ESBD_379720_1729885561966_Attachment I - MetLife Invoice 11.24.xlsx

XLSX spreadsheet 126 KB Posted

Attached to
Life, Short & Long Term Disability Employee Benefits
Solicitation number
2510-006
Issued by
Travis County, Austin City, Texas

About this file

This document is a Request for Proposals (RFP) issued by the Travis County Healthcare District d/b/a Central Health for basic life & AD&D, voluntary life & AD&D, employer paid short-term disability, voluntary short-term disability, and employer paid long-term disability insurance coverage. The RFP seeks qualified vendors to provide these benefits to approximately 1,900 Central Health employees, with the goal of offering high-quality and valuable benefits at affordable pricing. The RFP provides a procurement schedule, with a proposal due date of November 14, 2024, and allows for a one-time open enrollment for all employees with no underwriting up to the guarantee issue amount. Central Health is seeking to bundle the life and disability coverages with the same vendor, but will contract with separate vendors if that is most advantageous.

The RFP does not mention any set-aside designations or restrictions on the types of organizations that can respond. There are no listed incumbent vendors or current contractors, and no specific details on existing infrastructure or technology that requires integration. The RFP does not provide any information on possible award values or budget ranges, though the historical claims data and premium information suggests this is a significant employee benefits contract for the Travis County Healthcare District.

View the file

Other files

File Type Posted
ESBD_379720_1729031363367_Attachment G - TRAVIS COUNTY HEALTHCARE DISTRICT ltd mpr_std mars report 08.01.2023 - 07.31.2024.xlsx XLSX spreadsheet
ESBD_379720_1730752713714_Addendum 7_Q&As.pdf PDF
ESBD_379720_1729885511235_Addendum 4 - Post Additional Attachments.pdf PDF
ESBD_379720_1729885656635_Attachment L - UHC Life Experience 122023 - current report.pdf PDF
ESBD_379720_1729030860092_RFP 2510-006 Life, Short_Long Term Disability.pdf PDF
ESBD_379720_1729031136155_Attachment C - UHC Life Experience 032018-current.pdf PDF
ESBD_379720_1729274028478_Addendum #2_Pre-Proposal Conference.pdf PDF
ESBD_379720_1729031192350_Attachment D - UHC Life paid claim report.xlsx XLSX spreadsheet
ESBD_379720_1729031266148_Attachment E - UHC Plan Documents.pdf PDF
ESBD_379720_1730744991694_RFP 2510-006_Addendum 5_ Amendment 1 - Update to Exhibit B_Response Template.pdf PDF
ESBD_379720_1730745131589_REVISED - Exhibit B - Response Template_ RFP 2510-006.xlsx XLSX spreadsheet
ESBD_379720_1729031411097_Attachment H - STD LTD Claim Status 9.1.23-8.31.24_Claim Status Report.xlsx XLSX spreadsheet
ESBD_379720_1729031079107_Attachment B - Employee Census - RFP 2510-006 Life & Disability.xlsx XLSX spreadsheet
ESBD_379720_1730749696996_Addendum 6 - Post Additional Attachment.pdf PDF
ESBD_379720_1729103901241_2510-006_Addendum 1_FAQs.pdf PDF
ESBD_379720_1730749720275_Attachment M - Additional Disability Experience.xlsx XLSX spreadsheet
ESBD_379720_1731522844628_RFP Amendment 2 - Schedule of Events Change.pdf PDF
ESBD_379720_1729885601758_Attachment J - UHC Life Experience 032018-112022.pdf PDF
ESBD_379720_1729634933127_Addendum 3 - Pre-Proposal Conference - Attendees and Recording.pdf PDF
ESBD_379720_1729030935121_Exhibit B - RFP 2510-006 Life & Disability Response Template.xlsx XLSX spreadsheet
ESBD_379720_1729885561966_Attachment I - MetLife Invoice 11.24.xlsx XLSX spreadsheet
ESBD_379720_1729885624841_Attachment K - UHC Life Experience 122022 - 122023 report.pdf PDF
ESBD_379720_1730745094878_RFP 2510 -006 - Amendment 1 - Update to Exhibit B - Response Template.pdf PDF
ESBD_379720_1730744991694_RFP 2510-006_Addendum 5_ Amendment 1 - Update to Exhibit B_Response Template.pdf PDF
ESBD_379720_1729634933127_Addendum 3 - Pre-Proposal Conference - Attendees and Recording.pdf PDF
ESBD_379720_1729031363367_Attachment G - TRAVIS COUNTY HEALTHCARE DISTRICT ltd mpr_std mars report 08.01.2023 - 07.31.2024.xlsx XLSX spreadsheet
ESBD_379720_1729885656635_Attachment L - UHC Life Experience 122023 - current report.pdf PDF
ESBD_379720_1730749720275_Attachment M - Additional Disability Experience.xlsx XLSX spreadsheet
ESBD_379720_1729885561966_Attachment I - MetLife Invoice 11.24.xlsx XLSX spreadsheet
ESBD_379720_1729031266148_Attachment E - UHC Plan Documents.pdf PDF
ESBD_379720_1729885601758_Attachment J - UHC Life Experience 032018-112022.pdf PDF
ESBD_379720_1729885624841_Attachment K - UHC Life Experience 122022 - 122023 report.pdf PDF
ESBD_379720_1729274028478_Addendum #2_Pre-Proposal Conference.pdf PDF
ESBD_379720_1729031136155_Attachment C - UHC Life Experience 032018-current.pdf PDF
ESBD_379720_1730745131589_REVISED - Exhibit B - Response Template_ RFP 2510-006.xlsx XLSX spreadsheet
ESBD_379720_1730749696996_Addendum 6 - Post Additional Attachment.pdf PDF
ESBD_379720_1729031192350_Attachment D - UHC Life paid claim report.xlsx XLSX spreadsheet
ESBD_379720_1730745094878_RFP 2510 -006 - Amendment 1 - Update to Exhibit B - Response Template.pdf PDF
ESBD_379720_1729031411097_Attachment H - STD LTD Claim Status 9.1.23-8.31.24_Claim Status Report.xlsx XLSX spreadsheet
ESBD_379720_1729030935121_Exhibit B - RFP 2510-006 Life & Disability Response Template.xlsx XLSX spreadsheet
ESBD_379720_1729030860092_RFP 2510-006 Life, Short_Long Term Disability.pdf PDF
ESBD_379720_1729885511235_Addendum 4 - Post Additional Attachments.pdf PDF
ESBD_379720_1729103901241_2510-006_Addendum 1_FAQs.pdf PDF
ESBD_379720_1729031079107_Attachment B - Employee Census - RFP 2510-006 Life & Disability.xlsx XLSX spreadsheet
ESBD_379720_1730752713714_Addendum 7_Q&As.pdf PDF
ESBD_379720_1729030935121_Exhibit B - RFP 2510-006 Life & Disability Response Template.xlsx XLSX spreadsheet
ESBD_379720_1729274028478_Addendum #2_Pre-Proposal Conference.pdf PDF
ESBD_379720_1729885511235_Addendum 4 - Post Additional Attachments.pdf PDF
ESBD_379720_1729103901241_2510-006_Addendum 1_FAQs.pdf PDF
ESBD_379720_1729031411097_Attachment H - STD LTD Claim Status 9.1.23-8.31.24_Claim Status Report.xlsx XLSX spreadsheet
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Text version

1003 - 11.24 MetLife - SLA

Customer Name:TRAVIS COUNTY HEALTHCARE DISTRICT
Division Name:TRAVIS COUNTY HEALTHCARE DISTRICT
Customer Number:Division:0003
Billing Period:11/01/2024 - 11/30/2024
Summary Totals
InsuredsDependents
Coverage TypeEE CountVolumePremiumDep. CountPremium
LTD618267248523374.4200
STD35035738114652.4600
Adjustments
Insured Last NameInsured First NameInsured IDDivisionDepartmentClassCoverage TypeAdjustment DateAdjust. CodePremiumTotal Premium
00030001LTD10/1/24A34.0734.07
00030001LTD10/1/24$3.95
00030001STD10/1/24$4.398.34
00030001LTD10/1/24A51.151.1
00030001LTD10/1/24$3.95
00030001STD10/1/24$4.398.34
00030001LTD10/1/24A23.4723.47
00030001LTD9/1/24X102.2102.2
00030001LTD10/1/24T-15.06-15.06
00030001LTD10/1/24T-15.06-15.06
00030001LTD10/1/24T-15.06-15.06
00030001LTD10/1/24A51.151.1
00030001LTD10/1/24A39.22
00030001STD10/1/24A43.2682.48
00030001LTD10/1/24A51.151.1
00030001LTD9/22/24A12.2
00030001STD9/22/24A13.4725.67
00030001LTD10/1/24A26.3526.35
00030001LTD10/1/24A21.0321.03
00030001LTD10/1/24$3.95
00030001STD10/1/24$4.398.34
00030001LTD10/1/24$4.394.39
00030001LTD10/1/24T-29.23
00030001STD10/1/24T-32.23-61.46
00030001LTD10/1/24A47.7147.71
00030001LTD10/1/24T-19.01-19.01
00030001LTD10/1/24A47.27
00030001STD10/1/24A52.1499.41
00030001LTD10/1/24T-51.1
00030001STD10/1/24T-56.98-108.08
00030001LTD10/1/24Y3.95
00030001STD10/1/24Y4.398.34
00030001LTD10/1/24T-15.06-15.06
00030001LTD10/1/24A24.6424.64
00030001LTD10/1/24A31.3531.35
00030001LTD10/1/24A45.9945.99
00030001LTD10/1/24A31
00030001STD10/1/24A34.1965.19
00030001LTD10/1/24A22.9222.92
00030001LTD10/1/24A47.27
00030001STD10/1/24A52.1499.41
00030001LTD10/1/24T-15.06
00030001STD10/1/24T-16.61-31.67
00030001LTD10/1/24T-15.06-15.06
00030001LTD10/1/24A23.1823.18
00030001LTD10/1/24A51.151.1
Bill Detail
Insured Last NameInsured First NameInsured IDDivisionDepartmentClassCoverage TypeCoverage TierPremiumVolumeTotal Premium
00030001LTDMember only51.1600051.1
00030001LTDMember only51.1600051.1
00030001LTDMember only28.71337128.71
00030001LTDMember only22.132598
00030001STDMember only24.4260046.55
00030001LTDMember only34.07400034.07
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only38.714545
00030001STDMember only42.69104981.4
00030001LTDMember only51.1600051.1
00030001LTDMember only35.794203
00030001STDMember only39.4897075.27
00030001LTDMember only32.683838
00030001STDMember only36.0688668.74
00030001LTDMember only22.752671
00030001STDMember only25.1161747.86
00030001LTDMember only43.085059
00030001STDMember only47.54116890.62
00030001LTDMember only23.912808
00030001STDMember only26.3764850.28
00030001LTDMember only21.61253821.61
00030001LTDMember only19.012232
00030001STDMember only2151640.01
00030001LTDMember only51.1600051.1
00030001LTDMember only24.14283424.14
00030001LTDMember only45.635358
00030001STDMember only50.35123795.98
00030001LTDMember only24.64289424.64
00030001LTDMember only24.632893
00030001STDMember only27.1966851.82
00030001LTDMember only44.165185
00030001STDMember only48.72119792.88
00030001LTDMember only29.183426
00030001STDMember only32.1979161.37
00030001LTDMember only17.12201117.12
00030001LTDMember only21.862567
00030001STDMember only24.1459346
00030001LTDMember only51.1600051.1
00030001LTDMember only42.29496542.29
00030001LTDMember only36.24250
00030001STDMember only39.9398176.13
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only33.09388533.09
00030001LTDMember only29.253435
00030001STDMember only32.2879361.53
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only25.052942
00030001STDMember only27.6467952.69
00030001LTDMember only26.123067
00030001STDMember only28.8270854.94
00030001LTDMember only51.1600051.1
00030001LTDMember only51.1600051.1
00030001LTDMember only29.8350029.8
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.1600051.1
00030001LTDMember only36.24250
00030001STDMember only39.9398176.13
00030001LTDMember only23.56276723.56
00030001LTDMember only50.04587550.04
00030001LTDMember only25.693016
00030001STDMember only28.3369654.02
00030001LTDMember only44.41521544.41
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only22.14260022.14
00030001LTDMember only49.245782
00030001STDMember only54.331335103.57
00030001LTDMember only45.755372
00030001STDMember only50.47124096.22
00030001LTDMember only23.192723
00030001STDMember only25.662948.79
00030001LTDMember only44.615238
00030001STDMember only49.21120993.82
00030001LTDMember only43.09506043.09
00030001LTDMember only32.86385932.86
00030001LTDMember only38.24449038.24
00030001LTDMember only23.18272223.18
00030001LTDMember only51.1600051.1
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only22.912690
00030001STDMember only25.2762148.18
00030001LTDMember only31.94375031.94
00030001LTDMember only47.095530
00030001STDMember only51.97127799.06
00030001LTDMember only24.04282324.04
00030001LTDMember only41.214839
00030001STDMember only45.46111786.67
00030001LTDMember only51.1600051.1
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only22.912690
00030001STDMember only25.2762148.18
00030001LTDMember only51.1600051.1
00030001LTDMember only26.1306526.1
00030001LTDMember only46.845500
00030001STDMember only51.69127098.53
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only37.94450
00030001STDMember only41.8102779.7
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only35.84204
00030001STDMember only39.5297175.32
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only23.97281523.97
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only26.493111
00030001STDMember only29.2271855.71
00030001LTDMember only38.33450038.33
00030001LTDMember only19.01223219.01
00030001LTDMember only21.91257321.91
00030001LTDMember only29.223431
00030001STDMember only32.2379261.45
00030001LTDMember only32.543821
00030001STDMember only35.988268.44
00030001LTDMember only24.192841
00030001STDMember only26.765650.89
00030001LTDMember only40.624770
00030001STDMember only44.81110185.43
00030001LTDMember only22.142600
00030001STDMember only24.4260046.56
00030001LTDMember only32.28379032.28
00030001LTDMember only26.113066
00030001STDMember only28.8270854.93
00030001LTDMember only37.964457
00030001STDMember only41.88102979.84
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only19.012232
00030001STDMember only2151640.01
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only39.17460039.17
00030001LTDMember only31.43369031.43
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only35.734196
00030001STDMember only39.4496975.17
00030001LTDMember only22.59265222.59
00030001LTDMember only36.24250
00030001STDMember only39.9398176.13
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only21.772557
00030001STDMember only24.0159045.78
00030001LTDMember only23.91280823.91
00030001LTDMember only51.1600051.1
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only44.95273
00030001STDMember only49.53121794.43
00030001LTDMember only34.28402534.28
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only23.91280823.91
00030001LTDMember only35.34145
00030001STDMember only38.9595774.25
00030001LTDMember only20.842448
00030001STDMember only2356543.84
00030001LTDMember only32.923865
00030001STDMember only36.389269.22
00030001LTDMember only37.05435037.05
00030001LTDMember only23.47275623.47
00030001LTDMember only45.9539045.9
00030001LTDMember only38.24449038.24
00030001LTDMember only41.444867
00030001STDMember only45.71112387.15
00030001LTDMember only27.19319327.19
00030001LTDMember only35.774200
00030001STDMember only39.4897075.25
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only26.473109
00030001STDMember only29.2271855.69
00030001LTDMember only21.982581
00030001STDMember only24.2659646.24
00030001LTDMember only51.1600051.1
00030001LTDMember only44.71525044.71
00030001LTDMember only45.145300
00030001STDMember only49.82122494.96
00030001LTDMember only41.084824
00030001STDMember only45.3111386.38
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only25.052942
00030001STDMember only27.6467952.69
00030001LTDMember only29.72349029.72
00030001LTDMember only22.36262622.36
00030001LTDMember only31.293675
00030001STDMember only34.5184865.8
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only47.995635
00030001STDMember only52.951301100.94
00030001LTDMember only23.16272023.16
00030001LTDMember only51.1600051.1
00030001LTDMember only35.34145
00030001STDMember only38.9595774.25
00030001LTDMember only21.38251121.38
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only23.162720
00030001STDMember only25.5662848.72
00030001LTDMember only36.974341
00030001STDMember only40.78100277.75
00030001LTDMember only51.1600051.1
00030001LTDMember only44.715250
00030001STDMember only49.33121294.04
00030001LTDMember only23.03270423.03
00030001LTDMember only40.914804
00030001STDMember only45.14110986.05
00030001LTDMember only35.3414535.3
00030001LTDMember only51.1600051.1
00030001LTDMember only51.1600051.1
00030001LTDMember only22.532646
00030001STDMember only24.8761147.4
00030001LTDMember only26.143070
00030001STDMember only28.8670955
00030001LTDMember only28.53335028.53
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only45.99540045.99
00030001LTDMember only46.53546446.53
00030001LTDMember only51.1600051.1
00030001LTDMember only24.382863
00030001STDMember only26.966151.28
00030001LTDMember only31.093651
00030001STDMember only34.3184365.4
00030001LTDMember only39.89468439.89
00030001LTDMember only51.1600051.1
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only46.845500
00030001STDMember only51.69127098.53
00030001LTDMember only33.593944
00030001STDMember only37.0891170.67
00030001LTDMember only21.2249021.2
00030001LTDMember only45.355325
00030001STDMember only50.02122995.37
00030001LTDMember only35.56417535.56
00030001LTDMember only37.34380
00030001STDMember only41.15101178.45
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.1600051.1
00030001LTDMember only47.3555547.3
00030001LTDMember only43.375092
00030001STDMember only47.86117691.23
00030001LTDMember only51.1600051.1
00030001LTDMember only39.224605
00030001STDMember only43.26106382.48
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only37.224370
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00030001STDMember only33.9883564.79
00030001LTDMember only26.453106
00030001STDMember only29.1871755.63
00030001LTDMember only23.18272223.18
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only17.12201117.12
00030001LTDMember only38.92457138.92
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only42.34967
00030001STDMember only46.68114788.98
00030001LTDMember only23.422750
00030001STDMember only25.8463549.26
00030001LTDMember only51.1600051.1
00030001LTDMember only51.1600051.1
00030001LTDMember only40.034700
00030001STDMember only44.16108584.19
00030001LTDMember only24.632893
00030001STDMember only27.1966851.82
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only43.69513043.69
00030001LTDMember only24.63289324.63
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only48.85730
00030001STDMember only53.851323102.65
00030001LTDMember only15.06176815.06
00030001LTDMember only36.224254
00030001STDMember only39.9798276.19
00030001LTDMember only27.04317627.04
00030001LTDMember only19.962344
00030001STDMember only22.0254141.98
00030001LTDMember only41.654890
00030001STDMember only45.95112987.6
00030001LTDMember only23.522762
00030001STDMember only25.9763849.49
00030001LTDMember only45.955395
00030001STDMember only50.67124596.62
00030001LTDMember only48.26566748.26
00030001LTDMember only51.1600051.1
00030001LTDMember only29.42345529.42
00030001LTDMember only20.37239220.37
00030001LTDMember only25.352977
00030001STDMember only27.9668753.31
00030001LTDMember only43.445100
00030001STDMember only47.9117791.34
00030001LTDMember only24.632893
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00030001LTDMember only33.623948
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00030001LTDMember only51.1600051.1
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00030001LTDMember only51.16000
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00030001LTDMember only22.532646
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00030001LTDMember only31.94375131.94
00030001LTDMember only50.665949
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00030001LTDMember only25.262967
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00030001LTDMember only31364031
00030001LTDMember only18.77220418.77
00030001LTDMember only47.27555047.27
00030001LTDMember only40.974810
00030001STDMember only45.18111086.15
00030001LTDMember only15.06176815.06
00030001LTDMember only28.753376
00030001STDMember only31.7177960.46
00030001LTDMember only22.122597
00030001STDMember only24.4260046.54
00030001LTDMember only29.883509
00030001STDMember only32.9781062.85
00030001LTDMember only43.865150
00030001STDMember only48.39118992.25
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only40.98481340.98
00030001LTDMember only30.553587
00030001STDMember only33.782864.25
00030001LTDMember only22.532646
00030001STDMember only24.8761147.4
00030001LTDMember only20.732434
00030001STDMember only22.8756243.6
00030001LTDMember only51.065995
00030001STDMember only56.331384107.39
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only23.91280823.91
00030001LTDMember only30.753610
00030001STDMember only33.9483464.69
00030001LTDMember only26.13065
00030001STDMember only28.8270854.92
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only50.425920
00030001STDMember only55.641367106.06
00030001LTDMember only22.2260722.2
00030001LTDMember only51.16000
00030001STDMember only56.981400108.08
00030001LTDMember only28.963400
00030001STDMember only31.9578560.91
00030001LTDMember only25.41298425.41
00030001LTDMember only44.695248
00030001STDMember only49.29121193.98
00030001LTDMember only51.1600051.1
00030001LTDMember only51.1600051.1
00030001LTDMember only30.833621
00030001STDMember only34.0383664.86
Total for this billing period37305.18
Totals
Total for this billing period including adjustments38026.88
OUTSTANDING DUE AS OF 10/15/202438937.69
GRAND TOTAL DUE - PLEASE PAY THIS AMOUNT76964.57

1004 - 11.24 MetLife - L6Z

Customer Name:TRAVIS COUNTY HEALTHCARE DISTRICT
Division Name:COMMUNITY CARE
Customer Number:Division:0004
Billing Period:11/01/2024 - 11/30/2024
Summary Totals
InsuredsDependents
Coverage TypeEE CountVolumePremiumDep. CountPremium
LTD1282447975438714.1600
STD81668062227883.4100
Adjustments
Insured Last NameInsured First NameInsured IDDivisionDepartmentClassCoverage TypeAdjustment DateAdjust. CodePremiumTotal Premium
00040001LTD10/1/24A16.44
00040001STD10/1/24A18.1534.59
00040001LTD10/1/24T-22.69
00040001STD10/1/24T-25.03-47.72
00040001LTD10/1/24T-43.82-43.82
00040001LTD10/1/24T-22.09
00040001STD10/1/24T-24.38-46.47
00040001LTD9/1/24$6.046.04
00040001LTD10/1/24T-15.56-15.56
00040001LTD10/1/24T-22.43
00040001STD10/1/24T-24.75-47.18
00040001LTD10/1/24A17.9317.93
00040001LTD9/22/24A17.9317.93
00040001LTD10/1/24$1.12
00040001STD10/1/24$1.272.39
00040001LTD10/1/24T-32.68-32.68
00040001LTD10/1/24A51.1
00040001STD10/1/24A56.98108.08
00040001LTD10/1/24A51.1
00040001STD10/1/24A56.98108.08
00040001LTD10/1/24A51.1
00040001STD10/1/24A56.98108.08
00040001LTD10/1/24A17.9317.93
00040001LTD10/1/24A16.4416.44
00040001LTD10/1/24A51.1
00040001STD10/1/24A56.98108.08
00040001LTD10/1/24A31.1831.18
00040001LTD10/1/24T-21.26
00040001STD10/1/24T-23.44-44.7
00040001LTD10/1/24T-12.2
00040001STD10/1/24T-13.47-25.67
00040001LTD10/1/24T-21.26-21.26
00040001LTD10/1/24A51.151.1
00040001LTD10/1/24A43.2643.26
00040001LTD10/1/24$6.48
00040001STD10/1/24$7.1613.64
00040001LTD10/1/24T-50.89-50.89
00040001LTD10/1/24T-17.8-17.8
00040001LTD10/1/24T-20.65-20.65
00040001LTD10/1/24A17.1217.12
00040001LTD10/1/24$-8.07
00040001STD10/1/24$-9.48-17.55
00040001LTD10/1/24A16.4416.44
00040001LTD10/1/24$-4.42
00040001STD10/1/24$-5.49-9.91
00040001LTD10/1/24F36.22
00040001STD10/1/24F39.9776.19
00040001LTD10/1/24A17.9317.93
00040001LTD10/1/24A17.817.8
00040001LTD10/1/24Y2.78
00040001STD10/1/24Y3.055.83
00040001LTD10/1/24Y-18.82-18.82
00040001LTD10/1/24X21.2621.26
00040001LTD10/1/24T-18.82
00040001STD10/1/24T-20.76-39.58
00040001LTD10/1/24T-34.44
00040001STD10/1/24T-38.01-72.45
00040001LTD10/1/24A25.125.1
00040001LTD10/1/24T-21.48-21.48
00040001LTD10/1/24A32.6832.68
00040001LTD10/1/24T-22.56
00040001STD10/1/24T-24.91-47.47
00040001LTD10/1/24T-18.41
00040001STD10/1/24T-20.31-38.72
00040001LTD7/1/24X71.7271.72
00040001LTD10/1/24A16.4416.44
00040001LTD10/1/24$5.93
00040001STD10/1/24$6.5512.48
00040001LTD5/1/24X117
00040001STD5/1/24X129.18246.18
00040001LTD10/1/24A34.0734.07
00040001LTD10/1/24A51.151.1
00040001LTD10/1/24A40.7140.71
00040001LTD10/1/24$2.252.25
00040001LTD10/1/24T-21.8
00040001STD10/1/24T-24.05-45.85
00040001LTD10/1/24A38.96
00040001STD10/1/24A42.9881.94
00040001LTD10/1/24$0.84
00040001STD10/1/24$0.931.77
00040001LTD10/1/24A26.5726.57
00040001LTD10/1/24T-37.13
00040001STD10/1/24T-40.98-78.11
00040001LTD10/1/24A51.151.1
Bill Detail
Insured Last NameInsured First NameInsured IDDivisionDepartmentClassCoverage TypeCoverage TierPremiumVolumeTotal Premium
00040001LTDMember only51.1600051.1
00040001LTDMember only44.485223
00040001STDMember only49.08120693.56
00040001LTDMember only21.88256921.88
00040001LTDMember only22.522644
00040001STDMember only24.8761147.39
00040001LTDMember only22.492641
00040001STDMember only24.8361047.32
00040001LTDMember only51.16000
00040001STDMember only56.981400108.08
00040001LTDMember only34.994108
00040001STDMember only38.5894873.57
00040001LTDMember only23.44275223.44
00040001LTDMember only29.683485
00040001STDMember only32.7680562.44
00040001LTDMember only51.1600051.1
00040001LTDMember only51.16000
00040001STDMember only56.981400108.08
00040001LTDMember only19.552296
00040001STDMember only21.5753041.12
00040001LTDMember only20.59241820.59
00040001LTDMember only36.784320
00040001STDMember only40.5899777.36
00040001LTDMember only19.32267
00040001STDMember only21.2952340.59
00040001LTDMember only20.112361

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File details come from the government source that posted it. Updated .