Exhibit_C__Offset_Report.xlsx

XLSX spreadsheet 25 KB Posted

Attached to
Group Life & Disability and Supplemental Health Benefits
Solicitation number
RFP-1-26-12
Issued by
Brevard County, Florida

About this file

This is a Group Claim Offset Report for Policy 641728, prepared by Standard Insurance Company as of June 30, 2026, documenting long-term disability (LTD) claims and benefit offsets for a Florida county's group life and disability benefits program. The report details 23 active claims across multiple claimants with various offset types including Pension/Social Security (PS), Pension (P1), and Social Security Disability (SD) offsets. Claims range from incurrence dates beginning in 2011 through 2025, with gross benefits spanning from approximately $1,400 to $3,500. Offset amounts vary significantly, with Social Security Disability offsets generally ranging from $1,100 to $2,100 and other offset types ranging from $200 to $4,160. The report includes offset start dates and end dates for each claim, with end dates extending through various years between 2060 and 2087.

The offset report reflects the county's existing fully insured group benefit arrangement with Standard Insurance Company, effective since January 1, 2019. All claims shown maintain an "Active" status with offset statuses primarily marked as "Active" (A), "Eligible" (E), or "Suspended" (S). The report is marked as confidential and proprietary, intended only for authorized company personnel with legitimate business reasons for access. This documentation serves as baseline information for the county's evaluation of its current LTD claims experience as it prepares to solicit proposals for expanded voluntary benefit offerings including accident, hospital indemnity, and critical illness coverage, with contract implementation targeted for January 1, 2027.

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Text version

Offset Report 641728

Policy 641728
Group Claim Offset Report
As Of 06/30/2026
THE INFORMATION IN THESE REPORTS IS CONFIDENTIAL AND PROPRIETARY. THESE REPORTS ARE TO BE ACCESSIBLE ONLY TO THOSE COMPANY
PERSONNEL WHO HAVE A LEGITIMATE BUSINESS REASON TO EXAMINE THE INFORMATION. THESE REPORTS MAY NOT BE REDISCLOSED
WITHOUT THE WRITTEN AUTHORIZATION OF STANDARD INSURANCE COMPANY.
PolicyClaimProductClaim TypeGenderStatusIncurred DateClose DateGross BenefitOffset IDOffset StatusOffset AmountOffset Start DateOffset End Date
641728FE7836LTLTFA2/20/171,497.54PDA632.871/1/189/21/65
641728FQ2809LTLTFA1/9/181,560.00PDA729.946/14/182/29/64
641728FQ2809LTLTFA1/9/181,560.00SDA1,385.007/1/182/29/64
641728FV6007LTLTFA4/16/181,503.84PSE1,333.005/29/295/26/67
641728FV6007LTLTFA4/16/181,503.84SDA1,333.0010/1/185/26/67
641728GS9233LTLTFA11/22/191,799.06P1E20011/22/205/8/70
641728GS9233LTLTFA11/22/191,799.06SDA1,554.0012/1/255/8/70
641728GT7579LTLTFA12/11/182,127.90PDA1,312.214/7/221/27/71
641728GT7579LTLTFA12/11/182,127.90SDA1,760.006/1/191/27/71
641728HX2224LTLTMA7/25/213,089.60PSA3,510.793/1/225/22/77
641728JW3253LTLTMA4/17/232,791.18P1E2004/17/249/27/68
641728JW3253LTLTMA4/17/232,791.18SDE1,310.0010/1/239/27/68
641728JY7739LTLTMA1/13/231,902.47P1E2001/13/242/18/66
641728JY7739LTLTMA1/13/231,902.47SDA1,545.007/1/232/18/66
641728KL4323LTLTMA8/1/233,476.45PDS4,011.919/1/234/28/70
641728KL4323LTLTMA8/1/233,476.45SDE1,388.001/1/244/28/70
641728KL9022LTLTMA5/18/241,983.13P1S758.9410/1/2411/18/66
641728KL9022LTLTMA5/18/241,983.13SDA1,698.0010/1/2411/18/66
641728LK4488LTLTFA1/24/253,185.62P1S2,724.859/1/2512/4/68
641728LK4488LTLTFA1/24/253,185.62SDE1,362.007/1/2512/4/68
641728LL0283LTLTMA2/10/253,020.58P1E2002/10/267/3/87
641728LL0283LTLTMA2/10/253,020.58SDE1,336.007/1/257/3/87
641728LR0763LTLTMA2/10/252,348.14P1A4,160.234/1/253/11/70
641728LR0763LTLTMA2/10/252,348.14SDE1,226.008/1/253/11/70
641728LS1343LTLTMA4/26/252,288.79P1E2004/26/2612/13/65
641728LS1343LTLTMA4/26/252,288.79SDA2,141.0012/1/2512/13/65
641728MM5912LTLTMA10/4/253,082.86P1E20010/4/268/26/67
641728MM5912LTLTMA10/4/253,082.86SDE1,347.004/1/268/26/67
641728VN7975LTLTFA7/27/111,967.01PDA868.5912/1/118/12/60
641728VN7975LTLTFA7/27/111,967.01SDA1,199.001/1/128/12/60
641728VS2980LTLTMA9/13/121,431.40PDA566.369/13/1311/28/62
641728VS2980LTLTMA9/13/121,431.40SDA1,181.003/1/1311/28/62
641728VS4645LTLTFA12/17/121,439.71SDA1,216.006/1/187/6/78
641728VV0733LTLTFA1/23/141,560.00PDA656.014/1/1612/31/64
641728VV0733LTLTFA1/23/141,560.00SDA1,086.004/1/1512/31/64

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