ESBD_398114_1740251854848_F022710 LTD Claims Status Report 10.1.2019-12.30.2024.xlsx
XLSX spreadsheet 102 KB Posted
- Attached to
- Life and Disability Plans
- Solicitation number
- RFP2025-015
- Issued by
- Henderson County, Texas
About this file
This is a Long-Term Disability (LTD) claims status report for the City of Waco, covering the period from October 1, 2019, to December 30, 2024. The report details 12 LTD claims filed by full-time City of Waco employees, tracking their status, benefit amounts, and claim durations. Of these claims, four are closed, three were denied, two are pending, two are approved, and one resulted in death. The claims are administered by Dearborn Life Insurance Company, operating as Blue Cross and Blue Shield of Texas.
The total benefits paid across all claims amount to $287,472.46, with individual claim payments ranging from $0 to $117,517.07. The highest monthly benefit amount was $4,044.56, while the ages of claimants ranged from 30 to 69 years old. Denials were due to various reasons including pre-existing conditions, failure to provide required information, and eligibility issues. Currently active claims include two approved cases with benefit periods extending to March 2025 and November 2034, respectively.
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Text version
Claim Status Report_Excel
Claim Status Report for CITY OF WACO
| Group Number: | F022710 | ||||||||||||||||||||||||
| Line of Coverage: | ALL | ||||||||||||||||||||||||
| From Date: | 10/01/2019 | ||||||||||||||||||||||||
| To Date: | 12/30/2024 | ||||||||||||||||||||||||
| Data as of Date: | 12/28/2024 | ||||||||||||||||||||||||
| Employee | Eligibility | Claim | Benefit | Claim | Latest | Age | Last Date | Max | Claimant | Employer | Physician | Required | |||||||||||||
| Account | Account Name | Location | Product Type | Coverage | Product | Employee | Eligibility | Class | Claim | Status | Status Reason | Received | Begin | Approved | Benefit | Total Paid | Payment | at | of | Event Date | Duration | Statement | Statement | Statement | Information |
| Number | Description | Type | ID | Class | Description | Number | Date | Date | Through | Amount | Date | Event | Work | Date | Rec'd | Rec'd | Rec'd | Completed | |||||||
| Number | Date | Date | |||||||||||||||||||||||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-49772 | Closed | Other | 05/13/2020 | 11/01/2020 | 10/31/2022 | $2,625.76 | $61,862.68 | 09/09/2022 | 40 | 05/04/2020 | 05/05/2020 | 05/17/2046 | 05/13/2020 | 05/13/2020 | 05/14/2020 | 05/14/2020 | ||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-71552 | Denied | Pre-existing Condition | 02/03/2021 | 07/06/2021 | $1,716.78 | $0.00 | 40 | 01/03/2021 | 01/07/2021 | 07/16/2047 | 02/03/2021 | 02/03/2021 | 02/03/2021 | 02/03/2021 | ||||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-70336 | Closed | Return to Work | 02/04/2021 | 06/04/2021 | 10/13/2021 | $1,712.88 | $6,368.15 | 10/22/2021 | 32 | 12/06/2020 | 12/06/2020 | 04/06/2055 | 01/20/2021 | 01/20/2021 | 01/20/2021 | 01/20/2021 | ||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-109117 | Closed | Advance Pay & Close | 04/19/2022 | 10/18/2022 | 11/10/2022 | $2,221.31 | $592.35 | 12/14/2022 | 51 | 04/20/2022 | 04/21/2022 | 11/14/2037 | 04/19/2022 | 04/19/2022 | 04/19/2022 | 04/21/2022 | ||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-269459 | Pending | 07/03/2024 | 09/09/2024 | $4,044.56 | $0.00 | 69 | 03/12/2024 | 03/13/2024 | 09/08/2025 | 07/17/2024 | 07/03/2024 | 07/03/2024 | 07/17/2024 | |||||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-129379 | Denied | Failure to Provide Required | 12/19/2022 | 05/25/2023 | $1,798.16 | $0.00 | 49 | 11/23/2022 | 11/26/2022 | 06/21/2040 | 12/19/2022 | 12/19/2022 | 12/19/2022 | 12/19/2022 | ||||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-109956 | Closed | Death | 04/29/2022 | 08/25/2022 | 03/11/2024 | $3,890.00 | $21,239.80 | 04/24/2024 | 55 | 02/25/2022 | 02/26/2022 | 09/15/2033 | 04/29/2022 | 04/29/2022 | 04/29/2022 | 04/29/2022 | ||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-39012 | Denied | Eligibility For Coverage Not Satisfied | 12/04/2019 | $0.00 | $0.00 | 58 | 06/24/2019 | 06/25/2019 | 10/20/2027 | 12/04/2019 | 12/10/2019 | 12/19/2019 | 12/19/2019 | |||||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-64255 | Closed | Other | 11/04/2020 | 04/27/2021 | 04/26/2023 | $1,352.00 | $31,606.76 | 03/13/2023 | 32 | 10/28/2020 | 10/29/2020 | 02/24/2055 | 11/09/2020 | 11/06/2020 | 11/04/2020 | 11/09/2020 | ||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-294109 | Pending | 12/10/2024 | 02/04/2024 | $0.00 | $0.00 | 30 | 08/08/2023 | 08/08/2023 | 04/26/2060 | 12/10/2024 | 12/10/2024 | 12/10/2024 | 12/10/2024 | |||||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-70456 | Approved | 01/21/2021 | 10/19/2020 | 11/04/2034 | $3,615.97 | $117,517.07 | 12/18/2024 | 52 | 04/19/2020 | 04/22/2020 | 11/04/2034 | 01/21/2021 | 01/21/2021 | 01/21/2021 | 01/21/2021 | |||
| 1 | CITY OF WACO | LTD | LTD | Long Term Disability | 1 | All Full-time EEs | GDC-72192 | Approved | 02/10/2021 | 08/02/2021 | 03/01/2025 | $2,004.52 | $48,285.65 | 12/02/2024 | 53 | 02/02/2021 | 02/03/2021 | 01/05/2035 | 02/10/2021 | 02/10/2021 | 02/10/2021 | 02/10/2021 |
Insurance products issued by Dearborn Life Insurance Company, 701 E. 22nd St. Suite 300, Lombard, IL 60148. Blue Cross and Blue Shield of Texas is the trade name of Dearborn Life Insurance Company, an independent licensee of the Blue Cross and Blue Shield Association. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
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