This is my first time enrolling. 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: You can download and print a temporary card via your Aetna Navigator account or request a new physical card by reaching out to Aetna. Member IDs are also listed in the “Benefits” section of each employee’s Justworks account.
UnitedHealthcare: You may view and print ID cards once logged in to your myuhc.com account. Physical ID cards are set to ship prior to your effective coverage date. 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.
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
If I choose my plan after the effective date, and I have expenses before my enrollment is processed, what do I do?
Please contact Justworks Support at firstname.lastname@example.org or 888-534-1711 and we’ll be happy to guide you through the claims submission process.
What happens to my deductible?
Deductibles are based on the calendar year so they won’t reset until January 1. The plan carrier will automatically carry over your deductible balance to the new plan, so you’ll continue to pay towards the deductible through December 31, unless the balance is met.
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.
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 can I enroll in the FSA?
FSAs are based on the calendar year. If the benefit is available to you, open enrollment will occur in December for the following year.
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: 866-695-8622 or email@example.com
How can I tell if my medications are covered?
Good news! Your carrier has online tools for coverage, pricing, pharmacy search, etc. See below for the relevant links:
Aetna: Find detailed information on prescription coverage in the plan details PDF for each plan. Use Aetna's Find a Medication tool to find a specific drug and its price, under your plan found on both Aetna Navigator and the Aetna Mobile app!
UnitedHealthcare: OptumRx is the pharmacy care services manager for the plans. You can search for pharmacies using this link.
UnitedHealthcare also provides a Prescription Drug List, which is a list of commonly prescribed medications covered by the plan. Medications are put into tiers that determine their cost.
Once you've registered for a myuhc.com account, navigate to "Pharmacies & Prescriptions" where you'll be able to manage any existing prescriptions, order refills, get drug cost estimates and find ways to save on your medications.
Use the Health4Me app to enroll for home delivery, find pharmacies, refill prescriptions/set reminders, estimate and compare medication costs, and/or search the plan's PDL!
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 firstname.lastname@example.org or 888-534-1711 and we’ll be happy to help out!