Companies may offer benefits like medical, dental, vision, life, or disability coverage. Open enrollment is the period of time each year when eligible employees can enroll in or waive coverage, change plans, and add or remove dependents. It usually starts shortly before the company renews their benefits with the carrier. This article covers what employees need to know about enrollment and what admins need to know about renewing their company’s benefits.
Note: Medical insurance carriers typically update their plans and premiums every year. If you have dental, vision, life, or disability coverage, the plans often stay the same, but the rates might change.
You cannot make changes outside of open enrollment unless you experience a qualifying life event, like marriage, birth of a child, or loss of other coverage. If you do not make changes during open enrollment, your current coverage renews as-is. If you’re not currently enrolled, you’ll stay unenrolled.
If you do not want coverage, you still need to sign in and waive your benefits.
Before you can enroll in benefits, you need to complete and sign your Form W-4 in Gusto. This makes sure we withhold the right amount from your pay.
For help picking a plan, watch this video on plan types, insurance terms, and how to choose the right coverage.
When you’re ready, go to enroll in or waive benefits.
Note: If you’re also an admin, make sure you switch to your employee profile to enroll.
Your open enrollment period usually starts shortly before your company’s benefits renew. We’ll email you when it’s time to enroll. You can also ask your employer or check Gusto for your benefits renewal date.
To see your benefits renewal date in Gusto:
Go to Benefits.
Under Medical, click View.
Look at the coverage period.
The first date is the day that this coverage began.
The second date is the last day of coverage for this plan. The day after that is your renewal date, which is when the changes you make at open enrollment will be effective. Open enrollment starts sometime before this date, so we can process your changes with the carriers.
We invite all eligible new hires to enroll in benefits once they’re onboarded to Gusto, no matter when they start. You’ll have 30 days from your start date to enroll in or waive coverage.
Go to find your health insurance member ID to see when you’ll get your card and what to do if you need care while you wait for confirmation of coverage.
Carriers can take several weeks to process coverage. If they approve coverage after the effective date, this is known as retroactive approval. This means you can submit claims for in-network care you received while waiting for the carrier to approve your coverage.
If your company is switching insurance carriers, make sure you use your new ID card once the new plan takes effect.
Each year, you have the option to renew your current plans or make changes to the carrier, plans, company contribution, or new hire waiting period.
To renew your benefits, go to renew your company's health benefits. For more guidance on preparing for renewal, check out our blog. If you want to start offering commuter benefits or new ancillary coverage (dental, vision, life, or disability), you can set these up in Gusto anytime.
If your benefits are managed by Gusto, we’ll handle your renewal and open enrollment. If you manage your benefits on your own, we’ll email you when it’s time to renew or change them. You can also view your renewal date right in Gusto.
To view your renewal date:
Go to Benefits.
Scroll to Active benefits. The plans listed under “Managed by Gusto” are the plans that we’ll manage your renewal and open enrollment for.
If you have multiple lines of coverage and your company set them up at different times, they may have different renewal dates. We’ll ask you at your next renewal if you want to align the renewal dates.
Under Medical, click View.
On the right are the effective dates.
The first date is the day that this coverage period began.
The second date is the last day of coverage for this period. The day after that is your renewal date, which is when renewal/open enrollment changes will take effect. Open enrollment starts a few weeks prior to this date so we can process your changes with the carriers.
Check out the renewal timeline to learn more about what to expect in the lead-up to open enrollment.
This video covers the open enrollment process and frequently asked questions. Click the links below to skip to specific parts of the video.
When you'll hear from your onboarding advocate and how to contact them
What to expect from the time you select your plan offerings until the insurance carrier confirms your coverage
Deductions and carrier billing
When employee payroll deductions start
Making payments to your insurance carrier
Demo: Find enrollment info in the open enrollment admin dashboard
See your open enrollment dates
Your application checklist and how to upload company documents
Plan details and a cost breakdown
Open enrollment FAQs for admins
Tracking your team's enrollment progress
Why all employees, whether they're enrolling or waiving, need to complete open enrollment
How we notify eligible new hires to enroll
Demo: How to enroll in or waive coverage
For admins, how to enroll yourself in benefits by switching to your employee profile
For employees, how to choose or waive coverage in Gusto
If you're waiving coverage, why selecting a waiver reason is important to your company's benefits application
Viewing your enrollment status, plan details, and carrier contact info
Demo: the employee benefits dashboard
Coverage and deduction details
Carrier contact information
If you experience a qualifying life event, how to change your benefits in Gusto
Demo: the admin benefits dashboard
How to add more benefits
Plan details and carrier contact info
Insurance carriers may need more documents or information to process your application. If so, we'll email you and add the task to your application checklist in Gusto.
Here’s what forms you can expect to submit, based on your company type:
Company type
Tax form to provide
C-corp
Depends on the carrier—we'll let you know what the carrier requests
S-corp
Depends on the carrier—we'll let you know what the carrier requests
LLC taxed as a C-corp
LLC taxed as a partnership
Taxed as a single-member LLC
Since we do not generate your company’s tax forms, ask your accountant if you need help finding them.
If you received a tax extension last year, send last year’s form and a copy of your extension form.
If this task is on your application checklist in Gusto, your insurance carrier needs one or more documents to process your application.
To submit a document:
Go to Benefits.
Under Your new benefits application, click Complete tasks.
Under Application checklist, click Upload documents.
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 a maximum file size of 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 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 resubmit.
We invite all eligible new hires to enroll in benefits once they’re onboarded to Gusto, no matter when they start. They have 30 days from their start date to enroll in or waive coverage.
New hires are not included in the company-wide open enrollment list, but you can view their enrollment status in their employee profile.
If your team hasn’t completed open enrollment by the scheduled end date and there’s enough time before the carrier’s submission deadline, we’ll automatically extend open enrollment. Employees who haven’t finished choosing coverage will keep getting reminder emails.
Carriers can take several weeks to process coverage. If they approve coverage after the effective date has passed, this is known as retroactive approval. This means employees can submit claims for in-network care they received while waiting for the carrier to approve their coverage.
Go to find your health insurance member ID to see when employees will get their card and what to do if they need to access care while you wait for the insurance carrier to confirm coverage. If you’re switching carriers, make sure employees use their new ID card once the new plan takes effect.
If you want to offer other benefits, like dental, vision, life, or disability coverage, you can add it at any time. Sign in to Gusto to see quotes and add plans.
Note: If your team was recently in open enrollment for other coverage, you can see quotes after the current benefits’ effective date has passed.