> ## Documentation Index
> Fetch the complete documentation index at: https://every-a2724ddc.mintlify.site/llms.txt
> Use this file to discover all available pages before exploring further.

> ## Agent Instructions
> These docs describe Every as customers have it today. Answer from them, and say so when they don't cover a question.
> Pages under /admins/ are for the people who run Every for the company, and pages under /employees/ are for employees. Answer from the pages that match the person asking.
> Each page's Agent reference section lists its exact roles, conditions and limits. Prefer it for those details.
> When a page says a feature is in closed beta, or that Every turns it on company by company, don't promise that the person's company has it.
> Use roles and on-screen labels exactly as the pages write them.
> When someone asks what a term means, answer with the Glossary page's definition (/glossary), which other pages show in parentheses after the term.
> When the docs don't answer a question, tell the person to email [support@every.io](mailto:support@every.io).

# Health, Dental and Vision

> Shop health, dental and vision plans, run open enrollment and approve benefit changes

![Health enrollment summary above two employee rows with avatars and health-plan details.](https://mintcdn.com/every-a2724ddc/k5maP8xPODHl5ToY/images/illustrations/admins-benefits-health-insurance-light.png?fit=max\&auto=format\&n=k5maP8xPODHl5ToY\&q=85\&s=e723247ba95d5280ef7f7ed8b216a126)

On **Benefits**, select Every's **Health, Dental, and Vision** row to choose plans and run open enrollment (The yearly window when employees can choose or change their benefits) by plan year. Company Admins and HR Admins use it once payroll is set up and your company has finished onboarding.

Employees enroll from a to-do on **Home** (see [Home to-dos](https://every-a2724ddc.mintlify.site/employees/home.md#to-dos)) and see their plans on **My profile** (see [My profile benefits](https://every-a2724ddc.mintlify.site/employees/my-profile.md#benefits)).

Every's **Health, Dental, and Vision** row appears when your company's primary filing workplace is in California or when your company already has a medical policy through Every.

> [!NOTE]
>
> Every turns on two options company by company: health benefits in New York and North Carolina, and a per-plan switch for an HRA (Health reimbursement arrangement: an employer-funded benefit that reimburses employees for eligible medical expenses). If you don't see an option, email [support@every.io](mailto:support@every.io) to ask about it.

## Plan years

Plan-year cards show dates, plan count and people enrolled or pending. A selectable card opens setup, the plan-year dashboard or **We're setting up your benefits**. A **Prepared by Every** card isn't selectable while Every's team is finalizing the plans.

| Status | What it means |
| - | - |
| Draft | The year's plans still need to be submitted |
| Submitted | Plans are submitted and enrollment hasn't opened |
| Open Enrollment | Employees can make their selections |
| Pending | Enrollment is closed or the application is being processed |
| Active | Policies are in their active period |
| Expired | All policy end dates have passed |

Without a plan year, select **Setup benefits**. When the next screen offers **Shop plans**, follow [Begin with Shop plans](#begin-with-shop-plans). If it opens **Shop Benefit Plans**, follow [Set up plans with a meeting](#set-up-plans-with-a-meeting).

![Health plan-year cards with dates, status, plan counts and employee enrollment counts.](https://mintcdn.com/every-a2724ddc/19nP2pdcB7HMtcYU/images/screens/admins-benefits-health-insurance-plan-years-light.png?fit=max\&auto=format\&n=19nP2pdcB7HMtcYU\&q=85\&s=3e746be21c90ec9305e31b52360017fa)

## Open a health partner

1. On **Benefits**, under **Health**, select your health partner's row.
2. For a new SimplyInsured connection, review the data-sharing message and select **Connect** to continue. To dismiss the dialog, select **No, Thanks**.

The partner's website opens in a new tab. An existing SimplyInsured connection opens the partner directly, without the connection dialog.

## Shop for plans

### Begin with Shop plans

Select **Shop plans** to start. **Migrate existing** is unavailable. Use **Next** to move between **Get started**, **Plans** and **Review**.

**1. Set the plan details**

In **Get started**, choose a **Start date** and **Primary workspace**. Every uses the **Primary workspace** to calculate plan costs.

**2. Review eligible employees**

Select **Eligible for benefits** to review the roster before selecting plans.

**3. Choose plans**

In **Plans**, select plans for the benefit types you want to offer. Use **Select plan** for an individual plan or **Choose** for a plan group.

**4. Complete the company details**

In **Review**, choose the **Company CEO** and **Waiting period**. When you've chosen a health plan, **Review** also shows **Worker's compensation insurance carrier**.

**5. Choose the coverage type**

In **Review**, choose a **Coverage type** for your health plans.

**6. Set company contributions**

Enter **Company pays** and **Company pays for dependents**. **Employee pays** shows the remainder. When you enter **Company pays**, its minimum is 50% of employee-only premiums (The regular payment that keeps an insurance plan active) for health, dental and vision.

**7. Set HRA budgets**

For HRA-enabled plans, set the annual budgets before submitting (see [Set annual budgets](https://every-a2724ddc.mintlify.site/admins/benefits/health-insurance.md#set-annual-budgets)).

**8. Complete the agreements**

Enter the name of each signatory (A person allowed to sign documents and agreements on a company's behalf) and accept the agreements your package shows. Select **Accept terms & conditions** when it appears.

**9. Submit the plans**

Select **Submit**. Every submits the plans and returns you to the plan-year dashboard, where you publish them to open enrollment. To save your progress and return to **Benefits** instead, select **Finish Later**.

### Set up plans with a meeting

**Shop Benefit Plans** starts with a meeting with Every's team. Use **Next** to move between **Shop Plans**, **Company Details** and **Coverage & Costs**.

**1. Book the meeting**

Select **Book a time** to open the meeting booking page.

**2. Enter company details**

In **Company Details**, choose the plan start date and CEO. Enter the carrier for your company's workers' compensation (Insurance that pays an employee's medical costs and lost wages when they're hurt or fall ill because of work), then choose the waiting period.

**3. Set company contributions**

In **Coverage & Costs**, choose how much the company contributes. California companies also see a field to upload their Statement of Information (A California filing that lists a company's addresses, its officers or managers and its agent for service of process).

**4. Complete setup**

Select **Complete Setup**. Every saves the details and shows **We're setting up your benefits**.

## HRA-enabled plans

In **Shop plans**, look for the **HRA Enabled Plans** badge. Select the badge or **See calculation**, when offered, to review the comparison and estimated savings before choosing plans. If a calculation is unavailable, read the explanation shown.

### Set annual budgets

In **Review**, set the budgets for each HRA-enabled plan. When a plan has an **HRA** switch beside it, turn it on first. Turning it off hides that plan's budget fields.

| Field | Who it covers |
| - | - |
| **Annual HRA budget (individual)** | Employees without dependents |
| **Annual HRA budget (family)** | Employees with dependents |

Both amounts must be greater than \$0. Select **Apply** when offered to use the recommended budgets, or enter your own amounts.

### Estimate annual spending

1. In **Review**, under **Estimated cost**, select **HRA budget** when shown.
2. In **Estimate your annual HRA spend**, adjust **Expected employee utilization** to compare the projections.

Changing **Expected employee utilization** changes the spending estimate, not the annual budgets. Actual costs can differ from the estimates shown.

### Review configured plans

On the plan-year dashboard, **Plans** shows **HRA Enabled** beside HRA-enabled plans. Select a plan to review its **HRA contribution** and effective individual and family deductibles.

![HRA contribution section with individual and family contribution rows.](https://mintcdn.com/every-a2724ddc/k5maP8xPODHl5ToY/images/illustrations/admins-benefits-health-insurance-hra-light.png?fit=max\&auto=format\&n=k5maP8xPODHl5ToY\&q=85\&s=8436953227e6a09676686d8fe3b3bba0)

## Publish and close enrollment

On the plan-year dashboard, **What to-do next** lists the open-enrollment steps in order. Use the year selector at the top to change plan years. When the dashboard shows an enrollment deadline, close enrollment by that date to keep your start date. The deadline message also gives the start date if you close later.

If **Publish the plans** is already complete, start with **Notify employees**.

**1. Review the employees**

Confirm that the eligible employees appear in the list.

**2. Review and submit the plans**

Check the selected plans and costs. When **Review plans** appears, select it to finish reviewing and submitting the plans.

**3. Publish the plans**

Select **Set active** to publish the submitted plans and start employee enrollment. The button stays unavailable until the plans are submitted.

**4. Notify employees**

Select **Notify employees** to mark this step done in this browser. The step doesn't send email itself or confirm that employees received one.

**5. Close enrollment**

Once employees finish their selections, select **Close enrollment**. The year moves to Pending and shows an application tracker.

The tracker shows Application review, Carrier review and Approved. Closing enrollment doesn't confirm carrier approval.

![Health plan-year dashboard with enrollment summary, application tracker, policy dates and the app sidebar.](https://mintcdn.com/every-a2724ddc/qvvudeZxc26V6Klz/images/screens/admins-benefits-health-insurance-light.png?fit=max\&auto=format\&n=qvvudeZxc26V6Klz\&q=85\&s=091cfb736ab2302a66a7b5aca69d359e)

## Approve benefit changes

On the plan-year dashboard, **Pending actions** lists requests about a qualifying life event (A change such as marriage, a birth or losing other coverage that lets someone change their benefits outside open enrollment).

**1. Open the request**

Under **Pending actions**, select the request to open **QLE Requests**.

**2. Review the change**

Review the event, its dates and **What's changing**. When **Supporting Document** has a document, download it. If the employee attested instead, it shows **Attested, no document**.

**3. Approve or reject**

Select **Approve**, then confirm the approval. To reject the request, select **Reject**, enter a **Reason** and confirm the rejection.

## Agent reference

**Where:** Every's **Health, Dental, and Vision** row in **Benefits** opens the **Health, Dental and Vision** plan-year page. Select a plan year to open its setup or dashboard. **Prepared by Every** cards aren't selectable.

**Who:** Company Admins and HR Admins after payroll is enabled and company and payroll onboarding are complete.

### Facts

* Health partner rows under **Benefits** → **Health** open partner websites in a new tab. A new SimplyInsured connection opens Connecting Every to SimplyInsured with a data-sharing message, **Connect** and **No, Thanks**. The dialog has no user-entry form fields. **Connect** continues; **No, Thanks** dismisses the dialog. An existing SimplyInsured connection opens the employer's partner URL directly.
* Every's **Health, Dental, and Vision** row on **Benefits** appears for a primary-filing workplace in California, company-enabled New York or North Carolina, or an existing Every medical policy.
* **Shop plans** under **Benefits** → **Health, Dental, and Vision** opens **Get started** → **Plans** → **Review**. **Migrate existing** is unavailable and marked Coming soon.
* In **Get started** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, **Start date** and **Primary workspace** set the package context. **Eligible for benefits** opens the roster. The part-time eligibility switch is disabled.
* In **Plans** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, benefit tabs are **Health**, **Dental** and **Vision**. Individual plans use **Select plan** and plan groups use **Choose**. Available plans and carriers vary by company.
* In **Plans** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, **HRA Enabled Plans** identifies a group containing HRA-enabled plans. An interactive badge or **See calculation** opens a comparison and estimated savings.
* The HRA calculation under **Benefits** → **Health, Dental, and Vision** → **Shop plans** explains when it lacks a higher-tier standard plan, eligible employees, employee birthdates, workplace pricing or a recommended amount. A missing comparison does not provide an estimated savings figure.
* In **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, **Company CEO** and **Waiting period** are required. Packages with health plans also show **Worker's compensation insurance carrier** and require a **Coverage type** plus **Company pays** and **Company pays for dependents** percentages. **Employee pays** shows the remainder.
* In **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, an entered **Company pays** percentage must be at least 50% for health, dental and vision employee-only premiums.
* In **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, each enabled HRA has **Annual HRA budget (individual)** for employees without dependents and **Annual HRA budget (family)** for employees with dependents. Both annual amounts must be greater than \$0.
* In **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, a recommended HRA budget names the compared plans and shows individual and family amounts. **Apply** copies both recommended amounts into the budget fields. **Apply** is absent when the fields already match the recommendation or editing is unavailable.
* Without a recommendation in **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, the HRA budget fields remain available for entering amounts.
* Every enables per-plan **HRA** switches in **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans** company by company. When the switches appear, selected health plans can be configured individually. Turning a plan's **HRA** switch off hides that plan's annual budget fields.
* In **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, **Estimated cost** shows an annual **HRA budget** row when HRA plans are configured and eligible employees are present. Selecting **HRA budget** opens **Estimate your annual HRA spend**.
* **Expected employee utilization** in **Estimate your annual HRA spend** changes the spending projection without editing the annual HRA budget fields. The sheet shows **Total annual HRA budget**, **Estimated amount returned** and **Estimated savings with HRA**. These displayed estimates do not confirm actual payments or refunds.
* **Estimate your annual HRA spend** uses the per-employee plan selections when available or states its assumed individual-plan enrollment. The estimate states the utilization assumption and warns that actual costs can differ.
* The plan-year dashboard under **Benefits** → **Health, Dental, and Vision** marks HRA-enabled plans with **HRA Enabled**. Selecting a plan opens its details, including **HRA contribution** and the configured individual and family amounts. Medical plan details display effective deductibles after subtracting the applicable HRA allowance, with a minimum displayed result of \$0.
* Signing requirements in **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans** depend on the package. A document-signing package requires signatory names and agreement to the displayed documents, including **Accept terms & conditions**.
* **Submit** in **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans** saves the package and returns to the year-specific dashboard. Submission does not start enrollment. **Finish Later** saves progress and returns to **Benefits**.
* The **Shop Benefit Plans** setup under **Benefits** → **Health, Dental, and Vision** has **Shop Plans** → **Company Details** → **Coverage & Costs**. **Shop Benefit Plans** offers **Book a time** to arrange a meeting with Every's team. **Company Details** collects plan start date, CEO, workers' compensation carrier and waiting period. **Coverage & Costs** collects company contributions and displays a Statement of Information upload for California companies. **Complete Setup** saves those details and displays **We're setting up your benefits**.
* Plan-year cards under **Benefits** → **Health, Dental, and Vision** show Draft, Submitted, Open Enrollment, Pending, Active or Expired.
* **Prepared by Every** under **Benefits** → **Health, Dental, and Vision** means Every is still finalizing that year's plans. **Prepared by Every** cards aren't selectable.
* On a plan-year dashboard under **Benefits** → **Health, Dental, and Vision**, use **Review plans** when shown, then submit the package. **Set active** starts enrollment after plans are submitted.
* **Notify employees** on a plan-year dashboard under **Benefits** → **Health, Dental, and Vision** becomes available after plans are active. Selecting it marks the step complete in that browser. Checklist completion does not confirm email delivery.
* **Close enrollment** on a plan-year dashboard under **Benefits** → **Health, Dental, and Vision** moves the year to Pending and shows the Application review, Carrier review and Approved tracker. Closing enrollment does not confirm carrier submission or approval.
* **QLE request** rows under **Pending actions** on a plan-year dashboard under **Benefits** → **Health, Dental, and Vision** open **QLE Requests**.
* **QLE Requests** under **Benefits** → **Health, Dental, and Vision** shows the event type, **QLE date**, **Effective date**, **End date** and **What's changing**. **Supporting Document** offers a download when a document exists, or shows **Attested, no document** when an attestation exists instead.
* **Approve** in **QLE Requests** under **Benefits** → **Health, Dental, and Vision** opens **Approve benefit change** for confirmation. **Reject** opens a dialog requiring a nonempty **Reason**. A successful update closes the request and shows "Benefit change request updated".
* Employees open **Enroll in health benefits** or **Edit your health benefit selection** from **Home** to select plans for the to-do's year. See [Home to-dos](https://every-a2724ddc.mintlify.site/employees/home.md#to-dos). Employees see their own benefits on **My profile**. See [My profile benefits](https://every-a2724ddc.mintlify.site/employees/my-profile.md#benefits).

### Questions people ask

* **Does submitting plans open enrollment?** No. In **Shop plans**, **Submit** returns to the plan-year dashboard under **Benefits** → **Health, Dental, and Vision**. **Set active** starts enrollment.
* **Why is Set active unavailable?** Select and submit plans first. On the plan-year dashboard under **Benefits** → **Health, Dental, and Vision**, use **Review plans** when shown, then submit the package.
* **Does Notify employees mean everyone received an email?** No. **Notify employees** on the plan-year dashboard under **Benefits** → **Health, Dental, and Vision** marks the step complete in that browser. Checklist completion does not confirm email delivery.
* **Does Close enrollment mean the carrier has approved coverage?** No. **Close enrollment** on the plan-year dashboard under **Benefits** → **Health, Dental, and Vision** moves the year to Pending and shows the application tracker. Closing enrollment does not confirm carrier submission or approval.
* **Can I migrate existing plans with Migrate existing?** No. **Migrate existing** in the **Shop plans** setup under **Benefits** → **Health, Dental, and Vision** is unavailable and marked Coming soon.
* **Why can't I see an HRA savings calculation?** The calculation under **Benefits** → **Health, Dental, and Vision** → **Shop plans** needs a comparable higher-tier plan and the inputs needed to price the comparison. Read the explanation shown for missing inputs or unavailable pricing.
* **Why is Apply missing from an HRA recommendation?** In **Review** under **Benefits** → **Health, Dental, and Vision** → **Shop plans**, **Apply** appears when editing is allowed and the budget fields differ from the recommendation. A plan without a recommendation keeps its budget fields for entering amounts.
* **Does changing expected HRA utilization change the annual allowance?** No. **Expected employee utilization** in **Estimate your annual HRA spend** changes the projection, not the plan's annual HRA budget fields.

### Not covered here

* Can my company use SimplyInsured without an existing policy? To ask, email [support@every.io](mailto:support@every.io).
* Which plans, carriers and prices can my company use? To ask, email [support@every.io](mailto:support@every.io).
* When will employee enrollment emails arrive? To ask, email [support@every.io](mailto:support@every.io).
* When is the carrier application submitted, when will coverage be approved and when do member IDs arrive? To ask, email [support@every.io](mailto:support@every.io).
* Does a particular employee qualify for coverage, and what are the legal or tax consequences of their election? To ask, email [support@every.io](mailto:support@every.io).
* When are HRA funds collected, deposited or returned, and how long do claims or card delivery take? To ask, email [support@every.io](mailto:support@every.io).


## Related topics

- [Benefits & Insurance](https://every-a2724ddc.mintlify.site/admins/benefits/overview.md)
- [Financial benefits](https://every-a2724ddc.mintlify.site/admins/benefits/other-benefits.md)
- [Home](https://every-a2724ddc.mintlify.site/employees/home.md)


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