Attachment 9 - Claim Run Reference Sheet_Lot 2.pdf
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- Solicitation number
- RFP 680 26-042/DJ 2
- Issued by
- Palm Beach County, Florida
About this file
This document is a Claims Experience Report Reference Sheet for StanCorp Financial Group, Inc., prepared for a Florida state and local contract opportunity involving Long Term & Short Term Disability Insurance and Term Life coverage. The reference sheet provides line-by-line explanations of claim data fields that appear in the 2010 StanCorp Financial Group, Inc. Claims Experience Report, serving as a guide for interpreting claim information submitted under Lot 2 of the disability and life insurance contract.
The reference sheet defines key data elements used in claims reporting, including claim number, claimant name, gender, coverage type (such as State Mandated Disability, Long Term Disability, Short Term Disability, and Life Insurance), and product classifications (ranging from Basic Life and Additional Life to Dependent Life and Accidental Death & Dismemberment coverage). Critical claim-related dates documented include birth date, incurred date, approved date, and term date, while financial information encompasses benefit amounts, payments made during the current period, total cumulative payments since claim inception, and reserve amounts held at the beginning and end of reporting periods to cover future liabilities. This documentation establishes the framework for standardizing and communicating claims experience data between the insurer and the contracting jurisdiction.
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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).
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