ESBD_379720_1729031192350_Attachment D - UHC Life paid claim report.xlsx
XLSX spreadsheet 68 KB Posted
- Solicitation number
- 2510-006
- Issued by
- Travis County, Austin City, Texas
About this file
This document appears to be a paid claim report for the Travis County Healthcare District's group life insurance policy with UHC Life. The report covers the period from September 1, 2023 to September 1, 2024 and includes claims for basic and supplemental life insurance benefits. In January 2024, there were two closed claims totaling $116,222.47, and in July 2024, there was one closed claim totaling $69,075.62, for a total of $185,298.09 in paid claims during the reporting period.
The report provides details on the claimant's gender, age at the time of the claim, claim status, incurred date, payment date, and net benefit amount. It also includes a summary of the paid claims by product type, with $127,186.86 in basic life insurance claims and $58,111.24 in supplemental life insurance claims.
View the file
Other files
Show 40 more
Latest 50 of 68 listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Sheet1
| Selection Parameters |
| 305532 |
| ALL |
| 09/01/2023 to 09/01/2024 |
Accident,Critical Illness,FMLA,HIPP,Life,LTD,PFML,STD
FACETS
| TRAVIS COUNTY HEALTHCARE DISTRICT | Group Effective Date: 03/01/2018 | ||||||
| Subgroup: 1002 - L6Z COMMUNITY CARE | |||||||
| Claim | Benefit | Gender | Age at Incurred Date | Status * | Incurred Date | Payment Date | Net Benefit Amount |
| 203020776 | Life - Basic | F | 63 | Closed | 01/22/2024 | 02/22/2024 | $58,111.24 |
| 203020776 | Life - Supplemental | F | 63 | Closed | 01/22/2024 | 02/22/2024 | $58,111.24 |
| January 2024 Incurred Total: | $116,222.47 | ||||||
| 203415168 | Life - Basic | F | 60 | Closed | 07/07/2024 | 08/15/2024 | $69,075.62 |
| July 2024 Incurred Total: | $69,075.62 | ||||||
| Subgroup 00001002 Total: | $185,298.09 | ||||||
| Group Total: | $185,298.09 |
&"times new roman,Regular"&7 Run Date: 9/9/2024 3:46:12 PM &"Times New Roman,Regular"&8 * Claim Status Descriptions:
Appealed: Claim has been disputed | Closed: Claim is closed | In Process: Claim is in adjudication process | Incomplete: C
Sheet2
Paid Claim Detail by Incurred Date
| Selection Parameters | Values on Report | |
| Group/Customer: | 305532 | 00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT |
| Subgroup/Policy: | ALL | 1002 |
| Incurred Date Range: | 09/01/2023 to 09/01/2024 | 01/22/2024 to 07/07/2024 |
Business Segment: Accident,Critical Illness,FMLA,HIPP,Life,LTD,PFML,STD Life
Source System: FACETS
TRAVIS COUNTY HEALTHCARE DISTRICT
| All Subgroups by Product | Net Benefit Amount | |
| Life - Basic | $127,186.86 | |
| Life - Supplemental | $58,111.24 | |
| All Subgroups by Product Total | $185,298.09 |
&"times new roman,Regular"&7 Run Date: 9/9/2024 3:46:12 PM &"Times New Roman,Regular"&8 * Claim Status Descriptions:
Appealed: Claim has been disputed | Closed: Claim is closed | In Process: Claim is in adjudication process | Incomplete: C image1.png image2.jpg
File details come from the government source that posted it. Updated .