This is my first time enrolling. Help!
We're happy to! Make your way to our all-in-one Resource Center for any open enrollment questions you may have.
How long will it take to process my enrollment and when will I receive my ID card?
You can expect your plan enrollment to process in 48-72 hours. Once processed, you may access a digital ID card via your carrier's website and/or mobile app (see more below). Physical ID card shipment and availability is subject to the carrier and your enrollment date.
Aetna: Physical ID cards will ship within 5-10 business days from the date your enrollment is processed in Aetna. You may download and print a temporary card via your Aetna Navigator account. Member WIDs are also listed in the “Benefits” section of each employee’s Justworks account.
Lastly, if looking to access a digital version of your ID card, the Aetna Health app is available for iPhone and Android. Once you've registered for an account (same credentials as your Aetna Navigator account), your home dashboard will show your WID number, along with an arrow to access your digital ID card.
UnitedHealthcare: Physical ID cards are set to ship to your home address prior to your effective coverage date. You may view and print ID cards once logged in to your myuhc.com account. If you need a new ID card, navigate to "Help" then "How do I get a replacement ID card?". You will be able to request a replacement card for yourself and any dependents you may have on your plan.
MetLife & Aetna Dental: Dental cards are not provided by the carrier. Use your social security number to provide proof of coverage.
Kaiser Permanente: Digitial ID cards are typically available prior to your effective date if you enrolled by the 15th of the month prior to coverage. Physical ID card availability is similar, is subject to your enrollment date, and is based on when the enrollment is received and processed by Kaiser.
You will receive physical ID cards for each family member enrolled. Only four ID cards can be sent in a single envelope, so if your plan has 4 or more members enrolled, you will receive two or more envelopes with the ID cards.
Plan Structure & Administration:
How can I tell if my doctor is in-network?
First, find the plan or network at the top of each plan details PDF in Justworks. Your current network is also listed in the “Benefits” section of your Justworks account.
Then go to the relevant provider website to see if your provider is "in-network" for the plan you selected.
Aetna's website: http://www.aetna.com/dse/search
UnitedHealthcare's website: https://www.uhc.com/find-a-physician
Kaiser Permanente's website: https://healthy.kaiserpermanente.org/doctors-locations
What happens to my deductible?
If an employee switches plans with difference deductible amounts during the open enrollment, the total amount previously paid towards their deductible this calendar year (January 1st - October 31st) will be credited toward the deductible on their new Aetna plan effective November 1.
For example, if your employee is enrolled in a plan with a $3000 deductible and has already paid $1500 toward the deductible, that $1500 would be carried over toward the deductible of their new plan.
If the employee then enrolls for a plan with a $2000 deductible during open enrollment, this would mean the employee has only $500 left to reach the deductible.
All deductibles accumulators refresh on January 1, as they run on a calendar year basis. In this example, the employee deductible accumulator (or what they’ve paid toward it) would restart at $0 as of January 1, 2020. The employee would have to reach the new $2000 deductible starting from $0 before coinsurance applies in 2020.
What is a waiting period?
A waiting period is the length of time that a new employee must satisfy before becoming benefits eligible and enrolling in insurance benefits upon joining a company. Justworks plans can include a 0-day, 30-day, or 60-day waiting period.
Employee's health insurance coverage can only start on the 1st of the month, so it's important to note that once an employee's waiting period is completed, the coverage for the plan they select in open enrollment will be effective the 1st of the month following their benefits eligible date.
Ex. Start date is September 9, with a 0-day waiting period. An employee will have from September 9th - October 9th to complete enrollment, with their coverage becoming effective October 1st.
Read more about waiting periods here.
Who can be a dependent?
Dependents include a spouse and children, as well as domestic partners if you provide the proper documentation.
What’s the difference between a copay and coinsurance?
A copay is the dollar amount an employee has to pay for a specific type of service or visit, regardless of its cost, before the deductible is met. Co-insurance is the percentage of costs that a provider will cover once an employee satisfies their deductible. (For more information about health insurance terms, you can check out our Health Insurance Glossary).
When is FSA open enrollment?
FSAs are based on the calendar year, from January 1st to December 31st. If the benefit is available to you, open enrollment will occur in December for the following year. We'll contact you to let you know when open enrollment is beginning!
If you're currently enrolled in an FSA, be sure to use your funds before the end of the year, as they are "use it or lose it!"
What is an HSA?
A Health Savings Account is a pre-tax savings account for employees who are enrolled in a High Deductible Health Plan. Those who are enrolled in HDHPs will be able to contribute towards HSAs immediately once their plans are active. Learn more about HSAs.
When will my benefits be effective?
Benefits for new employees become effective on the first of the month after enrollment is opened, even if enrollment is opened on the first of the month. For example, if a company with no waiting period welcomes a new employee on 9/15, the employee’s benefits will be effective on 10/1. If the company had a 60-day waiting period, enrollment for this employee would open on 11/15, and benefits would be effective 12/1.
After the annual open enrollment period for all employees, any changes in coverage become effective on November 1.
I have questions about specific medical services, procedures, claims, or costs. Who can help me?
Employees with specific questions related to these topics should reach out to their carrier directly or Health Advocate. Health Advocate is a third-party resource who can help answer questions about plans, claims, and provide help for finding specialists who accept your insurance. This service is available at no cost to anyone enrolled in a medical insurance plan through Justworks. The topics listed above typically involve “Protected Health Information” and can only be discussed with a HIPAA-compliant resource.
Aetna Member Services: 888-982-3862 | UnitedHealthcare Member Services: 866-414-1959 MetLife Member Services: 800-942-0854 | Health Advocate: 866-799-2728 or firstname.lastname@example.org
How can I tell if my medications are covered?
Good news! Your carrier has online tools for coverage, pricing, pharmacy search, etc.. You can find more information on how to Find a Medication in our Help Center article.
Will I receive a new medical/dental/vision card each year? Will my Member ID change after annual open enrollment?
Employees will maintain their same Member ID each year so you will continue using your existing medical and/or vision card. If you need a replacement card, you can access a copy through the relevant provider's website:
I’m having trouble enrolling in the open enrollment opportunity in Justworks. Who can help me?
Please contact Justworks Support at email@example.com or 888-534-1711 and we’ll be happy to help out!