ESBD_379720_1729885656635_Attachment L - UHC Life Experience 122023 - current report.pdf

182 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

Written by GovTribe AI ·

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 initial contract term is two years, with optional four one-year renewal periods.

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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Experience Summary by Incurred Month

Group/Customer:

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

All Subgroups and Products by Incurred Month

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $40,678.95 $0.00 0.00% 5,652 625,535,202 0

01/2024 $40,877.90 $116,222.47 284.32% 6,500 633,285,674 2

02/2024 $41,681.51 $0.00 0.00% 5,886 649,465,774 0

03/2024 $44,641.98 $0.00 0.00% 6,035 667,597,570 0

04/2024 $44,677.54 $0.00 0.00% 6,065 669,060,570 0

05/2024 $44,761.24 $0.00 0.00% 6,100 673,385,834 0

06/2024 $44,796.36 $0.00 0.00% 6,083 673,619,834 0

07/2024 $44,589.69 $69,075.62 154.91% 6,100 673,385,834 1

08/2024 $45,081.60 $0.00 0.00% 6,100 673,385,834 0

09/2024 $44,796.36 $0.00 0.00% 0 0 0

All subgroups and Products Total

$436,583.13 $185,298.09 42.44% 54521 $5,938,722,126 3

Page 1 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $1,449.96 $0.00 0.00% 1,266 $96,663,900 0

Benefit Type Total $1,449.96 $0.00 0.00% 0

Page 2 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $1,469.10 $0.00 0.00% 1,278 $97,939,900 0

02/2024 $1,504.59 $0.00 0.00% 1,318 $100,305,900 0

03/2024 $1,523.95 $0.00 0.00% 1,305 $101,595,500 0

04/2024 $1,524.31 $0.00 0.00% 1,306 $101,620,500 0

05/2024 $1,531.88 $0.00 0.00% 1,310 $102,125,500 0

06/2024 $1,519.55 $0.00 0.00% 1,300 $101,303,500 0

07/2024 $1,520.84 $0.00 0.00% 1,310 $102,125,500 0

08/2024 $1,530.71 $0.00 0.00% 1,310 $102,125,500 0

09/2024 $1,519.55 $0.00 0.00% 0 $0 0

Benefit Type Total $13,644.48 $0.00 0.00% 0

Page 3 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Basic

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $3,866.56 $0.00 0.00% 1,266 $96,663,900 0

Benefit Type Total $3,866.56 $0.00 0.00% 0

Page 4 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Basic

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $3,917.59 $58,111.24 1483.34% 1,278 $97,939,900 1

02/2024 $4,012.24 $0.00 0.00% 1,318 $100,305,900 0

03/2024 $4,063.86 $0.00 0.00% 1,305 $101,596,500 0

04/2024 $4,064.81 $0.00 0.00% 1,306 $101,620,500 0

05/2024 $4,085.02 $0.00 0.00% 1,310 $102,125,500 0

06/2024 $4,052.14 $0.00 0.00% 1,300 $101,303,500 0

07/2024 $4,055.56 $69,075.62 1703.23% 1,310 $102,125,500 1

08/2024 $4,081.87 $0.00 0.00% 1,310 $102,125,500 0

09/2024 $4,052.14 $0.00 0.00% 0 $0 0

Benefit Type Total $36,385.23 $127,186.86 349.56% 2

Page 5 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Supplemental

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $17,010.18 $0.00 0.00% 640 $86,119,200 0

Benefit Type Total $17,010.18 $0.00 0.00% 0

Page 6 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Supplemental

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $16,947.34 $58,111.24 342.89% 641 $86,317,200 1

02/2024 $16,964.24 $0.00 0.00% 641 $86,717,200 0

03/2024 $18,561.87 $0.00 0.00% 693 $94,342,300 0

04/2024 $18,483.88 $0.00 0.00% 685 $93,497,300 0

05/2024 $18,508.32 $0.00 0.00% 683 $93,621,300 0

06/2024 $18,461.79 $0.00 0.00% 673 $93,082,300 0

07/2024 $18,337.55 $0.00 0.00% 683 $93,621,300 0

08/2024 $18,259.94 $0.00 0.00% 683 $93,621,300 0

09/2024 $18,461.79 $0.00 0.00% 0 $0 0

Benefit Type Total $162,986.72 $58,111.24 35.65% 1

Page 7 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Supplemental Dependent

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $1,045.33 $0.00 0.00% 190 $4,869,688 0

Benefit Type Total $1,045.33 $0.00 0.00% 0

Page 8 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Supplemental Dependent

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $1,045.33 $0.00 0.00% 190 $4,869,688 0

02/2024 $1,030.43 $0.00 0.00% 190 $4,879,688 0

03/2024 $1,120.56 $0.00 0.00% 200 $5,183,500 0

04/2024 $1,089.95 $0.00 0.00% 196 $5,088,500 0

05/2024 $1,085.93 $0.00 0.00% 197 $5,118,500 0

06/2024 $1,077.35 $0.00 0.00% 194 $5,048,500 0

07/2024 $1,076.21 $0.00 0.00% 197 $5,118,500 0

08/2024 $1,067.67 $0.00 0.00% 197 $5,118,500 0

09/2024 $1,077.35 $0.00 0.00% 0 $0 0

Benefit Type Total $9,670.78 $0.00 0.00% 0

Page 9 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Supplemental Dependent Child

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $488.00 $0.00 0.00% 244 $2,440,000 0

Benefit Type Total $488.00 $0.00 0.00% 0

Page 10 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Life - Supplemental Dependent Child

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $488.00 $0.00 0.00% 244 $2,440,000 0

02/2024 $488.00 $0.00 0.00% 244 $2,440,000 0

03/2024 $508.00 $0.00 0.00% 254 $2,540,000 0

04/2024 $498.00 $0.00 0.00% 249 $2,490,000 0

05/2024 $502.00 $0.00 0.00% 251 $2,510,000 0

06/2024 $498.00 $0.00 0.00% 249 $2,490,000 0

07/2024 $494.00 $0.00 0.00% 251 $2,510,000 0

08/2024 $490.00 $0.00 0.00% 251 $2,510,000 0

09/2024 $498.00 $0.00 0.00% 0 $0 0

Benefit Type Total $4,464.00 $0.00 0.00% 0

Page 11 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Voluntary AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $3,491.96 $0.00 0.00% 574 $141,529,250 0

Benefit Type Total $3,491.96 $0.00 0.00% 0

Page 12 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001002 - L6Z COMMUNITY CARE

Voluntary AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $3,524.19 $0.00 0.00% 572 $142,365,722 0

02/2024 $3,510.69 $0.00 0.00% 571 $141,840,722 0

03/2024 $2,447.65 $0.00 0.00% 596 $132,215,309 0

04/2024 $2,415.78 $0.00 0.00% 589 $130,665,309 0

05/2024 $2,429.28 $0.00 0.00% 584 $130,640,309 0

06/2024 $2,391.40 $0.00 0.00% 574 $128,240,309 0

07/2024 $2,377.90 $0.00 0.00% 584 $130,640,309 0

08/2024 $2,380.53 $0.00 0.00% 584 $130,640,309 0

09/2024 $2,391.40 $0.00 0.00% 0 $0 0

Benefit Type Total $23,868.82 $0.00 0.00% 0

Page 13 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Year and Product Summary Subgroup ID: 00001002

Year 2023

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $1,449.96 $0.00 0.00% 0

Life - Basic $3,866.56 $0.00 0.00% 0

Life - Supplemental $17,010.18 $0.00 0.00% 0

Life - Supplemental Dependent $1,045.33 $0.00 0.00% 0

Life - Supplemental Dependent Child $488.00 $0.00 0.00% 0

Voluntary AD&D $3,491.96 $0.00 0.00% 0

Year 2023 Total $27,351.99 $0.00 0.00% 0

Year 2024

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $13,644.48 $0.00 0.00% 0

Life - Basic $36,385.23 $127,186.86 349.56% 2

Life - Supplemental $162,986.72 $58,111.24 35.65% 1

Life - Supplemental Dependent $9,670.78 $0.00 0.00% 0

Life - Supplemental Dependent Child $4,464.00 $0.00 0.00% 0

Voluntary AD&D $23,868.82 $0.00 0.00% 0

Year 2024 Total $251,020.03 $185,298.09 73.82% 3

Year and Product Summary Total $278,372.02 $185,298.09 66.56% 3

Page 14 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Product Summary Subgroup ID: 00001002

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $15,094.44 $0.00 0.00% 0

Life - Basic $40,251.79 $127,186.86 315.98% 2

Life - Supplemental $179,996.90 $58,111.24 32.28% 1

Life - Supplemental Dependent $10,716.11 $0.00 0.00% 0

Life - Supplemental Dependent Child $4,952.00 $0.00 0.00% 0

Voluntary AD&D $27,360.78 $0.00 0.00% 0

Product Summary Total $278,372.02 $185,298.09 66.56% 3

Page 15 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $626.67 $0.00 0.00% 422 $41,777,700 0

Benefit Type Total $626.67 $0.00 0.00% 0

Page 16 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $648.91 $0.00 0.00% 444 $43,260,700 0

02/2024 $699.83 $0.00 0.00% 477 $46,655,250 0

03/2024 $754.08 $0.00 0.00% 495 $50,272,100 0

04/2024 $773.58 $0.00 0.00% 515 $51,572,100 0

05/2024 $792.86 $0.00 0.00% 530 $52,857,100 0

06/2024 $820.04 $0.00 0.00% 543 $54,669,100 0

07/2024 $825.24 $0.00 0.00% 530 $52,857,100 0

08/2024 $864.92 $0.00 0.00% 530 $52,857,100 0

09/2024 $820.04 $0.00 0.00% 0 $0 0

Benefit Type Total $6,999.50 $0.00 0.00% 0

Page 17 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Basic

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $1,671.11 $0.00 0.00% 422 $41,777,700 0

Benefit Type Total $1,671.11 $0.00 0.00% 0

Page 18 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Basic

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $1,730.43 $0.00 0.00% 444 $43,260,700 0

02/2024 $1,866.21 $0.00 0.00% 477 $46,655,250 0

03/2024 $2,010.88 $0.00 0.00% 495 $50,272,100 0

04/2024 $2,062.88 $0.00 0.00% 515 $51,572,100 0

05/2024 $2,114.28 $0.00 0.00% 530 $52,857,100 0

06/2024 $2,186.76 $0.00 0.00% 543 $54,669,100 0

07/2024 $2,200.64 $0.00 0.00% 530 $52,857,100 0

08/2024 $2,306.46 $0.00 0.00% 530 $52,857,100 0

09/2024 $2,186.76 $0.00 0.00% 0 $0 0

Benefit Type Total $18,665.30 $0.00 0.00% 0

Page 19 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Supplemental

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $8,554.11 $0.00 0.00% 234 $38,632,100 0

Benefit Type Total $8,554.11 $0.00 0.00% 0

Page 20 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Supplemental

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $8,572.84 $0.00 0.00% 235 $38,805,100 0

02/2024 $8,961.63 $0.00 0.00% 242 $40,289,100 0

03/2024 $10,818.09 $0.00 0.00% 263 $47,051,750 0

04/2024 $10,909.60 $0.00 0.00% 268 $47,520,750 0

05/2024 $10,874.83 $0.00 0.00% 270 $47,722,750 0

06/2024 $10,954.33 $0.00 0.00% 272 $48,355,750 0

07/2024 $10,858.26 $0.00 0.00% 270 $47,722,750 0

08/2024 $11,163.62 $0.00 0.00% 270 $47,722,750 0

09/2024 $10,954.33 $0.00 0.00% 0 $0 0

Benefit Type Total $94,067.53 $0.00 0.00% 0

Page 21 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Supplemental Dependent

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $553.08 $0.00 0.00% 85 $2,289,563 0

Benefit Type Total $553.08 $0.00 0.00% 0

Page 22 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Supplemental Dependent

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $574.80 $0.00 0.00% 86 $2,319,563 0

02/2024 $605.16 $0.00 0.00% 88 $2,379,563 0

03/2024 $698.47 $0.00 0.00% 89 $2,565,563 0

04/2024 $700.06 $0.00 0.00% 90 $2,580,563 0

05/2024 $686.72 $0.00 0.00% 89 $2,545,563 0

06/2024 $670.88 $0.00 0.00% 87 $2,485,563 0

07/2024 $677.24 $0.00 0.00% 89 $2,545,563 0

08/2024 $714.53 $0.00 0.00% 89 $2,545,563 0

09/2024 $670.88 $0.00 0.00% 0 $0 0

Benefit Type Total $5,998.74 $0.00 0.00% 0

Page 23 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Supplemental Dependent Child

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $168.00 $0.00 0.00% 84 $840,000 0

Benefit Type Total $168.00 $0.00 0.00% 0

Page 24 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Life - Supplemental Dependent Child

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $172.00 $0.00 0.00% 864 $860,000 0

02/2024 $178.00 $0.00 0.00% 89 $890,000 0

03/2024 $188.00 $0.00 0.00% 94 $940,000 0

04/2024 $192.00 $0.00 0.00% 96 $960,000 0

05/2024 $190.00 $0.00 0.00% 95 $950,000 0

06/2024 $192.00 $0.00 0.00% 96 $960,000 0

07/2024 $196.00 $0.00 0.00% 95 $950,000 0

08/2024 $204.00 $0.00 0.00% 95 $950,000 0

09/2024 $192.00 $0.00 0.00% 0 $0 0

Benefit Type Total $1,704.00 $0.00 0.00% 0

Page 25 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Voluntary AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

12/2023 $1,753.99 $0.00 0.00% 225 $71,932,201 0

Benefit Type Total $1,753.99 $0.00 0.00% 0

Page 26 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Subgroup/Policy: 00001003 - SLA CENTRAL HEALTH

Voluntary AD&D

Incurred Month/Year Premium/Fees Paid Claims (1) Loss Ratio Covered Lives Volume of

Coverage Number of

Claims

01/2024 $1,787.37 $0.00 0.00% 224 $72,907,201 0

02/2024 $1,860.49 $0.00 0.00% 231 $76,107,201 0

03/2024 $1,946.57 $0.00 0.00% 246 $79,022,948 0

04/2024 $1,962.69 $0.00 0.00% 250 $79,872,948 0

05/2024 $1,960.12 $0.00 0.00% 251 $80,312,212 0

06/2024 $1,972.12 $0.00 0.00% 252 $81,012,212 0

07/2024 $1,970.25 $0.00 0.00% 251 $80,312,212 0

08/2024 $2,017.35 $0.00 0.00% 251 $80,312,212 0

09/2024 $1,972.12 $0.00 0.00% 0 $0 0

Benefit Type Total $17,449.08 $0.00 0.00% 0

Page 27 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Year and Product Summary Subgroup ID: 00001003

Year 2023

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $626.67 $0.00 0.00% 0

Life - Basic $1,671.11 $0.00 0.00% 0

Life - Supplemental $8,554.11 $0.00 0.00% 0

Life - Supplemental Dependent $553.08 $0.00 0.00% 0

Life - Supplemental Dependent Child $168.00 $0.00 0.00% 0

Voluntary AD&D $1,753.99 $0.00 0.00% 0

Year 2023 Total $13,326.96 $0.00 0.00% 0

Year 2024

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $6,999.50 $0.00 0.00% 0

Life - Basic $18,665.30 $0.00 0.00% 0

Life - Supplemental $94,067.53 $0.00 0.00% 0

Life - Supplemental Dependent $5,998.74 $0.00 0.00% 0

Life - Supplemental Dependent Child $1,704.00 $0.00 0.00% 0

Voluntary AD&D $17,449.08 $0.00 0.00% 0

Year 2024 Total $144,884.15 $0.00 0.00% 0

Year and Product Summary Total $158,211.11 $0.00 0.00% 0

Page 28 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Product Summary Subgroup ID: 00001003

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $7,626.17 $0.00 0.00% 0

Life - Basic $20,336.41 $0.00 0.00% 0

Life - Supplemental $102,621.64 $0.00 0.00% 0

Life - Supplemental Dependent $6,551.82 $0.00 0.00% 0

Life - Supplemental Dependent Child $1,872.00 $0.00 0.00% 0

Voluntary AD&D $19,203.07 $0.00 0.00% 0

Product Summary Total $158,211.11 $0.00 0.00% 0

All Subgroups by Year and Product Summary

Year 2023

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $2,076.63 $0.00 0.00% 0

Life - Basic $5,537.67 $0.00 0.00% 0

Life - Supplemental $25,564.29 $0.00 0.00% 0

Life - Supplemental Dependent $1,598.41 $0.00 0.00% 0

Life - Supplemental Dependent Child $656.00 $0.00 0.00% 0

Voluntary AD&D $5,245.95 $0.00 0.00% 0

Year 2023 Total $40,678.95 $0.00 0.00% 0

Page 29 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

Year 2024

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $20,643.98 $0.00 0.00% 0

Life - Basic $55,050.53 $127,186.86 231.04% 2

Life - Supplemental $257,054.25 $58,111.24 22.61% 1

Life - Supplemental Dependent $15,669.52 $0.00 0.00% 0

Life - Supplemental Dependent Child $6,168.00 $0.00 0.00% 0

Voluntary AD&D $41,317.90 $0.00 0.00% 0

Year 2024 Total $395,904.18 $185,298.09 46.80% 3

All Subgroups by Year and Product Total $436,583.13 $185,298.09 42.44% 3

All Subgroups by Product

Products Premium/Fees Paid Claims (1) Loss Ratio Number of Claims

Life - AD&D $22,720.61 $0.00 0.00% 0

Life - Basic $60,588.20 $127,186.86 209.92% 2

Life - Supplemental $282,618.54 $58,111.24 20.56% 1

Life - Supplemental Dependent $17,267.93 $0.00 0.00% 0

Life - Supplemental Dependent Child $6,824.00 $0.00 0.00% 0

Voluntary AD&D $46,563.85 $0.00 0.00% 0

Page 30 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

Incurred Date Range:

Business Segment:

Selection Parameters

12/01/2023 to 09/01/2024

Life

305532

Subgroup/Policy: ALL

Values on Report

00305532 - TRAVIS COUNTY HEALTHCARE DISTRICT

1002, 1003

12/01/2023 to 09/01/2024

Life

ACIS,FACETS,Onbase,PRIME,UHOPSSource System:

TRAVIS COUNTY HEALTHCARE DISTRICT Group Effective Date: 03/01/2018

FACETS

All Subgroups Product Total $436,583.13 $185,298.09 42.44% 3

Page 31 of 31OFCR-01A; v3.6Run Date: 9/13/2024 8:33:47 AM

(1) Total claim dollars paid according to the month and year in which the claim was originally incurrred. Excludes Reserves and IBNR (Incurred But Not Reported).

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