23-Payments By Month 1223.xlsx

12 KB Posted

Attached to
Stop Loss Insurance
Solicitation number
RFP 26-023KB
Issued by
Fort Bend County, Texas

About this file

Written by GovTribe AI ·

The document is a monthly payments report from UnitedHealthcare, detailing financial transactions for policy number 000902915 across various benefit categories for the year 2023. The report is related to a stop loss insurance solicitation by Fort Bend Independent School District in Texas, covering administrative services for dental, medical, vision, pharmacy, and other healthcare benefits.

The payment report shows monthly variations in benefit payments across different policy suffixes (A, AA, AB, AC, AD, AE, AF, AG, AI), with total annual payments ranging from $7,735 for suffix A to $18,354,811 for suffix AI. The monthly payments fluctuate, with some months showing positive and negative adjustments, indicating a complex administrative services only (ASO) funding arrangement. The document is marked as confidential and contains proprietary business information, suggesting it is an internal financial tracking document for a healthcare benefits administration contract.

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Payments By Month

Payments By Month
Report Filter:
({Benefit Type Category} = Dental Benefit, FSA Benefit, Managed Pharmacy Benefit, Medical Benefit, Vision Benefit, HRA Benefit - Medical, HRA Benefit - Pharmacy) And ({-Policy Number} = 000902915) And ({Book Year/Month} = 2023-12, 2023-11, 2023-10, 2023-09, 2023-08, 2023-07, 2023-06, 2023-05, 2023-04, 2023-03, 2023-02, 2023-01) And ({Funding Arrangement Category} = Administrative Services Only)
'-Policy NumberSuffixBenefit PaymentMedicalTotal
Book Year/MonthPaymentsPayments
000902915A2023-03$4,381$4,381
000902915A2023-05($193)($193)
000902915A2023-06$50$50
000902915A2023-07$3,737$3,737
000902915A2023-11($309)($309)
000902915A2023-12$68$68
000902915ATotal$7,735$7,735
000902915AA2023-07($3,134)($3,134)
000902915AA2023-10($6,506)($6,506)
000902915AATotal($9,640)($9,640)
000902915AB2023-07($523)($523)
000902915ABTotal($523)($523)
000902915AC2023-01$869,471$869,471
000902915AC2023-02$889,674$889,674
000902915AC2023-03$966,055$966,055
000902915AC2023-04$931,112$931,112
000902915AC2023-05$834,937$834,937
000902915AC2023-06$875,249$875,249
000902915AC2023-07$1,002,689$1,002,689
000902915AC2023-08$1,212,655$1,212,655
000902915AC2023-09$1,122,705$1,122,705
000902915AC2023-10$956,975$956,975
000902915AC2023-11$1,280,117$1,280,117
000902915AC2023-12$997,433$997,433
000902915ACTotal$11,939,071$11,939,071
000902915AD2023-07($729)($729)
000902915AD2023-10($27)($27)
000902915ADTotal($756)($756)
000902915AE2023-01$853,641$853,641
000902915AE2023-02$528,224$528,224
000902915AE2023-03$809,938$809,938
000902915AE2023-04$842,490$842,490
000902915AE2023-05$750,236$750,236
000902915AE2023-06$694,662$694,662
000902915AE2023-07$985,203$985,203
000902915AE2023-08$1,298,642$1,298,642
000902915AE2023-09$612,492$612,492
000902915AE2023-10$772,562$772,562
000902915AE2023-11$939,160$939,160
000902915AE2023-12$929,105$929,105
000902915AETotal$10,016,353$10,016,353
000902915AF2023-01$26,226$26,226
000902915AF2023-02$13,099$13,099
000902915AF2023-03$14,330$14,330
000902915AF2023-04$6,469$6,469
000902915AF2023-05$6,872$6,872
000902915AF2023-06$11,579$11,579
000902915AF2023-07$19,751$19,751
000902915AF2023-08($36,000)($36,000)
000902915AF2023-09$20,198$20,198
000902915AF2023-10$28,513$28,513
000902915AF2023-11$24,348$24,348
000902915AF2023-12$23,748$23,748
000902915AFTotal$159,133$159,133
000902915AG2023-01$1,707,618$1,707,618
000902915AG2023-02$1,341,354$1,341,354
000902915AG2023-03$2,040,337$2,040,337
000902915AG2023-04$1,379,604$1,379,604
000902915AG2023-05$1,517,418$1,517,418
000902915AG2023-06$1,298,605$1,298,605
000902915AG2023-07$1,330,940$1,330,940
000902915AG2023-08$1,385,275$1,385,275
000902915AG2023-09$1,119,695$1,119,695
000902915AG2023-10$1,605,964$1,605,964
000902915AG2023-11$1,634,958$1,634,958
000902915AG2023-12$1,911,778$1,911,778
000902915AGTotal$18,273,546$18,273,546
000902915AI2023-01$1,468,800$1,468,800
000902915AI2023-02$1,285,654$1,285,654
000902915AI2023-03$1,718,749$1,718,749
000902915AI2023-04$1,230,113$1,230,113
000902915AI2023-05$1,367,238$1,367,238
000902915AI2023-06$1,507,324$1,507,324
000902915AI2023-07$1,357,253$1,357,253
000902915AI2023-08$1,942,320$1,942,320
000902915AI2023-09$1,505,038$1,505,038
000902915AI2023-10$1,561,164$1,561,164
000902915AI2023-11$1,465,433$1,465,433
000902915AI2023-12$1,945,726$1,945,726
000902915AITotal$18,354,811$18,354,811
This document contains UnitedHealthcare’s confidential and/or proprietary business information (PBI). PBI may only be used by
the recipient person/entity to which it is addressed. Recipient is liable for using and protecting UnitedHealthcare’s PBI from
further disclosure or misuse, consistent with recipient’s contractual obligations under any applicable administrative services
agreement, group policy contract, non-disclosure agreement or other applicable contract or law, including but not limited to the
U.S. Freedom of Information Act and state freedom of information law exemptions for “trade secrets”. The document may also
contain protected health information (PHI) and must be handled according to applicable state and federal law, including, but not
limited to HIPAA. Recipients who misuse information may be subject to both civil and criminal penalties.

File details come from the government source that posted it. Updated .