The critical difference

How Symetra Critical Illness Insurance helps clients solve multiple coverage challenges

We built our critical illness policy to address several coverage and claims challenges that employers often face. Wish you could exclude preexisting condition limitations? Add recurrence benefits? Address the rising costs of infertility and mental health treatments? With Symetra, you can.

We offer flexible plan designs, customizable benefits and coverage for a wide range of medical concerns, including infectious diseases, mental illness, infertility, diabetes, minor cancers and more.

11 common pain points our policy can address for your clients¹

1. Multiple diagnoses but only one payout

The challenge

Employees may be diagnosed with two different critical illnesses but only receive one benefit payout from their critical illness policy.

The Symetra solution

Our policy includes an additional occurrence benefit, so a diagnosis of a new, covered condition is payable with only a one-day waiting period between diagnoses.

2. Recurrences of the same condition with only one payout

The challenge

Insureds may not receive additional benefits from their critical illness policy after recurrences of the same condition.

The Symetra solution

Clients can choose to offer benefits for one, two, three, four or an unlimited number of recurrences of conditions such as heart attacks for up to 100% of the benefit amount. Waiting periods may be as short as six months between diagnoses.

3. Preexisting condition limitations

The challenge

Employees with preexisting conditions may not enroll in valuable benefits offered at work.

The Symetra solution

Our policy standardly excludes a preexisting condition limitation.

4. Lack of financial assistance for infertility treatments

The challenge

Employees trying to start families may need to use reproductive technology, but major medical plans don’t always cover it.

The Symetra solution

Our family planning module can provide a benefit payout if infertility medication, IUI, surgery, embryo implantation and/or egg retrieval is required as a result of infertility.

5. No coverage for diabetes

The challenge

Nearly 30 million Americans have been diagnosed with diabetes, yet many critical illness policies don’t cover it.²

The Symetra solution

Coverage is available for Type 2 diabetes and resulting severe complications.

6. Benefit limitations for minor vs. invasive cancer

The challenge

If an employee is diagnosed with breast cancer at an early stage, it may be considered a minor cancer and they’ll only receive a portion of their critical illness insurance benefits.

The Symetra solution

Invasive cancers are typically covered at a higher benefit percentage than minor cancers. We consider any type of breast cancer to be invasive, regardless of the stage.

7. No coverage for mental illnesses

The challenge

Half of lifelong mental illnesses begin by the age of 14, and three-quarters begin by age 24.³ Still, many mental illnesses aren’t included in typical critical illness policies.

The Symetra solution

Our policy can be designed to pay a benefit to insureds needing hospitalization due to severe mental illnesses.

8. Limited coverage for infectious diseases

The challenge

Employees diagnosed with infectious diseases not specifically named in a critical illness policy may not receive benefits.

The Symetra solution

Our policy covers any infectious disease that results in a hospitalization of three days or more to treat. And our definition of infectious disease includes coverage for future community-acquired or pandemic-type illnesses.

9. Caps for non-melanoma skin cancer benefits

The challenge

Some policies have a once-per-lifetime benefit payout or a maximum cap on benefits for non-melanoma skin cancer.

The Symetra solution

Our policy can pay the non-melanoma skin cancer benefit more than once.⁴

10. No coverage for a mini stroke (TIA)

The challenge

Many policies don’t include coverage for a transient ischemic attack, also known as a mini stroke.

The Symetra solution

We provide a benefit for this diagnosis under our enhanced core coverage.

11. Coverage for heart attacks, but not sudden cardiac arrest

The challenge

Employees who experience sudden cardiac arrest may be frustrated to find that their critical illness coverage for heart attacks doesn’t apply to their diagnosis.

The Symetra solution

Our enhanced core coverage pays claims for both heart attacks and sudden cardiac arrests.

Value at every stage of life

All employees have different needs, and they evolve over time. Symetra Critical Illness Insurance can meet these changing needs by covering medical conditions that appear in young adulthood, mid-life and beyond. Plus, our broad definitions of medical conditions make qualifying for claims easy, so your clients can be assured their employees will get the most out of their benefits.

To learn how Symetra Critical Illness Insurance can serve as the next solution for your clients, contact your Symetra representative.

Critical illness policies, insured by Symetra Life Insurance Company, 777 108th Avenue NE, Suite 1200, Bellevue, WA 98004, are not available in all U.S. states or any U.S. territory. They are designed to provide benefits at a preselected, fixed dollar amount for covered conditions. They are not a replacement for major medical or other comprehensive coverage, and do not satisfy the minimum essential coverage requirements of the Affordable Care Act. Base policy form number is SBC-04530 1/21. Coverage may be subject to exclusions, limitations, reductions and termination of benefit provisions.

¹ The solutions in this list may not be available in all states.

² “By the Numbers: Diabetes in America,” Centers for Disease Control and Prevention, accessed January 18, 2024.

³ “Facts & Statistics,” National Alliance on Mental Illness, accessed January 18, 2024.

⁴ Most benefits can be paid more than once if a recurrence benefit is included in the plan.