Customer support

Stop loss frequently asked questions

Have you heard about Group Online (GO)? GO is a convenient, user-friendly administration tool that allows you to securely access and manage your Symetra stop loss policy from anywhere at any time. Use GO to quickly access administrative forms, view billing statements, run customized reports and more! Learn more at symetra.com/LearnGO.

How do I pay premiums for the stop loss policy?

You can make payments via transfer from your financial institution (wire or ACH) or directly on the GO portal.

How do I submit a reimbursement request and/or a Potential Claim Notification?

Please submit reimbursement requests and/or the Potential Large Claim Alert/50% Notification form to ELCLMS@symetra.com.

What are the timing requirements for reimbursement requests?

Please refer to your state-specific Symetra stop loss policy. However, for most policies:

  • Specific claims must be filed within one year of the specific deductible being breached.
  • Aggregate claims must be filed within one year of the contract ending.

How do I find my assigned claim examiner and/or medical risk consultant?

Claim examiners and medical risk consultants are assigned to regional group managers. Call us at 1-800-426-7784 to find yours.

How do I find a 50% notification and/or claim reimbursement form?

Please submit requests for a 50% Notification and/or claim reimbursement form to ELCLMS@symetra.com.

What vendors do you utilize for cost containment?

Call us at 1-800-426-7784 to have a Symetra representative review our Claims Cost Containment Resource List with you.

What information is required to process a specific and/or stop loss claim?

Call us at 1-800-426-7784 to have a Symetra representative review our Administrative Guide with you.

What is the average processing time for reimbursement requests?

All clean reimbursement requests are processed within 5 business days. We will accommodate rush requests when notified at time of claim submission.

Do you have trigger diagnosis with ICD-10 Diagnostic Codes listed?

Call us at 1-800-426-7784 to have a Symetra representative review our Administrative Guide with you.

What payment options are available for reimbursements?

Reimbursements may be made via:

  • Check mailed to the TPA submitting the claim, unless otherwise requested in writing.
  • Electronic funds transfer (EFT). To request EFT, please contactto ELCLMS@symetra.com.