Getting Started

I just finished my enrollment. What now?

We encourage you to create an account on KaiserPermanente.org, as well as download the Kaiser Permanente app available on iTunes or Google Play. By creating an account, you can view lab results, chat online with Kaiser Permanente physicians, refill prescriptions, email your care team, check your plan's benefits, manage care for a family member, pay medical bills, and more.

Where can I find my insurance ID card?

You can find your ID card in a few different ways!

1. Digital ID card*: You may access a digital ID card via the Kaiser Permanente app. Once downloaded, open the app and sign in or register for an account. Once you've registered for an account, sign in and tap the membership card icon on the app dashboard.

The digital card lets you check-in for appointments, pick up your prescriptions, and provide your membership information at most Kaiser Permanente facilities.

*Not available to members in Northern California

2. Physical ID card: You will receive an ID card for each family member enrolled.

Note: Only four ID cards can be sent in a single envelope. If you have enrolled 5 or more people in the family, you will receive two or more envelopes with the ID cards.

ID card availability is subject to your enrollment date and is based on when the enrollment is received and processed by Kaiser Permanente.

What is an MRN number?

You will receive a Medical Record Number (MRN) after enrollment. The numbers are similar to social security numbers in the sense that they never change and follow you throughout your life, regardless of group or benefits changes. If you were previously enrolled in a Kaiser Permanente plan through another provider, you will have the same MRN

How can I find out if my doctor accepts my insurance?

You may use the Kaiser Permanente Find a Doctor and Location tool to search for your current doctor and facilities.

This tool is also helpful if you do not currently have a doctor but would like to find one.

How can I learn about the details and coverage limits of my plan?

To learn more about your plan and how services are covered, navigate to Benefits on the left navigation bar in Justworks. From there, you’ll be able to see your various plans (medical, dental, vision) and you can click View plan to find more details on each plan.

Are travel and lodging benefits included in my plan?

Yes! Our Kaiser Permanente policy covers both travel and lodging expenses (subject to IRS guidelines) for members who live in states where access to care has been limited or outlawed and where they must travel more than 50 miles to seek care in another state. Examples of eligible expenses can include gas, hotels, and airfare.

If you have specific coverage questions, please reach out to Health Advocate or contact Kaiser Permanente Member Services at:

English: 1-800-464-4000
Spanish: 1-800-788-0616
TTY for the hearing and speech impaired: 1-800-777-1370

How are abortion services covered on my plan?

When it comes to what’s covered for Justworks members under our master insurance policy with Kaiser, they provide the full range of comprehensive integrated women’s health services, including prenatal, maternity, family planning, contraception, and pregnancy termination services.

In general, what is covered by the policy doesn't dictate what services providers can or are willing to perform or provide. Any members with related questions are encouraged to contact the insurance carrier directly via Kaiser Permanente Member Services: 800-464-4000

Health Advocate is another resource that you can take advantage of for more specific coverage information. Covered employees can call 866-799-2728 or email answers@healthadvocate.com.

How can I best reach Kaiser Permanente?

You can reach out to Kaiser Permanente Member Services via the following channels if you are currently a member:

Member services information - including hours and numbers for specific regions, can be found here.

You may also contact Member Services, 24 hours a day, 7 days a week at:

English: 1-800-464-4000
Spanish: 1-800-788-0616
TTY for the hearing and speech impaired: 1-800-777-1370

Common Terms

What is a deductible?

A deductible is an amount you must spend before your insurance begins to pay claims. Member cost-sharing for certain services, as indicated in the plan, are excluded from charges to meet the deductible. Pharmacy expenses do not apply to your deductible.

What is an out of pocket maximum?

An out of pocket maximum is the most you have to pay out of your own pocket for covered services in a given plan year.

What is co-insurance?

Co-insurance is the percentage of health insurance expenses you pay after you’ve met your deductible.

What is a co-pay?

A co-pay is the flat amount you are responsible to pay for a covered service after you’ve met your deductible.

Enrollment

What is open enrollment and how does it affect me?

Open enrollment is the designated time each year when you can enroll in health insurance. Employees have two open enrollment opportunities each year:

1) when they join a company and can select their initial plan, also known as new hire enrollment

2) when the company’s policy renews in November.

Unless a qualifying life event occurs, open enrollment is the only time an employee can enroll in benefits.

What is a qualifying life event?

A qualifying life event is a change that enables employees to enroll in benefits outside of open enrollment. A qualifying life event can include one of the following situations:

1) marriage / domestic partnership

2) divorce or separation

3) birth or adoption of a child

4) loss of previous coverage

5) moving (this is not a guaranteed event, please contact support@justworks.com for more information on what qualifies).

When you have a qualifying life event, you can make updates to your benefits coverage by submitting proof of the QLE within 30 days of the event within your Justworks account.

I want to add a dependent to my coverage. How can I do that?

Dependents must be added to your plan during open enrollment unless they experience a qualifying life event. If a qualifying event does occur, simply navigate to your Benefits in Justworks and select the Change coverage button to signal that you need to add a dependent to your plan.

I want to change my plan selection. How can I do that?

You can change your plan if you’re still in open enrollment or if you have a qualifying life event. In either of these cases, please reach out to support@justworks.com or log in to your Justworks account to request a change in benefits.

I want to cancel my coverage. How can I do that?

In order to cancel your benefits outside of the open enrollment period, you will need a qualifying life event, such as a spouse obtaining new group health insurance. In this case, we would require a letter from the insurance company showing the new coverage effective date. We need to ensure there isn’t a lapse in coverage and will require this within 30 days of the effective date.

What are the eligibility requirements for health insurance?

An employee must be classified as “full-time” or “part-time” working 30+ hours per week in order to be eligible for health insurance in Justworks. Contractors are not eligible for health insurance.

Disclaimer

This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.