This article is about Justworks PEO. What product am I using?
What are Supplemental Health Benefits?
Supplemental health benefits pay lump-sum cash directly to you if you or a covered family member suffers an illness, experiences an injury, or is admitted into the hospital. Check out our blog article for more information on each benefit offered and when they’d be a good fit.
How are these different from my standard medical insurance?
Health insurance helps pay your doctors and hospitals. Supplemental Health Benefits pay cash directly to you, helping to cover deductibles, groceries, rent, childcare, transportation, or other everyday expenses that can come with an unexpected medical event.
They provide extra peace of mind and financial protection, particularly popular with people who have a High Deductible Health Plan (HDHP), support dependents, have a family medical history of serious illness, are planning a procedure or future pregnancy, or simply want to prepare for life’s unexpected moments.
Why should I enroll through Justworks instead of buying a policy on my own?
When you enroll through Justworks, you receive access to discounted group rates, curated plans that are specifically designed to work alongside your core medical coverage, and automatic payroll deductions.
Plan Options & Coverage
What types of supplemental health benefits are available and which one is right for me?
You have access to three different benefits, depending on your needs. You can enroll in one—or combine multiple—to build the protection that's right for you:
Critical Illness Insurance:
Best if you are concerned about a critical diagnosis. It pays a lump-sum amount if you are diagnosed with a covered serious condition, like cancer, a heart attack, or a stroke..
Accident Insurance:
Best if you are concerned about injuries from accidents (like falls, sports, or car accidents). It pays set amounts for injury treatments), hospitalization, physical therapy, emergency room treatment, and transportation.
Hospital Indemnity Insurance:
Best if you are concerned about the cost of being in the hospital. It pays cash for hospital admissions and/or each day you are in the hospital (including Intensive Care). This may be a good fit if you think you may need a procedure or if you plan to grow your family in the future.
Check out our blog for more information!
Can I enroll in more than one type of benefit?
Yes, you can enroll in more than one of these benefits at the same time.
Can I receive payouts from multiple plans for the same event?
Yes, in most cases. Critical Illness, Accident, and Hospital Indemnity Insurance typically pay separate, fixed cash benefits based on their own rules. If one event triggers more than one policy (for example, a car accident that leads to a hospital stay), you can often receive payments from each plan, subject to their specific limits and exclusions.
Are pre-existing conditions covered?
Certain pre-existing conditions are not covered. Please review your specific Aflac plan details for more information on exclusions.
Can I choose how much coverage I want?
Yes. Each Supplemental Health Benefit offers multiple coverage options, so you can choose the level of financial protection that best fits your needs and budget.
Critical Illness Insurance:
Choose a benefit amount of $10,000, $20,000, $30,000, $40,000, or $50,000 if you're diagnosed with a covered serious illness.
Accident Insurance:
Choose between coverage that pays up to $3,500 or up to $7,500 per covered accident.
Hospital Indemnity Insurance:
Choose between a plan that pays $500 per hospital admission + $100 per night or $1,000 per admission + $200 per night for covered hospital stays.
During Open Enrollment, you'll be able to compare your options, review what's covered, and see your personalized premium before making your selections.
Eligibility & Enrollment
Who is eligible to enroll?
Benefits-eligible employees at companies who are offering medical insurance through Justworks’ Large Group Master Policy, excluding New Mexico residents and unpaid owners.
The following employees are eligible:
- Full-Time Employees
- Part-Time Employees (must be working 30+ hours and benefits-eligible)
- Paid Owners
- Unpaid Owners are not eligible for this benefit.
Who can I cover on my plan?
You can elect to cover just yourself, or add your spouse and children. Children can stay on the plan until they reach age 26.
When can I enroll?
You can enroll when you are newly eligible as a new hire, during your annual Open Enrollment period, or due to a Qualified Life Event (QLE).
How do I add dependent(s)?
To enroll your dependents in any of your company benefits, you must first add their information during the health insurance enrollment flow.
Important Notes:
Medical Coverage is Optional: You are not required to enroll your dependents in your medical coverage. However, you must add their profiles to the system during this initial step so they appear as selectable options when you enroll in supplemental health benefits later.
Critical Illness Coverage: If you add child dependents to your profile, they will be automatically included in your Critical Illness coverage at no extra cost.
Do I have to answer health questions or take a medical exam?
No. These plans are initially offered on a guaranteed-issue basis. There is no "Statement of Health" required, and there are no waiting periods.
Can I cancel my coverage later?
Yes, you can cancel your policy by contacting Aflac Customer Service at 800-433-3036. However, please be aware that if you cancel, you can only re-elect coverage during Open Enrollment or if you experience a QLE.
Costs & Payment
Who pays for these benefits, and how much are they?
These are employee-paid benefits. Premiums vary based on the benefits you choose, your coverage level, and who you're covering. Some plans start at just a few dollars per paycheck, and you'll be able to view your exact cost in Justworks during Open Enrollment before you enroll.
These benefits also include annual wellness rewards for eligible preventive exams you likely would’ve completed anyways, which can help offset some—or even more than—the cost of your premiums.
How do I pay my premiums?
Premiums are paid through convenient payroll deductions.
Are my premiums and payouts taxed?
Premiums are currently set as post-tax. Because of this, the benefit money paid out to you for a claim is completely tax-free.
Filing Claims & Using Your Benefits
How do these benefits work when I need them?
If you experience a covered injury, illness, or hospital stay, you contact Aflac to file a claim. Once approved, the benefit is paid directly to you, and you can use the money however you’d like.
Do I have to use the money for medical bills?
No. You can use the funds however you choose—whether that means paying for rent, groceries, childcare, or simply replacing lost earnings from being out of work while you recover.
What is the wellness incentive reward program?
Aflac pays you cash benefits just for staying on top of your health by getting eligible yearly checkups (like physicals, dental exams, and eye exams). Critical Illness and Accident plans pay $75 per covered family member each year, and Hospital Indemnity pays $50, offsetting some—or even more than—the cost of your premiums.
If you hold multiple policies, Aflac has streamlined the process: filing a single wellness claim will automatically pay out benefits from all eligible plans you are enrolled in.
How do I file a claim?
- Online: Submit your claim at aflacgroupinsurance.com.
- Email: Scan and email your claim form to groupclaimfiling@aflac.com.
- Fax: 866-849-2970.
- Mail: Post Office Box 84075, Columbus, Georgia 31993.
How do I receive my money?
The fastest way to get paid is via direct deposit. Log in at aflac.com/myaflac, go to My Account > Manage Account > Billing and Direct Deposit, and enter your banking information.
Leaving Your Employer
What happens to my coverage if I leave my job or retire?
Your coverage is fully portable.
How do I take my coverage with me?
To take your coverage with you after leaving your employer, complete the Continuation of Coverage Form and submit it within 31 days of your termination date.
Disclaimer
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for accounting, 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.