With the first round of Patient Protection and Affordable Care Act (PPACA) provisions set to take effect on Sept. 23, 2010, Symetra Life Insurance Company is ready to help employers manage costs and meet their obligations under the new healthcare law with its limited benefit insurance products and updated medical stop-loss policy. “We recognize the challenges employers face as PPACA requirements begin to roll out this week,” said Michael Fry, executive vice president of Symetra’s Group Division. “Medical plan expenses are going up, mini-meds are in transition, and the overall healthcare environment has become exponentially more complex. We’ve spent the last six months working with our distribution partners to make sure we have the right solutions in place as employers look to comply with the Act.” Symetra launched an updated stop-loss policy on Sept. 1, 2010 in most states. The revisions offer greater flexibility to tailor policies by state and by individual employer. This allows Symetra to design coverage that addresses a client’s specific needs. Medical stop-loss policies are purchased by employers with self-funded health plans. Employers pay for medical claims up to a certain deductible, and the stop-loss insurance carrier covers claims payments above that level, effectively capping risk. Among the changes going into effect this week are restrictions on annual maximums and the elimination of lifetime maximums. Most self-funded plans are required to make these changes beginning with their first renewal after Sept. 23, 2010. Symetra announced in June 2010 it would offer options for unlimited annual and lifetime benefits with its stop-loss insurance coverage on all new and renewed policies with effective dates of Sept. 1, 2010 or later. The future of certain expense-based — or “mini-med” — group plans remains unclear under PPACA. For the next few years, these group health plans must apply annually for a waiver to continue operating with annual coverage limitations beyond what the new law permits. For employers who want greater certainty, Symetra offers Select Benefits, a fixed-indemnity group insurance policy that is exempt from many of the Act’s provisions, including the restriction on annual maximums. Unlike mini-med providers, Symetra is not required to obtain a waiver to continue to provide limited benefit coverage to its participants.
Limited benefit medical products, like Select Benefits, offer employers a less-expensive, though less comprehensive, option for providing medical benefits to employees and their dependents. Select Benefits policies provide fixed benefit payments for routine services and preventive care, such as doctor’s office visits, as well as benefits for inpatient hospital stays, including ICU and mental health facilities. The policies are particularly suited to companies with part-time, seasonal or temporary workers where major medical plans are impractical or financially out of reach; or to companies looking to supplement their existing major medical plans to reduce the effect of high deductibles for their employees.Earlier this year, Symetra announced a new “Shared Maximum” option on its Select Benefits policies, giving employee participants more flexibility in accessing the medical benefits they use the most. The Shared Maximum option combines a pre-set group of benefits that share a combined calendar-year maximum, ranging from $10,000 to $100,000. While some plan designs limit doctor’s office visits to two or three visits per year, for example, the Shared Maximum option allows participants to visit a doctor as many times as they wish — as long as the fixed payments don’t exceed the policy maximum when combined with other benefits used in a calendar year. “As the healthcare market continues to evolve, group insurance carriers will need to revise and redesign their medical insurance policies to stay current with the law,” said Fry. “With our strong product lineup, Symetra is ready, willing and able to meet the needs of employers in this changing marketplace.” About Symetra Symetra Life Insurance Company is a subsidiary of Symetra Financial Corporation (NYSE: SYA), a diversified financial services company based in Bellevue, Wash. In business since 1957, Symetra provides employee benefits, annuities and life insurance through a national network of benefit consultants, financial institutions, and independent agents and advisors. For more information, visit www.symetra.com. Symetra medical stop-loss and select benefits policies are insured by Symetra Life Insurance Company, 777 108 th Avenue NE, Suite 1200, Bellevue, WA 98004 and are not available in all U.S. states or any U.S. territory. AOXP-343 9/10