Attachment 5B - Claim Run Reference Sheet.pdf
PDF 536 KB Posted
- Solicitation number
- RFP 680 26-042/DJ 1
- Issued by
- Palm Beach County, Florida
About this file
This is a Claims Experience Report reference sheet prepared by StanCorp Financial Group, Inc., documenting claim run information for a Florida state and local government entity's disability and life insurance programs. The document serves as a line-by-line explanation guide for understanding claim data related to Long Term Disability (LTD), Short Term Disability (STD), Term Life Insurance, and related supplemental products including Accidental Death and Dismemberment (AD&D), Dependent Life coverage, and various employer and vendor accommodation benefits. The reference sheet defines standard data fields used in claims reporting, including claim numbers, claimant demographics, coverage types, product classifications, and key dates such as birth date, incurrence date, approval date, and claim closure date.
The document provides detailed definitions of financial and administrative metrics essential for claims management and reporting, including benefit amounts prior to any income reductions, amounts paid during specific periods, cumulative claim payments, and reserve amounts held at period beginning and end to cover future liabilities. The reference sheet includes notation for pending claims and adjustment or overpayment recovery indicators reflected through negative payment amounts. This standardized format enables consistent tracking and reporting of disability and life insurance claims across multiple product lines and coverage types for the Florida government entity's employee benefits program.
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Text version
© 2010 StanCorp Financial Group, Inc.
Claims Experience Report Information Line by Line
Item Explanation
Claim Number System-assigned number
Claimant Name Last Name of claimant. If Dependent Life claims, last name of covered member.
Gender M = Male, F = Female
Coverage
Type of Coverage:
SD = State Mandated Disability LTD = Long Term Disability STD = Short Term Disability TERM = Life Insurance TPD2 = Life Waiver of Premium DEP = Dependent Life AD&D = Accidental Death and Dismemberment
Product
AA = Additional Accidental Death & Dismemberment BA = Basic Accidental Death & Dismemberment AL = Additional Life ALB = Assisted Living Benefit ASL = Additional Spouse Dependent Life BL = Basic Life DL = Dependent Life L1 = Employer Reasonable Accomodation Benefit L2 = Vendor Reasonable Accomodation Benefit L4 = Employer Rehab Benefit L6 = Vendor Expense Benefit LSB = Lifetime Security Benefit LT = Long Term Disability ST = Short Term Disability XCL = Child Dependents Life XDL = Spouse and Child Dependents Life XSL = Spouse Dependents Life
Birth Date The month and year in which the claimant was born.
Incurred Date The month and year in which death or disability occurred.
Approved Date The month and year the claim was approved by Standard.
Term Date The month and year the claim was closed.
Pending Claim is pending.
Benefit Shown only for STD and LTD – The benefit prior to any reduction for income from other sources (i.e., the gross benefit).
Paid This Period The amount paid during the time period covered by the claims run. Negative amounts reflect adjustment and/or overpayment recoveries.
Paid This Claim The total amount paid since the incurred date of the claim.
Reserve End of Period This is the reserve held by Standard at the end of the time period covered by the claims run (set aside to pay future liabilities).
Reserve Beginning of Period This is the reserve held by Standard at the beginning of the time period covered by the claims run (set aside to pay future liabilities).
File details come from the government source that posted it. Updated .