Attachment K - STD Claims Status.pdf

1 MB Posted

Attached to
State of Nebraska Short-Term Disability (STD) and Long-Term Disability (LTD) Insurance
Solicitation number
120084 O5
Issued by
Lancaster County, Nebraska

About this file

Written by GovTribe AI ·

This is a claims status report from UnitedHealthcare showing Short Term Disability (STD) claims data for State of Nebraska employees under Group #00306147, Subgroup 1002, for the period of July 1, 2019 through October 28, 2024. The report details closed, incomplete, in process, and open STD claims, including claim numbers, claimant gender, date of birth, claim entry dates, proof dates, and claim closure dates.

The report shows detailed tracking of hundreds of STD claims, with statuses indicating various stages of the claims process - from initial filing through closure. The majority of claims listed are marked as "Closed" with defined start and end dates, while a smaller number are labeled as "Incomplete," "In Process," or "Open." The data shows claims processing times typically ranging from 1-6 months, though some extend longer. The report uses standardized date formatting and includes notes explaining that incomplete claims are still in information collection, in process claims are under adjudication, and open claims are in payment status.

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Other files

File Type Posted
120084 O5 SOLICITATION ADDENDUM ONE final.docx DOCX document
Attachment I - STD Payment Details.xlsx XLSX spreadsheet
120084 O5- Addendum Two- Revised Schedule of Events.pdf PDF
120084 O5 RFP STD LTD Insurance.docx DOCX document
Attachment P Claim details for SAE from 07.01.2019.pdf PDF
Attachment A Requirements Matrix.docx DOCX document
Attachment C Current Short Term Disability Benefits.pdf PDF
UnitedHealthCare BAFO cost.pdf PDF
120084 O5 Cost Proposal.xlsx XLSX spreadsheet
BAFO 120084 O5 FinalEvaluationDocument.pdf PDF
Attachment F - LTD Group Paid by month.pdf PDF
Attachment J - LTD Claims Status.pdf PDF
List of Respondents.pdf PDF
Attachment G- STD Group Paid by month.pdf PDF
120084 O5 RFP STD LTD Insurance.pdf PDF
Attachment K - STD Claims Status.pdf PDF
UnitedHealthCare (stacked).pdf PDF
120084 O5- Addendum Three - Revised Schedule of Events.pdf PDF
Metlife Response (stacked).pdf PDF
Addendum 4 - Revised Schedule of Events.pdf PDF
120084 O5 Intent to Award.pdf PDF
Attachment N Historical LTD and STD Premium Payments.xlsx XLSX spreadsheet
Attachment O October 2024 STD LTD Monthly Invoice.pdf PDF
Attachment E - STD open and closed paid claim summary.pdf PDF
120084 O5 SolicitationEvaluationCriteria.pdf PDF
Metlife Response BAFO cost.pdf PDF
Attachment D - LTD open and closed paid claim summary.pdf PDF
120084 O5 BAFO Cost Proposal.xlsx XLSX spreadsheet
Attachment H - LTD Payment Details.xlsx XLSX spreadsheet
Attachment M EligibilityCensus.xlsx XLSX spreadsheet
Attachment L Census LTD STD.xlsx XLSX spreadsheet
Attachment B Current Long Term Disability Benefits.pdf PDF
120084 O5 RFP STD LTD Insurance.docx DOCX document
Attachment L Census LTD STD.xlsx XLSX spreadsheet
Attachment G- STD Group Paid by month.pdf PDF
120084 O5 SOLICITATION ADDENDUM ONE final.docx DOCX document
Attachment B Current Long Term Disability Benefits.pdf PDF
Attachment I - STD Payment Details.xlsx XLSX spreadsheet
120084 O5 Cost Proposal.xlsx XLSX spreadsheet
Attachment O October 2024 STD LTD Monthly Invoice.pdf PDF
Attachment J - LTD Claims Status.pdf PDF
Metlife Response (stacked).pdf PDF
Attachment H - LTD Payment Details.xlsx XLSX spreadsheet
Metlife Response BAFO cost.pdf PDF
120084 O5 Intent to Award.pdf PDF
Attachment E - STD open and closed paid claim summary.pdf PDF
120084 O5- Addendum Three - Revised Schedule of Events.pdf PDF
Attachment D - LTD open and closed paid claim summary.pdf PDF
Attachment C Current Short Term Disability Benefits.pdf PDF
Attachment M EligibilityCensus.xlsx XLSX spreadsheet
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Claim Number Gender Date of Birth Enter Date Proofs Date Latest To Date 200767420 M 10/19/1959 07/20/2019 08/22/2019 01/01/0001

200767501 F 09/22/1972 07/23/2019 08/14/2019 01/01/0001

200767602 F 03/18/1975 07/24/2019 07/24/2019 01/01/0001

200767956 F 03/21/1960 07/29/2019 08/13/2019 01/01/0001

200767957 F 08/26/1990 07/29/2019 08/08/2019 01/01/0001

200768272 M 03/04/1969 08/01/2019 08/08/2019 01/01/0001

200768748 F 08/19/1980 08/07/2019 08/27/2019 01/01/0001

200768946 M 12/27/1963 08/09/2019 08/09/2019 01/01/0001

200769070 F 03/03/1958 08/11/2019 08/28/2019 09/26/2019

200769425 F 11/29/1956 08/15/2019 08/21/2019 01/01/0001

200769867 M 09/30/1984 08/21/2019 08/21/2019 01/01/0001

200769883 F 12/12/1977 08/21/2019 09/30/2019 09/26/2019

200770222 F 12/11/1975 08/28/2019 09/06/2019 09/04/2019

200770226 F 05/25/1960 08/28/2019 09/09/2019 09/19/2019

200770392 F 11/26/1967 08/30/2019 10/09/2019 11/18/2019

200770414 F 05/04/1960 08/30/2019 09/19/2019 09/12/2019

200770873 F 11/04/1958 09/09/2019 10/04/2019 10/29/2019

200770880 F 03/26/1991 09/09/2019 09/23/2019 01/01/0001

200771070 F 11/05/1966 09/11/2019 09/24/2019 09/12/2019

200771392 F 01/07/1996 09/17/2019 10/04/2019 10/28/2019

200771611 F 12/13/1967 09/19/2019 09/25/2019 01/01/0001

200771664 M 02/12/1965 09/20/2019 10/10/2019 01/01/0001

03/11/2020

STD Closed 09/04/2019 01/01/0001 11/01/2019

STD Closed 09/09/2019 01/01/0001

10/11/2019

Short Term Disability Closed 09/09/2019 09/16/2019 11/25/2019

Short Term Disability Closed 08/20/2019 08/27/2019

12/23/2019

STD Closed 09/11/2019 01/01/0001 11/04/2019

Short Term Disability Closed 09/01/2019 09/08/2019

12/12/2019

Short Term Disability Closed 08/08/2019 08/15/2019 02/18/2020

Short Term Disability Closed 10/02/2019 10/09/2019

12/11/2019

Short Term Disability Closed 08/08/2019 08/15/2019 10/22/2019

Short Term Disability Closed 08/12/2019 08/19/2019

09/06/2019

Short Term Disability Closed 07/30/2019 08/06/2019 05/26/2020

STD Closed 08/15/2019 01/01/0001

04/09/2020

STD Closed 08/08/2019 01/01/0001 09/25/2019

Short Term Disability Closed 08/08/2019 08/15/2019

08/28/2019

STD Closed 07/28/2019 01/01/0001 11/07/2019

STD Closed 06/22/2019 01/01/0001

08/14/2019

STD Closed 07/16/2019 01/01/0001 09/16/2019

STD Closed 07/11/2019 01/01/0001

12/04/2019

STD Closed 07/13/2019 01/01/0001 09/17/2019

STD Closed 07/12/2019 01/01/0001

09/06/2019

STD Closed 06/24/2019 01/01/0001 08/27/2019

STD Closed 07/23/2019 01/01/0001

STATE OF NEBRASKA Group Effective Date: 07/01/2019 Subgroup: 1002 - STATE OF NEBRASKA

Benefit Status * Incurred Date Initial From Date Close Date

STD STD

FACETS

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

Run Date: 10/28/2024 1:29:32 PM

* Claim Status Descriptions:

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Attachment K

STD STD

FACETS

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

200771851 F 09/13/1966 09/24/2019 10/04/2019 09/24/2019

200772098 F 04/11/1964 09/27/2019 10/11/2019 01/10/2020

200772166 M 07/14/1957 09/27/2019 10/21/2019 01/01/0001

200773043 M 10/19/1975 10/04/2019 10/04/2019 01/01/0001

200773130 F 05/30/1979 10/07/2019 10/18/2019 10/28/2019

200773262 F 07/11/1953 10/08/2019 10/18/2019 10/26/2019

200773903 M 08/04/1984 10/16/2019 10/16/2019 01/01/0001

200774363 F 05/08/1974 10/21/2019 10/29/2019 11/04/2019

200774383 F 11/26/1957 10/21/2019 10/25/2019 01/01/0001

200774464 M 12/31/1965 10/22/2019 11/06/2019 11/26/2019

200774772 F 04/28/1988 10/24/2019 10/24/2019 01/01/0001

200775054 F 03/23/1976 10/29/2019 11/11/2019 10/17/2019

200775190 F 12/07/1991 10/30/2019 11/05/2019 10/28/2019

200775430 F 04/23/1970 10/31/2019 12/09/2019 01/01/0001

200775545 M 06/14/1965 11/01/2019 01/03/2020 11/18/2019

200775562 F 03/17/1995 11/01/2019 11/14/2019 01/01/0001

200775958 F 08/13/1995 11/06/2019 11/14/2019 01/01/0001

200776430 F 02/09/1972 11/11/2019 12/02/2019 03/06/2020

200777141 F 07/21/1995 11/20/2019 12/05/2019 12/06/2019

200777176 F 01/17/1961 11/20/2019 12/11/2019 11/12/2019

200777287 F 01/22/1972 11/21/2019 11/21/2019 01/01/0001

200777498 F 03/21/1987 11/25/2019 12/10/2019 01/01/0001

200777968 F 09/19/1967 12/03/2019 12/05/2019 01/01/0001

200778559 F 07/01/1997 12/10/2019 12/24/2019 01/01/0001

200778759 F 02/20/1990 12/12/2019 12/13/2019 03/03/2020 03/09/2020Short Term Disability Closed 12/10/2019 12/17/2019

03/05/2020

STD Closed 11/23/2019 01/01/0001 01/04/2020

STD Closed 11/07/2019 01/01/0001

12/04/2019

STD Closed 11/15/2019 01/01/0001 03/13/2020

STD Closed 11/16/2019 01/01/0001

01/15/2020

Short Term Disability Closed 10/29/2019 11/05/2019 12/19/2019

Short Term Disability Closed 11/17/2019 11/24/2019

02/18/2020

Short Term Disability Closed 11/25/2019 12/02/2019 04/02/2020

STD Closed 11/07/2019 01/01/0001

08/20/2021

STD Closed 10/30/2019 01/01/0001 08/05/2020

Short Term Disability Closed 10/14/2019 10/21/2019

11/13/2019

STD Closed 12/03/2019 01/01/0001 01/15/2020

Short Term Disability Closed 10/14/2019 10/21/2019

12/17/2019

Short Term Disability Closed 09/20/2019 09/20/2019 11/19/2019

STD Closed 11/04/2019 01/01/0001

12/05/2019

Short Term Disability Closed 10/02/2019 10/02/2019 06/15/2020

STD Closed 09/27/2019 01/01/0001

12/03/2019

Short Term Disability Closed 10/16/2019 10/23/2019 01/07/2020

STD Closed 11/01/2019 01/01/0001

10/28/2019

Short Term Disability Closed 09/28/2019 10/05/2019 12/23/2019

Short Term Disability Closed 09/24/2019 10/01/2019

10/28/2019

STD Closed 09/17/2019 01/01/0001 11/20/2019

STD Closed 08/24/2019 01/01/0001

10/11/2019

Short Term Disability Closed 10/15/2019 10/22/2019 01/15/2020

Short Term Disability Closed 09/07/2019 09/07/2019

Run Date: 10/28/2024 1:29:32 PM

* Claim Status Descriptions:

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

200778936 M 01/17/1955 12/13/2019 12/24/2019 03/02/2020

200779473 F 10/15/1961 12/20/2019 01/07/2020 01/13/2020

200780044 F 01/03/1985 01/02/2020 02/06/2020 01/01/0001

200780101 F 07/03/1989 01/02/2020 02/05/2020 01/01/0001

200780458 F 06/06/1988 01/06/2020 01/15/2020 03/02/2020

200780567 F 03/01/1984 01/08/2020 01/16/2020 01/16/2020

200780583 F 11/05/1966 01/08/2020 01/10/2020 01/01/0001

200780636 F 09/18/1984 01/09/2020 02/11/2020 01/01/0001

200780880 F 11/19/1989 01/10/2020 03/17/2020 03/28/2020

200781254 M 09/26/1978 01/15/2020 02/17/2020 01/21/2020

200781256 F 05/02/1969 01/15/2020 01/21/2020 01/23/2020

200781299 F 01/28/1961 01/15/2020 01/17/2020 01/02/2020

200781482 F 01/03/1967 01/21/2020 02/18/2020 05/07/2020

200782172 M 12/31/1958 01/30/2020 01/30/2020 01/01/0001

200782412 F 04/12/1989 02/04/2020 02/24/2020 04/01/2020

200782880 M 09/14/1959 02/11/2020 02/24/2020 01/01/0001

200783111 F 04/25/1982 02/13/2020 03/09/2020 01/01/0001

200783116 F 01/12/1975 02/13/2020 02/13/2020 01/01/0001

200783719 F 10/02/1980 02/20/2020 06/30/2020 01/01/0001

200783855 F 04/03/1989 02/23/2020 03/04/2020 03/01/2020

200784097 F 05/11/1976 02/26/2020 03/09/2020 01/01/0001

200784642 F 11/02/1988 03/03/2020 03/16/2020 04/18/2020

200784675 F 09/22/1972 03/03/2020 05/08/2020 01/01/0001

200784710 F 10/18/1975 03/04/2020 04/30/2020 03/11/2020

200784909 F 11/07/1988 03/05/2020 03/19/2020 04/29/2020

07/10/2020

Short Term Disability Closed 03/18/2020 03/25/2020 04/22/2020

Short Term Disability Closed 02/18/2020 02/25/2020

03/26/2020

STD Closed 02/24/2020 01/01/0001 07/01/2020

Short Term Disability Closed 03/06/2020 03/13/2020

03/25/2020

STD Closed 02/24/2020 01/01/0001 06/02/2020

Short Term Disability Closed 02/21/2020 02/28/2020

04/17/2020

STD Closed 05/27/2020 01/01/0001 02/09/2021

STD Closed 02/03/2020 01/01/0001

04/20/2020

STD Closed 02/13/2020 01/01/0001 05/26/2020

STD Closed 02/11/2020 01/01/0001

03/11/2020

Short Term Disability Closed 02/19/2020 02/26/2020 03/04/2020

STD Closed 07/12/2019 01/01/0001

01/28/2020

Short Term Disability Closed 12/24/2019 12/27/2019 09/01/2020

Short Term Disability Closed 12/24/2019 12/31/2019

02/27/2020

Short Term Disability Closed 01/07/2020 01/14/2020 02/05/2020

Short Term Disability Closed 01/07/2020 01/14/2020

02/19/2020

Short Term Disability Closed 03/14/2020 03/21/2020 03/26/2020

STD Closed 02/01/2020 01/01/0001

01/29/2020

STD Closed 02/27/2020 01/01/0001 02/02/2021

Short Term Disability Closed 12/31/2019 01/07/2020

02/17/2020

Short Term Disability Closed 01/06/2020 01/13/2020 03/06/2020

STD Closed 01/27/2020 01/01/0001

01/15/2020

STD Closed 01/23/2020 01/01/0001 03/30/2020

Short Term Disability Closed 12/12/2019 12/19/2019

Short Term Disability Closed 12/10/2019 12/17/2019 03/05/2020

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

200785019 M 09/22/1957 03/09/2020 03/23/2020 01/01/0001

200785035 M 12/21/1969 03/09/2020 03/25/2020 01/01/0001

200785910 F 08/05/1982 03/19/2020 04/13/2020 05/13/2020

200786436 F 01/20/1991 03/25/2020 04/16/2020 05/18/2020

200786703 F 08/27/1993 03/26/2020 03/26/2020 01/01/0001

200786843 F 07/02/1961 03/30/2020 04/06/2020 04/22/2020

200787363 F 09/03/1986 04/02/2020 05/20/2020 06/06/2020

200787370 F 10/27/1980 04/02/2020 04/13/2020 06/03/2020

200787665 M 10/19/1975 04/06/2020 04/13/2020 01/01/0001

200787892 F 06/14/1987 04/07/2020 05/29/2020 05/27/2020

200787915 F 03/04/1991 04/08/2020 07/01/2020 08/17/2020

200788005 F 12/07/1991 04/09/2020 04/09/2020 01/01/0001

200788209 F 03/07/1968 04/14/2020 04/28/2020 04/14/2020

200788374 M 11/20/1997 04/15/2020 04/16/2020 01/01/0001

200788595 F 12/13/1965 04/17/2020 05/21/2020 01/01/0001

200788723 M 08/23/1978 04/21/2020 06/02/2020 01/01/0001

200789133 F 08/12/1987 04/27/2020 06/03/2020 07/08/2020

200789307 U 01/01/1800 04/29/2020 04/29/2020 01/01/0001

200789337 M 10/21/1966 04/30/2020 05/04/2020 05/05/2020

200789503 M 04/26/1961 05/04/2020 06/01/2020 06/01/2020

200789531 F 11/01/1966 05/04/2020 05/21/2020 05/05/2020

200789627 F 03/08/1962 05/05/2020 05/21/2020 09/28/2020

200789712 F 02/13/1978 05/07/2020 05/21/2020 05/02/2020

200789864 F 07/29/1958 05/08/2020 05/18/2020 05/06/2020

200789931 F 06/21/1978 05/11/2020 05/20/2020 05/21/2020 06/01/2020Short Term Disability Closed 04/08/2020 04/15/2020

07/02/2020

Short Term Disability Closed 03/24/2020 03/31/2020 06/18/2020

Short Term Disability Closed 05/01/2020 05/01/2020

06/08/2020

Short Term Disability Closed 04/20/2020 04/27/2020 02/05/2021

Short Term Disability Closed 04/27/2020 05/04/2020

02/09/2021

Short Term Disability Closed 04/29/2020 05/06/2020 03/18/2021

Short Term Disability Closed 04/02/2020 04/09/2020

07/01/2020

STD Closed 03/21/2020 01/01/0001 06/20/2020

Short Term Disability Closed 05/13/2020 05/20/2020

07/22/2020

STD Closed 02/05/2020 01/01/0001 10/12/2020

STD Closed 04/13/2020 01/01/0001

02/03/2021

STD Closed 04/04/2020 01/01/0001 06/01/2020

Short Term Disability Closed 03/27/2020 04/03/2020

08/14/2020

STD Closed 03/31/2020 01/01/0001 02/24/2021

Short Term Disability Closed 06/22/2020 06/29/2020

06/11/2020

Short Term Disability Closed 04/01/2020 04/08/2020 07/10/2020

STD Closed 03/27/2020 01/01/0001

06/02/2020

Short Term Disability Closed 03/24/2020 03/31/2020 05/27/2020

Short Term Disability Closed 04/24/2020 05/01/2020

05/12/2020

Short Term Disability Closed 03/15/2020 03/22/2020 06/08/2020

STD Closed 03/07/2020 01/01/0001

04/24/2020

Short Term Disability Closed 04/06/2020 04/13/2020 04/15/2022

Short Term Disability Closed 03/18/2020 03/25/2020

04/20/2020

STD Closed 03/03/2020 01/01/0001 07/16/2020

STD Closed 01/09/2020 01/01/0001

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

200790040 F 03/22/1984 05/12/2020 05/19/2020 06/18/2020

200790056 F 07/25/1988 05/13/2020 06/24/2020 01/01/0001

200790160 M 03/07/1986 05/14/2020 05/29/2020 06/29/2020

200790208 F 07/24/1990 05/14/2020 06/02/2020 05/22/2020

200790330 F 07/26/1967 05/18/2020 06/05/2020 05/13/2020

200790370 F 07/24/1956 05/19/2020 06/01/2020 05/19/2020

200790574 M 02/25/1985 05/20/2020 07/01/2020 01/01/0001

200790882 F 06/21/1956 05/27/2020 06/08/2020 01/01/0001

200790968 F 03/05/1983 05/27/2020 06/02/2020 05/26/2020

200790978 F 04/17/1953 05/27/2020 06/22/2020 03/30/2020

200791196 F 02/07/1985 05/29/2020 06/30/2020 09/18/2020

200791330 F 09/17/1978 06/02/2020 07/10/2020 01/01/0001

200791498 F 08/21/1974 06/03/2020 06/10/2020 01/01/0001

200791506 F 07/08/1966 06/03/2020 06/16/2020 01/01/0001

200792011 F 04/22/1975 06/09/2020 06/15/2020 07/28/2020

200792534 F 01/23/1960 06/16/2020 06/16/2020 01/01/0001

200792633 F 01/31/1963 06/17/2020 07/15/2020 09/30/2020

200792737 F 09/28/1964 06/19/2020 06/24/2020 01/01/0001

200792854 F 07/16/1988 06/22/2020 07/02/2020 07/25/2020

200792997 M 12/25/1968 06/22/2020 07/17/2020 08/24/2020

200793064 F 03/18/1973 06/23/2020 06/23/2020 01/01/0001

200793508 F 09/13/1966 06/26/2020 07/02/2020 09/24/2020

200793561 F 03/11/1979 06/26/2020 06/29/2020 05/25/2020

200793710 F 04/17/1953 06/29/2020 06/30/2020 06/15/2020

200793736 F 09/13/1966 06/29/2020 08/14/2020 07/06/2020

08/05/2020

Short Term Disability Closed 06/19/2020 06/26/2020 10/15/2020

Short Term Disability Closed 05/29/2020 06/05/2020

11/16/2020

Short Term Disability Closed 05/06/2020 05/13/2020 08/05/2020

Short Term Disability Closed 07/02/2020 07/02/2020

09/03/2020

STD Closed 06/18/2020 01/01/0001 06/30/2020

Short Term Disability Closed 06/25/2020 07/02/2020

10/22/2020

Short Term Disability Closed 06/13/2020 06/20/2020 08/05/2020

STD Closed 06/05/2020 01/01/0001

08/16/2020

Short Term Disability Closed 07/06/2020 07/13/2020 10/12/2020

STD Closed 06/29/2020 01/01/0001

06/24/2020

Short Term Disability Closed 06/16/2020 06/23/2020 08/05/2020

STD Closed 06/11/2020 01/01/0001

09/01/2020

STD Closed 05/29/2020 01/01/0001 06/22/2020

STD Closed 02/29/2020 01/01/0001

08/05/2020

Short Term Disability Closed 07/24/2020 07/31/2020 08/05/2020

Short Term Disability Closed 03/16/2020 03/23/2020

06/15/2020

Short Term Disability Closed 05/17/2020 05/24/2020 06/16/2020

STD Closed 05/12/2020 01/01/0001

07/01/2020

STD Closed 06/25/2020 01/01/0001 08/13/2020

Short Term Disability Closed 03/20/2020 03/27/2020

09/29/2020

Short Term Disability Closed 05/04/2020 05/04/2020 06/18/2020

Short Term Disability Closed 04/30/2020 05/07/2020

09/28/2020

Short Term Disability Closed 05/27/2020 06/03/2020 07/22/2020

STD Closed 06/07/2020 01/01/0001

Short Term Disability Closed 05/06/2020 05/06/2020 06/26/2020

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202002465 F 07/15/1986 07/06/2020 07/06/2020 01/01/0001

202002467 F 07/15/1986 07/06/2020 07/07/2020 01/01/0001

202003375 F 07/20/1981 07/08/2020 07/22/2020 09/01/2020

202003514 F 07/15/1986 07/10/2020 01/01/0001

202003712 U 04/05/1971 07/14/2020 07/14/2020 08/26/2020

202003786 M 08/22/1969 07/14/2020 07/27/2020 07/16/2020

202004109 M 08/21/1962 07/20/2020 08/12/2020 01/01/0001

202004172 F 05/29/1989 07/21/2020 10/21/2020 11/23/2020

202004226 F 04/03/1989 07/22/2020 08/12/2020 06/01/2020

202004244 F 12/12/1960 07/22/2020 08/07/2020 09/21/2020

202004475 F 10/10/1963 07/27/2020 08/12/2020 08/11/2020

202004503 F 10/21/1963 07/27/2020 11/10/2020 01/01/0001

202004891 F 03/28/1984 07/31/2020 08/10/2020 09/21/2020

202005101 F 10/01/1969 08/04/2020 08/11/2020 08/13/2020

202005660 M 06/22/1982 08/10/2020 08/14/2020 10/01/2020

202005686 F 02/13/1978 08/11/2020 01/01/0001

202005748 M 10/24/1981 08/11/2020 08/27/2020 08/24/2020

202005748 M 10/24/1981 08/11/2020 08/27/2020 01/01/1900

202005957 F 08/30/1987 08/13/2020 08/17/2020 08/14/2020

202005968 U 09/03/1988 08/13/2020 09/14/2020 10/19/2020

202006006 F 10/29/1990 08/13/2020 08/20/2020 09/13/2020

202006182 F 08/18/1982 08/17/2020 08/14/2020 01/01/0001

202006183 F 01/25/1994 08/17/2020 01/01/0001

202006226 F 10/15/1961 08/17/2020 09/08/2020 10/26/2020

202006242 F 10/20/1957 08/17/2020 09/29/2020 01/01/0001 02/25/2021STD Closed 08/01/2020 01/01/0001

02/05/2021

Short Term Disability Closed 08/07/2020 08/15/2020 04/15/2021

STD Closed 07/18/2020 01/01/0001

09/16/2020

STD Closed 07/28/2020 01/01/0001 08/31/2020

Short Term Disability Closed 08/02/2020 08/09/2020

09/15/2020

Short Term Disability Closed 08/24/2020 08/31/2020 10/05/2020

Short Term Disability Closed 07/03/2020 07/10/2020

12/02/2020

STD Closed 07/14/2020 01/01/1900 12/02/2020

Short Term Disability Closed 07/14/2020 07/14/2020

11/16/2020

STD Closed 01/01/1900 01/01/0001 02/05/2021

Short Term Disability Closed 08/11/2020 08/18/2020

11/23/2021

Short Term Disability Closed 08/05/2020 08/12/2020 01/20/2021

Short Term Disability Closed 07/21/2020 07/21/2020

11/04/2020

STD Closed 01/01/1900 01/01/0001 11/10/2020

Short Term Disability Closed 07/24/2020 07/31/2020

08/27/2020

Short Term Disability Closed 08/07/2020 08/14/2020 01/29/2021

Short Term Disability Closed 05/13/2020 05/20/2020

10/30/2020

Short Term Disability Closed 10/13/2020 10/20/2020 12/03/2020

STD Closed 06/05/2020 01/01/0001

10/26/2020

Short Term Disability Closed 06/02/2020 06/09/2020 09/16/2020

Short Term Disability Closed 06/23/2020 06/23/2020

02/05/2021

STD Closed 01/01/1900 01/01/0001 01/28/2021

Short Term Disability Closed 06/17/2020 06/24/2020

01/28/2021

STD Closed 06/24/2020 01/01/0001 02/15/2021

STD Closed 06/24/2020 01/01/0001

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202006408 U 03/06/1979 08/19/2020 09/17/2020 10/30/2020

202006410 U 06/08/1962 08/19/2020 09/01/2020 01/01/0001

202006575 U 04/09/1991 08/20/2020 09/22/2020 10/29/2020

202006739 F 05/13/1985 08/24/2020 09/14/2020 10/23/2020

202006898 F 09/24/1969 08/26/2020 08/26/2020 09/29/2020

202006920 U 07/12/1962 08/26/2020 09/08/2020 11/30/2020

202007370 F 06/25/1969 09/01/2020 09/15/2020 10/13/2020

202007528 M 07/29/1983 09/02/2020 09/02/2020 09/25/2020

202007551 M 01/22/1959 09/02/2020 09/21/2020 01/01/0001

202007562 F 01/28/1958 09/02/2020 09/09/2020 10/30/2020

202007807 U 08/17/1973 09/08/2020 11/03/2020 01/01/0001

202008060 M 11/30/1970 09/11/2020 09/10/2020 10/16/2020

202008222 F 05/09/1976 09/14/2020 10/06/2020 01/01/0001

202008466 F 03/10/1975 09/16/2020 09/21/2020 09/21/2020

202008624 F 03/11/1979 09/17/2020 09/18/2020 09/14/2020

202008721 U 06/12/1980 09/18/2020 10/20/2020 12/01/2020

202008739 F 10/30/1985 09/18/2020 02/15/2021 01/01/0001

202009632 F 04/28/1997 10/01/2020 09/30/2020 11/11/2020

202009828 F 07/27/1968 10/01/2020 10/20/2020 10/20/2020

202010468 F 01/14/1986 10/05/2020 10/13/2020 11/02/2020

202010484 F 01/25/1972 10/05/2020 10/16/2020 10/13/2020

202010695 M 05/26/1976 10/07/2020 10/20/2020 01/01/0001

202010859 F 11/18/1965 10/08/2020 10/01/2020 10/21/2020

202010934 F 02/28/1959 10/08/2020 10/08/2020 03/03/2021

202011024 F 04/20/1952 10/09/2020 10/12/2020 11/30/2020

03/11/2021

Short Term Disability Closed 09/09/2020 09/16/2020 04/27/2021

Short Term Disability Closed 03/07/2020 02/03/2021

12/03/2020

Short Term Disability Closed 09/21/2020 09/28/2020 07/21/2021

STD Closed 09/18/2020 01/01/0001

10/28/2020

Short Term Disability Closed 08/30/2020 08/30/2020 07/21/2021

Short Term Disability Closed 10/06/2020 10/13/2020

11/09/2020

Short Term Disability Closed 09/21/2020 09/28/2020 12/01/2020

Short Term Disability Closed 09/28/2020 10/05/2020

11/06/2020

STD Closed 10/19/2020 01/01/0001 03/01/2021

Short Term Disability Closed 10/21/2020 10/28/2020

10/27/2020

Short Term Disability Closed 08/31/2020 09/07/2020 09/29/2020

Short Term Disability Closed 08/30/2020 09/06/2020

02/22/2021

STD Closed 08/31/2020 01/01/0001 02/15/2021

Short Term Disability Closed 09/08/2020 09/15/2020

11/17/2021

STD Closed 11/03/2020 01/01/0001 11/19/2020

Short Term Disability Closed 08/28/2020 09/04/2020

12/09/2020

STD Closed 08/25/2020 01/01/0001 12/01/2020

Short Term Disability Closed 08/11/2020 08/18/2020

11/24/2020

Short Term Disability Closed 09/16/2020 09/23/2020 11/30/2020

Short Term Disability Closed 08/14/2020 08/21/2020

10/05/2020

Short Term Disability Closed 08/18/2020 08/25/2020 02/19/2021

Short Term Disability Closed 08/28/2020 09/04/2020

10/27/2020

Short Term Disability Closed 09/02/2020 09/09/2020 10/20/2020

STD Closed 08/04/2020 01/01/0001

Short Term Disability Closed 09/17/2020 09/24/2020 10/22/2020

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202011386 M 10/16/1968 10/14/2020 10/19/2020 11/23/2020

202011662 F 12/20/1993 10/19/2020 10/19/2020 10/30/2020

202012025 F 05/11/1980 10/21/2020 10/20/2020 01/01/0001

202012184 F 05/01/1973 10/22/2020 01/01/0001

202012330 F 05/17/1967 10/23/2020 11/02/2020 01/01/0001

202012388 M 03/29/1960 10/24/2020 11/02/2020 12/07/2020

202012388 M 03/29/1960 10/24/2020 11/02/2020 01/01/1900

202012399 F 05/19/1977 10/24/2020 11/04/2020 11/23/2020

202012401 F 11/28/1961 10/24/2020 11/09/2020 10/05/2020

202012412 F 12/26/1983 10/24/2020 11/10/2020 11/30/2020

202012840 M 05/11/1959 10/29/2020 01/01/0001

202012912 F 10/30/1985 10/30/2020 11/05/2020 12/02/2020

202012912 F 10/30/1985 10/30/2020 11/05/2020 01/01/1900

202013179 F 09/25/1960 11/04/2020 01/01/0001

202013183 F 04/02/1989 11/04/2020 11/30/2020 12/24/2020

202013859 F 10/31/1963 11/09/2020 11/21/2020 12/02/2020

202013898 F 05/17/1967 11/09/2020 11/16/2020 01/01/0001

202013950 F 07/02/1985 11/10/2020 11/25/2020 01/13/2021

202014257 F 03/01/1958 11/12/2020 11/12/2020 01/27/2021

202014801 F 08/25/1966 11/17/2020 01/04/2021 03/08/2021

202014880 F 10/30/1995 11/17/2020 11/23/2020 01/01/0001

202014936 F 03/13/1985 11/18/2020 11/16/2020 10/24/2020

202015021 F 07/15/1972 11/19/2020 11/23/2020 03/30/2021

202015734 M 09/12/1970 11/24/2020 01/01/0001

202015981 F 07/05/1994 11/30/2020 01/25/2021 03/03/2021 03/01/2021Short Term Disability Closed 01/20/2021 01/27/2021

03/23/2021

STD Closed 11/14/2020 01/01/0001 02/11/2021

Short Term Disability Closed 09/28/2020 10/05/2020

02/08/2021

Short Term Disability Closed 08/29/2020 09/05/2020 12/22/2020

STD Closed 10/10/2020 01/01/0001

08/04/2021

Short Term Disability Closed 11/23/2020 11/30/2020 03/09/2021

Short Term Disability Closed 10/07/2020 10/14/2020

11/19/2020

Short Term Disability Closed 11/06/2020 11/13/2020 12/18/2020

STD Closed 10/10/2020 01/01/0001

01/13/2021

Short Term Disability Closed 11/03/2020 11/10/2020 01/07/2021

Short Term Disability Closed 11/11/2020 11/18/2020

12/04/2020

STD Closed 08/29/2020 01/01/0001 03/25/2021

STD Closed 10/14/2020 01/01/1900

12/15/2020

Short Term Disability Closed 10/14/2020 10/21/2020 12/04/2020

STD Closed 10/03/2020 01/01/0001

12/02/2020

Short Term Disability Closed 11/02/2020 11/09/2020 01/21/2021

Short Term Disability Closed 08/14/2020 08/21/2020

11/30/2020

Short Term Disability Closed 11/02/2020 11/16/2020 02/05/2021

STD Closed 09/11/2020 01/01/1900

11/19/2020

Short Term Disability Closed 09/11/2020 09/18/2020 11/30/2020

STD Closed 10/10/2020 01/01/0001

01/27/2021

STD Closed 10/15/2020 01/01/0001 12/09/2020

STD Closed 09/03/2020 01/01/0001

11/19/2020

Short Term Disability Closed 10/05/2020 10/12/2020 03/23/2021

Short Term Disability Closed 09/08/2020 09/15/2020

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202016091 F 08/30/1994 12/01/2020 12/10/2020 01/19/2021

202016438 F 07/22/1970 12/03/2020 12/09/2020 01/01/0001

202016889 F 09/25/1996 12/07/2020 01/12/2021 02/06/2021

202017045 F 10/20/1982 12/08/2020 12/17/2020 11/30/2020

202017482 F 09/12/1964 12/11/2020 12/29/2020 03/22/2021

202017729 F 12/05/1988 12/15/2020 12/17/2020 12/21/2020

202018282 M 03/17/1962 12/22/2020 01/01/0001

202018289 F 08/05/1975 12/22/2020 12/21/2020 01/09/2021

202018690 F 01/31/1963 12/28/2020 01/01/0001

202019252 F 06/03/1991 12/31/2020 01/08/2021 01/01/0001

202100269 M 10/09/1997 01/06/2021 02/02/2021 01/16/2021

202100492 M 07/29/1964 01/07/2021 02/05/2021 03/29/2021

202100502 F 04/28/1970 01/07/2021 01/22/2021 03/15/2021

202100703 F 07/31/1956 01/11/2021 02/22/2021 03/18/2021

202101267 F 08/17/1996 01/14/2021 01/20/2021 01/28/2021

202101440 M 11/11/1966 01/15/2021 02/02/2021 02/22/2021

202101800 U 06/12/1980 01/21/2021 01/29/2021 03/29/2021

202101884 F 08/17/1962 01/21/2021 02/05/2021 03/29/2021

202101919 F 11/30/1996 01/21/2021 01/01/0001

202102171 M 06/14/1965 01/25/2021 03/05/2021 01/19/2021

202102332 M 04/26/1961 01/26/2021 03/24/2021 02/18/2021

202102504 M 12/27/1963 01/27/2021 01/01/0001

202102884 F 02/11/1999 02/01/2021 04/15/2021 01/01/0001

202103403 F 10/05/1991 02/02/2021 01/01/0001

202103801 F 10/12/1973 02/05/2021 02/05/2021 02/19/2021

03/22/2021

Short Term Disability Closed 01/25/2021 02/01/2021 05/19/2021

STD Closed 01/29/2021 01/01/0001

03/15/2021

STD Closed 04/14/2021 01/01/0001 04/30/2021

STD Closed 01/20/2021 01/01/0001

04/12/2021

Short Term Disability Closed 12/30/2020 01/06/2021 04/22/2021

Short Term Disability Closed 12/13/2020 12/20/2020

05/03/2021

STD Closed 12/31/2020 01/01/0001 03/09/2021

Short Term Disability Closed 02/01/2021 02/08/2021

03/11/2021

Short Term Disability Closed 12/28/2020 01/04/2021 05/03/2021

Short Term Disability Closed 01/11/2021 01/18/2021

05/03/2021

Short Term Disability Closed 01/14/2021 01/21/2021 03/02/2021

Short Term Disability Closed 12/21/2020 12/28/2020

03/29/2021

Short Term Disability Closed 12/07/2020 12/14/2020 05/24/2021

Short Term Disability Closed 01/13/2021 01/20/2021

01/27/2021

Short Term Disability Closed 01/03/2021 01/10/2021 03/02/2021

STD Closed 01/07/2021 01/01/0001

02/09/2021

STD Closed 01/06/2021 01/01/0001 03/17/2021

Short Term Disability Closed 12/09/2020 12/16/2020

12/29/2020

STD Closed 12/11/2020 01/01/0001 02/08/2021

Short Term Disability Closed 11/26/2020 12/03/2020

02/22/2021

Short Term Disability Closed 12/29/2020 01/05/2021 03/23/2021

Short Term Disability Closed 11/18/2020 11/25/2020

01/26/2021

Short Term Disability Closed 12/26/2020 01/02/2021 04/22/2021

STD Closed 11/13/2020 01/01/0001

Short Term Disability Closed 11/15/2020 11/22/2020 01/15/2021

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202104250 F 10/03/1981 02/11/2021 02/12/2021 01/01/0001

202104351 F 02/16/1995 02/11/2021 03/11/2021 04/14/2021

202104431 M 10/23/1984 02/12/2021 01/01/0001

202105161 F 01/08/1982 02/17/2021 03/22/2021 04/19/2021

202105194 M 10/25/1974 02/18/2021 03/10/2021 05/24/2021

202105552 F 12/14/1958 02/22/2021 03/05/2021 05/17/2021

202105560 F 03/21/1968 02/22/2021 03/05/2021 05/24/2021

202105725 M 11/15/1956 02/24/2021 03/09/2021 01/01/0001

202105736 M 12/05/1963 02/24/2021 02/24/2021 03/22/2021

202105783 M 07/12/1961 02/24/2021 03/10/2021 03/30/2021

202107105 F 07/09/1955 03/05/2021 01/01/0001

202107319 M 08/24/1959 03/09/2021 04/05/2021 01/01/0001

202107617 F 03/23/1976 03/10/2021 04/16/2021 05/25/2021

202107996 F 09/02/1999 03/15/2021 04/14/2021 05/10/2021

202111505 F 03/15/1995 03/22/2021 05/21/2021 06/18/2021

202112075 F 10/26/1969 03/25/2021 03/26/2021 04/19/2021

202112413 M 01/13/1963 03/29/2021 05/05/2021 09/28/2021

202112615 F 10/17/1955 03/31/2021 04/27/2021 05/07/2021

202113116 M 08/10/1992 04/01/2021 06/28/2021 04/20/2021

202113381 F 08/06/1989 04/05/2021 05/11/2021 06/05/2021

202113481 F 02/13/1978 04/06/2021 04/09/2021 05/27/2021

202115705 M 03/03/1972 04/16/2021 04/23/2021 05/28/2021

202115900 F 03/05/1983 04/20/2021 04/23/2021 05/17/2021

202116320 F 11/01/1966 04/23/2021 05/26/2021 05/24/2021

202116864 F 09/13/1966 04/29/2021 05/10/2021 04/26/2021 05/19/2021Short Term Disability Closed 04/09/2021 04/16/2021

05/05/2021

Short Term Disability Closed 05/13/2021 05/20/2021 06/03/2021

Short Term Disability Closed 04/07/2021 04/14/2021

07/12/2021

Short Term Disability Closed 04/22/2021 04/29/2021 02/12/2022

Short Term Disability Closed 04/03/2021 04/03/2021

02/21/2022

Short Term Disability Closed 04/24/2021 05/01/2021 05/20/2021

Short Term Disability Closed 03/18/2021 03/18/2021

09/08/2021

Short Term Disability Closed 10/30/2020 11/06/2020 05/10/2021

Short Term Disability Closed 03/23/2021 03/30/2021

06/03/2021

Short Term Disability Closed 03/03/2021 03/10/2021 05/27/2021

Short Term Disability Closed 04/23/2021 04/30/2021

06/01/2021

Short Term Disability Closed 02/08/2021 02/15/2021 09/30/2021

Short Term Disability Closed 03/07/2021 03/07/2021

04/20/2021

STD Closed 02/26/2021 01/01/0001 04/28/2021

STD Closed 11/19/2020 01/01/0001

05/26/2021

Short Term Disability Closed 02/14/2021 02/21/2021 05/18/2021

Short Term Disability Closed 11/30/2020 12/07/2020

08/19/2021

STD Closed 11/16/2020 01/01/0001 04/13/2021

Short Term Disability Closed 02/01/2021 02/08/2021

06/25/2021

Short Term Disability Closed 01/21/2021 01/28/2021 06/24/2021

Short Term Disability Closed 02/25/2021 03/04/2021

03/30/2021

Short Term Disability Closed 02/18/2021 02/25/2021 05/03/2021

STD Closed 02/02/2021 01/01/0001

03/22/2021

Short Term Disability Closed 02/17/2021 02/24/2021 03/29/2021

STD Closed 02/03/2021 01/01/0001

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202116931 F 07/26/1967 04/29/2021 05/12/2021 05/28/2021

202117101 F 09/07/1972 04/30/2021 06/24/2021 07/07/2021

202117897 M 01/23/1980 05/05/2021 01/01/0001

202118234 F 06/06/1987 05/07/2021 05/21/2021 06/29/2021

202118471 M 12/16/1972 05/11/2021 06/16/2021 05/27/2021

202118607 F 09/06/1964 05/12/2021 06/28/2021 07/12/2021

202119036 F 01/24/1963 05/17/2021 05/28/2021 01/01/0001

202119039 M 04/25/1984 05/17/2021 05/25/2021 05/25/2021

202120200 F 11/08/1976 05/18/2021 06/18/2021 01/01/0001

202120353 M 03/04/1969 05/19/2021 06/04/2021 09/01/2021

202120364 F 09/27/1978 05/19/2021 05/24/2021 06/25/2021

202121775 F 10/23/1987 05/25/2021 05/25/2021 06/30/2021

202121975 M 06/28/1969 05/26/2021 06/04/2021 06/17/2021

202123151 F 10/07/1981 05/28/2021 06/11/2021 07/01/2021

202123189 F 01/17/1986 05/28/2021 07/07/2021 08/23/2021

202124553 F 04/10/1996 06/04/2021 06/04/2021 07/18/2021

202124614 F 07/25/1976 06/07/2021 06/07/2021 06/12/2021

202124687 F 04/08/1960 06/08/2021 06/16/2021 06/25/2021

202124718 M 07/11/1959 06/08/2021 07/12/2021 07/26/2021

202124876 M 11/20/1969 06/09/2021 06/17/2021 09/20/2021

202124880 F 01/09/1986 06/09/2021 06/24/2021 07/30/2021

202124926 F 01/05/1991 06/09/2021 07/08/2021 06/17/2021

202125299 F 02/06/1972 06/14/2021 06/16/2021 07/05/2021

202125301 F 01/31/1969 06/14/2021 06/30/2021 01/01/0001

202125379 F 07/15/1997 06/15/2021 06/28/2021 07/26/2021

07/01/2021

Short Term Disability Closed 06/01/2021 06/08/2021 09/23/2021

STD Closed 02/13/2021 01/01/0001

12/28/2021

Short Term Disability Closed 05/14/2021 05/21/2021 06/24/2021

Short Term Disability Closed 05/19/2021 05/26/2021

12/18/2021

Short Term Disability Closed 06/03/2021 06/10/2021 06/25/2021

Short Term Disability Closed 05/18/2021 05/25/2021

08/23/2021

Short Term Disability Closed 06/21/2021 06/28/2021 02/19/2022

Short Term Disability Closed 06/04/2021 06/11/2021

06/11/2021

Short Term Disability Closed 05/24/2021 05/31/2021 06/17/2021

Short Term Disability Closed 05/23/2021 05/30/2021

06/22/2021

Short Term Disability Closed 06/28/2021 07/05/2021 08/05/2021

Short Term Disability Closed 05/06/2021 05/13/2021

06/22/2021

Short Term Disability Closed 05/24/2021 05/31/2021 06/11/2021

Short Term Disability Closed 05/19/2021 05/26/2021

02/19/2022

Short Term Disability Closed 05/21/2021 05/28/2021 07/26/2021

Short Term Disability Closed 06/01/2021 06/08/2021

06/07/2021

STD Closed 05/14/2021 01/01/0001 06/24/2021

Short Term Disability Closed 05/12/2021 05/19/2021

10/03/2022

STD Closed 05/18/2021 01/01/0001 06/11/2021

Short Term Disability Closed 06/08/2021 06/08/2021

06/03/2021

Short Term Disability Closed 04/11/2021 04/18/2021 10/26/2021

Short Term Disability Closed 05/18/2021 05/25/2021

05/04/2022

STD Closed 04/28/2021 01/01/0001 06/18/2021

Short Term Disability Closed 03/05/2021 03/12/2021

Short Term Disability Closed 04/30/2021 05/07/2021 06/04/2021

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202125483 F 08/15/1984 06/16/2021 01/01/0001

202125557 F 02/06/1974 06/16/2021 07/15/2021 01/01/0001

202125564 F 05/03/1989 06/16/2021 06/24/2021 07/19/2021

202125867 F 03/09/1977 06/21/2021 07/19/2021 01/01/0001

202126086 F 01/08/1982 06/22/2021 06/24/2021 07/16/2021

202127687 F 05/31/1959 06/25/2021 06/25/2021 07/30/2021

202127765 F 01/09/1976 06/28/2021 07/23/2021 07/26/2021

202127835 M 06/14/1965 06/28/2021 08/12/2021 07/08/2021

202127929 M 12/30/1964 06/29/2021 08/09/2021 06/06/2021

202128015 F 06/22/1979 06/29/2021 07/15/2021 09/27/2021

202128537 F 10/19/1977 07/01/2021 07/12/2021 01/01/0001

202128643 M 06/28/1969 07/02/2021 07/26/2021 09/27/2021

202128910 F 11/10/1994 07/07/2021 07/26/2021 08/02/2021

202129585 M 01/10/1970 07/14/2021 01/01/0001

202129667 F 08/24/1954 07/14/2021 08/11/2021 09/28/2021

202129706 F 11/01/1989 07/15/2021 07/28/2021 07/15/2021

202130737 M 01/07/1963 07/16/2021 01/01/0001

202131076 M 09/16/1970 07/19/2021 08/05/2021 01/01/0001

202131838 F 11/05/1968 07/19/2021 09/02/2021 07/29/2021

202132198 F 09/27/1978 07/22/2021 07/22/2021 08/30/2021

202132247 M 07/12/1976 07/22/2021 01/01/0001

202132403 F 11/01/1969 07/26/2021 08/05/2021 09/06/2021

202132448 F 05/19/1977 07/26/2021 09/13/2021 10/20/2021

202132507 F 12/05/1988 07/26/2021 08/04/2021 08/19/2021

202132634 F 09/22/1986 07/28/2021 08/09/2021 09/24/2021 08/30/2021Short Term Disability Closed 07/30/2021 08/06/2021

09/28/2021

Short Term Disability Closed 07/06/2021 07/13/2021 10/07/2021

Short Term Disability Closed 09/08/2021 09/15/2021

09/07/2021

Short Term Disability Closed 07/12/2021 07/19/2021 09/07/2021

STD Closed 06/24/2021 01/01/0001

07/19/2021

Short Term Disability Closed 07/22/2021 07/29/2021 08/25/2021

Short Term Disability Closed 06/29/2021 07/06/2021

08/31/2021

STD Closed 06/25/2021 01/01/0001 08/31/2021

STD Closed 04/14/2021 01/01/0001

09/02/2021

Short Term Disability Closed 05/20/2021 05/27/2021 08/16/2021

Short Term Disability Closed 08/03/2021 08/10/2021

08/26/2021

STD Closed 02/10/2021 01/01/0001 08/31/2021

Short Term Disability Closed 07/07/2021 07/14/2021

08/11/2021

Short Term Disability Closed 07/26/2021 08/02/2021 02/12/2022

STD Closed 07/01/2021 01/01/0001

09/20/2021

Short Term Disability Closed 04/05/2021 04/05/2021 11/02/2021

Short Term Disability Closed 03/22/2021 03/29/2021

08/05/2021

Short Term Disability Closed 06/23/2021 06/30/2021 08/24/2021

Short Term Disability Closed 06/21/2021 06/28/2021

08/16/2021

Short Term Disability Closed 06/24/2021 07/01/2021 08/25/2021

Short Term Disability Closed 05/26/2021 05/26/2021

08/03/2021

STD Closed 07/12/2021 01/01/0001 08/31/2021

Short Term Disability Closed 05/25/2021 06/01/2021

07/29/2021

STD Closed 07/01/2021 01/01/0001 08/31/2021

STD Closed 06/16/2021 01/01/0001

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202132792 F 10/26/1979 07/28/2021 09/01/2021 09/15/2021

202133696 F 08/05/1982 08/02/2021 09/16/2021 10/31/2021

202134017 F 07/06/1964 08/05/2021 09/21/2021 07/06/2021

202138553 F 07/21/1986 08/13/2021 08/13/2021 01/01/0001

202138574 F 01/25/1974 08/13/2021 08/13/2021 09/20/2021

202138587 F 09/21/1968 08/13/2021 08/13/2021 01/01/0001

202138593 F 04/04/1967 08/13/2021 01/01/0001

202139854 F 03/09/1981 08/16/2021 08/24/2021 09/02/2021

202139973 M 08/07/1962 08/17/2021 09/15/2021 01/01/0001

202141252 F 09/06/1951 08/30/2021 09/24/2021 10/25/2021

202141363 M 07/11/1966 08/30/2021 08/31/2021 09/28/2021

202141627 F 11/10/1953 09/01/2021 09/17/2021 10/25/2021

202142219 F 07/06/1966 09/08/2021 09/17/2021 09/01/2021

202142226 F 02/09/1993 09/08/2021 10/08/2021 01/01/0001

202142237 F 10/28/1992 09/08/2021 10/06/2021 11/05/2021

202143292 F 12/27/1989 09/14/2021 09/30/2021 10/09/2021

202143309 F 09/20/1991 09/14/2021 10/12/2021 10/27/2021

202143354 F 09/10/1981 09/14/2021 09/23/2021 09/23/2021

202143424 F 01/31/1986 09/15/2021 09/23/2021 01/01/0001

202143674 F 12/27/1989 09/16/2021 10/19/2021 11/25/2021

202144877 F 11/25/1959 09/20/2021 10/06/2021 10/10/2021

202145040 F 12/10/1972 09/21/2021 10/25/2021 11/01/2021

202145111 F 06/12/1965 09/22/2021 09/24/2021 10/18/2021

202145994 F 11/05/1975 09/29/2021 10/13/2021 10/25/2021

202146697 F 02/28/1995 10/01/2021 11/23/2021 12/30/2021

12/02/2021

Short Term Disability Closed 11/17/2021 11/24/2021 12/07/2021

Short Term Disability Closed 08/22/2021 08/22/2021

06/06/2022

Short Term Disability Closed 09/16/2021 09/23/2021 10/12/2021

Short Term Disability Closed 10/04/2021 10/11/2021

11/18/2021

Short Term Disability Closed 09/24/2021 10/01/2021 02/19/2022

Short Term Disability Closed 10/14/2021 10/21/2021

10/12/2021

STD Closed 09/07/2021 01/01/0001 11/04/2021

Short Term Disability Closed 09/09/2021 09/16/2021

12/01/2021

Short Term Disability Closed 10/01/2021 10/08/2021 10/19/2021

Short Term Disability Closed 08/26/2021 09/02/2021

10/21/2021

Short Term Disability Closed 09/10/2021 09/17/2021 10/13/2021

STD Closed 08/26/2021 01/01/0001

02/19/2022

Short Term Disability Closed 08/02/2021 08/09/2021 09/24/2021

Short Term Disability Closed 08/09/2021 08/16/2021

07/14/2022

Short Term Disability Closed 08/18/2021 08/25/2021 03/18/2022

Short Term Disability Closed 03/24/2021 01/01/2021

11/04/2021

STD Closed 06/08/2021 01/01/0001 10/05/2021

Short Term Disability Closed 07/29/2021 08/05/2021

09/23/2021

STD Closed 08/14/2021 01/01/0001 09/13/2021

STD Closed 08/04/2021 01/01/0001

08/31/2021

Short Term Disability Closed 08/10/2021 08/17/2021 09/14/2021

STD Closed 08/01/2021 01/01/0001

10/20/2021

Short Term Disability Closed 06/14/2021 06/21/2021 10/28/2021

Short Term Disability Closed 09/05/2021 09/12/2021

Short Term Disability Closed 07/14/2021 07/21/2021 04/28/2022

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202146763 M 12/21/1957 10/01/2021 10/19/2021 01/01/0001

202147114 M 08/20/1959 10/05/2021 11/15/2021 01/01/0001

202147297 M 06/24/1973 10/06/2021 10/07/2021 11/15/2021

202147389 F 08/28/1993 10/06/2021 11/19/2021 12/29/2021

202147468 M 11/14/1974 10/07/2021 11/04/2021 01/01/0001

202147476 F 10/31/1963 10/07/2021 10/11/2021 11/26/2021

202147620 M 06/20/1985 10/07/2021 10/19/2021 10/25/2021

202147779 F 06/22/1988 10/08/2021 10/20/2021 11/11/2021

202148421 F 09/14/1978 10/14/2021 10/21/2021 11/30/2021

202148914 F 12/14/1958 10/19/2021 11/22/2021 01/03/2022

202150810 F 09/25/1971 10/22/2021 11/02/2021 11/26/2021

202150865 F 08/25/1992 10/25/2021 11/01/2021 01/01/0001

202150976 F 02/13/1978 10/25/2021 10/25/2021 11/24/2021

202151174 M 04/28/1976 10/26/2021 12/03/2021 05/26/2022

202151745 M 06/01/1972 11/01/2021 12/01/2021 01/01/0001

202152608 M 11/09/1954 11/01/2021 11/22/2021 01/12/2022

202153013 F 06/15/1982 11/02/2021 11/22/2021 01/01/0001

202153158 F 12/11/1975 11/02/2021 12/03/2021 11/16/2021

202154619 F 08/30/1985 11/12/2021 01/13/2022 01/01/0001

202183226 M 06/01/1972 11/17/2021 01/01/0001

202183506 M 12/09/1962 11/18/2021 12/02/2021 12/29/2021

202183800 F 04/30/1993 11/19/2021 11/19/2021 01/01/0001

202184203 F 02/06/1972 11/23/2021 12/07/2021 05/18/2022

202184209 F 03/20/1995 11/23/2021 12/08/2021 01/26/2022

202184428 M 07/12/1961 11/24/2021 12/08/2021 01/25/2022 01/06/2022Short Term Disability Closed 11/16/2021 11/23/2021

04/26/2022

Short Term Disability Closed 11/30/2021 12/07/2021 12/14/2021

Short Term Disability Closed 11/10/2021 11/17/2021

05/10/2022

STD Closed 11/13/2021 01/01/0001 01/04/2022

Short Term Disability Closed 10/28/2021 11/04/2021

01/27/2022

STD Closed 10/13/2021 01/01/0001 01/04/2022

STD Closed 01/08/2022 01/01/0001

01/06/2022

Short Term Disability Closed 09/28/2021 10/05/2021 12/14/2021

STD Closed 08/17/2021 01/01/0001

12/14/2021

Short Term Disability Closed 09/27/2021 10/04/2021 12/11/2021

STD Closed 10/14/2021 01/01/0001

02/19/2022

Short Term Disability Closed 11/18/2021 11/25/2021 05/26/2022

Short Term Disability Closed 10/25/2021 11/01/2021

12/01/2021

STD Closed 10/14/2021 01/01/0001 01/11/2022

Short Term Disability Closed 09/12/2021 09/12/2021

12/15/2021

Short Term Disability Closed 10/25/2021 11/01/2021 03/03/2022

Short Term Disability Closed 10/19/2021 10/26/2021

11/08/2021

Short Term Disability Closed 09/15/2021 09/22/2021 12/01/2021

Short Term Disability Closed 10/01/2021 10/08/2021

11/12/2021

Short Term Disability Closed 10/08/2021 10/15/2021 03/28/2022

STD Closed 10/21/2021 01/01/0001

12/09/2021

Short Term Disability Closed 11/08/2021 11/15/2021 12/08/2021

Short Term Disability Closed 09/27/2021 10/05/2021

02/25/2022

STD Closed 10/04/2021 01/01/0001 12/01/2021

STD Closed 10/05/2021 01/01/0001

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202184578 M 05/18/1962 11/29/2021 11/29/2021 01/01/0001

202184596 F 04/20/1952 11/29/2021 12/03/2021 01/31/2022

202185662 F 12/22/1989 12/01/2021 01/24/2022 01/15/2022

202185936 F 03/16/1983 12/02/2021 12/06/2021 03/07/2022

202186114 F 09/22/1990 12/03/2021 01/01/0001

202186194 F 11/02/1988 12/06/2021 12/06/2021 12/12/2021

202186298 F 04/23/1970 12/06/2021 12/30/2021 12/20/2021

202186470 F 08/30/1985 12/07/2021 02/04/2022 01/01/0001

202186746 M 05/17/1965 12/09/2021 01/04/2022 01/01/0001

202186971 F 08/17/1984 12/10/2021 12/29/2021 01/10/2022

202187054 F 05/05/1993 12/13/2021 04/12/2022 05/20/2022

202187177 F 09/29/1985 12/14/2021 01/14/2022 12/29/2021

202191039 M 12/05/1961 12/21/2021 12/30/2021 01/24/2022

202191247 F 07/31/1968 12/23/2021 02/17/2022 12/13/2021

202191364 F 10/28/1992 12/27/2021 12/30/2021 02/06/2022

202191991 F 05/12/1994 12/28/2021 02/08/2022 02/22/2022

202192102 M 10/17/1975 12/28/2021 12/29/2021 01/06/2022

202206109 M 05/12/1983 01/04/2022 01/01/0001

202209332 F 10/28/1987 01/06/2022 01/06/2022 01/30/2022

202209952 F 11/08/1980 01/06/2022 01/26/2022 01/01/0001

202210300 F 04/10/1986 01/11/2022 01/19/2022 01/29/2022

202210319 F 01/20/1991 01/11/2022 03/24/2022 04/15/2022

202210379 F 08/12/1975 01/11/2022 01/01/0001

202210520 F 05/31/1959 01/12/2022 01/21/2022 03/25/2022

202212150 M 01/07/1963 01/18/2022 03/08/2022 01/01/0001

04/04/2022

STD Closed 06/15/2021 01/01/0001 04/15/2022

Short Term Disability Closed 01/13/2022 01/20/2022

04/15/2022

STD Closed 01/01/1900 01/01/0001 08/01/2022

Short Term Disability Closed 03/04/2022 03/11/2022

04/13/2022

Short Term Disability Closed 12/18/2021 12/25/2021 02/28/2022

STD Closed 01/25/2022 01/01/0001

07/14/2022

Short Term Disability Closed 12/18/2021 12/25/2021 01/25/2022

STD Closed 12/22/2021 01/01/0001

02/28/2022

Short Term Disability Closed 12/02/2021 12/09/2021 03/07/2022

Short Term Disability Closed 01/10/2022 01/17/2022

02/28/2022

Short Term Disability Closed 12/10/2021 12/17/2021 01/07/2022

Short Term Disability Closed 12/01/2021 12/08/2021

02/28/2022

Short Term Disability Closed 10/13/2021 10/20/2021 04/14/2022

Short Term Disability Closed 10/25/2021 11/01/2021

03/07/2022

Short Term Disability Closed 03/25/2022 04/01/2022 05/04/2022

Short Term Disability Closed 11/07/2021 11/14/2021

02/12/2022

STD Closed 12/15/2021 01/01/0001 02/15/2022

STD Closed 01/25/2022 01/01/0001

12/10/2021

Short Term Disability Closed 11/19/2021 11/26/2021 02/03/2022

Short Term Disability Closed 10/17/2021 10/24/2021

04/05/2022

STD Closed 12/02/2021 01/01/0001 01/24/2022

Short Term Disability Closed 11/15/2021 11/22/2021

12/14/2021

Short Term Disability Closed 12/01/2021 12/08/2021 01/28/2022

Short Term Disability Closed 11/17/2021 11/24/2021

STD Closed 10/26/2021 01/01/0001 01/19/2022

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202212983 F 04/06/1966 01/20/2022 04/21/2022 04/11/2022

202213025 M 07/11/1991 01/20/2022 01/26/2022 01/20/2022

202214245 F 02/13/1990 01/24/2022 01/01/0001

202214349 F 07/25/1976 01/24/2022 01/27/2022 02/03/2022

202214433 F 09/25/1960 01/25/2022 02/10/2022 11/22/2021

202214814 F 02/01/1983 01/25/2022 01/31/2022 02/22/2022

202215179 M 11/27/1982 01/26/2022 01/26/2022 01/25/2022

202215210 M 09/11/1988 01/26/2022 01/26/2022 02/10/2022

202215564 F 05/25/1960 01/28/2022 01/31/2022 03/28/2022

202215766 M 08/07/1957 01/31/2022 02/17/2022 03/07/2022

202216558 M 02/22/1970 02/01/2022 02/14/2022 03/31/2022

202223305 M 05/28/1969 02/02/2022 01/01/0001

202223592 F 08/12/1997 02/03/2022 04/11/2022 03/31/2022

202223669 M 08/07/1957 02/04/2022 03/22/2022 01/01/0001

202223889 M 07/25/1992 02/07/2022 02/24/2022 02/07/2022

202224003 M 06/28/1961 02/07/2022 02/24/2022 03/29/2022

202224248 F 10/23/1995 02/09/2022 03/02/2022 02/14/2022

202224561 F 10/06/1961 02/11/2022 03/01/2022 05/21/2022

202226753 M 09/08/1965 02/11/2022 03/17/2022 05/27/2022

202226923 F 12/14/1958 02/14/2022 02/23/2022 02/28/2022

202226942 F 09/25/1960 02/14/2022 03/30/2022 01/01/0001

202234597 M 11/02/1974 02/22/2022 03/15/2022 12/13/2021

202234734 M 05/26/1993 02/23/2022 03/01/2022 05/05/2022

202234839 F 08/02/1976 02/23/2022 03/04/2022 01/01/0001

202234862 M 08/30/1958 02/23/2022 03/11/2022 01/01/0001 05/17/2022STD Closed 01/25/2022 01/01/0001

04/25/2022

STD Closed 02/20/2022 01/01/0001 05/11/2022

Short Term Disability Closed 02/07/2022 02/14/2022

04/07/2022

Short Term Disability Closed 11/24/2021 12/01/2021 04/18/2022

STD Closed 02/24/2022 01/01/0001

03/29/2023

Short Term Disability Closed 02/08/2022 02/15/2022 04/27/2022

Short Term Disability Closed 01/10/2022 01/17/2022

03/23/2022

Short Term Disability Closed 02/23/2022 03/02/2022 06/17/2022

Short Term Disability Closed 02/07/2022 02/07/2022

03/23/2023

Short Term Disability Closed 02/08/2022 02/15/2022 04/06/2022

Short Term Disability Closed 01/24/2022 01/31/2022

04/15/2022

STD Closed 11/16/2021 01/01/0001 03/28/2022

Short Term Disability Closed 02/17/2022 02/24/2022

02/21/2022

STD Closed 01/11/2022 01/01/0001 08/01/2022

Short Term Disability Closed 12/16/2021 12/23/2021

06/07/2022

Short Term Disability Closed 11/16/2021 11/23/2021 03/03/2022

Short Term Disability Closed 01/31/2022 01/01/2022

02/28/2022

Short Term Disability Closed 01/05/2022 01/12/2022 02/28/2022

Short Term Disability Closed 01/16/2022 01/23/2022

03/07/2022

Short Term Disability Closed 01/18/2022 01/25/2022 03/07/2022

Short Term Disability Closed 10/12/2021 10/19/2021

08/10/2022

Short Term Disability Closed 01/24/2022 01/31/2022 02/28/2022

STD Closed 01/04/2022 01/01/0001

04/28/2022

Short Term Disability Closed 01/10/2022 01/17/2022 02/28/2022

Short Term Disability Closed 02/28/2022 03/07/2022

Run Date: 10/28/2024 1:29:32 PM

Incomplete: Started, information collection in process | In Process: Adjudication in process | Open: Payments in process | Suspend:

Selection Parameters Values on Report

306147 00306147 - STATE OF NEBRASKA

ALL 1002

07/01/2019 to 10/28/2024 07/20/2019 to 10/25/2024

202234930 F 09/24/1970 02/24/2022 02/24/2022 01/01/0001

202237326 F 01/21/1969 03/01/2022 03/08/2022 05/26/2022

202239675 M 10/16/1968 03/04/2022 03/29/2022 05/31/2022

202239783 F 08/30/1991 03/07/2022 03/11/2022 04/18/2022

202240167 F 08/03/1981 03/09/2022 03/31/2022 02/22/2022

202240894 M 01/16/1992 03/15/2022 03/31/2022 04/09/2022

202240993 M 10/19/1975 03/15/2022 05/04/2022 04/06/2022

202244679 F 10/13/1996 03/23/2022 04/15/2022 05/16/2022

202244896 F 10/13/1996 03/24/2022 04/22/2022 01/01/0001

202245494 F 06/17/1984 03/30/2022 04/18/2022 05/27/2022

202247269 M 07/29/1964 04/03/2022 04/25/2022 05/23/2022

202247287 F 10/03/1995 04/04/2022 04/12/2022 05/25/2022

202247297 F 08/07/1984 04/04/2022 04/13/2022 01/01/0001

202253631 F 03/14/1960 04/08/2022 04/26/2022 09/30/2022

202253836 F 11/10/1989 04/11/2022 05/24/2022 01/01/0001

202254031 F 08/26/1980 04/12/2022 04/29/2022 05/16/2022

202275856 F 11/27/1966 04/14/2022 06/16/2022 05/23/2022

202275917 M 11/02/1974 04/15/2022 04/14/2022 05/23/2022

202291780 M 07/25/1992 04/20/2022 04/21/2022 01/01/0001

202291839 M 05/03/1965 04/21/2022 06/15/2022 07/15/2022

202292359 M 01/09/1989 04/25/2022 05/17/2022 05/16/2022

202292421 F 05/16/1995 04/25/2022 01/01/0001

202292489 F 07/03/1989 04/26/2022 08/16/2022 06/27/2022

202292731 M 04/21/1969 04/27/2022 05/17/2022 09/20/2022

202301432 M 10/26/1999 05/09/2022 05/09/2022 01/01/0001

11/17/2022

STD Closed 04/09/2022 01/01/0001 05/17/2022

Short Term Disability Closed 04/26/2022 01/01/2022

09/21/2022

Short Term Disability Closed 05/16/2022 05/23/2022 09/30/2022

STD Closed 01/01/1900 01/01/0001

06/27/2023

Short Term Disability Closed 04/19/2022 04/26/2022 05/31/2022

Short Term Disability Closed 01/07/2022 01/14/2022

05/04/2022

STD Closed 04/21/2022 01/01/0001…

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