If your company offers health insurance with Gusto, start here with your benefits questions. As your broker and payroll system of record, we're here to help with enrollment and deduction questions. When it comes to carrier-specific questions including premium payments and what's covered, you can find your carrier's contact info in the Benefits section of your Gusto account.
To set up or add benefits to Gusto, you can get started right from your admin account.
Setting up insurance benefits for the first time? See quotes and apply for small group health insurance from your admin account.
Some carriers require proof of workers' compensation on your application—check out workers' compensation requirements by state.
If you offer medical insurance with Gusto, you can add more benefits anytime. Click your desired line of coverage below for next steps:
Already offer insurance and want Gusto to be your broker? Transfer your company's benefits to Gusto.
Want to automate your payroll deductions and let employees enroll in benefits right from Gusto while keeping your existing broker? Set up the broker integration.
Check out our guide to open enrollment to learn about timing, how to enroll, required tax forms, and more. You can also watch an open enrollment webinar that includes enrollment demonstrations and answers to your most important coverage questions.
Check out our complete guide to open enrollment for answers to frequently asked questions (including how to enroll in or waive coverage, how admins and owners can enroll, ID card info, and more).
When your company is in open enrollment, admins can contact their dedicated onboarding specialist with any questions.
If you're on owner's draw and want to enroll, set up an employee account and classify the employee as an owner so you can participate in the company's benefits package. This lets the owner access benefits information and participate in annual open enrollment through their Gusto account.
If you're an admin: make sure to switch to your employee profile so you can choose coverage for yourself.
Eligible new hires can start choosing benefits while onboarding. If your company has a new hire waiting period, benefits may start up to 90 days after your first day of work—look for the "Coverage effective date" in your Benefits tab to see when your benefits will start.
If you need help choosing coverage, check out these resources:
The insurance carriers only let employees enroll, waive, or change plans when they're newly eligible, during open enrollment, or if they experience a qualifying life event.
If you or an eligible dependent have experienced a qualifying life event (such as losing or gaining other coverage, getting married, or having a baby), you can change your benefits in Gusto.
After an employee leaves the company or changes from full-time eligible to part-time/ineligible, their last day of coverage depends on your company's termination policy. It's often the last day of the month that they left the company or became ineligible—admins can find the termination policy in the Benefits section of your admin account.
Heads up for your insurance invoice: the insurance carrier may take a couple billing cycles to process someone's termination of benefits. If you see a dismissed employee on your company insurance invoice, continue to pay the full amount. You'll see a credit applied within one or two billing cycles.
If your company is subject to COBRA or state continuation, a dismissed employee will receive an email with their coverage options and next steps 3 days after their last day of work. This also applies to employees who lost coverage as a result of moving from full-time/eligible to part-time/ineligible.
Remember: if you don’t want to enroll in continuation coverage, you can also shop plans on the individual market. If you’re eligible, you can also enroll as a dependent on a spouse or parent’s existing plan. The termination of your current coverage is a qualifying life event that allows you to enroll outside open enrollment.
Check out the links below for answers to frequently asked questions about using your coverage.
Employees have several resources when it comes to understanding insurance terms and what your plan covers:
Employees can manage medical, dental, vision, life, and disability claims directly with their insurance carrier. Sign in to your member portal or call your carrier for filing instructions or any other claims information. You can find your carrier's phone number on the back of your ID card or in your Gusto Benefits section.
If you have an HSA, FSA, DCFSA, or commuter benefits, you can manage claims through your Gusto Benefits Card Manager.
If you're planning to hire a benefits-eligible, admins can estimate their benefits cost in Gusto.
Eligible new hires can see quotes and choose plans when onboarding to Gusto.
Once an employee enrolls in benefits through Gusto, we'll automatically collect their contributions through payroll deductions. Deducted funds remain in the company bank account for admins to pay directly to the insurance carrier.
When someone enrolls in benefits, their payroll deductions will begin after the carrier has processed their coverage and once the benefits are effective. You can find your enrollment status in the Benefits section of your Gusto account. If the carrier confirms your coverage after the benefits are effective, we'll apply deduction corrections.
If someone's enrollment change is processed after your company runs payroll for that pay period, we’ll apply corrections to upcoming payrolls to make sure the missed amounts are caught up.
Benefits admins must pay your company's insurance carriers on time and keep your employees' employment statuses up to date in Gusto. At the end of your plan year, we'll email benefits admins when it's time to start the renewal and open enrollment process.
Once your benefits are effective, you'll receive monthly premium invoices from your carriers for the total cost of your company's coverage. Remember to pay these on time to avoid the carrier terminating your group plan. Invoices are distributed differently by each carrier but you can expect them to be sent monthly, either by email or snail mail.
Check out this article to learn about how benefit deductions and premiums move, how to send payments to your carrier, and more.
If an employee changes from part-time to full-time, or from full-time to part-time, update their employment status. If the change affects their benefits eligibility, we'll invite them to enroll or let their carrier know they've become ineligible for coverage. For ineligible employees, check out the "Dismissals and loss of eligibility section" above for more info.
When an employee leaves the company, we'll terminate their benefits after their dismissal date. Check out the "Dismissals and loss of eligibility" section above for more info.
Your company's insurance plans renew once a year. This is when the insurance carriers update their plans and rates, benefits admins can change the company offerings (add, change, or remove plans; change the company contribution or new hire waiting period), and when employees go through open enrollment.