Workers’ Compensation
Of the following user types on the Justworks platform, which will be covered by our WC policy?
TPA, unpaid owner, PT W2, vendor paid owner, 1099, FT W2, contractor, paid intern
unpaid owner, PT W2, paid owner, FT W2, paid intern
Which carrier(s) do we offer for Dental & Vision?
Aetna, MetLife
What does EAP stand for? Who is Justworks' EAP?
Employee Assistance Program, Health Advocate
How many Aetna plans can a team offer? What's the minimum employer contribution?
6
50% of the most affordable plan offered on the employee-only tier
What is the name of the company that administers our HSA, FSA, and commuter benefits for our clients?
Optum Financial
Who is our WC underwriter? Who is our WC broker?
Zurich, Aon Risk Services
How many Dental and Vision plans do we offer and how many of each can the employer offer to their employees?
Dental: 7 available, 3 offered
Vision: 3 available, 2 offered
Who submits an STD or LTD claim in app? Employer or employee?
Employee
Name a state in which our Aetna POS plans have to convert to a PPO plan?
Alaska
Idaho
Missouri
Montana
South Dakota
Name 3 of the 7 UHC states at Justworks.
CO, AZ, WA, IL, MO, MN, NC
Which states are monopolistic (aka will need to obtain their own WC coverage if employees are housed there)?
North Dakota, Ohio, Washington, Wyoming
Which Dental plans include adult orthodontics?
Aetna DMO, Aetna PPO1, MetLife PPO1
How many employer-paid STD and LTD policies do we have? How many employee-paid STD and LTD policies do we have?
2 employer-paid STD policies; 2 employer-paid LTD policies; 1 employee-paid STD policy; 1 employee-paid LTD policy
What's the participation requirement for master?
What's the participation requirement for Sage BCBS? Sage UHC?
Master = 50%
Sage BCBS = 70% excluding valid waivers (carrying insurance elsewhere)
Sage UHC = 50% excluding valid waivers (carrying insurance elsewhere)
Which carrier can we now run alongside all Plus Aetna deals in all states?
Kaiser
When does our WC policy renew each year?
June 1st
Our Dental plans show a "Benefit Max" in lieu of an "Out Of Pocket Max." What is the difference between "Out of pocket max" and "Benefit max"?
The maximum amount that the insurance will pay in a calendar year
Slavic 401k...
- new plan set-up fee: ?
- one-time roll-over fee: ? & per account: ?
- annual fee per account: ?
Slavic 401k...
- new plan set-up fee: $0
- one-time roll-over fee: $350
- one-time fee per account rolled over: $3
- annual fee per account: $75
What are all the Kaiser markets?
South California
Northern California
Georgia
Northwest (Oregon)
MAS (VA, DC, MD)
Hawaii
Fill in the blank: Members are eligible if they are enrolled in an Aetna medical plan, reside in a state that restricts access to covered services*, and need to travel more than XMILES outside of the state in which they reside for care.
100 miles
Our WC policy has no limit. But our Employer's Liability (EL) does. What is EL and what is the limit?
Medical, Dental, and Vision policy holders with Justworks receive medical cards in the mail for 2 of these 3 policies. Which two are they?
Medical & Vision
How many mental health consultations are included with HealthAdvocate at no additional cost? *hint-this is a separate perk from TalkSpace :D
3 from BetterHelp
What is 140% Medicare vs. 80% UCR? When is it advantageous to have a plan with one over the other?
140% Medicare = out-of-network reimbursement based on medicare rates; national averages; to determine the base fee for reimbursement, Aetna uses 140% of a particular service as determined by the Medicare fee schedule.
80% UCR = out-of-network reimbursement based on usual, customary, and reasonable (UCR) rates; regional average; Aetna will pay 80% of the cost based on the UCR
*UCR (based on NYC in our case) better in harder to afford cities (i.e. NYC, SF, LA, etc.) because it is a stronger reimbursement
WORKERS' COMPENSATION: What happens if a company sponsors a sports team?
Denied.