Spotlight

Open Enrollment

Welcome to Open Enrollment with Justworks!

We know choosing the right health insurance plan can be confusing. We created this guide to walk you through tough enrollment questions to help you make the right health insurance plan selections.

Want to follow along? Pull up your plan selections in Justworks.

Open Enrollment

Welcome to Open Enrollment with Justworks!

We know choosing the right health insurance plan can be confusing. We created this guide to walk you through tough enrollment questions to help you make the right health insurance plan selections.

Want to follow along? Pull up your plan selections in Justworks.

Open Enrollment

Welcome to Open Enrollment with Justworks!

We know choosing the right health insurance plan can be confusing. We created this guide to walk you through tough enrollment questions to help you make the right health insurance plan selections.

Want to follow along? Pull up your plan selections in Justworks.

Open Enrollment

Welcome to Open Enrollment with Justworks!

We know choosing the right health insurance plan can be confusing. We created this guide to walk you through tough enrollment questions to help you make the right health insurance plan selections.

Want to follow along? Pull up your plan selections in Justworks.

Understand Plan Options

Read our guide to get familiar with healthcare plan options

Get our Healthcare Savings Guidepost, a short guide perfect for anyone looking for specific strategies to decrease their healthcare costs.

Questions? We've got you covered.

Can I select a different plan if I change my mind later on?

If you’re still within the open enrollment period, yes, you can change your plan selection. Watch this video to learn about changing your plan once the open enrollment period is over.

During the open enrollment period, you'll be able to change or reset your plan selections within Justworks if you change your mind. Just make sure to change and finalize your plan selection before the end of the enrollment period. After that date, you won't be able to change your plan unless you experience a Qualifying Life Event, or QLE.

How do I read a health insurance plan?

In this video, we’ll walk you through the different sections you’ll see while choosing a health insurance plan in Justworks and important things to keep in mind while reviewing your plan options.

Who can I talk to if I have questions?

There are many people and resources available to support you through this process! We've created a simple directory with more details and contact information which you can find below. Here we will be answering general health insurance questions on public Slack from 2-3 PM EST every weekday of open enrollment.

Download our directory

What happens to my deductible if I enroll in a new plan now? Will what I already pay rollover? Or will I start over on November 1st?

One thing to note is that all plans accessible through Justworks have embedded deductibles. This means that no individual is responsible for meeting more than their individual deductible, even if they are on a family plan.

While new plans start November 1, deductible accumulators reset each calendar year on January 1.

For plans selected during open enrollment and effective November 1, you’ll have a deductible credit for what you’ve already paid toward the deductible for this calendar year on your current plan applied to your new plan until January 1. January 1 will mark the restart of your deductible accumulator for the new calendar year.

If I decline to renew my coverage, am I still able to seek coverage elsewhere?

Yes, if you are currently enrolled for medical insurance but do not renew it, you can use your termination of coverage letter from the carrier to seek coverage through the marketplace. If you are eligible to be a dependent on someone else’s plan (like a spouse or parent), you can also use your termination of coverage letter to enroll for their plan.

If I decline coverage, will I be eligible for COBRA?

No, you would not be eligible for COBRA at this time, since you would be voluntarily declining your coverage.

I’m planning on having a child over the next year, what do I need to know?

You can find general information about pregnancy-related coverage in the Plan Details section or Summary of Benefits and Coverage document for each plan. We've also created a discussion guide and checklist of potential childbirth-related medical expenses, as well as a short course on financial planning for first-time parents.

Learn More

Example of pregnancy/childbirth coverage information in an SBC.

Example of pregnancy/childbirth coverage information in an SBC.

Take our free short course to get in control of your short and long-term financial future as you enter parenthood.

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I just had a child. What should I be considering as I choose my plan this year?

If you're adding a child to your plan for the first time, it's always a good idea to search the plan's network to see if your child's pediatrician (if you already have one) is in-network or out-of-network. You should also consider the various pediatric services you may need, and review the costs associated with those services. Some plans will cover a higher percentage of the cost for these services than others, and some may not cover them at all. To learn more, you can review the Plan Details and Summary of Benefits and Coverage (SBC) documents in Justworks, or contact Health Advocate for additional help.

Be aware that if you're moving to an employee + children or family plan from a different enrollment tier, there will be a change in cost, which will impact your paycheck deductions. You can review the plan costs at each tier directly in Justworks in the enrollment flow.

How do I find out if my existing prescriptions are covered under a plan?

Check each plan’s “Summary of Benefits and Coverage” (SBC) document and look for the section labeled “If you need drugs to treat your illness or condition” (see example screen above) to get general information about prescription coverage. Then, check the carrier's preferred drug list to see how the drug is classified and to find out the rate.

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.

Kaiser Permanente: Kaiser’s formulary is a list of drugs that have been approved for members by the Kaiser Permanente Pharmacy and Therapeutics Committee.

UnitedHealthcare: You can search for network pharmacies through OptumRx, the pharmacy care services manager for UHC plans. 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.

Example of prescription drug info in a plan SBC.

Example of prescription drug info in a plan SBC.

How do I find information on mental health coverage?

Check the “Plan Details” section in the Justworks enrollment flow and look for the section titled “Mental Health Services.” There, you’ll see what you’ll have to pay for mental health providers that are in-network or out-of-network under a specific plan. You’ll be able to compare copays for in-network coverage across different plans. The “Summary of Benefits and Coverage” (SBC) for each plan is located in the employee documents section in Justworks, and will also include information about mental health coverage.

Example of where to locate Plan Details

Example of what a mental health coverage section looks like in Plan Details.

Aetna members can access additional mental health support through Health Advocate’s Employee Assistance Program.

Learn How

Take our free short course to better understand how to find and pay for mental health support.

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I just got married. Should my spouse and I be on the same health insurance plan?

In this video, we’ll walk you through four questions you can ask yourself to help determine the best health insurance arrangement for you and your spouse.

How will adding my spouse onto my insurance as a dependent impact my coverage?

Watch this video to learn about the two major factors to consider if you’re thinking about adding your spouse as a dependent: the impact it will have on cost, and how it will affect the plan you choose.

A couple other things to keep in mind:If you do add your spouse to your plan as a dependent, don’t forget to cancel their previous coverage, if any. If your spouse retains outside medical insurance and is added to your medical plan, one of the plans would be considered primary. This has an impact on how each carrier may reimburse you or how much they may cover your spouse’s care.If you’d also like to add your dependent to your vision and dental insurance plans in addition to your medical plan, be sure to add them to those plans in the Justworks enrollment flow.