How Gusto health insurance works
When you buy health insurance in Gusto, Gusto is your broker of record. You pick a small group plan from the carriers available in your state, Gusto handles enrollment and payroll deductions, and Gusto earns a commission from the carrier. It doesn't charge an extra admin fee when it's your broker. If you keep an outside broker and connect the plan to Gusto, Gusto charges $6 per eligible employee per month.
In practice the quote often moves through a chain: Gusto as broker, a general agency, then the carrier. Each layer is paid through commissions that are built into the premium you pay.
So is the insurance good?
The plans are real, mainstream carrier plans. A Blue Shield PPO bought through Gusto is the same plan you'd get through any broker, at the same filed price. Quality depends on the plan you choose:
- Network: PPO plans are broader; HMO and EPO plans are cheaper but narrower.
- Deductible and out-of-pocket maximum: what your team actually pays when they get care.
- Metal level: bronze, silver, gold and platinum change premiums and cost-sharing.
What Gusto can't do is change the economics. You're still buying a fully insured small group plan, so you pay the carrier's rates, and the carrier keeps whatever it doesn't spend on claims.
My take
| Your situation | My take |
|---|---|
| Already on Gusto payroll, want a standard plan fast | Gusto is a convenient way to buy it |
| Want lower cost than carrier rates | Gusto can't help; the price is the carrier's |
| Want a richer plan for recruiting | Look at a Prescience plan |
| Want to keep Gusto payroll but change insurance | Easy: Prescience connects to Gusto |
Keep Gusto payroll, upgrade the plan
At Prescience, we design and run your company's health plan, from setup and enrollment to claims, compliance and COBRA. What your team gets:
- An effective $0 deductible, so the plan helps from the first visit.
- Simple copays shown before a visit, capped by a low out-of-pocket maximum.
- A broad national PPO network, plus providers we contract with directly.
- 24/7 physician-led care navigation: a care team that finds the right provider, books appointments and explains costs up front.
What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees. You keep your payroll provider, and the plan can start mid-year.
See what your team would pay with Prescience
Answer a few questions about your team and get a quote in about 60 seconds, or talk it through with one of our benefits experts.
