Appendix_C_-_Life_and_Disability_Insurance_Experience_Reports.pdf

ORANGE COUNTY BOARD OF COUNTY COMMISSIONERS

Group Policy 641718

REFUNDING EXPERIENCE REPORT

Basic Life

1/1/2022 1/1/2007 1/1/2002 1/1/2002 through through through through

9/30/2022 9/30/2022 12/31/2006 9/30/2022

Earned Premium 147,138 4,101,639 3,664,734 7,766,373

Paid Claims 638,160 10,707,471 2,819,049 13,526,520

Change in Active Claim Reserves 19,350 (485,825) 1,703,175 1,217,350

Change in IBNR Reserves (194) (27,223) 66,719 39,496

Conversions 706 26,692 57,726 84,418

Total Incurred Claims 658,022 10,221,116 4,646,669 14,867,785

Less:

Commissions 0 71,108 128,244 199,352

Premium Taxes 2,576 71,779 64,132 135,911

Admin Fees 0 0 0 0 Other Expenses and Risk Charges 33,881 648,632 440,400 1,089,032

Total Expenses and Risk Charges 36,457 791,519 632,776 1,424,295

Balance (547,341) (6,910,996) (1,614,711) (8,525,707) cb

10/18/2022

641718 ORANGE COUNTY BOARD OF COUNTY COMMISSIONERS

Group Claim Experience as of 10/31/2002 1/1/2018 through 9/30/2022

THE INFORMATION IN THESE REPORTS IS CONFIDENTIAL AND PROPRIETARY. THESE REPORTS ARE TO BE ACCESSIBLE ONLY TO THOSE COMPANY PERSONNEL WHO HAVE A LEGITIMATE BUSINESS REASON TO EXAMINE THE INFORMATION. THESE REPORTS MAY NOT BE REDISCLOSED

WITHOUT THE WRITTEN AUTHORIZATION OF STANDARD INSURANCE COMPANY.

Claim Number Gender Coverage Product Birth Date Incurred

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

E46312 M TERM BL Nov-62 Jun-17 Mar-18 Mar-18 42,000.00 42,000.00 42,000.00 E46363 M TERM BL Feb-72 Aug-17 Sep-17 Jun-18 70,000.00 70,000.00 70,000.00 E59770 F TERM BL Jan-78 Oct-17 Mar-18 Apr-18 31,000.00 31,000.00 E54142 M TERM BL Feb-70 Dec-17 Jan-18 Aug-18 45,000.00 45,000.00 E64995 M TERM BL Nov-77 Apr-18 May-18 Jun-18 55,000.00 55,000.00 E65990 M TERM BL Feb-86 May-18 May-18 Jun-18 42,000.00 42,000.00 E69288 M TERM BL Apr-57 Jun-18 Jun-18 Jun-18 93,000.00 93,000.00 E70020 F TERM BL Aug-58 Jun-18 Jul-18 Jul-18 32,000.00 32,000.00 E73017 M TERM BL Oct-57 Aug-18 Aug-18 Aug-18 43,000.00 43,000.00 E74096 M TERM BL Aug-58 Aug-18 Feb-19 Feb-19 52,000.00 52,000.00 E77917 M TERM BL Aug-63 Oct-18 Oct-18 Nov-18 37,000.00 37,000.00 E79335 M TERM BL Dec-54 Oct-18 Nov-18 Jan-19 36,000.00 36,000.00 E81414 F TERM BL Dec-56 Nov-18 Dec-18 Dec-18 87,000.00 87,000.00 E83858 M TERM BL Jan-63 Jan-19 Jan-19 Feb-19 57,000.00 57,000.00 E86795 M TERM BL Jul-54 Feb-19 Feb-19 Feb-19 51,000.00 51,000.00 E88063 M TERM BL Oct-66 Feb-19 Mar-19 Mar-19 40,000.00 40,000.00 E88359 M TERM BL Jul-60 Feb-19 Mar-19 Mar-19 45,000.00 45,000.00 E98188 F TERM BL Dec-61 Jun-19 Jul-19 Aug-19 50,000.00 50,000.00 F01766 F TERM BL Jun-60 Jul-19 Aug-19 Aug-19 81,000.00 81,000.00 F03819 F TERM BL Apr-76 Aug-19 Sep-19 Feb-20 30,000.00 30,000.00 F05519 M TERM BL Nov-54 Sep-19 Oct-19 Oct-19 30,000.00 30,000.00 F08228 F TERM BL Sep-47 Nov-19 Nov-19 Feb-20 20,500.00 20,500.00 F14955 F TERM BL Dec-59 Jan-20 Feb-20 Feb-20 43,000.00 43,000.00 F20188 F TERM BL Sep-59 Mar-20 Apr-20 Apr-20 180,000.00 180,000.00 F20658 F TERM BL Jan-76 Apr-20 Apr-20 Apr-20 40,000.00 40,000.00 F21449 F TERM BL Mar-63 Apr-20 Apr-20 Nov-20 55,000.00 55,000.00

Claim Number Gender Coverage Product Birth Date Incurred

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

F22085 F TERM BL Jan-65 Apr-20 May-20 Apr-21 38,000.00 38,000.00 F23789 M TERM BL Apr-56 May-20 May-20 Jun-20 83,000.00 83,000.00 F24580 F TERM BL Oct-67 May-20 Jun-20 Jun-20 38,000.00 38,000.00 F43063 F TERM BL Aug-60 Jun-20 Mar-21 Mar-21 36,000.00 36,000.00 F30568 M TERM BL May-62 Aug-20 Sep-20 Jan-21 37,000.00 37,000.00 F31457 F TERM BL Jul-76 Aug-20 Sep-20 Sep-20 109,000.00 109,000.00 F42855 M TERM BL Sep-69 Dec-20 Jan-21 Jul-21 46,000.00 46,000.00 F48072 M TERM BL Oct-63 Feb-21 Mar-21 Mar-21 20,000.00 20,000.00 F48471 M TERM BL Apr-61 Feb-21 Mar-21 Mar-21 78,000.00 78,000.00 F46218 F TERM BL Mar-68 Feb-21 Feb-21 Feb-21 41,000.00 41,000.00 F51846 F TERM BL Nov-75 Mar-21 Apr-21 Apr-21 39,000.00 39,000.00 F54320 M TERM BL Jul-90 Apr-21 Jun-21 Sep-21 49,000.00 49,000.00 F54333 M TERM BL Jan-88 Apr-21 May-21 May-21 44,000.00 44,000.00 F54690 M TERM BL Dec-74 May-21 Jun-21 Jun-21 70,000.00 70,000.00 F57320 M TERM BL Sep-88 May-21 Jul-21 Aug-21 48,000.00 48,000.00 F58959 M TERM BL Sep-78 Jun-21 Jul-21 Aug-21 58,000.00 58,000.00 F60794 F TERM BL Dec-80 Jul-21 Aug-21 Jan-22 54,000.00 54,000.00 F62086 M TERM BL Aug-68 Aug-21 Aug-21 Aug-21 48,000.00 48,000.00 F62091 M TERM BL Oct-66 Aug-21 Aug-21 Aug-21 57,000.00 57,000.00 F62944 M TERM BL Feb-71 Aug-21 Sep-21 Sep-21 59,000.00 59,000.00 F63315 F TERM BL Apr-67 Aug-21 Sep-21 Sep-21 83,000.00 83,000.00 F63687 M TERM BL Mar-66 Aug-21 Sep-21 Sep-21 62,000.00 62,000.00 F64614 F TERM BL Oct-63 Aug-21 Sep-21 Sep-21 50,000.00 50,000.00 F63810 M TERM BL Jul-67 Aug-21 Sep-21 Sep-21 37,000.00 37,000.00 F63172 F TERM BL Jun-90 Aug-21 Sep-21 Sep-21 32,000.00 32,000.00 F74843 F TERM BL Sep-53 Aug-21 Jan-22 Jan-22 33,800.00 33,800.00 F66057 M TERM BL Jul-64 Sep-21 Nov-21 Nov-21 50,000.00 50,000.00 F64907 F TERM BL Jul-70 Sep-21 Oct-21 Oct-21 34,000.00 34,000.00 F69904 M TERM BL Oct-65 Oct-21 Nov-21 Nov-21 71,000.00 71,000.00 F75883 M TERM BL Aug-68 Dec-21 50,000.00 F84402 F TERM BL Feb-61 Jan-22 May-22 May-22 43,000.00 43,000.00 F79849 M TERM BL Feb-61 Feb-22 Mar-22 Mar-22 56,000.00 56,000.00 F80812 F TERM BL Dec-60 Feb-22 Mar-22 Apr-22 71,000.00 71,000.00 F86479 M TERM BL Mar-54 Apr-22 May-22 May-22 113,750.00 113,750.00 F87449 M TERM BL Dec-56 Apr-22 May-22 May-22 97,500.00 97,500.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

F87450 M TERM BL Aug-63 May-22 Jun-22 Jun-22 57,000.00 57,000.00 F89007 F TERM BL Apr-76 May-22 Jun-22 Jun-22 33,000.00 33,000.00 F90798 M TERM BL Apr-62 May-22 Aug-22 Aug-22 57,000.00 57,000.00 F93140 F TERM BL Dec-69 Jul-22 Sep-22 Oct-22 22,110.00 22,110.00 10,890.00 F93711 M TERM BL Aug-91 Jul-22 Oct-22 Oct-22 46,000.00

A47641 F TPD2 BL Oct-58 Aug-02 Sep-02 22,000.00 14,300.00 14,300.00 A52809 M TPD2 BL Apr-56 Oct-02 Jan-03 May-20 53,950.00 A78525 F TPD2 BL Sep-54 Jan-03 Mar-03 Sep-19 24,700.00 A99535 M TPD2 BL Dec-56 Sep-03 Mar-04 Dec-21 38,350.00 B22370 F TPD2 BL Feb-61 Jul-04 Apr-05 Apr-22 27,950.00 B23372 M TPD2 BL Feb-59 Jul-04 May-05 Jan-18 26,000.00 B24966 F TPD2 BL May-70 Nov-04 May-05 24,000.00 15,600.00 15,600.00 B31260 F TPD2 BL Sep-72 Jan-05 Jan-06 27,000.00 17,550.00 17,550.00 B31818 M TPD2 BL Jun-53 May-05 Sep-06 Jun-18 24,700.00 B53708 F TPD2 BL Dec-57 Jun-05 Sep-06 48,000.00 31,200.00 31,200.00 B40174 F TPD2 BL May-69 Nov-05 Jan-06 38,000.00 24,700.00 24,700.00 B44347 M TPD2 BL Mar-50 Feb-06 Sep-06 Apr-20 21,547.50 B51110 M TPD2 BL Jul-59 May-06 Oct-06 50,000.00 32,500.00 32,500.00 B52329 F TPD2 BL Jan-56 Jun-06 Jul-06 Aug-21 24,050.00 B68948 F TPD2 BL Jan-61 Jun-06 Apr-07 27,000.00 17,550.00 17,550.00 B80424 M TPD2 BL Sep-74 Dec-06 Apr-08 36,000.00 23,400.00 23,400.00 B76176 M TPD2 BL Jan-56 Jan-07 Aug-07 Feb-21 31,200.00 B85254 F TPD2 BL Aug-60 Mar-07 Sep-10 Jan-21 23,400.00 B99689 F TPD2 BL Nov-61 Sep-07 Jul-08 22,000.00 14,300.00 14,300.00 C29454 F TPD2 BL Jul-55 Mar-08 Sep-09 Jul-20 30,550.00 C17124 F TPD2 BL Jun-53 May-08 Feb-09 Jun-18 20,150.00 C15808 F TPD2 BL Aug-56 Jun-08 Jan-09 May-22 20,150.00 C80054 F TPD2 BL Apr-60 Dec-08 May-11 64,000.00 41,600.00 41,600.00 C22052 F TPD2 BL May-54 Feb-09 Apr-09 Jun-19 37,700.00 C35382 F TPD2 BL Aug-55 Mar-09 Oct-09 Sep-20 17,550.00 C35440 F TPD2 BL Mar-55 Apr-09 Apr-10 Mar-20 27,300.00 C42328 M TPD2 BL Dec-54 Jun-09 Jan-10 Nov-18 23,400.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

C45953 F TPD2 BL Apr-61 Sep-09 Aug-10 42,000.00 27,300.00 27,300.00 C71830 M TPD2 BL Nov-57 Jun-10 Feb-11 Dec-19 27,300.00 D04126 F TPD2 BL Feb-65 Aug-10 Mar-12 32,000.00 20,800.00 20,800.00 D09846 M TPD2 BL Jan-62 Nov-10 Oct-12 86,000.00 55,900.00 55,900.00 C86011 F TPD2 BL Jul-70 Feb-11 Aug-11 Sep-21 22,100.00 D09219 M TPD2 BL Apr-59 Nov-11 Jun-12 35,000.00 22,750.00 22,750.00 D13965 M TPD2 BL Mar-72 Nov-11 Jul-12 27,000.00 17,550.00 17,550.00 D20527 F TPD2 BL Sep-59 Apr-12 Oct-12 Apr-20 24,050.00 D27176 M TPD2 BL Jul-54 May-12 Jan-13 Feb-19 33,150.00 D22909 F TPD2 BL Jul-53 Jun-12 Nov-12 Jul-18 20,150.00 D40390 F TPD2 BL Nov-69 Oct-12 Mar-14 May-19 24,700.00 D37668 M TPD2 BL Oct-66 Dec-12 Jun-13 Feb-19 26,000.00 D46547 M TPD2 BL Feb-61 Jun-13 Oct-13 40,000.00 26,000.00 26,000.00 D66778 F TPD2 BL Sep-57 Jan-14 Jul-14 Sep-22 33,800.00 D78929 M TPD2 BL May-67 Jul-14 Jan-15 Mar-21 20,150.00 D81863 M TPD2 BL Jul-58 Jul-14 Sep-16 37,000.00 24,050.00 24,050.00 D87210 M TPD2 BL Jan-59 Aug-14 Jun-15 49,000.00 31,850.00 31,850.00 D93974 F TPD2 BL Jan-78 Oct-14 Jan-16 Feb-18 20,150.00 D93653 M TPD2 BL Oct-72 Nov-14 Jul-16 Oct-20 29,900.00 D90268 M TPD2 BL Oct-65 Feb-15 Jul-15 Apr-20 39,000.00 D95647 F TPD2 BL Feb-63 Mar-15 Sep-15 Aug-19 27,300.00 D96875 M TPD2 BL Aug-57 Mar-15 Oct-15 Aug-22 32,500.00 E02934 F TPD2 BL Jun-67 Jun-15 Jan-16 Jan-18 23,400.00 E22793 M TPD2 BL Apr-56 Oct-15 Jun-17 May-21 22,100.00 E20117 M TPD2 BL Feb-57 Dec-15 Nov-16 Feb-22 24,700.00 E13444 F TPD2 BL Sep-73 Dec-15 Aug-16 Jan-20 26,000.00 E21022 M TPD2 BL Nov-66 Feb-16 Nov-16 Jul-18 29,900.00 E17094 F TPD2 BL May-59 Mar-16 Oct-16 Mar-19 20,800.00 E17282 F TPD2 BL Jan-69 Mar-16 Oct-16 May-22 20,800.00 E24486 M TPD2 BL Oct-71 Apr-16 Jul-17 Oct-18 27,300.00 E99521 M TPD2 BL Dec-63 Nov-16 Jul-19 53,000.00 34,450.00 E45454 M TPD2 BL Jan-65 Jan-17 Jun-18 Mar-20 15,375.00 E53178 F TPD2 BL May-71 Feb-17 Mar-18 16,500.00 E43551 M TPD2 BL Jun-61 Feb-17 Jun-18 10,125.00 E48454 M TPD2 BL Apr-76 Apr-17 Mar-19 Jun-20 16,875.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

E54249 F TPD2 BL Aug-62 May-17 Mar-18 11,250.00 E53048 M TPD2 BL Jun-77 Sep-17 Jul-18 Oct-19 13,875.00 E59270 M TPD2 BL Jan-75 Jan-18 Apr-18 Oct-22 57,000.00 37,050.00 E74760 F TPD2 BL Dec-62 May-18 May-19 84,000.00 54,600.00 E91731 F TPD2 BL Aug-61 Oct-18 Sep-19 35,000.00 22,750.00 E99758 F TPD2 BL Feb-67 Feb-19 Oct-19 43,000.00 27,950.00 F25379 M TPD2 BL Sep-68 Dec-19 Oct-20 44,000.00 28,600.00 F24622 F TPD2 BL Mar-62 Jan-20 Aug-20 48,000.00 31,200.00 F27075 F TPD2 BL Aug-70 Feb-20 Sep-20 55,000.00 35,750.00 F30619 F TPD2 BL Aug-65 Apr-20 Oct-20 87,000.00 56,550.00 F40434 M TPD2 BL Sep-74 May-20 Mar-21 46,000.00 29,900.00 F43109 F TPD2 BL May-65 Aug-20 Mar-21 49,000.00 31,850.00 F58571 M TPD2 BL Jul-73 Aug-20 Aug-21 73,000.00 47,450.00 F51693 F TPD2 BL Dec-84 Nov-20 Aug-21 32,000.00 20,800.00 F59463 F TPD2 BL Jul-78 Jan-21 Oct-21 36,000.00 23,400.00 F62172 F TPD2 BL Dec-62 Mar-21 Sep-21 47,000.00 30,550.00 F73277 F TPD2 BL Apr-74 Jun-21 Apr-22 32,000.00 20,800.00 F78006 M TPD2 BL Feb-60 Oct-21 Feb-22 Oct-22 49,000.00 31,850.00 F93688 F TPD2 BL Oct-56 Dec-21 Aug-22 53,950.00 35,067.50 F93902 M TPD2 BL May-56 Feb-22 Aug-22 34,450.00 22,392.50 D89561 F TPD2 BL Aug-57 Nov-14 Jun-15 44,000.00 28,600.00 28,600.00

Waiver of Premium

D83471 M AD&D BA Jan-51 Feb-15 Nov-16 Nov-18 8,565.48 15,481.34 E51217 M AD&D BA Jun-86 Oct-17 Jan-18 Mar-18 84,000.00 84,000.00 84,000.00 E51217 M AD&D BA Jun-86 Oct-17 Mar-18 10,000.00 E51217 M AD&D BA Jun-86 Oct-17 Mar-18 5,000.00 E65990 M AD&D BA Feb-86 May-18 Jun-18 Jun-18 84,000.00 84,000.00 F03819 F AD&D BA Apr-76 Aug-19 Sep-19 Feb-20 60,000.00 60,000.00 F03819 F AD&D BA Apr-76 Aug-19 Sep-19 Feb-20 20,000.00 20,000.00 F30568 M AD&D BA May-62 Aug-20 Jan-21 Jan-21 74,000.00 74,000.00 F31457 F AD&D BA Jul-76 Aug-20 Sep-20 Sep-20 218,000.00 218,000.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

E46363 M TERM AL Feb-72 Aug-17 Jun-18 Jun-18 110,000.00 110,000.00 110,000.00 E54142 M TERM AL Feb-70 Dec-17 Jan-18 Aug-18 80,000.00 80,000.00 E64995 M TERM AL Nov-77 Apr-18 May-18 Jun-18 60,000.00 60,000.00 E65990 M TERM AL Feb-86 May-18 May-18 Jun-18 100,000.00 100,000.00 E69288 M TERM AL Apr-57 Jun-18 Jun-18 Jun-18 90,000.00 90,000.00 E70020 F TERM AL Aug-58 Jun-18 Jul-18 Jul-18 100,000.00 100,000.00 E73017 M TERM AL Oct-57 Aug-18 Aug-18 Aug-18 200,000.00 200,000.00 E79335 M TERM AL Dec-54 Oct-18 Nov-18 Jan-19 20,000.00 20,000.00 E81414 F TERM AL Dec-56 Nov-18 Dec-18 Dec-18 50,000.00 50,000.00 E83858 M TERM AL Jan-63 Jan-19 Jan-19 Feb-19 70,000.00 70,000.00 E88359 M TERM AL Jul-60 Feb-19 Mar-19 Mar-19 30,000.00 30,000.00 E98188 F TERM AL Dec-61 Jun-19 Jul-19 Aug-19 80,000.00 80,000.00 F08228 F TERM AL Sep-47 Nov-19 Nov-19 Feb-20 50,000.00 50,000.00 F20188 F TERM AL Sep-59 Mar-20 Apr-20 Apr-20 37,000.00 37,000.00 F20658 F TERM AL Jan-76 Apr-20 Apr-20 Apr-20 80,000.00 80,000.00 F21449 F TERM AL Mar-63 Apr-20 Jul-20 Nov-20 80,000.00 80,000.00 F22085 F TERM AL Jan-65 Apr-20 May-20 Apr-21 40,000.00 40,000.00 F23789 M TERM AL Apr-56 May-20 May-20 Jun-20 70,000.00 70,000.00 F24580 F TERM AL Oct-67 May-20 Jun-20 Jun-20 70,000.00 70,000.00 F30568 M TERM AL May-62 Aug-20 Sep-20 Jan-21 70,000.00 70,000.00 F31457 F TERM AL Jul-76 Aug-20 Sep-20 Sep-20 200,000.00 200,000.00 F42855 M TERM AL Sep-69 Dec-20 Jan-21 Jul-21 90,000.00 90,000.00 F48072 M TERM AL Oct-63 Feb-21 Mar-21 Mar-21 42,000.00 42,000.00 F48471 M TERM AL Apr-61 Feb-21 Mar-21 Mar-21 10,000.00 10,000.00 F51846 F TERM AL Nov-75 Mar-21 Apr-21 Apr-21 20,000.00 20,000.00 F54333 M TERM AL Jan-88 Apr-21 May-21 May-21 10,000.00 10,000.00 F54690 M TERM AL Dec-74 May-21 Jun-21 Jun-21 170,000.00 170,000.00 F62086 M TERM AL Aug-68 Aug-21 Aug-21 Aug-21 10,000.00 10,000.00 F62091 M TERM AL Oct-66 Aug-21 Aug-21 Aug-21 40,000.00 40,000.00 F62944 M TERM AL Feb-71 Aug-21 Sep-21 Sep-21 50,000.00 50,000.00 F63687 M TERM AL Mar-66 Aug-21 Sep-21 Sep-21 200,000.00 200,000.00 F63810 M TERM AL Jul-67 Aug-21 Sep-21 Sep-21 40,000.00 40,000.00 F64614 F TERM AL Oct-63 Aug-21 Sep-21 Sep-21 50,000.00 50,000.00 F63172 F TERM AL Jun-90 Aug-21 Sep-21 Sep-21 20,000.00 20,000.00 F66057 M TERM AL Jul-64 Sep-21 Nov-21 Nov-21 20,000.00 20,000.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

F69904 M TERM AL Oct-65 Oct-21 Nov-21 Nov-21 170,000.00 170,000.00 F75883 M TERM AL Aug-68 Dec-21 30,000.00 F79849 M TERM AL Feb-61 Feb-22 Mar-22 Mar-22 120,000.00 120,000.00 F86479 M TERM AL Mar-54 Apr-22 May-22 May-22 130,000.00 130,000.00 F87449 M TERM AL Dec-56 Apr-22 May-22 May-22 53,300.00 53,300.00 F87450 M TERM AL Aug-63 May-22 Jun-22 Jun-22 30,000.00 30,000.00 F89007 F TERM AL Apr-76 May-22 Jun-22 Jun-22 90,000.00 90,000.00 F90798 M TERM AL Apr-62 May-22 Aug-22 Aug-22 70,000.00 70,000.00 F93711 M TERM AL Aug-91 Jul-22 Oct-22 Oct-22 10,000.00

A52809 M TPD2 AL Apr-56 Oct-02 Jan-03 May-20 45,500.00 A78525 F TPD2 AL Sep-54 Jan-03 Mar-03 Sep-19 45,500.00 A99535 M TPD2 AL Dec-56 Sep-03 Mar-04 Dec-21 65,000.00 B31260 F TPD2 AL Sep-72 Jan-05 Jan-06 30,000.00 19,500.00 19,500.00 B31818 M TPD2 AL Jun-53 May-05 Sep-06 Jun-18 32,500.00 B40174 F TPD2 AL May-69 Nov-05 Jan-06 70,000.00 45,500.00 45,500.00 B51110 M TPD2 AL Jul-59 May-06 Oct-06 40,000.00 26,000.00 26,000.00 B68948 F TPD2 AL Jan-61 Jun-06 Apr-07 40,000.00 26,000.00 26,000.00 B52329 F TPD2 AL Jan-56 Jun-06 Jul-06 Aug-21 26,000.00 B76176 M TPD2 AL Jan-56 Jan-07 Aug-07 Feb-21 32,500.00 B99689 F TPD2 AL Nov-61 Sep-07 Jul-08 40,000.00 26,000.00 26,000.00 C29454 F TPD2 AL Jul-55 Mar-08 Sep-09 Jul-20 13,000.00 C17124 F TPD2 AL Jun-53 May-08 Feb-09 Jun-18 19,500.00 C22052 F TPD2 AL May-54 Feb-09 Apr-09 Jun-19 39,000.00 C42328 M TPD2 AL Dec-54 Jun-09 Jan-10 Nov-18 13,000.00 D20527 F TPD2 AL Sep-59 Apr-12 Dec-12 Apr-20 117,000.00 E22793 M TPD2 AL Apr-56 Oct-15 Jun-17 May-21 104,000.00 E59270 M TPD2 AL Jan-75 Jan-18 Apr-18 Oct-22 60,000.00 39,000.00 E91731 F TPD2 AL Aug-61 Oct-18 Sep-19 100,000.00 65,000.00 E99758 F TPD2 AL Feb-67 Feb-19 Oct-19 40,000.00 26,000.00 F25379 M TPD2 AL Sep-68 Dec-19 Oct-20 170,000.00 110,500.00 F27075 F TPD2 AL Aug-70 Feb-20 Sep-20 110,000.00 71,500.00 F30619 F TPD2 AL Aug-65 Apr-20 Oct-20 200,000.00 130,000.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

F40434 M TPD2 AL Sep-74 May-20 Mar-21 110,000.00 71,500.00 F58571 M TPD2 AL Jul-73 Aug-20 Aug-21 40,000.00 26,000.00 F59463 F TPD2 AL Jul-78 Jan-21 Oct-21 40,000.00 26,000.00 F62172 F TPD2 AL Dec-62 Mar-21 Sep-21 70,000.00 45,500.00 F73277 F TPD2 AL Apr-74 Jun-21 Apr-22 130,000.00 84,500.00 F78006 M TPD2 AL Feb-60 Oct-21 Feb-22 Oct-22 10,000.00 6,500.00 F93688 F TPD2 AL Oct-56 Dec-21 Aug-22 6,500.00 4,225.00 F93902 M TPD2 AL May-56 Feb-22 Aug-22 78,000.00 50,700.00

Waiver of Premium

E51217 M AD&D AA Jun-86 Oct-17 Mar-18 Mar-18 20,000.00 20,000.00 E65990 M AD&D AA Feb-86 May-18 Jun-18 Jun-18 200,000.00 200,000.00 F30568 M AD&D AA May-62 Aug-20 Jan-21 Jan-21 140,000.00 140,000.00 F31457 F AD&D AA Jul-76 Aug-20 Sep-20 Sep-20 400,000.00 400,000.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

E54244 F DEP XS May-77 Nov-17 Jan-18 Feb-18 50,000.00 50,000.00 E53386 M DEP XS Aug-51 Dec-17 Jan-18 Jan-18 26,000.00 26,000.00 26,000.00 E63504 F DEP XS Apr-65 Mar-18 May-18 May-18 50,000.00 50,000.00 E63988 M DEP XS Jun-60 Apr-18 May-18 May-18 10,000.00 10,000.00 E64997 M DEP XS Nov-77 Apr-18 May-18 May-18 50,000.00 50,000.00 E69890 F DEP XS Jun-48 Jun-18 Jul-18 Jul-18 20,000.00 20,000.00 E71275 M DEP XS Oct-64 Jul-18 Jul-18 Jul-18 50,000.00 50,000.00 E73016 F DEP XS Sep-56 Aug-18 Aug-18 Aug-18 50,000.00 50,000.00 E77220 M DEP XS Nov-57 Sep-18 Oct-18 Oct-18 40,000.00 40,000.00 E75990 M DEP XS Dec-46 Sep-18 Sep-18 Sep-18 5,000.00 5,000.00 E77911 M DEP XS Apr-47 Oct-18 Oct-18 Dec-18 10,000.00 10,000.00 E86758 F DEP XS Jun-50 Jan-19 Feb-19 Feb-19 6,500.00 6,500.00 E87885 M DEP XS Sep-47 Feb-19 Mar-19 Mar-19 25,000.00 25,000.00 E92994 F DEP XS Dec-74 Mar-19 Apr-19 Apr-19 50,000.00 50,000.00 E93561 M DEP XS May-52 Apr-19 May-19 May-19 30,000.00 30,000.00 E98584 M DEP XS Aug-59 Jun-19 Jul-19 Jul-19 10,000.00 10,000.00 E98756 F DEP XS Dec-47 Jun-19 Jul-19 Jul-19 5,000.00 5,000.00 E99517 F DEP XS Nov-50 Jul-19 Jul-19 Jul-19 32,500.00 32,500.00 F10843 M DEP XS Apr-52 Nov-19 Dec-19 Dec-19 32,500.00 32,500.00 F19273 M DEP XS Aug-49 Feb-20 Mar-20 Mar-20 10,000.00 10,000.00 F21264 F DEP XS Mar-52 Apr-20 Apr-20 Apr-20 32,500.00 32,500.00 F30573 F DEP XS Jul-58 Jul-20 Aug-20 Aug-20 50,000.00 50,000.00 F31893 F DEP XS Mar-71 Aug-20 Sep-20 Oct-20 50,000.00 50,000.00 F35680 F DEP XS Oct-44 Aug-20 Oct-20 Oct-20 17,500.00 17,500.00 F39985 M DEP XS Dec-57 Nov-20 Dec-20 Jun-21 150,000.00 150,000.00 F47876 M DEP XS Dec-59 Nov-20 Apr-21 May-21 50,000.00 50,000.00 F49746 F DEP XS Nov-74 Mar-21 Apr-21 Apr-21 50,000.00 50,000.00 F49406 M DEP XS Feb-77 Mar-21 Mar-21 Mar-21 50,000.00 50,000.00 F54337 F DEP XS Jan-79 Apr-21 Jul-21 Jul-21 50,000.00 50,000.00 F54208 M DEP XS Apr-59 Apr-21 May-21 Jun-21 50,000.00 50,000.00 F59257 M DEP XS Jul-65 Jun-21 Jul-21 Jul-21 50,000.00 50,000.00 F61227 M DEP XS May-62 Jul-21 Aug-21 Aug-21 30,000.00 30,000.00 F56587 M DEP XS May-56 May-21 Jun-21 Jun-21 47,000.00 47,000.00 F62093 M DEP XS Apr-79 Aug-21 Aug-21 Aug-21 50,000.00 50,000.00 F64615 M DEP XS Jan-57 Aug-21 Sep-21 Sep-21 50,000.00 50,000.00

Date Approved

Date Term Date Pending Benefit Paid This Period

Paid This Claim

Ending Reserve

Beginning Reserve

F63812 M DEP XS Dec-65 Aug-21 Sep-21 Sep-21 20,000.00 20,000.00 F66632 M DEP XS Oct-54 Sep-21 Oct-21 Oct-21 50,000.00 50,000.00 F66732 M DEP XS Oct-62 Sep-21 Oct-21 Oct-21 20,000.00 20,000.00 F68231 F DEP XS Feb-68 Oct-21 Nov-21 Nov-21 50,000.00 50,000.00 F70854 M DEP XS Oct-50 Nov-21 Dec-21 Dec-21 25,000.00 25,000.00 F77613 M DEP XS Nov-59 Jan-22 Feb-22 Feb-22 40,000.00 40,000.00 F80810 F DEP XS Aug-67 Feb-22 Mar-22 Mar-22 50,000.00 50,000.00 F84760 F DEP XS Dec-70 Apr-22 Apr-22 Apr-22 50,000.00 50,000.00 F91142 M DEP XS Mar-45 Jun-22 Jul-22 Jul-22 17,500.00 17,500.00 F97648 F DEP XS Mar-62 Aug-22 Sep-22 Sep-22 30,000.00 30,000.00 F98327 M DEP XS Aug-68 Sep-22 Oct-22 Oct-22 50,000.00

E79877 M DEP XC Jul-18 Oct-18 Nov-18 Nov-18 10,000.00 10,000.00 E81727 M DEP XC Dec-92 Dec-18 Feb-19 Feb-19 10,000.00 10,000.00 E83261 M DEP XC Oct-99 Jan-19 Jan-19 Jan-19 10,000.00 10,000.00 E92218 F DEP XC Jan-96 Apr-19 Apr-19 Apr-19 10,000.00 10,000.00 F07121 M DEP XC Nov-95 Oct-19 Nov-19 Nov-19 10,000.00 10,000.00 F18411 F DEP XC Dec-97 Mar-20 Mar-20 Mar-20 10,000.00 10,000.00 F23609 M DEP XC Jun-97 May-20 May-20 May-20 10,000.00 10,000.00 F47879 M DEP XC Dec-18 Sep-20 Mar-21 Mar-21 10,000.00 10,000.00 F59498 F DEP XC Oct-09 Jul-21 Jul-21 Jul-21 5,000.00 5,000.00 F62078 F DEP XC Feb-08 Aug-21 Oct-21 Oct-21 10,000.00 10,000.00 F62081 F DEP XC Apr-98 Aug-21 Sep-21 Sep-21 10,000.00 10,000.00 F80811 M DEP XC Mar-04 Feb-22 Mar-22 Mar-22 10,000.00 10,000.00

1/1/2018 through 9/30/2022

THE INFORMATION IN THESE REPORTS IS CONFIDENTIAL AND PROPRIETARY. THESE REPORTS ARE TO BE ACCESSIBLE ONLY TO THOSE COMPANY PERSONNEL WHO HAVE A LEGITIMATE BUSINESS REASON TO EXAMINE THE INFORMATION. THESE REPORTS MAY NOT BE REDISCLOSED

WITHOUT THE WRITTEN AUTHORIZATION OF STANDARD INSURANCE COMPANY.

Claim Number Gender Coverage Product Birth Date Incurred Date

Approved Date

Term Date Pending Benefit Paid

This Period Paid

This Claim Ending Reserve

Beginning Reserve

FM7530 M LTD LT Jan-75 Jan-18 Feb-18 2,809.73 101,823.42 101,823.42 12,650.00 FT7498 F LTD LT Mar-52 Feb-18 Jul-18 Sep-18 2,059.04 2,340.09 2,340.09 FU7972 F LTD LT Dec-62 May-18 Sep-18 4,152.40 19,261.57 19,261.57 16,688.06 FW5437 F LTD LT Oct-67 Apr-18 Oct-18 Mar-19 1,729.05 3,815.97 3,815.97 FY6012 F LTD LT Nov-87 Jul-18 Dec-18 Jan-21 3,734.43 3,734.43 FZ3652 F LTD LT Jun-59 Aug-18 Jan-19 Jan-21 39,709.20 39,709.20 FZ1442 F LTD LT Aug-59 Jul-18 Jan-19 Jan-22 18,218.92 18,218.92 FZ7371 F LTD LT Nov-55 Aug-18 Feb-19 Feb-19 3,491.25 1,652.14 1,652.14 GA1294 F LTD LT Dec-54 Aug-18 Feb-19 Feb-22 27,848.08 27,848.08 GD2893 F LTD LT Aug-59 Nov-18 Apr-19 Jun-19 3,769.30 5,414.60 5,414.60 GC6131 F LTD LT Nov-63 Feb-19 Apr-19 Mar-21 1,850.00 1,850.00 GB7189 F LTD LT Aug-61 Oct-18 Apr-19 Jul-21 1,730.08 6,700.00 6,700.00 GE2540 F LTD LT May-59 Dec-18 May-19 Mar-20 1,628.51 15,334.21 15,334.21 GF1123 M LTD LT Oct-68 Nov-18 Jun-19 Aug-19 2,083.69 6,095.13 6,095.13 GE4344 F LTD LT Nov-51 Dec-18 Jun-19 Feb-20 33,382.10 33,382.10 GG5719 F LTD LT Nov-56 Feb-19 Jul-19 Aug-19 2,210.47 927.07 927.07 GG4136 M LTD LT Sep-66 Apr-19 Jul-19 Jul-21 2,664.79 52,258.60 52,258.60 GG7139 F LTD LT Feb-67 Feb-19 Jul-19 2,106.88 4,894.89 4,894.89 8,222.00 GF7577 F LTD LT Jun-77 Oct-18 Aug-19 Aug-19 3,171.58 5,202.13 5,202.13 GH4816 M LTD LT Jul-97 Dec-18 Aug-19 Sep-19 2,287.67 2,287.67 GJ2931 F LTD LT Nov-55 Feb-19 Aug-19 Sep-19 2,024.72 522.38 522.38 GH4854 F LTD LT Feb-91 Mar-19 Aug-19 Nov-19 2,229.13 5,424.14 5,424.14 GJ7279 F LTD LT Feb-69 Apr-19 Oct-19 2,398.06 43,976.41 43,976.41 10,156.00 GL9119 M LTD LT Jan-53 Jun-19 Nov-19 Dec-19 6.45 6.45

Claim Number Gender Coverage Product Birth Date Incurred Date

Approved Date

Term Date Pending Benefit Paid

This Period Paid

This Claim Ending Reserve

Beginning Reserve

GM2467 F LTD LT Dec-59 Mar-19 Nov-19 Jan-20 2,142.23 2,864.11 2,864.11 GL7929 M LTD LT Jan-58 Jun-19 Nov-19 Jan-20 1,811.54 100.00 100.00 GN7978 F LTD LT Apr-68 Aug-19 Dec-19 Mar-20 2,254.64 1,632.81 1,632.81 GM4852 F LTD LT Mar-58 Jul-19 Dec-19 Sep-21 2,547.66 2,076.67 2,076.67 GP2525 M LTD LT Nov-62 Aug-19 Jan-20 3,483.21 30,988.73 30,988.73 46,434.30 GP0709 F LTD LT Feb-71 Oct-19 Feb-20 Apr-21 2,785.62 19,499.34 19,499.34 GQ2034 F LTD LT Aug-62 Aug-19 Feb-20 May-22 70,996.44 70,996.44 GQ7032 M LTD LT Feb-62 Jun-19 Mar-20 May-21 1,894.97 14,976.33 14,976.33 GU4477 F LTD LT Jun-62 Nov-19 May-20 Jun-21 4,251.92 1,287.10 1,287.10 GP1603 M LTD LT Oct-73 Dec-19 May-20 1,669.07 6,234.61 6,234.61 8,821.00 GV5025 F LTD LT Oct-65 Jan-20 Jun-20 May-21 2,140.16 8,673.83 8,673.83 GS9310 F LTD LT Jun-51 Nov-19 Jun-20 Aug-21 27,828.30 27,828.30 GV3562 M LTD LT Sep-68 Dec-19 Jun-20 Sep-22 2,196.31 22,590.52 22,590.52 GU8134 F LTD LT Mar-62 Jan-20 Jun-20 2,664.22 27,639.54 27,639.54 39,377.98 GW6603 M LTD LT Dec-74 Jan-20 Jul-20 May-21 3,143.32 18,251.69 18,251.69 GV7811 M LTD LT Dec-60 Feb-20 Jul-20 Aug-22 25,028.77 25,028.77 GV9542 F LTD LT Aug-70 Feb-20 Jul-20 2,867.07 71,411.58 71,411.58 146,920.29 GW1204 M LTD LT Jan-59 Feb-20 Jul-20 4,392.62 26,746.56 26,746.56 GY4530 F LTD LT Aug-60 Feb-20 Aug-20 Sep-20 5,641.57 4,367.71 4,367.71 GX2932 F LTD LT Aug-69 Mar-20 Aug-20 Sep-22 50,553.28 50,553.28 GX2923 F LTD LT Mar-56 Mar-20 Aug-20 3,499.33 34,511.19 34,511.19 7,388.75 GX9245 F LTD LT Aug-65 Apr-20 Aug-20 4,320.87 2,400.00 2,400.00 7,331.00 GZ2122 F LTD LT Feb-57 Feb-20 Sep-20 Sep-20 2,475.21 2,075.96 2,075.96 GY5993 F LTD LT May-65 Mar-20 Sep-20 Dec-20 2,619.69 10,054.73 10,054.73 HA9237 M LTD LT Feb-56 Mar-20 Oct-20 Nov-21 3,313.19 22,088.04 22,088.04 HC5183 M LTD LT May-80 Jun-20 Nov-20 May-21 2,160.59 11,639.31 11,639.31 HB2401 M LTD LT Jun-66 May-20 Nov-20 2,657.39 11,176.71 11,176.71 11,258.22 HC3622 M LTD LT Feb-61 Jun-20 Dec-20 Feb-22 2,754.75 1,749.98 1,749.98 HC5197 M LTD LT Sep-74 May-20 Dec-20 2,409.83 2,975.84 2,975.84 12,071.00 HF2785 F LTD LT Mar-68 Sep-20 Jan-21 Feb-21 2,021.60 5,869.07 5,869.07 HE2123 F LTD LT Jun-60 Jul-20 Jan-21 1,648.27 34,294.73 34,294.73 12,372.92 HD4598 F LTD LT May-65 Aug-20 Jan-21 2,572.60 12,116.28 12,116.28 33,106.80

Approved Date

Term Date Pending Benefit Paid

This Period Paid

This Claim Ending Reserve

Beginning Reserve

HE0860 M LTD LT Nov-58 Sep-20 Jan-21 3,155.12 1,900.00 1,900.00 589.00 HF6502 F LTD LT Jan-74 Sep-20 Feb-21 Mar-21 1,882.25 485.62 485.62 HF9897 F LTD LT Apr-60 Sep-20 Feb-21 Mar-21 2,133.92 619.69 619.69 HF5548 M LTD LT Apr-74 Aug-20 Feb-21 Jul-21 2,009.22 10,280.48 10,280.48 HF4003 F LTD LT Aug-62 Sep-20 Mar-21 2,261.83 24,559.14 24,559.14 653.33 HJ6230 F LTD LT May-67 Nov-20 Apr-21 May-21 1,591.08 6.45 6.45 HK0186 M LTD LT Jul-54 Oct-20 Apr-21 2,254.86 16,235.48 16,235.48 436.00 HJ2221 F LTD LT Dec-84 Nov-20 Apr-21 1,591.08 25,457.28 25,457.28 2,986.40 HL4118 M LTD LT Jul-73 Aug-20 Jun-21 3,649.00 12,894.09 12,894.09 94,861.11 HM0503 F LTD LT Nov-60 Dec-20 Jun-21 3,084.58 8,593.52 8,593.52 13,566.78 HM7372 F LTD LT Jul-78 Jan-21 Jul-21 Nov-22 1,767.86 24,578.91 24,578.91 55,675.87 HD3621 F LTD LT Mar-62 Oct-20 Jul-21 3,360.52 57,128.84 57,128.84 82,958.48 HP2798 M LTD LT Feb-71 Jan-21 Aug-21 Aug-21 3,046.86 4,330.17 4,330.17 HQ0138 M LTD LT Dec-70 Feb-21 Aug-21 Oct-21 2,454.73 6,182.82 6,182.82 HP3762 F LTD LT Dec-62 Mar-21 Aug-21 2,316.82 9,549.99 9,549.99 1,659.00 HQ8557 M LTD LT Oct-65 Mar-21 Sep-21 Oct-21 3,748.87 3,051.01 3,051.01 HQ1836 M LTD LT Aug-71 Feb-21 Sep-21 2,874.08 25,658.92 25,658.92 153,090.87 HQ1894 M LTD LT Jan-56 May-21 Sep-21 1,843.21 3,378.09 3,378.09 1,001.76 HU6383 F LTD LT Apr-74 Jun-21 Dec-21 1,559.88 13,887.92 13,887.92 51,955.17 HV4118 F LTD LT Feb-81 Jul-21 Jan-22 Aug-22 3,106.02 22,828.65 22,828.65 HV5982 M LTD LT Oct-57 Jul-21 Jan-22 1,827.14 800.00 800.00 2,730.00 HV8379 F LTD LT Dec-61 Jul-21 Jan-22 2,509.33 22,341.07 22,341.07 67,579.49 HV6425 M LTD LT Jan-59 Aug-21 Jan-22 1,905.13 15,037.00 15,037.00 22,994.23 HW5598 F LTD LT Sep-87 Jun-21 Feb-22 Jul-22 2,502.21 17,273.26 17,273.26 HV7032 M LTD LT Feb-87 Jun-21 Feb-22 1,704.82 13,965.81 13,965.81 36,037.33 HW4930 M LTD LT Feb-60 Oct-21 Feb-22 2,410.54 500.00 500.00 4,570.00 HZ8892 F LTD LT May-79 Jun-21 Mar-22 Mar-22 2,467.73 1,521.96 1,521.96 HY8137 F LTD LT Apr-87 Oct-21 Mar-22 Jun-22 1,709.63 2,591.97 2,591.97 HX1945 F LTD LT Jul-71 Aug-21 Mar-22 2,305.50 15,901.05 15,901.05 13,322.50 HZ1324 F LTD LT Oct-65 Oct-21 Apr-22 Apr-22 2,705.34 6.67 6.67 HY8672 M LTD LT Jul-64 Aug-21 Apr-22 2,845.22 19,509.96 19,509.96 97,196.39 HZ1204 F LTD LT Jan-68 Sep-21 Apr-22 1,864.58 12,852.36 12,852.36 48,821.07

Approved Date

Term Date Pending Benefit Paid

This Period Paid

This Claim Ending Reserve

Beginning Reserve

JB8191 M LTD LT May-52 Oct-21 May-22 2,792.18 13,872.55 13,872.55 19,143.15 JB4387 M LTD LT Dec-77 Oct-21 Jun-22 May-22 2,464.80 2,483.10 2,483.10 JE1251 F LTD LT May-65 Feb-22 Jul-22 3,107.23 2,806.45 2,806.45 118,042.88 JD7212 F LTD LT Oct-56 Dec-21 Aug-22 4,116.71 11,525.27 11,525.27 45,908.60 JE7850 M LTD LT May-56 Jan-22 Aug-22 2,620.95 1,915.04 1,915.04 2,026.00 JD7771 M LTD LT Feb-61 Apr-22 Aug-22 2,482.90 25,500.87 JD2401 M LTD LT May-76 Jun-22 Sep-22 1,925.49 28,986.94 JG0167 M LTD LT Dec-65 Aug-22 Sep-22 3,945.46 142,085.66 JH3538 M LTD LT Mar-91 Dec-21 Oct-22 P 1,724.12 28,410.20 JG9660 M LTD LT Jul-67 Apr-22 Oct-22 P 2,702.38 47,296.90 JF5108 M LTD LT Nov-62 Aug-22 P 3,205.34 56,093.45

HX3893 M LTD ML Feb-61 Jun-20 Jan-22 Feb-22 918.25 13,380.19 13,380.19 JC1441 M LTD ML Jan-56 May-21 Jun-22 614.40 6,758.40 6,758.40 7,901.18

Assisted Living Benefit

HQ6660 M LTD SB Feb-71 Jan-21 Aug-21 Aug-21 4,810.41 4,810.41 HT4123 M LTD SB Oct-65 Mar-21 Oct-21 Oct-21 11,246.61 11,246.61 HX6020 M LTD SB Feb-56 Mar-20 Jan-22 Nov-21 9,939.57 9,939.57 HY7528 M LTD SB Dec-74 Jan-20 Feb-22 May-21 9,429.96 9,429.96 HY7553 M LTD SB Feb-61 Jun-20 Mar-22 Feb-22 8,264.25 8,264.25

Survivor Benefit

1/1/2018 through 9/30/2022

THE INFORMATION IN THESE REPORTS IS CONFIDENTIAL AND PROPRIETARY. THESE REPORTS ARE TO BE ACCESSIBLE ONLY TO THOSE COMPANY PERSONNEL WHO HAVE A LEGITIMATE BUSINESS REASON TO EXAMINE THE INFORMATION. THESE REPORTS MAY NOT BE REDISCLOSED

WITHOUT THE WRITTEN AUTHORIZATION OF STANDARD INSURANCE COMPANY.

Claim Number Gender Coverage Product Birth Date Incurred Date

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

FM8553 M STD ST Dec-63 Nov-16 May-18 May-17 1,467.67 1,467.67 FV5129 M STD ST Jul-58 Jan-17 Oct-18 Feb-17 1,080.48 1,080.48 GL4586 F STD ST Oct-69 Mar-17 Oct-19 Apr-17 71.43 71.43 FF1747 F STD ST Aug-65 Jul-17 Aug-17 Jan-18 1,022.85 19,177.74 FH5813 F STD ST Aug-60 Aug-17 Nov-17 Jan-18 1,303.73 15,813.49 FJ9574 M STD ST Sep-61 Sep-17 Nov-17 Mar-18 9,234.27 16,521.12 FH1436 M STD ST Jun-77 Sep-17 Nov-17 Mar-18 4,612.10 9,338.47 FK1601 F STD ST Mar-61 Oct-17 Dec-17 Jan-18 1,343.04 5,468.12 FK8625 F STD ST Aug-89 Oct-17 Dec-17 Feb-18 5,068.80 6,698.08 FH8834 F STD ST May-83 Oct-17 Nov-17 Apr-18 5,061.82 7,873.92 FJ0966 F STD ST Aug-85 Oct-17 Nov-17 Dec-17 525.84 5,033.02 FK1300 F STD ST Sep-84 Oct-17 Dec-17 Feb-18 4,097.63 6,034.71 FJ9069 F STD ST Aug-77 Nov-17 Dec-17 Jan-18 627.64 763.36 FK0639 F STD ST Mar-73 Nov-17 Jan-18 Jan-18 2,544.18 2,544.18 FK8590 F STD ST Aug-49 Nov-17 Dec-17 Jan-18 121.43 121.43 FK8619 M STD ST Jun-56 Nov-17 Dec-17 Feb-18 3,348.24 4,988.21 FK8643 F STD ST May-67 Nov-17 Jan-18 May-18 13,192.44 13,192.44 FL0256 F STD ST Sep-60 Nov-17 Dec-17 Feb-18 3,765.60 4,931.12 FL7700 M STD ST Apr-76 Nov-17 Jan-18 Feb-18 1,907.63 1,907.63 FM5209 F STD ST Oct-73 Nov-17 Jan-18 Mar-18 7,725.74 7,725.74 FJ6123 F STD ST Nov-64 Nov-17 Nov-17 Jan-18 824.75 2,047.30 FJ9132 F STD ST Aug-84 Nov-17 Nov-17 Jan-18 1,187.26 1,888.80 FK5763 F STD ST Jul-82 Nov-17 Dec-17 Feb-18 3,231.35 5,581.42 FL7857 M STD ST Jan-74 Nov-17 Jan-18 Mar-18 4,672.09 4,672.09 FL8312 F STD ST Feb-75 Nov-17 Jan-18 Mar-18 4,505.72 4,505.72

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

FP6503 F STD ST Jul-57 Nov-17 Apr-18 May-18 550.00 550.00 FK0896 F STD ST Sep-86 Dec-17 Dec-17 Jan-18 1,068.88 1,603.32 FK2357 F STD ST Aug-52 Dec-17 Jan-18 Feb-18 2,132.22 2,132.22 FK4857 F STD ST Jun-83 Dec-17 Dec-17 Feb-18 1,255.48 1,255.48 FK4939 F STD ST Nov-86 Dec-17 Dec-17 Jan-18 2,123.56 2,638.38 FK5933 F STD ST Nov-80 Dec-17 Dec-17 Jan-18 1,491.44 1,594.29 FL1850 F STD ST Aug-80 Dec-17 Jan-18 Jan-18 2,131.74 2,131.74 FM4753 M STD ST Jul-69 Dec-17 Feb-18 Jun-18 10,973.20 10,973.20 FM5856 F STD ST Dec-87 Dec-17 Feb-18 Apr-18 5,057.07 5,057.07 FM7577 M STD ST Aug-93 Dec-17 Feb-18 Mar-18 3,877.10 3,877.10 FL3194 F STD ST May-84 Dec-17 Jan-18 Jan-18 1,498.65 1,498.65 FL4376 F STD ST Apr-61 Dec-17 Jan-18 Jun-18 4,957.68 4,957.68 FM1464 F STD ST Mar-95 Dec-17 Jan-18 Feb-18 2,078.61 2,078.61 FM5705 F STD ST Nov-89 Dec-17 Feb-18 Jan-18 1,846.93 1,846.93 FL2699 F STD ST Apr-59 Dec-17 Dec-17 Feb-18 2,592.59 2,592.59 FL2812 F STD ST Nov-83 Dec-17 Jan-18 Jan-18 1,554.29 1,554.29 FL5986 F STD ST Dec-71 Jan-18 Feb-18 Mar-18 521.70 521.70 FM1813 F STD ST Jun-59 Jan-18 Feb-18 May-18 20,380.56 20,380.56 FN0692 M STD ST Dec-61 Jan-18 Feb-18 Mar-18 7,827.48 7,827.48 FN1385 F STD ST Sep-87 Jan-18 Feb-18 Mar-18 2,787.56 2,787.56 FP2696 F STD ST Jun-55 Jan-18 Apr-18 Jul-18 1,632.00 1,632.00 FM7967 M STD ST Nov-02 Jan-18 Feb-18 Feb-18 67.86 67.86 FN3471 M STD ST May-61 Jan-18 Feb-18 Mar-18 1,274.95 1,274.95 FN7600 F STD ST May-67 Jan-18 Mar-18 May-18 781.25 781.25 FM7434 F STD ST Dec-54 Jan-18 Feb-18 Mar-18 2,837.33 2,837.33 FN1445 F STD ST May-64 Jan-18 Feb-18 Mar-18 3,849.71 3,849.71 FL9765 F STD ST Jun-84 Jan-18 Jan-18 Mar-18 2,736.93 2,736.93 FM2612 F STD ST Feb-65 Feb-18 Feb-18 Mar-18 3,648.81 3,648.81 FM4669 F STD ST Jun-89 Feb-18 Mar-18 Mar-18 1,895.08 1,895.08 FM8512 F STD ST Jun-86 Feb-18 Feb-18 Apr-18 2,362.98 2,362.98 FN2797 F STD ST Apr-57 Feb-18 May-18 Apr-18 2,433.06 2,433.06 FN4830 F STD ST Jul-53 Feb-18 Mar-18 May-18 3,591.18 3,591.18 FP3751 F STD ST Oct-56 Feb-18 Mar-18 Mar-18 395.91 395.91

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

FP5725 F STD ST Jan-72 Feb-18 Apr-18 May-18 3,195.77 3,195.77 FM3629 M STD ST Nov-73 Feb-18 Mar-18 Apr-18 4,413.27 4,413.27 FM9500 M STD ST Jul-56 Feb-18 Mar-18 May-18 6,517.24 6,517.24 FN0182 M STD ST May-85 Feb-18 Mar-18 Mar-18 82.15 82.15 FN6611 F STD ST Apr-63 Feb-18 Mar-18 Mar-18 48.87 48.87 FN8123 M STD ST Jul-71 Feb-18 Mar-18 Apr-18 5,033.64 5,033.64 FN8506 M STD ST Jul-70 Feb-18 Mar-18 Aug-18 8,488.53 8,488.53 FN8579 M STD ST Jan-66 Feb-18 Apr-18 May-18 4,208.47 4,208.47 FN9760 F STD ST Mar-84 Feb-18 Mar-18 Mar-18 1,489.31 1,489.31 FN9865 F STD ST Aug-63 Feb-18 Mar-18 Mar-18 749.72 749.72 FP1954 F STD ST Mar-52 Feb-18 Mar-18 Aug-18 11,404.80 11,404.80 FP3133 M STD ST Mar-76 Feb-18 Mar-18 Apr-18 1,746.13 1,746.13 FP5984 F STD ST Aug-61 Feb-18 Apr-18 Apr-18 185.71 185.71 FP9896 M STD ST Aug-83 Feb-18 Apr-18 Apr-18 2,246.02 2,246.02 FM9027 F STD ST Oct-83 Feb-18 Mar-18 Mar-18 2,782.08 2,782.08 FN7475 F STD ST Oct-86 Feb-18 Mar-18 Jun-18 4,698.01 4,698.01 FP2512 F STD ST Oct-67 Mar-18 Apr-18 May-18 4,334.36 4,334.36 FP2679 F STD ST Jan-72 Mar-18 Apr-18 Apr-18 1,737.14 1,737.14 FP6174 F STD ST Apr-63 Mar-18 Apr-18 May-18 1,319.13 1,319.13 FP9279 M STD ST May-64 Mar-18 Apr-18 Jun-18 4,023.76 4,023.76 FQ1492 M STD ST Oct-11 Mar-18 Apr-18 Apr-18 1,280.79 1,280.79 FQ3216 F STD ST Jun-59 Mar-18 Apr-18 May-18 3,063.53 3,063.53 FQ7260 F STD ST Mar-89 Mar-18 May-18 May-18 96.43 96.43 FN1318 F STD ST Mar-84 Mar-18 Mar-18 May-18 4,707.56 4,707.56 FP9460 F STD ST Dec-87 Mar-18 Apr-18 May-18 2,549.71 2,549.71 FQ3236 F STD ST Oct-82 Mar-18 Apr-18 Apr-18 676.39 676.39 FQ4201 F STD ST Jan-60 Mar-18 Apr-18 Jun-18 3,727.96 3,727.96 FQ9774 F STD ST Aug-69 Mar-18 May-18 May-18 489.52 489.52 FQ9833 F STD ST Feb-53 Mar-18 May-18 May-18 2,636.40 2,636.40 FR4071 F STD ST Aug-84 Mar-18 May-18 May-18 2,320.54 2,320.54 FQ9691 F STD ST Dec-71 Mar-18 May-18 Jun-18 5,994.26 5,994.26 FQ9533 F STD ST Aug-58 Mar-18 May-18 Jun-18 3,849.00 3,849.00 FN7088 F STD ST May-67 Mar-18 Apr-18 May-18 1,602.28 1,602.28

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

FP4779 F STD ST Oct-86 Apr-18 May-18 Jun-18 150.00 150.00 FQ4596 M STD ST May-69 Apr-18 May-18 Apr-18 324.23 324.23 FQ9323 M STD ST May-68 Apr-18 May-18 Jun-18 2,511.38 2,511.38 FR7926 F STD ST Aug-84 Apr-18 May-18 Jun-18 1,989.07 1,989.07 FS0507 F STD ST Nov-86 Apr-18 Jun-18 May-18 42.86 42.86 FQ8160 F STD ST Mar-69 Apr-18 May-18 Jun-18 2,394.56 2,394.56 FQ9649 F STD ST Feb-86 Apr-18 May-18 Jun-18 1,798.65 1,798.65 FR5309 M STD ST Jun-89 Apr-18 May-18 Jul-18 3,917.82 3,917.82 FR5497 M STD ST Nov-65 Apr-18 May-18 Jul-18 3,460.32 3,460.32 FR7394 F STD ST Mar-80 Apr-18 May-18 May-18 1,086.00 1,086.00 FS0543 F STD ST Oct-67 Apr-18 Jun-18 Oct-18 5,166.72 5,166.72 FS2842 M STD ST Apr-56 Apr-18 Jun-18 Jul-18 3,495.19 3,495.19 FR1170 F STD ST Jan-72 Apr-18 May-18 May-18 520.79 520.79 FP8462 F STD ST Jan-90 May-18 May-18 Jul-18 3,113.46 3,113.46 FQ3980 F STD ST Feb-84 May-18 May-18 Jun-18 42.86 42.86 FR0468 F STD ST Nov-71 May-18 Jun-18 Jun-18 2,046.76 2,046.76 FS0517 F STD ST Apr-69 May-18 Jun-18 Oct-18 11,267.64 11,267.64 FS1595 M STD ST Dec-70 May-18 Jun-18 Jul-18 1,883.50 1,883.50 GU7695 M STD ST Dec-66 May-18 Jun-20 Jun-18 64.28 64.28 FR7880 M STD ST May-68 May-18 Jun-18 Jun-18 1,999.10 1,999.10 FT1777 F STD ST May-75 May-18 Jul-18 Sep-18 6,322.23 6,322.23 FS4838 F STD ST Jan-82 Jun-18 Jun-18 Sep-18 2,813.83 2,813.83 FS9458 F STD ST Mar-93 Jun-18 Jun-18 Aug-18 1,959.55 1,959.55 FT0857 F STD ST Jun-60 Jun-18 Jul-18 Jul-18 1,138.31 1,138.31 FT0991 F STD ST Nov-83 Jun-18 Jul-18 Jul-18 342.04 342.04 FT2945 F STD ST Nov-02 Jun-18 Jul-18 Aug-18 691.61 691.61 FT4758 M STD ST Jul-58 Jun-18 Jul-18 Jul-18 479.29 479.29 FU3055 F STD ST Jun-85 Jun-18 Aug-18 Aug-18 4,163.70 4,163.70 FU9602 M STD ST Sep-67 Jun-18 Aug-18 Aug-18 1,200.00 1,200.00 FW1311 M STD ST Nov-70 Jun-18 Oct-18 Oct-18 983.87 983.87 FY4558 F STD ST Oct-64 Jun-18 Nov-18 Jul-18 3,158.73 3,158.73 FS3568 F STD ST Oct-64 Jun-18 Jul-18 Sep-18 7,191.97 7,191.97 FT0611 F STD ST Jan-66 Jun-18 Jun-18 Aug-18 5,941.01 5,941.01

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

FT0747 F STD ST Nov-71 Jun-18 Jul-18 Jul-18 443.86 443.86 FT0842 F STD ST Nov-68 Jun-18 Jul-18 Sep-18 974.58 974.58 FT4157 F STD ST Nov-71 Jun-18 Jul-18 Aug-18 9,880.99 9,880.99 FT4271 F STD ST Nov-87 Jun-18 Jul-18 Aug-18 4,341.60 4,341.60 FU3120 F STD ST Apr-59 Jun-18 Aug-18 Jul-18 1,621.06 1,621.06 FM7536 F STD ST Jul-77 Jun-18 Jun-18 Jul-18 2,242.11 2,242.11 FS7339 M STD ST Jan-60 Jun-18 Jun-18 Aug-18 1,903.80 1,903.80 FT3660 F STD ST Jan-72 Jun-18 Jul-18 Aug-18 2,167.22 2,167.22 FS6577 F STD ST Mar-89 Jul-18 Jul-18 Aug-18 503.28 503.28 FT3186 F STD ST Jun-85 Jul-18 Jul-18 Sep-18 3,537.73 3,537.73 FU0226 F STD ST Feb-82 Jul-18 Aug-18 Oct-18 4,357.67 4,357.67 FU6726 F STD ST Aug-89 Jul-18 Aug-18 Aug-18 1,986.12 1,986.12 FU9171 F STD ST Nov-02 Jul-18 Sep-18 Aug-18 392.07 392.07 FV1785 F STD ST May-61 Jul-18 Sep-18 Oct-18 2,296.96 2,296.96 FW2884 F STD ST Aug-59 Jul-18 Oct-18 Jan-19 10,726.54 10,726.54 FT5262 F STD ST Mar-57 Jul-18 Jul-18 Nov-18 7,306.28 7,306.28 FU1768 F STD ST Nov-87 Jul-18 Aug-18 Jan-19 11,755.53 11,755.53 FU3372 M STD ST Mar-55 Jul-18 Aug-18 Oct-18 3,295.43 3,295.43 FU9083 M STD ST Nov-02 Jul-18 Aug-18 Aug-18 928.15 928.15 FU9148 F STD ST Nov-02 Jul-18 Aug-18 Oct-18 4,650.31 4,650.31 FV0676 F STD ST Mar-65 Jul-18 Sep-18 Sep-18 3,266.25 3,266.25 FU6641 F STD ST Dec-53 Jul-18 Aug-18 Aug-18 865.13 865.13 FV5072 M STD ST Jun-77 Aug-18 Sep-18 Oct-18 1,969.71 1,969.71 FV5662 F STD ST Oct-80 Aug-18 Sep-18 Sep-18 1,076.29 1,076.29 FV8986 F STD ST Aug-76 Aug-18 Oct-18 Nov-18 4,525.16 4,525.16 FW0356 M STD ST Jan-58 Aug-18 Oct-18 Oct-18 1,058.37 1,058.37 FW1958 F STD ST Mar-86 Aug-18 Oct-18 Oct-18 767.87 767.87 FW3202 F STD ST Nov-55 Aug-18 Oct-18 Feb-19 17,165.79 17,165.79 FW3237 F STD ST Dec-72 Aug-18 Oct-18 Oct-18 1,852.40 1,852.40 FX3424 F STD ST Jun-84 Aug-18 Oct-18 Oct-18 4,436.46 4,436.46 FZ1342 F STD ST Dec-54 Aug-18 Jan-19 Feb-19 1,708.04 1,708.04 FU1718 F STD ST Nov-94 Aug-18 Aug-18 Oct-18 1,934.75 1,934.75 FU6587 M STD ST Oct-62 Aug-18 Sep-18 Jan-19 14,063.73 14,063.73

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

FU7782 F STD ST Jun-59 Aug-18 Sep-18 Jan-19 11,755.52 11,755.52 FU9669 M STD ST Sep-70 Aug-18 Aug-18 Aug-18 88.93 88.93 FV4057 F STD ST Aug-78 Sep-18 Oct-18 Nov-18 2,451.08 2,451.08 FV6599 F STD ST May-72 Sep-18 Oct-18 Jan-19 6,270.47 6,270.47 FV8678 F STD ST Oct-83 Sep-18 Oct-18 Oct-18 1,952.68 1,952.68 FW5550 F STD ST Oct-91 Sep-18 Nov-18 Oct-18 1,896.48 1,896.48 FX4980 M STD ST Dec-56 Sep-18 Nov-18 Oct-18 494.32 494.32 FV1806 F STD ST Feb-82 Sep-18 Sep-18 Nov-18 2,262.33 2,262.33 FW1972 M STD ST Nov-64 Sep-18 Oct-18 Oct-18 1,280.76 1,280.76 FV9962 F STD ST Jan-58 Sep-18 Sep-18 Oct-18 799.90 799.90 FY1612 F STD ST Dec-60 Sep-18 Dec-18 Nov-18 1,070.82 1,070.82 FW5168 F STD ST Sep-60 Oct-18 Nov-18 Dec-18 1,459.16 1,459.16 FW8698 F STD ST Nov-89 Oct-18 Oct-18 Nov-18 1,960.26 1,960.26 FX5945 F STD ST May-69 Oct-18 Nov-18 Feb-19 6,409.86 6,409.86 FX6353 M STD ST Aug-58 Oct-18 Nov-18 Jan-19 82.14 82.14 FX6670 F STD ST May-71 Oct-18 Nov-18 Dec-18 1,925.47 1,925.47 FX8557 M STD ST Nov-82 Oct-18 Nov-18 Nov-18 890.80 890.80 FY0377 F STD ST Jan-68 Oct-18 Nov-18 Feb-19 4,941.35 4,941.35 FY0806 M STD ST May-66 Oct-18 Nov-18 Nov-18 276.88 276.88 FY2637 M STD ST Mar-63 Oct-18 Nov-18 Jan-19 2,483.28 2,483.28 FY5632 F STD ST Jun-69 Oct-18 Dec-18 Jan-19 67.91 67.91 FU1678 F STD ST Jan-80 Oct-18 Nov-18 Dec-18 82.15 82.15 FX2000 M STD ST Jun-59 Oct-18 Oct-18 Jan-19 5,591.84 5,591.84 FX5829 F STD ST Nov-72 Oct-18 Nov-18 Jan-19 1,443.37 1,443.37 FX6242 F STD ST Aug-61 Oct-18 Nov-18 Apr-19 7,391.96 7,391.96 FX6877 F STD ST Dec-71 Oct-18 Nov-18 Dec-18 753.97 753.97 FX6013 F STD ST Mar-59 Nov-18 Dec-18 Jan-19 71.43 71.43 FX8203 F STD ST Aug-62 Nov-18 Dec-18 Jan-19 1,863.98 1,863.98 FX8457 F STD ST Jul-75 Nov-18 Dec-18 Jan-19 2,508.38 2,508.38 FX9736 F STD ST Aug-59 Nov-18 Dec-18 May-19 18,946.41 18,946.41 FY3013 F STD ST Aug-93 Nov-18 Dec-18 Mar-19 4,957.21 4,957.21 FY7909 M STD ST Oct-68 Nov-18 Dec-18 May-19 11,398.00 11,398.00 FZ7529 F STD ST Feb-71 Nov-18 Jan-19 Feb-19 4,768.00 4,768.00

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

FY5058 F STD ST Aug-84 Nov-18 Dec-18 Feb-19 2,904.29 2,904.29 FY6144 M STD ST Mar-68 Nov-18 Dec-18 Mar-19 7,688.16 7,688.16 FZ4074 F STD ST Jun-85 Nov-18 Jan-19 Jan-19 937.82 937.82 FY1238 F STD ST Jun-54 Nov-18 Nov-18 Dec-18 593.99 593.99 FW8304 F STD ST Jun-89 Dec-18 Jan-19 Feb-19 96.43 96.43 FY0827 F STD ST Jan-89 Dec-18 Jan-19 Jan-19 1,019.57 1,019.57 FY4078 M STD ST Mar-54 Dec-18 Dec-18 Feb-19 3,626.45 3,626.45 FY4818 F STD ST Feb-86 Dec-18 Feb-19 Jan-19 96.43 96.43 FZ2583 F STD ST Mar-69 Dec-18 Jan-19 Feb-19 3,629.74 3,629.74 FZ3843 M STD ST Nov-96 Dec-18 Jan-19 Apr-19 5,054.08 5,054.08 FZ4050 F STD ST Nov-51 Dec-18 Jan-19 Jun-19 21,882.34 21,882.34 FZ6964 M STD ST Nov-83 Dec-18 Jan-19 Apr-19 6,526.17 6,526.17 FZ9105 F STD ST Aug-72 Dec-18 Jan-19 Mar-19 4,761.46 4,761.46 GA0976 M STD ST Mar-57 Dec-18 Jan-19 Apr-19 7,315.11 7,315.11 GA5887 F STD ST Apr-76 Dec-18 Feb-19 Mar-19 1,611.60 1,611.60 GC0429 F STD ST Sep-80 Dec-18 Mar-19 Mar-19 1,783.62 1,783.62 GF1962 M STD ST Jul-97 Dec-18 Jul-19 Jun-19 5,911.98 5,911.98 FY8942 M STD ST Aug-64 Dec-18 Dec-18 Jan-19 2,398.52 2,398.52 GA7035 F STD ST Jun-81 Dec-18 Feb-19 Jun-19 11,265.28 11,265.28 FZ5190 F STD ST Dec-81 Dec-18 Dec-18 Feb-19 3,569.14 3,569.14 FZ3701 F STD ST May-59 Dec-18 Jan-19 Jun-19 8,268.40 8,268.40 FX6564 F STD ST May-78 Jan-19 Feb-19 Mar-19 850.95 850.95 FZ1817 M STD ST Apr-87 Jan-19 Feb-19 Mar-19 1,413.63 1,413.63 FZ5725 F STD ST Feb-67 Jan-19 Feb-19 Feb-19 46.44 46.44 FZ7899 F STD ST Nov-87 Jan-19 Jan-19 Feb-19 2,567.32 2,567.32 GA7604 M STD ST Jun-62 Jan-19 Feb-19 Mar-19 157.14 157.14 GA8019 F STD ST Aug-90 Jan-19 Feb-19 Mar-19 2,315.95 2,315.95 GA8530 M STD ST May-97 Jan-19 Feb-19 Mar-19 1,025.73 1,025.73 GA9191 F STD ST May-82 Jan-19 Feb-19 May-19 6,651.09 6,651.09 GB4838 F STD ST May-61 Jan-19 Mar-19 Mar-19 1,059.05 1,059.05 GB8308 F STD ST Mar-57 Jan-19 Mar-19 Mar-19 1,945.83 1,945.83 GD6557 F STD ST Jul-81 Jan-19 May-19 Apr-19 4,279.60 4,279.60 GG0212 M STD ST Jul-60 Jan-19 Jun-19 Mar-19 89.29 89.29

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

GB1234 F STD ST Apr-74 Jan-19 Feb-19 Mar-19 146.43 146.43 GA2611 F STD ST Oct-61 Jan-19 Mar-19 Apr-19 5,264.16 5,264.16 GA3235 F STD ST Apr-59 Jan-19 Jan-19 Feb-19 505.62 505.62 FZ5565 F STD ST Mar-96 Jan-19 Feb-19 Mar-19 2,041.12 2,041.12 FZ5351 F STD ST Oct-82 Feb-19 Feb-19 Mar-19 1,512.96 1,512.96 FZ5365 F STD ST Jun-80 Feb-19 Feb-19 Mar-19 96.43 96.43 GA2709 F STD ST Jun-59 Feb-19 Mar-19 Apr-19 8,988.58 8,988.58 GA3320 F STD ST Jun-85 Feb-19 Mar-19 Mar-19 501.42 501.42 GA9057 F STD ST Mar-67 Feb-19 Feb-19 Mar-19 1,199.22 1,199.22 GB3954 F STD ST Nov-56 Feb-19 Mar-19 Aug-19 12,853.01 12,853.01 GB3985 F STD ST Jun-96 Feb-19 Mar-19 May-19 6,457.68 6,457.68 GB6183 F STD ST Dec-93 Feb-19 Mar-19 Apr-19 1,978.69 1,978.69 GB8599 F STD ST Jun-90 Feb-19 Mar-19 Apr-19 2,269.73 2,269.73 GB8879 M STD ST Jan-88 Feb-19 Mar-19 Jun-19 7,512.85 7,512.85 GC0303 F STD ST Nov-63 Feb-19 Apr-19 Aug-19 11,744.64 11,744.64 GC0427 M STD ST May-68 Feb-19 Mar-19 Apr-19 2,697.56 2,697.56 GC1007 F STD ST Mar-75 Feb-19 Mar-19 Mar-19 1,025.33 1,025.33 GC7356 M STD ST Oct-57 Feb-19 May-19 Apr-19 1,054.95 1,054.95 GB0563 F STD ST Mar-88 Feb-19 Feb-19 Aug-19 12,844.80 12,844.80 GE4908 F STD ST Nov-55 Feb-19 May-19 Aug-19 8,411.04 8,411.04 GE5690 F STD ST Dec-64 Feb-19 May-19 Jul-19 5,277.70 5,277.70 GA4455 F STD ST Jun-85 Feb-19 Feb-19 Apr-19 1,618.96 1,618.96 GB8829 F STD ST Feb-67 Feb-19 Mar-19 Aug-19 11,669.76 11,669.76 GB9529 F STD ST Aug-57 Feb-19 Mar-19 Mar-19 212.90 212.90 GB2908 F STD ST May-62 Feb-19 Mar-19 Mar-19 1,713.99 1,713.99 FZ9459 F STD ST Feb-89 Mar-19 Apr-19 May-19 3,042.51 3,042.51 GA2526 F STD ST Oct-67 Mar-19 Mar-19 May-19 5,933.48 5,933.48 GB3993 F STD ST Jun-84 Mar-19 Mar-19 Apr-19 2,410.78 2,410.78 GB8255 F STD ST Apr-90 Mar-19 Mar-19 Apr-19 2,685.28 2,685.28 GC5101 F STD ST Feb-91 Mar-19 Apr-19 Sep-19 12,095.19 12,095.19 GC5793 M STD ST Nov-59 Mar-19 Apr-19 Jun-19 4,093.56 4,093.56 GC7082 M STD ST Apr-62 Mar-19 Apr-19 Apr-19 1,472.18 1,472.18 GC7276 F STD ST Dec-96 Mar-19 Apr-19 Apr-19 1,415.28 1,415.28

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

GC8129 F STD ST Jul-53 Mar-19 Apr-19 Jun-19 3,716.56 3,716.56 GC8727 F STD ST Feb-83 Mar-19 Apr-19 Apr-19 1,481.16 1,481.16 GC9366 F STD ST Jun-84 Mar-19 Apr-19 Jun-19 4,453.53 4,453.53 GD2243 F STD ST Jun-60 Mar-19 Apr-19 Apr-19 835.36 835.36 GD3743 F STD ST May-57 Mar-19 Apr-19 May-19 2,258.97 2,258.97 GD5312 F STD ST Jan-74 Mar-19 Apr-19 May-19 2,625.58 2,625.58 GF4771 M STD ST Apr-56 Mar-19 Jun-19 Aug-19 5,507.67 5,507.67 GD8070 F STD ST Dec-84 Mar-19 May-19 May-19 96.43 96.43 GC4091 F STD ST Oct-56 Mar-19 Mar-19 Jun-19 10,226.16 10,226.16 GC8461 F STD ST Feb-69 Apr-19 Apr-19 Oct-19 8,695.96 8,695.96 GC8989 F STD ST Aug-80 Apr-19 Apr-19 May-19 2,007.06 2,007.06 GC9539 F STD ST Mar-69 Apr-19 Apr-19 Jun-19 3,684.55 3,684.55 GD4358 F STD ST Mar-90 Apr-19 May-19 Jun-19 2,885.34 2,885.34 GD9133 F STD ST Nov-71 Apr-19 May-19 Jun-19 2,925.63 2,925.63 GD9809 F STD ST Oct-84 Apr-19 Apr-19 May-19 302.33 302.33 GE0988 F STD ST Mar-62 Apr-19 May-19 May-19 21.43 21.43 GE1327 M STD ST Jul-56 Apr-19 May-19 Jul-19 6,022.53 6,022.53 GE2769 F STD ST Nov-80 Apr-19 May-19 Jun-19 1,968.52 1,968.52 GE2838 F STD ST Aug-57 Apr-19 May-19 Aug-19 5,928.45 5,928.45 GE3573 M STD ST Nov-62 Apr-19 May-19 Aug-19 3,831.11 3,831.11 GE3976 M STD ST Dec-89 Apr-19 Jul-19 Jun-19 3,939.70 3,939.70 GE5119 F STD ST Aug-81 Apr-19 Jun-19 Jul-19 3,812.09 3,812.09 GE7978 M STD ST Jul-71 Apr-19 May-19 May-19 1,946.79 1,946.79 GF2623 F STD ST Nov-59 Apr-19 Jun-19 Jun-19 484.10 484.10 GF8854 M STD ST Sep-66 Apr-19 Jul-19 Oct-19 7,906.47 7,906.47 GF0161 F STD ST Apr-57 Apr-19 Jun-19 Jun-19 2,573.89 2,573.89 GD3136 F STD ST Sep-88 Apr-19 Apr-19 Jun-19 2,925.86 2,925.86 GD8236 F STD ST Mar-66 Apr-19 Apr-19 May-19 967.31 967.31 GC3458 F STD ST Nov-87 May-19 Jun-19 Jul-19 1,888.67 1,888.67 GD9362 F STD ST Jul-64 May-19 Jun-19 Aug-19 3,351.23 3,351.23 GE4038 F STD ST Dec-66 May-19 Jun-19 Jul-19 4,279.56 4,279.56 GE8563 F STD ST Dec-86 May-19 Jun-19 Jul-19 2,469.60 2,469.60 GE9022 F STD ST Oct-86 May-19 Jun-19 Jun-19 434.10 434.10

Approved Date

Term Date Pending Benefit

Paid This

Period

Paid This Claim

Ending Reserve

Beginning Reserve

GE9991 F STD ST Dec-63 May-19 Jun-19 Jun-19 2,123.70 2,123.70 GF2417 F STD ST Jul-81 May-19 Jun-19 Jul-19 96.43 96.43 GF6207 M STD ST Aug-71 May-19 Jun-19 Aug-19 2,943.58 2,943.58 GF7125 F STD ST Sep-68 May-19 Jul-19 Sep-19 6,456.39 6,456.39 GF8187 M STD ST Aug-85 May-19 Jun-19 Aug-19 4,426.95 4,426.95 GF8508 M STD ST Jan-63 May-19 Jul-19 Oct-19 10,849.63 10,849.63 GF9917 M STD ST Dec-55 May-19 Jul-19 Sep-19 3,477.27 3,477.27 GG9312 M STD ST Mar-67 May-19 Aug-19 Jun-19 1,272.86 1,272.86 GH9540 F STD ST Jan-78 May-19 Aug-19 Jun-19 850.28 850.28 GD0647 F STD ST Sep-90 May-19 May-19 Aug-19 4,301.54 4,301.54 GD4822 F STD ST Dec-59 May-19 May-19 Oct-19 11,647.94 11,647.94 GE8103 F STD ST Nov-66 May-19 May-19 May-19 17.86 17.86 GA2643 F STD ST Jul-86 May-19 Jun-19 Jun-19 1,764.87 1,764.87 GE3974 F STD ST Apr-96 May-19 May-19 Jun-19 1,448.68 1,448.68 GE7580 M STD ST Nov-63 Jun-19 Jun-19 Aug-19 2,296.63 2,296.63 GF2700 M STD ST Jul-89 Jun-19 Jun-19 Sep-19 7,533.27 7,533.27 GF3901 F STD ST Jan-69 Jun-19 Jul-19 Aug-19 1,382.07 1,382.07 GF5176 M STD ST Oct-89 Jun-19 Jul-19 Aug-19 3,434.41 3,434.41 GF7691 F STD ST Mar-73 Jun-19 Jul-19 Aug-19 2,114.96 2,114.96 GF9357 M STD ST May-56 Jun-19 Jun-19 Oct-19 6,810.80 6,810.80 GG0886 F STD ST Aug-79 Jun-19 Jul-19 Jul-19 1,112.24 1,112.24 GG1216 M STD ST Jun-59 Jun-19 Jun-19 Sep-19 3,549.04 3,549.04 GG2907 M STD ST Jan-58 Jun-19 Jul-19 Dec-19 9,191.59 9,191.59 GG3850 M STD ST Dec-61 Jun-19 Jul-19 Jun-19 972.27 972.27 GG3857 M STD ST Feb-47 Jun-19 Jul-19 Jul-19 1,732.92 1,732.92 GG8519 M STD ST Apr-82 Jun-19 Aug-19 Sep-19 6,372.41 6,372.41 GH8477 M STD ST Jun-75 Jun-19 Aug-19 Aug-19 537.45 537.45 GN0869 M STD ST Feb-62 Jun-19 Feb-20 Dec-19 5,080.79 5,080.79 GF9196 M STD ST Jan-53 Jun-19 Jul-19 Dec-19 13,166.86 13,166.86 GF6039 F STD ST Oct-83 Jun-19 Jun-19 Jul-19 1,859.79 1,859.79…