This article is about Justworks PEO and Payroll. What product am I using?
What is a health insurance reimbursement?
Justworks has partnered with a company called Thatch so your employer can give you a monthly pre-tax allowance to purchase individual health insurance. This program is called an Individual Coverage Health Reimbursement Arrangement, or ICHRA for short. You can use Thatch to purchase any individual plan available in your region. If the health insurance plan you choose exceeds your budget, the remaining amount is a pretax deduction from your paycheck.
Why are health insurance reimbursements good for me?
Health insurance reimbursements are designed to work around you.
- Greater choice: Pick a plan that fits your doctors, prescriptions, and coverage needs
- Added value: If your employer allows it, use leftover funds on other eligible healthcare expenses like copays, medicine, or sunscreen
- More take-home pay: Your allowance is tax-free
- Flexibility: Your coverage can stay with you, even if you leave your job
- Support: Thatch helps you choose a plan and answers questions along the way
What is Thatch and how does it work?
Thatch is the platform where you choose and manage your health insurance. It helps you compare plans, enroll in coverage that fits your needs, and handles premium payments using your employer’s allowance. You’ll also get support along the way to help you make decisions and manage your benefits.
Enrollment and Setup
How do I enroll in my ICHRA?
-
Sign up using the link in the Thatch invitation email.
You'll receive an email from Thatch with a link to sign up. Click the link to create your Thatch account and set up your login information. -
Add your information and review your Thatch budget.
Tell us about yourself and any dependents you want to cover with your insurance plans. -
Choose your insurance.
Review your medical plan options, and use the filters to find the one that’s right for you. If your employer is offering dental and vision coverage through Thatch, you’ll see these plan options after you select your medical insurance. To speak with a licensed plan advisor, request to schedule a call. -
Confirm selections.
Carefully review the information Thatch shares after you pick your insurance. In some cases, the insurance carrier you select may require additional information or steps.
I’m still deciding which plan to choose. How can Thatch help?
During onboarding, you’ll see options to filter for medical insurance that fits your needs. Use the help icon to ‘Ask Thatch’ about healthcare terminology, plan guidance, and anything else! If you’re not sure which plan is best for you, tell ‘Ask Thatch’ you want to schedule a call with their licensed advisors, and they’ll be happy to help.
How long do I have to pick a plan?
Your employer has selected an enrollment window for you. If you’re unsure when it ends, please see your invite email. Please note: if you pick a plan during the last two business days of the month, you’ll be enrolled for the month after. For example, if you enroll on March 30th, your coverage will begin May 1st. And if you need more time, please email support@thatch.com.
When will my insurance coverage begin?
Your coverage will begin on the 1st of the month after you select your plan, unless:
- You pick your plan during the last two days of the month, in which case your coverage will start on the 1st of the month after next. For example, if you pick your medical plan on March 30th, your plan will begin May 1st.
- You are enrolling during national open enrollment (in November) for January 1st coverage. If you are not sure, please ask your employer.
When can I expect my member ID cards?
Your member ID and policy number are generated by your insurance company, not Thatch or Justworks. Your insurance company will usually send your member ID in the mail 2–3 weeks after your coverage starts.
Benefits Usage
What are Qualified Medical Expenses?
If your employer allows, you can spend leftover funds on qualified medical expenses (QMEs) for things like prescriptions, copays, MRIs, sunscreen, allergy medicine and more. See a full list of eligible expense types or text 842-824 to talk to their Thatchbot once you’ve enrolled on Thatch.
What is the Thatch Marketplace?
The Thatch Marketplace lets you use any remaining allowance (after paying your health insurance premiums) on health and wellness services curated by Thatch, like mental health support, preventive care, and fitness. You can also use leftover funds on other qualifying medical expenses outside the marketplace.
Note: Availability of the Thatch Marketplace and eligible expenses may vary based on your employer’s setup.
Do allowances roll over?
Yes, leftover allowances roll over monthly, but they do not roll over year to year. Your allowance only accrues within the calendar year and will reset each year on January 1. You'll still have 90 days to submit any outstanding reimbursements from the prior year, and you can find more information here on how to submit reimbursements.
How do QLEs work on Thatch?
A Qualifying Life Event (QLE) is a major life change—such as moving to a new state, getting married, or having a baby—that allows you to update or change your health insurance outside of the annual Open Enrollment Period. If you experience a QLE and need to make a change to your coverage, you have 30 days from the date of your QLE to report it to Thatch and initiate the plan change process. Learn more here.
Why is my carrier sending me a bill?
Not to worry! This is standard practice for insurance carriers because you are the policy holder of the individual medical plan. Thatch will pay this bill unless they’ve informed you otherwise. If you are concerned about your premium payments, please don’t hesitate to check with support@thatch.com.
When can I change my medical benefits?
When you are first invited to Thatch, you will enroll during your employer’s enrollment window. If you need to make changes after that window closes, please contact support@thatch.com. After 60 days from your coverage start date, you cannot change your medical plan until the federal open enrollment window, unless you have a qualifying life event (QLE). The federal open enrollment window starts in November and Thatch will share the timeframe you have to make changes, which is typically through early December to avoid gaps in coverage.
What happens if I leave my employer?
If you are moving on from your employer, or your employer leaves Thatch, your insurance policies through Thatch do not automatically cancel. You have the option of continuing to remain on your Thatch insurance, or cancelling to get coverage elsewhere. Learn more here.
Who should I go to for more questions?
To learn more about Thatch and FAQs, check out their help center. Feel free to contact them directly at support@thatch.com for troubleshooting, enrollment, billing, QLEs, or eligibility questions. If you have questions about your specific plan, reference this directory to call your carrier.