2021-12_LTD_Invoice_(01).pdf

This document is an invoice detail from United Healthcare eAdministration for Pinellas County's Payroll BCC and CCC department, located at 14 S. Ft. Harrison Ave., 3rd Fl., Clearwater, FL 33756. The invoice covers the coverage period from 12/01/2021 to 12/31/2021, with an invoice date of 11/15/2021 and a due date of 12/01/2021. The invoice is for a Long Term Disability plan, with a current period count of 1,954 and a current period volume of $100,051,736.

The total billed amount is $39,201.77, with no retro amount and a total premium due of $38,477.16. The invoice uses a rate of $0.3900 and is associated with Group ID 306594 and Subgroup ID 1003. The document provides options to make a payment, download the invoice to Excel, or return to the list of invoices.