you have any questions about paying your Guardian invoice, contact a Guardian representative at (800) 627-4200.

Online and Autopay

Sign in to your portal. Click Billing. Fill in the invoice information to complete the process. Once you have received your first invoice, you can set up autopay: Search for the form on Guardian Anytime.  Enter the form number: GG-414. Click View beside the Guard-O-Matic Application. Download and fill out the form with the required information. Email the form and a voided check to [email protected]. Include the date you would like the money drafted from your account (usually the due date).

Check

Use the P.O. Box or address listed on your invoice and mail a check or money order directly. Remember to include your Group ID number and Plan Name on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.

Health Net

When you sign up for a new Health Net policy, your first payment is called a binder premium and must be paid by ACH.

Online and Autopay

Register for the Health Net employer portal online. In the top-right corner, click Register. Click I’m an Employer. Enter your group number and request an access key. When your access key arrives, follow the instructions to complete your registration. Once you have registered, we recommend you set up autopay: Click Pay My Bill. Click Manage Payment Profile & Accounts. Click Add Payment Method to add your bank account. Click Set Up Recurring Payments. Click Add Recurring Payment. Complete the steps to complete the autopay setup.

Check

Use the P.O. Box listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your Health Net ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.

Humana

When you sign up for a new Humana policy, your first payment is called a binder premium and must be paid by ACH.

Online and Autopay	Register online. Register as a "new employer." Use the employer portal to pay your monthly bills. Once you have registered we recommend you set up autopay: Sign in to your portal. Click eBilling. Click Change Recurring Payment. Set up automatic payments.
Check	Use the P.O. Box listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your Humana ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.
Phone	Call (888) 505-0132. Identify yourself as the group administrator, and provide your group number and banking info.

Kaiser Permanente (KP)

When you sign up for a new Kaiser Permanente policy, your first payment is called a binder premium and must be paid by ACH.

Online and Autopay	Go to Kaiser's online payment page. Click One-Time Payment. Once you have registered we recommend you set up autopay: Go to Kaiser's online payment page. Sign in or register for an employer portal. Set up the automatic payments.
Check	Use the P.O. Box or address listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your KP ID number on the check. Your Purchaser ID will be listed on your first bill. For the payment to process on time, make sure the payment is postmarked on or before the due date.
Phone	Call the number listed on your invoice.

United Healthcare (UHC)

When you sign up for a new UHC policy, your first payment is called a binder premium and must be paid by ACH.

Online and Autopay	Sign in to your UHC account to pay online and/or set up autopay.
Check	Use the P.O. Box or address listed on your invoice and mail a check or money order directly. Remember to include the payment coupon from your invoice and write your UHC ID number on the check. For the payment to process on time, make sure the payment is postmarked on or before the due date.
Phone	Call (866) 764-7736, and give your group number. Provide your policy number, bill group number, billing zip code, and customer number located on the top right of your invoice.

Because carrier invoices are typically generated 15–30 days in advance, it's common for insurance carriers to take 1–2 billing cycles to remove a dismissed employee.

If you see a dismissed employee on your invoice, pay the full total anyway—you'll receive a credit for the overpayment once the carrier is finished processing the termination. 

If it's been more than 2 billing cycles and the employee is still active on the invoice, contact us from the Help section of your account.