Benefits
Symetra Health
A supplemental health insurance plan
Already a Symetra Health customer?
Overview
Stay competitive and retain talent with supplemental health benefits that can make a difference in your employees’ lives.
As medical costs continue to rise, employees can have a hard time covering expenses for even moderate health conditions. You can help by giving employees the opportunity to enroll in Symetra Health, a supplemental health insurance plan that provides benefits for over 13,000 conditions.
Note: Symetra Health is only available in a limited number of states at this time. Please contact your Symetra representative if you have questions regarding product availability.
Watch our brief video to learn how this innovative plan can help protect your employees' finances if they experience an unexpected illness or injury.
How it works
Symetra Health benefits are based solely on diagnosis codes. Each covered diagnosis falls into a covered category: Moderate, Severe, or Catastrophic. Each category has its own benefit amount, and every Symetra Health plan includes coverage for all three levels.
Sample plan:
Moderate benefit amount = $300
Severe benefit amount = $1,000
Catastrophic benefit amount = $2,000
Symetra Health helps employees pay for out-of-pocket costs like copays, deductibles or other expenses, all without having to provide a lengthy explanation of their accident or hospital stay.
Easy to use
- Employees submit claims within minutes online or via the Symetra Health mobile app.
- Benefits are paid directly to the claimant's PayPal, Venmo or bank account within 72 hours of an approved claim.
- Dedicated member support means your employees will be able to talk to the same person every time.
Easy to implement
- Use our Symetra Health Enroll platform, or build us into your existing administration technology.
- Enjoy paperless implementation and on-demand access to policy documents, enrollment data and plan administration tools through an online portal.
- Choose to offer as a voluntary or contributory plan, or cover 100% of the premium.
- Give employees a simple way to help protect their finances with rates starting as low as the monthly price of a TV streaming subscription.
Plan design options and examples of covered conditions
Plan design options
Choose to offer one, two or all three plan designs, with the flexibility to customize the benefit amounts in each plan.
Base
Moderate: $200
Severe: $500
Catastrophic: $1,000
Classic
Moderate: $300
Severe: $1,000
Catastrophic: $2,000
Premier
Moderate: $500
Severe: $1,500
Catastrophic: $3,000
Examples of covered conditions
This list is for illustrative purposes only. Symetra Health covers over 13,000 conditions across all three categories of severity.
Moderate
Anaphylactic reactions
Basal cell carcinoma
Bell's palsy
Benign breast tumor
Concussion
Dehydration
Foreign body in eye/ear/nose
Hepatitis C
Kidney stone
Knee sprain
Laceration
Pneumonia
Preterm newborn (34-35 weeks)
Simple fracture
Severe
Acute respiratory failure
Appendicitis
Benign neoplasm
Chronic adenoiditis/tonsillitis
Deep-vein thrombosis
Detached retina
Diverticulitis
Gallstones
Inguinal hernia
Preterm newborn (32-33 weeks)
Pulmonary embolism
Torn ACL
Torn rotator cuff
Unstable angina
Catastrophic
Abdominal aortic aneurysm
ALS (Lou Gehrig's disease)
Alzheimer's disease
Cardiac arrest
Heart attack
HIV
Leukemia
Malignant neoplasm
Multiple sclerosis
Parkinson's disease
Perforation of intestine
Preterm newborn (<31 weeks)
Sepsis
Spina bifida
Next steps
To learn more, contact your benefits broker or consultant.
IMPORTANT: This is a fixed indemnity policy, NOT health insurance
This fixed indemnity policy may pay you a limited dollar amount if you’re sick or hospitalized. You’re still responsible for paying the cost of your care.
- The payment you get isn’t based on the size of your medical bill.
- There might be a limit on how much this policy will pay each year.
- This policy isn’t a substitute for comprehensive health insurance.
- Since this policy isn’t health insurance, it doesn’t have to include most Federal consumer protections that apply to health insurance.
Looking for comprehensive health insurance?
- Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.
- To find out if you can get health insurance through your job, or a family member’s job, contact the employer.
Questions about this policy?
- For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners’ website (naic.org) under “Insurance Departments.”
- If you have this policy through your job, or a family member’s job, contact the employer.
Symetra Health is insured by Symetra Life Insurance Company, 777 108th Avenue NE, Suite 1200, Bellevue, WA 98004. Products, features, terms and conditions may vary by state. It is designed to provide benefits at a preselected, fixed dollar amount for covered diagnoses. This policy provides limited benefit coverage and is a supplement to health insurance. It is not a replacement for major medical or other comprehensive coverage, and does not satisfy the minimum essential coverage requirements of the Affordable Care Act. Base policy form number is SBC-05540 03/22.
Administration of Symetra Health is managed by a third-party administrator that provides enrollment, claims and billing administration. Coverage may be subject to exclusions, limitations, reductions and termination of benefit provisions.
If you're an employer in Arizona, please click this link to view the exclusions and limitations for Symetra Health.