Medical, Dental, and Vision (Employer)
Who is eligible for benefits?
All full-time employees, certain owners, and any part-time employees working on average at least 30 hours of service per week are eligible for benefits. To set the standard hours for a part-time employee, navigate to the “Change Employment” screen of the employee profile.
When is our plan year?
Justworks’ plan year is November 1 – October 31.
The company will have the opportunity to change the plans made available to employees and/or employee contribution levels every Fall during the company plan selection process.
All employees will go through open enrollment each Fall, following company selection.
If an employee switches plans during the open enrollment in the Fall, there is a deductible credit for what the employee has paid into the deductible from one Aetna plan to the new Aetna plan.
How are plan premiums paid?
The company is invoiced fees intended to cover Justworks’ full cost one month in advance, and the company is then credited back as employees pay their portion of the premiums over the two pay periods in the benefit month. For example, Justworks pays the full premium for February in January, and the employees are deducted for one half of their February contribution from each of two paychecks in February.
When are new employees eligible for benefits?
In general, employees are eligible for benefits on the first of the month following their Justworks start date. For example, if an employee starts any day in August, their coverage will be effective September 1. However, a company may set up a 30- or 60-day waiting period which would delay the eligibility date.
New employees have 30 days to pick their plans.
What happens if an employee leaves mid-month?
Employees will remain on their medical, dental, and/or vision plans until the end of the calendar month. Since benefits-related billing takes place a month in advance, if a company has already paid fees intended to cover Justworks’ costs for the next month’s coverage, Justworks will reimburse the company.
Employees will receive a COBRA packet directly from our COBRA administrator within 30 days of the employee’s loss of coverage.
Medical, Dental, and Vision (Employee)
How do I get specific answers about my health insurance needs?
Contact Aetna Member Services at 1-800-704-7287
What happens if I miss the open enrollment deadline?
Outside of the open enrollment period, you must experience a Qualifying Life Event (QLE) to enroll, cancel, or change plans. Learn more about QLEs here.
Can I roll over my existing deductible to my new Aetna plan?
If you just started participating in one of the Justworks plans, please submit your last EOB (Explanation of Benefits) from your prior carrier via fax to (859) 455-8650. You should include your new Aetna Member ID number and indicate “Requesting Credit.” If you don’t have access to a fax, you can mail to the address on the back of your Aetna ID card.
During our annual open enrollment in the fall, this will happen automatically.
When will I get my ID card in the mail?
You can expect to receive your insurance card within 7-10 business days after the effective date of your coverage.
If you enroll dependents, they won’t receive separate cards.
ID cards are on “durable paper” – don’t accidentally throw these away!
If you require a new ID card, you can request a physical card directly from Aetna Member Services or download a digital one to print from your Aetna Navigator account.
What if I need my ID number before I get my card in the mail?
You can find your ID number in Justworks after your plan is effective. Go to You > Benefits.
After the effective date, if your number is still listed as pending, you can create an Aetna Navigator account to print out an ID card. See the link from your Justworks account.
Will I get a separate ID card for dental?
If you enroll in Aetna dental, you can simply use your medical ID card. If you enroll in MetLife dental, you just need to provide your SSN to your dentist.
When will premiums be deducted from my paycheck?
Premiums are deducted from two paychecks each month.
What if I need to change my coverage?
Once coverage becomes effective, you are not able to make changes to your plan until the annual open enrollment in the fall, or if you experience a qualifying life event.
If you experience a qualifying life event and want to switch, go to your Justworks account (Go to You > Benefits > Click Change benefits)
Do we have gym reimbursement with Aetna?
No, but Aetna does have a number of discount programs.
Is international coverage included with any of these plans?
None of the Aetna insurance plans cover international care, except in the case of an emergency. To learn more about international coverage, check out this link from Aetna.
Can employees use One Medical if they don’t have medical coverage through Justworks?
Yes, all benefits-eligible employees have access to One Medical, if your company is making available Justworks’ Aetna medical plan.
What’s the One Medical enrollment code?
You can see this on the One Medical page of your Justworks account. Just go to Benefits under ‘You’ and click ‘See a doctor today - Primary care through One Medical.’ Above the sign-up button, the code will be highlighted in yellow.
How much does it cost to make available and become a member of One Medical?
As an employer, there is no cost to make available One Medical through Justworks.
The cost of a visit to One Medical is the same as the PCP office visit copay on an employee’s medical coverage.
What if an employee already has a membership to One Medical?
You can contact One Medical at 212-441-4383 to see if you’re eligible for a reimbursement.
Can dependents use One Medical?
Yes, but please note there’s limited pediatric coverage for dependents under age 14.
How can Health Advocate help me?
Health Advocate can help you review and negotiate your claims, find specialists in your network, and understand how care is covered under your plan.
Who has access to Health Advocate?
All employees and their spouses/domestic partners, dependents, and parents/parents-in-law.
When do we have access?
Your access will begin on your Justworks start date.