Third-party administrators (TPAs) do essential work for self-funded health plans by providing benefits expertise that saves them time and money. Symetra is a committed partner to TPAs who help our shared customers implement and access our stop loss coverage.

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Here are some of the many ways we support our TPA partners.

  • Implementation experience: Symetra is well-respected in our field for our seamless implementation process. We provide a friendly welcome and establish clear expectations upfront, so there are no surprises later. Our team works hard to keep everything running smoothly for our mutual customers.
  • Pre-review of plan document: Symetra reviews the plan document with the customer before coverage begins to ensure that there are no unexpected obstacles to reimbursement when claims are filed down the road.
  • Creating and implementing electronic data: From day one of the coverage, we’ll track the customer’s claims data to proactively offer cost-containment solutions and make things simpler at the time of claim.
  • GO portal: With our Group Online (GO) portal, customers can pay their premiums, check claims statuses and more, anytime/anywhere.
  • Symetra Compliance Solutions: Our value-add program (provided by Enquiron®) is included with every Symetra stop loss policy at no additional cost. Clients can log in to get answers to regulatory and compliance questions related to their health plan, access educational webinars, resources, tools and more.
  • Peace of mind: Our Claim Reimbursement Guidance Program (AKA, Technical Referral Assistance Program) helps customers avoid delays and surprises by letting groups find out–in advance–how Symetra will reimburse a stop loss claim according to the plan document. They can request a review at any time, for any reason-even before the specific deductible is met. If a claim requires review by an outside physician, we’ll submit it on the group’s behalf at no added cost. We’ll even fund the reimbursement in advance.

Symetra has been in the stop loss business for more than 45 years and we have supported TPAs in the past. From implementation to claims payment, we’re ready to help our TPA partners and our shared customers with any questions or issues that may arise.

To learn more, contact your Symetra representative.