Scheduled benefit accident
Financial protection for accidents big and small
Even common injuries like sprains and fractures can have a significant impact on employee finances. Our scheduled benefit accident insurance plan pays cash benefits for a wide variety of injuries and medical treatments to help reduce out-of-pocket costs.
Overview
Three standard plan designs—Base, Classic, and Premier—offer preset, increasing benefit amounts for injuries and related treatments such as dislocations, ligament tears, emergency care and follow-up appointments. Each plan can be customized to meet your clients’ specific needs. We standardly provide 24-hour coverage for accidents that occur on or off the job, but to reduce costs, we can offer non-occupational plans that only cover accidents occurring outside of work. |
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Enhanced scheduled benefit accident rider For minimal rate impact, choose our enhanced scheduled benefit accident rider, which adds: |
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27 additional covered injuries and diagnoses including:
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Initial accident benefit
Additional covered medical services
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These are only covered if they're required as a result of covered accidents that occur while the policy is in effect. |
Additional optional riders For an added premium, choose from the following benefits—several of which we pioneered—to further customize plans for your clients’ needs. Please note that products, features, terms and conditions may vary by state and may not be available in all U.S. states or any U.S. territory. Please contact your Symetra representative for additional information and state availability. |
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Family-focused benefit ridersParental caregiver benefit rider
Child care benefit rider
Pet care and boarding benefit rider
Catastrophic accident benefit ridersStandard
Enhanced
Organized sport activity benefit ridersChild organized sport activity benefit rider
Insured organized sport activity benefit rider |
First responder and health care worker benefit ridersFirst responder benefit rider
Health care worker benefit rider
Health systems additional benefit rider
Wellness screening benefit ridersStandard
Enhanced
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Compare our products
The following products, features, terms and conditions may vary by state and may not be available in all U.S. states or any U.S. territory. Please contact your Symetra representative for more information on state availability.
Product | Differentiators | Industry-specific features | Pairs well with: |
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Critical illness | Symetra considers any stage of breast cancer (even Stage 0) as invasive cancer in terms of benefit payouts. Optional benefits for mental illness, infertility treatments, sudden cardiac arrest, mini stroke (TIA) and more. Broad diagnosis requirements for medical conditions make it easy for employees to qualify for claims. Pays the organ transplant benefit when the need for a transplant identified, not after it's completed, so that more insureds qualify for claims. |
Benefits are available for diagnoses that health care workers may experience more frequently, like occupational HIV, TB and hepatitis, as well as for many community- and hospital-acquired infectious diseases that result in hospitalization. | Group disability: Serious illnesses often require time away from work. Having both plans helps employees recover from their medical bills and lost income. Stop loss: A $5,000 step-down deductible may be available for groups who offer Symetra Critical illness along with their Symetra Stop Loss policy. |
Scheduled benefit accident | An initial accident benefit is paid with every approved claim to help cover incidentals such as travel, parking and over-the-counter medication. Benefits for sprains, accidental poisoning, gunshot wounds, animal bites and other frequently seen injuries. Optional benefits to support parents, pet owners, organized sport participants, multigenerational households, first responders and health care workers. |
Health care workers can receive additional benefits if they’re injured while performing their job duties, including injuries resulting from workplace aggravated assaults and occupational HIV/HEP/TB exposures or diagnoses. They can also receive an increased benefit amount when they choose to visit a hospital or facility within their group’s system. First responders who sustain a covered injury while performing their standard occupational duties receive an additional benefit payout. They also receive benefits for gunshot wounds, workplace aggravated assault, occupational HIV/HEP/TB exposure or diagnosis and a line of duty death. |
Critical illness: Provide coverage for major illnesses as well as injuries—big and small—with both plans. Hospital indemnity: Serious accidents can lead to time in the hospital. Provide benefits for the injury, follow-up treatment and hospital stay with both plans. |
Per-occurrence accident | Option to cover one or three accidents per year, up to $10,000 per accident. Easy claims filing process. |
Simple, easy-to-understand product. |
Critical illness: Provide coverage for major illnesses as well as injuries—big and small—with both plans. Hospital indemnity: Serious accidents can lead to time in the hospital. Provide benefits for the injury, follow-up treatment and hospital stay with both plans. |
Hospital indemnity | Pays daily benefits to the employee or their covered spouse for routine childbirth, up to a specified number of days per year, with no preexisting condition limitation for pregnancy. No separate maximum for the number of times we’ll pay the higher initial day confinement benefit (admission benefit). Automatic coverage for newborns or newly adoptive children for 31 days, even with routine, uncomplicated births. |
Health care workers receive an increased benefit amount when they choose to visit a hospital or facility within their group’s system. Optional, HSA-compatible coverage for inpatient mental health, substance abuse and nursing facilities. Optional benefits for an observation unit, ambulance transport, surgical procedures and anesthesia. |
Group disability: Serious illnesses often require hospitalization. Having both plans helps employees recover from their hospital bills and lost income. Symetra Health: While hospital indemnity can pay for major medical events, including childbirth, Symetra Health can pay for over 13,000 moderate, severe and catastrophic diagnoses that may occur throughout the year. |
Symetra Health | Pays benefits solely based on diagnosis codes to the insured's Venmo, PayPal or bank account. Multiple diagnoses within the same year are covered, with no maximum number of payouts for moderate and severe conditions. |
Benefits for over 13,000 covered illnesses or injuries, including common conditions that may occur in active workforces, like concussions, dehydration and migraines. |
Hospital indemnity: This combination provides broad coverage of injuries and illnesses, while also providing substantial benefits for the most common reason for hospitalization—childbirth. |
FAQ
Do rates remain competitive when the enhanced scheduled benefit accident rider is included?
Yes. And if your client is switching from another carrier, we can compare in-force benefits and rates to provide the best options for each group.
Does your plan include benefits that other carriers don’t offer?
Yes. We’re currently the only carrier to offer coverage for sprains, electric shocks, carbon monoxide poisoning, mass shooting death, carjacking and hazardous chemical exposure, as well as optional benefits for parental caregivers (aka the “sandwich generation”).
What does the wellness benefit cover?
Our standard wellness benefit provides payments for 27 screenings, including mammograms, chest X-rays and child sports physicals. The enhanced version includes all the standard screenings plus annual physicals, biometric screenings, dental exams/cleanings, eye exams, immunizations and well-child exams.
Is your organized sport activity benefit rider only applicable to children?
We have options for children and adults. The child organized sport activity benefit rider pays a higher benefit amount if an insured child is injured during an organized sport. For an additional premium, the insured organized sport activity benefit rider pays a higher benefit amount if any covered dependent—adult or child, regardless of age—is injured during an organized sport.
Which benefit is automatically applied to every approved claim?
Under the enhanced scheduled benefit accident rider, an initial accident benefit ($50, $70, or $100) is automatically added to every approved claim to further help employees with out-of-pocket costs.
For clients new to accident insurance, do you have a simple "starter" plan?
You may want to consider our per-occurrence accident insurance, which covers one or three accidents per year under a simple plan design. Learn more here.
Broker resources
Video: Scheduled benefit accident insurance |
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Product guide (PDF) |
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Product guide for health care employers (PDF) |
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Marketing materials |
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Video library |
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Forms library |
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Find your local Symetra representative |
Want to learn more? Contact your Symetra representative today.
Scheduled benefit accident coverage, insured by Symetra Life Insurance Company, 777 108th Ave NE, Suite 1200, Bellevue, WA 98004, is not available in all U.S. states or any U.S. territory. It pays a fixed amount and does not cover losses due to sickness, nor does it cover the cost of all hospital and medical services. 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-03510 1/18.
Coverage may be subject to exclusions, limitations, reductions and termination of benefit provisions.
THE ACCIDENT POLICY IS ISSUED AS AN ACCIDENT ONLY POLICY. IT DOES NOT PAY BENEFITS FOR LOSS CAUSED BY ILLNESS.
The policies and riders are not available in all U.S. states or any U.S. territory. Terms and conditions may vary by the state in which they are available. A rider is a provision of the policy that may have additional costs, limitations, potential benefits and features that should never be confused with the base policy itself. Before evaluating the benefits of a rider, carefully examine the policy to which it is attached.
Enhanced Catastrophic Accident Benefit Rider form number in most states is SBC-03513-CAB 2/24. Organized Sport Activity Benefits Rider form number in most states is SBC-03513-COS 2/24. Family Care Benefits Rider form number in most states is SBC-03513-FCB 2/24. First Responder-Specific Benefits Rider form number in most states is SBC-03513-FRB 2/24. Health Care Worker-Specific Benefits Rider form number in most states is SBC-03513-HCW 2/24. Parental Caregiver Benefit Rider form number in most states is SBC-03513-PCB 2/24. Health System Additional Benefit Rider form number in most states is SBC-03515-HSR 6/23. Wellness Screening Benefits Rider form number in most states is SBC-03513 WEL 2/24.
WEB-1370 10/25