How to File a Claim
STD & LTD Claim Instructions
How to File a Claim
If you know you will be taking time off due to a scheduled surgery or maternity leave, please reach out to HR and Symetra with the dates you will be away from work. If your disability is due to an unplanned accident or illness, please contact HR and Symetra as soon as possible.
Claim Filing Instructions
Collect the following information:
- Your contact information and Social Security number
- Your job title and date of hire
- Your policy number – 01-021033-00
- Your condition—whether you’re out of work due to illness, injury, scheduled surgery, or pregnancy
- Your attending physician’s name, telephone, and fax
Contact Symetra to start your claim:
- Call 1-877-377-6773 to connect with the Symetra claims department
- A claims intake rep will initiate the claim immediately and walk you through the responsibilities of Symetra, WCMHS, and you the employee to clarify everyone’s roles and responsibilities in the claim process.
- Reach out with any questions by calling 1-877-377-6773 or emailing LADCLA@symetra.com
Short-Term Disability (STD)
Short-term disability (STD) is a benefit that provides income replacement for up to 26 weeks for employees who are unable to work due to a qualifying medical condition, such as injury, illness, or pregnancy. The benefit provides 50% of your basic weekly earnings, with a maximum weekly benefit of $2,000.
Accident: an injury that happens unexpectedly, without a deliberate plan or cause, resulting in disability.
If a participating employee becomes disabled due to an accident/injury (off the job), they are eligible to receive benefits on the first (1st) day of the disability due to accident/injury.
Illness: sickness, disease, pregnancy, or complications resulting from pregnancy. Also includes scheduled surgeries.
If a participating employee becomes disabled due to illness (including pregnancy), they are eligible to receive benefits on their eighth (8th) day of disability due to the illness. Please note that PTO will be applied (if available) for the waiting period, which is the length of time from the 1st day of disability due to illness to the 8th day when the benefit payments will begin.
Maternity Leave
Maternity leave is included in the same category as illness for the purposes of short-term disability, and so an eligible employee who will be going on maternity leave will also have a waiting period, where the benefit does not begin payment until the eighth (8th) day of the maternity leave.
Long-Term Disability (LTD)
Your long-term disability (LTD) benefits will begin 180 days after the date of disability or the date payments under the short-term disability plan end.
Your LTD benefit pays 60% of your basic monthly earnings to a monthly maximum of $5,000, with a monthly minimum of $100 or 10% of your gross monthly benefit, whichever is greater.
Life & AD&D Claim Instructions
WCMHS will file a life or accidental death claim on your behalf. In the event of a covered dependent’s passing, employees should contact Human Resources:
802-476-1729
Accident Claim Instructions
Your Accident Rider
The Agency provides employees with an accident policy that pays a certain benefit amount per injury; see certificate for specifics. This accident policy is automatically paired with your Silver medical plan and is paid for by WCMHS. If you are not enrolled in the Silver medical plan, you can enroll in accident coverage through payroll deductions.
When do I need to submit my claim?
All accident claims must be submitted within one year of the date of service. The first expense for an accident claim must be incurred within 60 days after the date of the accident.
Collect the following information:
- Your contact information and Social Security number
- Your job title and date of hire
- Your policy number – 13000000
- Your injury
- Date of injury
- Care received as a result of your injury (e.g. ambulance, hospital admission, surgery, follow-up visits, durable medical equipment, etc.)
- Your attending physician’s name, telephone, and fax
Contact Symetra to start your claim:
- Visit www.symetra.com/MyGO
- Click “Start My Claim”
- Answer the prompted questions
- Add any notes or comments
- Submit form
Reach out with any questions by calling 1-800-497-3699 or emailing sbclaims@symetra.com.
Hospital Indemnity Claim Instructions
Your Hospital Indemnity Benefit
This coverage provides a range of lump-sum benefits based on your hospitalization; see certificate for specifics. The benefits are paid directly to the insured and may be used for any purpose (healthcare or otherwise).
When do I need to submit my claim?
You have 90 days from the date of service to file a hospital indemnity insurance claim.
Collect the following information:
- Your contact information and Social Security number
- Your job title and date of hire
- Your policy number – 13000000
- Date of hospitalization
- Your attending physician’s name, telephone, and fax
Contact Symetra to start your claim:
- Visit www.symetra.com/MyGO
- Click “Start My Claim”
- Answer the prompted questions
- Add any notes or comments
- Submit form
Reach out with any questions by calling 1-800-497-3699 or emailing sbclaims@symetra.com.