Attachment_7_-_Technical_Exhibit_OCC_Life_Claims_Data_Jan_2011_to_Feb_2015.xlsx

XLSX spreadsheet 21 KB Posted Jul 13, 2015

Attached to: Life Insurance for the OCC
Solicitation number: CC15HQR0017
Issued by: Department of the Treasury Office of the Comptroller of the Currency

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Attachment 7 - Technical Exhibit OCC Life Claims Data Jan 2011 to Feb 2015

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Other files

File	Type	Posted
CC15HQR0017 _Life_Insurance _Responses_to_Questions.pdf	PDF	Jul 31, 2015
Attachment_2_-_Technical_Exhibit_OCC_Life_Census_2015-07-11.xlsx	XLSX spreadsheet	Jul 31, 2015
Attachment_8_-_Technical_Exhibit_OFR_Census_Report_PP06-2015_Life.xlsx	XLSX spreadsheet	Jul 31, 2015
CC15HQR0017 _Life_insurance _SF_1449.pdf	PDF	Jul 13, 2015
Attachment_8_-_Technical_Exhibit_OFR_Census.xlsx	XLSX spreadsheet	Jul 13, 2015
Attachment_1_-_Pricing_Structure.docx	DOCX document	Jul 13, 2015
Attachment_12_-_Questions_Form.docx	DOCX document	Jul 13, 2015
Attachment_11_-_OCC_IT_Accessibility_Questionnaire.docx	DOCX document	Jul 13, 2015
Attachment_14_-_Past_Performance_Questionnaires.docx	DOCX document	Jul 13, 2015
Attachment_5_-_Technical_Exhibit_Domestic_Partner_Affadavit.pdf	PDF	Jul 13, 2015
CC15HQR0017 _Life_Insurance _RFP.pdf	PDF	Jul 13, 2015
Attachment_4_-_Technical_Exhibit_OCC_Certificate.pdf	PDF	Jul 13, 2015
Attachment_2_-_Technical_Exhibit_Active_Employee_Census_Data_2015-03-21.xls	XLS spreadsheet	Jul 13, 2015
Attachment_3_-_Technical_Exhibit_Retiree_Census.xlsx	XLSX spreadsheet	Jul 13, 2015
Attachment_6_-_Technical_Exhibit_OCC_Group_Life_Optional_Rates.pdf	PDF	Jul 13, 2015
Attachment_13_-_Evaluation_Questionnaire.pdf	PDF	Jul 13, 2015
Attachment_9_-_Conditional_Access__to_Sensitive_but_Unclassified_Information_Non-Disclosure_Agreement.doc	DOC document	Jul 13, 2015
Attachment_10_-_Service_Provider_Self-Assessment.pdf	PDF	Jul 13, 2015
Life_insurance_synopsis_attachment.docx	DOCX document	Jun 22, 2015

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OCC Life Claims

Active and Retiree Paid Life claims January 2011 - February 2015

Gender EE Type Date of Loss Year of Birth Age STATE Cov Code Docar, Thomas: 9011: Basic Life 9111: Optional Life 9510: Dep Life 7710: Conversion Charge

Claim Amount	Interest Amount	Paid Date
M	OCC Spouse Life	Jan-11	1960	51	PA	9510	$ 62,990.00	0	Mar-11
M	OCC Spouse Life	Jan-11	1960	51	PA	9510	$ 6,510.00	0	Mar-11
F	OCC EE Basic Life	Mar-11	1953	58	DC	9011	$ 54,000.00	0	Jul-11
F	OCC EE Basic Life	Mar-11	1953	58	DC	9011	$ 54,000.00	0	Jul-11
F	OCC Retiree Basic Life	Apr-11	1927	84	DC	9011	$ 18,000.00	0	Jun-11
M	OCC EE Basic Life	Apr-11	1954	57	OK	9011	$ 181,000.00	0	May-11
M	OCC EE Optional Life	Apr-11	1954	57	OK	9111	$ 300,000.00	0	May-11
F	OCC EE Basic Life	Apr-11	1983	28	DC	7710	$ 28,500.00	0	Jun-11
F	OCC EE Basic Life	Apr-11	1983	28	DC	9011	$ 28,500.00	0	Jun-11
F	OCC EE Basic Life	Apr-11	1983	28	DC	7710	$ 28,500.00	0	Jun-11
F	OCC EE Basic Life	Apr-11	1983	28	DC	9011	$ 28,500.00	0	Jun-11
F	OCC EE Basic Life	Apr-11	1983	28	DC	9011	$ 28,500.00	0	Jun-11
F	OCC EE Basic Life	Apr-11	1983	28	DC	9011	$ 28,500.00	0	Jun-11
F	OCC Spouse Life	Apr-11	1959	52	DC	9510	$ 77,500.00	0	Jul-11
F	OCC Family Life	May-11	1994	17	DC	9510	$ 5,000.00	7.4	Jun-11
F	OCC EE Optional Life	Jul-11	1958	53	DC	9111	$ 225,000.00	656.51	Sep-11
F	OCC EE Basic Life	Jul-11	1958	53	DC	9011	$ 139,000.00	696.9	Nov-11
M	OCC Retiree Basic Life	Jul-11	1926	85	VA	9011	$ 4,750.00	0	Nov-11
M	OCC Retiree Basic Life	Jul-11	1926	85	VA	9011	$ 4,750.00	0	Nov-11
F	OCC EE Basic Life	Jul-11	1960	51	MN	9011	$ 117,000.00	230.79	Sep-11
F	OCC EE Optional Life	Jul-11	1960	51	MN	9111	$ 50,000.00	98.63	Sep-11
F	OCC Family Life	Aug-11	1959	52	PA	9510	$ 25,000.00	0	Sep-11
F	OCC EE Basic Life	Aug-11	1959	52	PA	9011	$ 150,000.00	0	Sep-11
M	OCC Retiree Basic Life	Sep-11	1944	67	TN	9011	$ 7,618.54	0	Oct-11
M	OCC Retiree Basic Life	Sep-11	1944	67	TN	9011	$ 6,881.46	0	Oct-11
F	OCC Retiree Basic Life	Oct-11	1954	57	TX	9011	$ 56,000.00	0	Nov-11
F	OCC Family Life	Nov-11	1966	45	TN	9510	$ 10,000.00	0	Jan-12
F	OCC Retiree Basic Life	Dec-11	1945	66	TX	9011	$ 23,000.00	0	Mar-12
M	OCC Retiree Basic Life	Dec-11	1946	65	NJ	9011	$ 24,250.00	0	Apr-12
M	OCC Spouse Life	Jan-12	1956	56	MN	9510	$ 106,000.00	53.73	Feb-12
M	OCC EE Basic Life	Mar-12	1956	56	NJ	9011	$ 169,000.00	0	Apr-12
M	OCC EE Optional Life	Mar-12	1956	56	NJ	9111	$ 300,000.00	0	Apr-12
M	OCC EE Basic Life	Apr-12	1966	46	CA	9011	$ 92,000.00	0	Jun-12
M	OCC EE Optional Life	Apr-12	1966	46	CA	9111	$ 50,000.00	0	Jun-12
M	OCC Retiree Basic Life	Apr-12	1934	78	MA	9011	$ 16,000.00	0	Jul-12
M	OCC Retiree Basic Life	May-12	1943	69	KS	9011	$ 18,250.00	0	Aug-12
M	OCC Retiree Basic Life	Oct-12	1940	72	CO	9011	$ 22,500.00	0	Nov-12
M	OTS Retiree Basic Life	Oct-12	1948	64	NM	9011	$ 232,000.00	0	Nov-12
M	OTS Retiree Basic Life	Oct-12	1923	89	CO	9011	$ 35,500.00	0	Feb-13
F	OCC Retiree Basic Life	Nov-12	1924	88	CA	9011	$ 7,750.00	0	Jun-13
M	OCC Retiree Basic Life	Nov-12	1956	56	VA	9011	$ 205,000.00	0	Jan-13
F	OTS Retiree Basic Life	Dec-12	1944		MD	9011	$ 85,200.00	0	Oct-12
F	OTS Retiree Basic Life	Dec-12	1944	68	MD	9011	$ 9,466.67	0	Jan-13
F	OTS Retiree Basic Life	Dec-12	1944	68	MD	9011	$ 47,333.33	0	Apr-13
M	OCC Retiree Basic Life	Dec-12	1950	62	MD	9011	$ 45,000.00	0	Jan-13
M	OCC Retiree Basic Life	Dec-12	1950	62	MD	9011	$ 45,000.00	0	Jan-13
M	OCC Retiree Basic Life	Feb-13	1950	63	OH	9011	$ 147,000.00	48.33	Mar-13
F	OCC Spouse Life	Feb-13	1951	62	CA	9510	$ 87,000.00	0	Apr-13
F	OCC Family Life	Feb-13	1951	62	CA	9510	$ 25,000.00	0	May-13
M	OCC Retiree Basic Life	Feb-13	1943	70	WA	9011	$ 26,000.00	0	Mar-13
M	OTS Retiree Basic Life	Mar-13	1947	66	TX	9011	$ 1,692.00	0	Apr-13
M	OTS Retiree Basic Life	Mar-13	1947	66	TX	9011	$ 171,308.00	0	Apr-13
F	OCC Retiree Basic Life	Mar-13	1919	94	CA	9011	$ 4,375.00	0	Aug-13
F	OCC Retiree Basic Life	Mar-13	1919	94	IN	9011	$ 4,375.00	0	Oct-13
F	OCC Retiree Basic Life	Mar-13	1925	88	NJ	9011	$ 18,250.00	0	Oct-14
M	OTS Retiree Basic Life	Apr-13	1950	63	PA	9011	$ 182,000.00	0	May-14
M	OCC Retiree Basic Life	Apr-13	1930	83	VA	9011	$ 18,750.00	0	Jun-13
M	OTS Retiree Basic Life	May-13	1944	69	GA	9011	$ 166,000.00	1555.4	Jun-13
M	OTS Retiree Basic Life	May-13	1934	79	CA	9011	$ 50,500.00	0	Jun-13
M	OCC Retiree Basic Life	Jun-13	1939	74	NY	9011	$ 75,000.00	0	Aug-13
M	OTS Retiree Basic Life	Jun-13	1944	69	NY	9011	$ 19,250.00	0	Jul-13
M	OTS Retiree Basic Life	Jun-13	1944	69	NY	9011	$ 19,250.00	0	Aug-13
M	OTS Retiree Basic Life	Jun-13	1944	69	CA	9011	$ (19,250.00)	0	Aug-13
M	OTS Retiree Basic Life	Jun-13	1944	69	TX	9011	$ 19,250.00	0	Aug-13
F	OTS Retiree Basic Life	Aug-13	1935	78	TX	9011	$ 23,250.00	0	Dec-13
F	OTS Retiree Basic Life	Aug-13	1943	70	CA	9011	$ 70,000.00	0	Oct-13
F	OTS Retiree Basic Life	Aug-13	1943	70	KY	9011	$ 70,000.00	0	Dec-13
M	OTS Retiree Basic Life	Sep-13	1930	83	AZ	9011	$ 36,000.00	0	Nov-13
M	OCC Retiree Basic Life	Nov-13	1945	68	VA	9011	$ 25,750.00	0	Dec-13
M	OCC Retiree Basic Life	Dec-13	1930	83	CA	9011	$ 28,500.00	0	Jan-14
F	OTS Retiree Basic Life	Dec-13	1929	84	CA	9011	$ 5,425.00	0	Feb-14
F	OTS Retiree Basic Life	Dec-13	1929	84	CA	9011	$ 4,650.00	0	Feb-14
F	OTS Retiree Basic Life	Dec-13	1929	84	IL	9011	$ 5,425.00	0	Feb-14
M	OCC Retiree Basic Life	Feb-14	1947	67	IL	9011	$ 38,000.00	0	Mar-14
M	OTS Retiree Basic Life	Feb-14	1947	67	IL	9011	$ 125,000.00	0	Mar-14
M	OTS Retiree Basic Life	Feb-14	1947	67	IL	9011	$ 125,000.00	0	Mar-14
M	OTS Retiree Basic Life	Mar-14	1939	75	GA	9011	$ 116,000.00	0	Apr-14
M	OTS Retiree Basic Life	Apr-14	1942	72	CA	9011	$ 51,500.00	0	May-14
F	OTS Retiree Basic Life	Apr-14	1940	74	CA	9011	$ 11,875.00	0	Jun-14
F	OTS Retiree Basic Life	Apr-14	1940	74	FL	9011	$ 11,875.00	0	Jul-14
F	OCC Retiree Basic Life	Jul-14	1941	73	CA	9011	$ 16,000.00	0	Sep-14
F	OCC EE Basic Life	Jul-14	1957	57	CA	9011	$ 34,250.00	0	Sep-14
F	OCC EE Basic Life	Jul-14	1957	57	CA	9011	$ 34,250.00	0	Sep-14
F	OCC EE Basic Life	Jul-14	1957	57	CA	9011	$ 34,250.00	0	Sep-14
F	OCC EE Basic Life	Jul-14	1957	57	CO	9011	$ 34,250.00	0	Sep-14
M	OCC EE Optional Life	Jul-14	1963	51	TX	9111	$ 200,000.00	0	Sep-14
M	OCC EE Basic Life	Jul-14	1963	51	CA	9011	$ 156,000.00	0	Sep-14
F	OCC Family Life	Jul-14	1997	17	TX	9510	$ 12,500.00	0	Sep-14
M	OCC Retiree Basic Life	Aug-14	1941	73	FL	9011	$ 75,000.00	0	Sep-14
M	OCC Retiree Basic Life	Aug-14	1949	65	CA	9011	$ 56,000.00	0	Sep-14
M	OCC EE Basic Life	Aug-14	1948	66	NJ	9011	$ 29,500.00	0	Nov-14
M	OCC EE Basic Life	Aug-14	1948	66	NJ	9011	$ 29,500.00	0	Nov-14
M	OCC EE Basic Life	Aug-14	1948	66	NJ	9011	$ 29,500.00	0	Nov-14
M	OCC EE Basic Life	Aug-14	1948	66	IA	9011	$ 29,500.00	0	Nov-14
M	OCC EE Basic Life	Sep-14	1984	30	MO	9011	$ 36,000.00	0	Dec-14
M	OCC EE Basic Life	Sep-14	1984	30	MO	9011	$ 36,000.00	0	Dec-14
M	OCC EE Basic Life	Sep-14	1984	30	MO	9011	$ 36,000.00	0	Dec-14
M	OCC EE Basic Life	Sep-14	1984	30	TX	9011	$ 36,000.00	0	Dec-14
M	OTS Retiree Basic Life	Sep-14	1954	60	NJ	9011	$ 91,200.00	0	Nov-14
M	OTS Retiree Basic Life	Sep-14	1954	60	NJ	9011	$ 11,400.00	107.52	Jan-15
M	OTS Retiree Basic Life	Sep-14	1954	60	TX	9011	$ 11,400.00	0	Jan-15
M	OTS Retiree Basic Life	Oct-14	1943	71	NJ	9011	$ 7,625.00	0	Oct-14
M	OTS Retiree Basic Life	Oct-14	1943	71	NJ	9011	$ 7,625.00	0	Oct-14
M	OCC Spouse Life	Oct-14	1963	51	NJ	9510	$ 76,000.00	0	Oct-14
M	OCC Family Life	Oct-14	1941	73	NJ	9510	$ 10,000.00	0	Oct-14
M	OTS Retiree Basic Life	Oct-14	1928	86	NJ	9011	$ 20,000.00	0	Nov-14
M	OCC Retiree Basic Life	Nov-14	1929	85	MO	9011	$ 19,500.00	0	Nov-14
F	OCC Retiree Basic Life	Nov-14	1936	78	TX	9011	$ 5,250.00	37.97	Dec-14
F	OCC Retiree Basic Life	Nov-14	1936	78	TX	9011	$ 5,250.00	39.7	Dec-14
F	OTS Retiree Basic Life	Nov-14	1931	83	CO	9011	$ 18,500.00	0	Jan-15
F	OTS Retiree Basic Life	Dec-14	1943	71	NJ	9011	$ 200,000.00	0	Jan-15
M	OCC Retiree Basic Life	Dec-14	1931	83	CO	9011	$ 12,250.00	0	Feb-15
							$ 6,433,750.00	$ 3,532.88

&16ATTACHMENT 7

File details come from the government source that posted it. Updated Nov 14, 2017.