RFP%2031786-00193%20Appendix%207.20%20Detail%20Claims%20Listing%20%E2%80%93%20Voluntary%20Term%20Life.xlsx

XLSX spreadsheet 485 KB Posted Aug 20, 2026

Attached to: Life and Accidental Death and Dismemberment Insurance - UPDATED
Solicitation number: RFP 31786-00193
Issued by: Davidson County, Tennessee

About this file

Written by GovTribe AI · Aug 21, 2026

This file contains detailed claims experience data for voluntary term life insurance coverage under Policy Number 34175 for the State of Tennessee. The document presents comprehensive death claim listings across multiple product lines including employee voluntary term life, spouse voluntary term life, voluntary child term life riders, and ported coverage options, with claims data spanning from 2018 through 2023. The data is organized by policy year and coverage type, detailing individual claim information including claim numbers, insured ages at death, dates of death, dates notices were received, payment dates, insurance amounts paid, interest paid, current reserves, prior reserves, and total incurred claims. The file serves as an actuarial reference document supporting the RFP 31786-00193 for voluntary term life insurance, providing historical claims experience necessary for bidders to assess risk and develop competitive pricing proposals.

The claims data demonstrates significant claim volume and payout activity across the reporting period, with employee voluntary term life representing the largest claims category. Annual employee claims totals range from approximately $4.9 million in 2018 to $5.6 million in 2020, with additional ported claims ranging from $1.6 million to $2.1 million annually. Spouse coverage claims are substantially lower, typically between $650,000 and $815,000 annually, while voluntary child rider claims remain minimal at $12,500 to $65,000 annually. The data includes entries marked as "Incurred but Not Reported" (IBNR) estimates and identifies certain accelerated death benefit claims. Current reserves and prior reserves are tracked to reflect outstanding claim liabilities and payment processing timelines, with most claims settling within several months of notice receipt. This comprehensive historical experience data enables potential insurers to establish appropriate premium rates, reserve adequacy, and claims management protocols for the state's voluntary life insurance program.

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Other files

File	Type	Posted
RFP_31786-00193_Appendix_7.28.pdf	PDF	Oct 14, 2026
RFP_31786-00193_Appendix_7.30.xlsx	XLSX spreadsheet	Oct 14, 2026
RFP_31786-00193_Life_and_ADD_RFP_Release_2.docx	DOCX document	Oct 14, 2026
RFP_31786-00193_Appendix_7.27.pdf	PDF	Oct 14, 2026
RFP_31786-00193_Appendix_7.15.xlsx	XLSX spreadsheet	Oct 14, 2026
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RFP_31786-00193_Appendix_7.29.pdf	PDF	Oct 14, 2026
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RFP_31786-00193_Appendix_7.25.xlsx	XLSX spreadsheet	Oct 14, 2026
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RFP_31786-00193_Amendment_One_Schedule_Update.docx	DOCX document	Oct 2, 2026
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31786-00193_Digital_Submission_Instructions.docx	DOCX document	Aug 20, 2026
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2018 Voluntary Term Life

RFP 31786-00193 Appendix 7.20 Detail Claims Listing – Voluntary Term Life

Employee Voluntary Term Life Insurance Claims Experience Policy Number: 34175

For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number	Age at
Death		Date of
Death			Date Notice
Received				Date
Paid					Insurance
Amount Paid				Interest
Paid		Current
Reserve				Prior
Reserve		Incurred

Claims

1300925	76	12/03/2017	01/10/2018	02/07/2018	$ 115,000.00	$ 207.95	$ 0.00	$ 115,000.00	$ 207.95
1301462	59	11/07/2017	02/02/2018	08/31/2018	65,000.00	528.90	0.00	0.00	65,528.90
1301975	62	01/02/2018	01/05/2018	02/05/2018	10,000.00	9.32	0.00	0.00	10,009.32
1306714	56	12/28/2017	02/14/2018	03/13/2018	300,000.00	616.44	0.00	0.00	300,616.44
1307991	59	12/30/2017	02/02/2018	11/14/2018	40,000.00	349.59	0.00	0.00	40,349.59
1309230	63	01/29/2018	02/07/2018	02/19/2018	50,000.00	28.77	0.00	0.00	50,028.77
1311091	57	01/27/2018	02/19/2018	04/05/2018	180,000.00	335.34	0.00	0.00	180,335.34
1311452	63	01/18/2018	02/16/2018	03/12/2018	10,000.00	14.52	0.00	0.00	10,014.52
1312554	73	02/13/2018	02/26/2018	03/05/2018	295,000.00	161.64	0.00	0.00	295,161.64
1315376	55	02/24/2018	03/12/2018	03/16/2018	205,000.00	112.33	0.00	0.00	205,112.33
1317541	55	03/10/2018	03/20/2018	04/04/2018	45,000.00	30.82	0.00	0.00	45,030.82
1318626	44	03/19/2018	03/22/2018	04/30/2018	225,000.00	242.46	0.00	0.00	225,242.46
1319672	70	02/21/2018	03/28/2018	05/25/2018	60,000.00	152.88	0.00	0.00	60,152.88
1321357	54	03/25/2018	04/04/2018	05/09/2018	500,000.00	605.48	0.00	0.00	500,605.48
1321759	66	03/24/2018	04/05/2018	10/12/2018	105,000.00	581.10	0.00	0.00	105,581.10
1325015	52	03/31/2018	05/02/2018	05/25/2018	100,000.00	150.68	0.00	0.00	100,150.68
1330156	57	05/04/2018	05/18/2018	06/22/2018	360,000.00	483.29	0.00	0.00	360,483.29
1333423	61	06/01/2018	06/04/2018	06/26/2018	75,000.00	51.37	0.00	0.00	75,051.37
1334480	59	04/30/2018	06/07/2018	07/11/2018	20,000.00	39.44	0.00	0.00	20,039.44
1335804	52	06/02/2018	06/20/2018	06/21/2018	100,000.00	52.05	0.00	0.00	100,052.05
1338949	66	06/21/2018	07/09/2018	07/17/2018	35,000.00	24.93	0.00	0.00	35,024.93
1339959	62	06/23/2018	07/12/2018	07/18/2018	80,000.00	54.79	0.00	0.00	80,054.79
1340014	69	07/03/2018	07/12/2018	09/10/2018	15,000.00	21.92	0.00	0.00	15,021.92
1344424	63	07/23/2018	08/02/2018	08/22/2018	200,000.00	164.38	0.00	0.00	200,164.38
1345539	63	06/28/2018	08/07/2018	08/28/2018	25,000.00	41.78	0.00	0.00	25,041.78
1350339	72	08/17/2018	09/10/2018	09/18/2018	70,000.00	61.37	0.00	0.00	70,061.37
1351814	50	09/09/2018	09/17/2018	10/01/2018	100,000.00	60.27	0.00	0.00	100,060.27
1352566	52	09/12/2018	09/17/2018	11/02/2018	30,000.00	42.49	0.00	0.00	30,042.49
1353940	59	09/11/2018	09/27/2018	09/28/2018	95,000.00	44.25	0.00	0.00	95,044.25
Employee Voluntary Term Life Insurance Claims Experience Policy Number: 34175

For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number	Age at
Death		Date of
Death			Date Notice
Received				Date
Paid					Insurance
Amount Paid				Interest
Paid		Current
Reserve				Prior
Reserve		Incurred

Claims

1356652 64		09/30/2018	10/09/2018	11/05/2018	$ 105,000.00	$ 85.86	$ 0.00	$ 0.00	$ 105,085.86
1361719 61		10/28/2018	11/02/2018	11/14/2018	150,000.00	69.86	0.00	0.00	150,069.86
1363233 75		11/09/2018	11/12/2018	12/24/2018	400,000.00	420.08	0.00	0.00	400,420.08
1365877 73		11/13/2018	11/27/2018	12/05/2018	60,000.00	36.16	0.00	0.00	60,036.16
1366105 67		11/17/2018	12/11/2018	01/15/2019	250,000.00	404.11	0.00	0.00	250,404.11
1368396 70		11/09/2018	12/07/2018	01/07/2019	100,000.00	161.64	0.00	0.00	100,161.64
1372733 58		12/22/2018	01/04/2019	01/21/2019	155,000.00	127.40	0.00	0.00	155,127.40
1372736 57		12/09/2018	01/04/2019	01/24/2019	100,000.00	126.03	0.00	0.00	100,126.03
1372738 49		12/20/2018	01/04/2019		0.00	0.00	400,000.00	0.00	400,000.00
D089808 53		01/18/2018	01/18/2018	02/27/2018	70,000.00	0.00	0.00	0.00	70,000.00	(A)
	39	Total Claims			$ 4,900,000.00	$ 6,701.69	$ 400,000.00	$ 115,000.00	$ 5,191,701.69
(A) Accelerated Death Benefit

Spouse Voluntary Term Life Insurance Claims Experience Policy Number: 34175 For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number	Age at
Death				Date of
Death			Date Notice
Received				Date
Paid					Insurance
Amount Paid			Interest
Paid		Current
Reserve		Prior
Reserve		Incurred

Claims

1268441	50	07/09/2017	07/10/2017	06/04/2018	$ 30,000.00	$ 271.23	$ 0.00	$ 30,000.00	$ 271.23
1302721	75	01/04/2018	01/09/2018	02/15/2018	15,000.00	17.26	0.00	0.00	15,017.26
1305557	67	01/16/2018	01/27/2018	02/23/2018	15,000.00	15.62	0.00	0.00	15,015.62
1309377	57	02/01/2018	02/09/2018	03/06/2018	30,000.00	27.12	0.00	0.00	30,027.12
1311789	67	02/16/2018	02/20/2018	05/16/2018	5,000.00	12.19	0.00	0.00	5,012.19
1317516	35	03/13/2018	03/19/2018	04/20/2018	30,000.00	31.23	0.00	0.00	30,031.23
1317765	70	03/16/2018	03/22/2018	04/05/2018	20,000.00	10.96	0.00	0.00	20,010.96
1319346	72	03/25/2018	03/27/2018	05/07/2018	20,000.00	23.56	0.00	0.00	20,023.56
1322461	70	04/01/2018	04/16/2018	04/27/2018	15,000.00	10.68	0.00	0.00	15,010.68
1323714	59	04/07/2018	04/20/2018	05/10/2018	30,000.00	27.12	0.00	0.00	30,027.12
1324013	72	04/07/2018	04/18/2018	04/20/2018	10,000.00	3.56	0.00	0.00	10,003.56
1325761	61	04/24/2018	04/26/2018	05/15/2018	15,000.00	8.63	0.00	0.00	15,008.63
1326324	65	04/06/2018	05/03/2018	05/07/2018	30,000.00	25.48	0.00	0.00	30,025.48
1328091	56	04/13/2018	05/08/2018	05/11/2018	20,000.00	15.34	0.00	0.00	20,015.34
1332063	65	04/23/2018	05/29/2018	06/05/2018	15,000.00	17.67	0.00	0.00	15,017.67
1334288	72	06/09/2018	06/14/2018	06/26/2018	15,000.00	6.99	0.00	0.00	15,006.99
1334890	67	06/01/2018	06/14/2018	06/15/2018	15,000.00	14.38	0.00	0.00	15,014.38
1339173	68	06/22/2018	07/03/2018	07/25/2018	15,000.00	13.56	0.00	0.00	15,013.56
1339938	53	05/13/2018	07/09/2018	07/19/2018	30,000.00	55.07	0.00	0.00	30,055.07
1344805	44	07/31/2018	08/10/2018	08/30/2018	30,000.00	24.66	0.00	0.00	30,024.66
1346007	36	08/08/2018	08/13/2018	09/27/2018	30,000.00	41.10	0.00	0.00	30,041.10
1348117	55	08/03/2018	08/24/2018	09/05/2018	30,000.00	27.12	0.00	0.00	30,027.12
1349083	67	08/18/2018	08/24/2018	09/20/2018	15,000.00	13.56	0.00	0.00	15,013.56
1349821	66	08/20/2018	09/04/2018	09/05/2018	15,000.00	6.58	0.00	0.00	15,006.58
1350811	63	08/14/2018	09/06/2018	09/10/2018	30,000.00	22.19	0.00	0.00	30,022.19
1351241	66	06/09/2018	09/10/2018	10/19/2018	15,000.00	54.25	0.00	0.00	15,054.25
1351841	57	09/06/2018	09/17/2018	09/21/2018	30,000.00	12.33	0.00	0.00	30,012.33
1353496	59	09/11/2018	09/19/2018	10/05/2018	30,000.00	13.56	0.00	0.00	30,013.56
Spouse Voluntary Term Life Insurance Claims Experience Policy Number: 34175

For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number	Age at
Death					Date of
Death				Date Notice
Received					Date
Paid						Insurance
Amount Paid				Interest
Paid			Current
Reserve				Prior
Reserve		Incurred

Claims

1353977	55	09/10/2018	09/26/2018	09/27/2018	$ 30,000.00	$ 13.97	$ 0.00	$ 0.00	$ 30,013.97
1356603	52	10/02/2018	10/11/2018	11/15/2018	30,000.00	27.33	0.00	0.00	30,027.33
1357047	55	06/02/2018	10/11/2018	10/24/2018	30,000.00	118.36	0.00	0.00	30,118.36
1357474	69	10/02/2018	10/11/2018	11/01/2018	15,000.00	12.33	0.00	0.00	15,012.33
1357655	73	05/05/2018	10/15/2018	10/22/2018	15,000.00	69.86	0.00	0.00	15,069.86
1372882	57	11/18/2018	01/03/2019	01/23/2019	30,000.00	54.25	0.00	0.00	30,054.25
1374112	50	12/13/2018	01/10/2019	01/16/2019	30,000.00	27.95	0.00	0.00	30,027.95
D097119	66	11/20/2018	11/20/2018	01/31/2019	15,000.00	0.00	0.00	0.00	15,000.00 (A)
	36	Total Claims			$ 795,000.00	$ 1,147.05	$ 0.00	$ 30,000.00	$ 766,147.05
(A) Accelerated Claim

Voluntary Child Term Life Rider Claims Experience Policy Number: 34175 For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number		Age at
Death					Date of
Death				Date Notice
Received					Date
Paid						Insurance
Amount Paid				Interest
Paid			Current
Reserve					Prior
Reserve		Incurred

Claims

1292365	20	11/07/2017	11/16/2017	03/09/2018	$ 10,000.00	$ 33.42	$ 0.00 $	10,000.00 $	33.42
1351963	18	08/29/2018	09/13/2018	09/14/2018	2,500.00	1.10	0.00	0.00	2,501.10
	2	Total Claims			$ 12,500.00	$ 34.52	$ 0.00 $	10,000.00 $	2,534.52

Employee Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number	Age at
Death					Date of
Death				Date Notice
Received					Date
Paid						Insurance
Amount Paid				Interest
Paid			Current
Reserve				Prior
Reserve			Incurred

Claims

1097558	66	01/07/2015	01/19/2015	06/28/2018	$ 6,000.00	$ 0.00	$ 0.00	$ 6,000.00	$ 0.00
1304126	62	01/13/2018	01/22/2018	02/07/2018	55,000.00	37.67	0.00	0.00	55,037.67
1308725	56	12/09/2017	02/03/2018	04/02/2018	25,000.00	70.96	0.00	0.00	25,070.96
1310302	64	02/01/2018	02/12/2018	03/02/2018	55,000.00	43.70	0.00	0.00	55,043.70
1310729	63	01/05/2018	02/15/2018	03/05/2018	5,000.00	8.08	0.00	0.00	5,008.08
1324146	55	04/17/2018	04/19/2018	07/27/2018	200,000.00	547.94	0.00	0.00	200,547.94
1325143	57	04/13/2018	04/23/2018	05/07/2018	75,000.00	49.32	0.00	0.00	75,049.32
1328392	54	05/07/2018	05/11/2018	06/07/2018	50,000.00	42.47	0.00	0.00	50,042.47
1330159	66	04/21/2018	05/18/2018	08/22/2018	30,000.00	93.16	0.00	0.00	30,093.16
1330771	65	05/14/2018	05/23/2018	06/15/2018	100,000.00	87.67	0.00	0.00	100,087.67
1331350	62	05/24/2018	05/31/2018	08/02/2018	80,000.00	736.44	20,000.00	0.00	100,736.44
1331668	69	05/26/2018	05/29/2018	06/14/2018	50,000.00	26.03	0.00	0.00	50,026.03
1335380	56	05/06/2018	06/19/2018	09/07/2018	55,000.00	186.85	0.00	0.00	55,186.85
1341377	68	07/05/2018	07/20/2018	09/05/2018	20,000.00	33.97	0.00	0.00	20,033.97
1346793	68	08/09/2018	08/17/2018	09/07/2018	25,000.00	19.86	0.00	0.00	25,019.86
1353995	69	09/09/2018	09/24/2018	10/15/2018	65,000.00	64.11	0.00	0.00	65,064.11
1360442	66	10/28/2018	10/29/2018	11/15/2018	25,000.00	12.33	0.00	0.00	25,012.33
1367310	69	11/13/2018	12/04/2018	12/28/2018	140,000.00	172.60	0.00	0.00	140,172.60
1371697	64	12/20/2018	12/27/2018	01/17/2019	160,000.00	122.74	0.00	0.00	160,122.74
1372049	68	12/26/2018	12/31/2018	01/31/2019	125,000.00	123.29	0.00	0.00	125,123.29
1372975	70	12/31/2018	01/04/2019	01/31/2019	95,000.00	80.68	0.00	0.00	95,080.68
1373468	62	12/18/2018	01/07/2019	01/30/2019	160,000.00	188.50	40,000.00	0.00	200,188.50
D091517	67	03/22/2018	03/22/2018	04/27/2018	55,000.00	0.00	0.00	0.00	55,000.00	(A)
	23	Total Claims			$ 1,656,000.00	$ 2,748.37	$ 60,000.00	$ 6,000.00	$ 1,712,748.37
(A) Accelerated Claim

Spouse Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number		Age at
Death					Date of
Death				Date Notice
Received						Date
Paid						Insurance
Amount Paid				Interest
Paid			Current
Reserve			Prior
Reserve		Incurred

Claims

1298302	67	12/17/2017	12/18/2017	02/20/2018	$ 25,000.00		$ 44.52		$ 0.00		$ 25,000.00		$ 44.52
1328772	55	05/02/2018	05/09/2018	06/05/2018	10,000.00		9.32		0.00		0.00		10,009.32
1343924	52	06/30/2018	08/01/2018	08/15/2018	30,000.00		37.81		0.00		0.00		30,037.81
1345149	60	07/31/2018	08/10/2018	09/05/2018	30,000.00		29.59		0.00		0.00		30,029.59
1346527	67	08/07/2018	08/13/2018	08/29/2018	25,000.00		15.07		0.00		0.00		25,015.07
1366062	69	11/18/2018	11/27/2018	12/17/2018	15,000.00		11.92		0.00		0.00		15,011.92
1371222	69	12/22/2018	12/28/2018	01/14/2019	30,000.00		18.90		0.00		0.00		30,018.90
7		Total Claims	$			165,000.00	$	167.13	$	0.00	$	25,000.00	$	140,167.13

Voluntary Child Rider Ported Claims Experience Policy Number: 34175 For the Period January 1, 2018 through December 31, 2018 Death Claims

	Claim Number		Age at
Death					Date of
Death				Date Notice
Received							Date
Paid						Insurance
Amount Paid				Interest
Paid			Current
Reserve				Prior
Reserve		Incurred

Claims

1353719	20	06/01/2018	09/20/2018	10/03/2018	$	10,000.00	$	33.97	$	0.00	$	0.00	$	10,033.97
	1	Total Claim			$	10,000.00	$	33.97	$	0.00	$	0.00	$	10,033.97

2019 Voluntary Term Life Employee Voluntary Term Life Insurance Claims Experience Policy Number: 34175 For the Period January 1, 2019 through December 31, 2019 Death Claims

	Claim Number	Age at
Death	Date of
Death			Date Notice
Received		Date
Paid				Insurance
Amount Paid						Interest
Paid			Current
Reserve					Prior
Reserve			Incurred

Claims

	1372738	49	12/20/2018	01/04/2019	03/11/2019	$ 400,000.00	$ 887.67	$ 0.00	$ 400,000.00	$ 887.67
	1373468	62	12/18/2018	01/07/2019	10/16/2019	200,000.00	241.10	0.00	0.00	200,241.10
	1374254	49	01/08/2019	01/10/2019	01/18/2019	275,000.00	75.34	0.00	0.00	275,075.34
	1375009	70	01/14/2019	01/14/2019	01/28/2019	165,000.00	63.29	0.00	0.00	165,063.29
	1378920	42	01/29/2019	01/30/2019	02/27/2019	165,000.00	131.10	0.00	0.00	165,131.10
	1379322	60	02/01/2019	04/17/2019	02/14/2019	50,000.00	17.81	0.00	0.00	50,017.81
	1383764	60	01/25/2019	02/22/2019	02/28/2019	150,000.00	139.73	0.00	0.00	150,139.73
	1383969	60	02/09/2019	02/27/2019	04/18/2019	120,000.00	223.56	0.00	0.00	120,223.56
	1384820	58	01/31/2019	02/27/2019	04/04/2019	30,000.00	51.78	0.00	0.00	30,051.78
	1385671	46	02/18/2019	03/05/2019	04/02/2019	240,000.00	197.26	0.00	0.00	240,197.26
	1386403	55	02/15/2019	03/07/2019	11/08/2019	195,000.00	1,421.10	0.00	0.00	196,421.10
	1386404	57	02/23/2019	03/07/2019	04/04/2019	25,000.00	27.40	0.00	0.00	25,027.40
	1387346	60	02/28/2019	03/12/2019	03/20/2019	80,000.00	43.84	0.00	0.00	80,043.84
	1388990	61	03/10/2019	03/19/2019	03/27/2019	55,000.00	25.62	0.00	0.00	55,025.62
	1390231	59	03/14/2019	03/22/2019	05/06/2019	55,000.00	79.86	0.00	0.00	55,079.86
	1395730	39	02/05/2019	04/17/2019	09/17/2019	75,000.00	302.05	0.00	0.00	75,302.05
	1396371	67	04/14/2019	04/23/2019	05/14/2019	50,000.00	41.10	0.00	0.00	50,041.10
	1396388	54	04/15/2019	04/23/2019	04/26/2019	275,000.00	82.88	0.00	0.00	275,082.88
	1397966	41	04/21/2019	04/30/2019	05/07/2019	250,000.00	109.59	0.00	0.00	250,109.59
	1399598	67	04/28/2019	05/09/2019	05/14/2019	25,000.00	10.96	0.00	0.00	25,010.96
	1400411	49	05/08/2019	05/13/2019	06/17/2019	250,000.00	241.11	0.00	0.00	250,241.11
	1401537	62	04/12/2019	05/17/2019	07/10/2019	100,000.00	243.84	0.00	0.00	100,243.84
	1402363	56	05/19/2019	05/22/2019	09/05/2019	205,000.00	295.90	0.00	0.00	205,295.90
	1402991	43	05/21/2019	05/24/2019	06/06/2019	60,000.00	26.30	0.00	0.00	60,026.30
	1413813	55	07/20/2019	07/22/2019	08/15/2019	225,000.00	160.27	0.00	0.00	225,160.27
	1415276	62	07/18/2019	07/30/2019	10/24/2019	25,000.00	61.98	0.00	0.00	25,061.98
	1415299	44	06/24/2019	07/30/2019		0.00	0.00	85,000.00	0.00	85,000.00
	1416940	72	08/01/2019	08/07/2019	08/28/2019	300,000.00	221.92	0.00	0.00	300,221.92
	1417994	64	08/08/2019	08/13/2019	09/12/2019	255,000.00	244.52	0.00	0.00	255,244.52
	1426097	61	09/11/2019	09/24/2019	10/01/2019	35,000.00	19.18	0.00	0.00	35,019.18
	1427011	62	09/13/2019	09/30/2019	10/28/2019	5,000.00	6.16	0.00	0.00	5,006.16
	1427056	74	09/17/2019	09/30/2019	10/14/2019	50,000.00	36.98	0.00	0.00	50,036.98
Employee Voluntary Term Life Insurance Claims Experience Policy Number: 34175

For the Period January 1, 2019 through December 31, 2019 Death Claims

	Claim Number	Age at
Death	Date of
Death			Date Notice
Received		Date
Paid				Insurance
Amount Paid					Interest
Paid			Current
Reserve				Prior
Reserve			Incurred

Claims

1428047	64	09/20/2019	10/02/2019	10/22/2019	$ 110,000.00		$ 96.44		$ 0.00		$ 0.00		$ 110,096.44
1429908	48	09/07/2019	10/15/2019	10/18/2019	20,000.00		22.47		0.00		0.00		20,022.47
1431073	59	10/19/2019	10/21/2019	10/30/2019	290,000.00		87.40		0.00		0.00		290,087.40
1431602	63	10/10/2019	10/29/2019		0.00		0.00		100,000.00		0.00		100,000.00
1434747	61	11/04/2019	11/08/2019	01/03/2020	175,000.00		278.09		0.00		0.00		175,278.09
1436315	43	11/03/2019	11/15/2019	12/18/2019	235,000.00		289.73		0.00		0.00		235,289.73
1439795	70	11/27/2019	12/10/2019	01/07/2020	50,000.00		56.16		0.00		0.00		50,056.16
1442037	67	11/29/2019	12/16/2019	12/20/2019	5,000.00		2.88		0.00		0.00		5,002.88
1446333	63	12/07/2019	01/07/2020		0.00		0.00		70,000.00		0.00		70,000.00
1448811	69	12/18/2019	01/29/2020		0.00		0.00		115,000.00		0.00		115,000.00
1449005	55	12/27/2019	01/29/2020		0.00		0.00		195,000.00		0.00		195,000.00
43		Total Claims	$			5,275,000.00	$	6,564.37	$	565,000.00	$	400,000.00	$	5,446,564.37

Spouse Voluntary Term Life Insurance Claims Experience Policy Number: 34175 For the Period January 1, 2019 through December 31, 2019 Death Claims

	Claim Number		Age at
Death		Date of
Death				Date Notice
Received					Date
Paid						Insurance
Amount Paid						Interest
Paid					Current
Reserve				Prior
Reserve					Incurred

Claims

1374920	61	01/11/2019	01/14/2019	02/06/2019	$ 15,000.00	$ 10.68	$ 0.00	$ 0.00	$ 15,010.68
1376208	60	01/01/2019	01/18/2019	03/01/2019	25,000.00	18.49	0.00	0.00	25,018.49
1378039	59	11/23/2018	01/29/2019	03/01/2019	30,000.00	61.64	0.00	0.00	30,061.64
1379181	37	01/18/2019	02/01/2019	02/11/2019	25,000.00	16.44	0.00	0.00	25,016.44
1379863	64	01/23/2019	02/22/2019	02/26/2019	25,000.00	23.29	0.00	0.00	25,023.29
1382607	75	02/09/2019	02/26/2019	02/28/2019	15,000.00	7.81	0.00	0.00	15,007.81
1382951	62	02/12/2019	02/19/2019	05/29/2019	15,000.00	37.60	0.00	0.00	15,037.60
1388902	68	03/15/2019	03/19/2019	04/09/2019	15,000.00	10.27	0.00	0.00	15,010.27
1391691	68	03/07/2019	04/03/2019	04/17/2019	15,000.00	16.85	0.00	0.00	15,016.85
1392813	65	03/17/2019	04/08/2019	04/10/2019	15,000.00	9.86	0.00	0.00	15,009.86
1393818	37	04/08/2019	04/09/2019	05/09/2019	20,000.00	16.99	0.00	0.00	20,016.99
1394341	79	03/29/2019	04/11/2019	04/16/2019	15,000.00	7.40	0.00	0.00	15,007.40
1395276	64	03/19/2019	04/17/2019	04/22/2019	30,000.00	27.95	0.00	0.00	30,027.95
1395381	50	04/13/2019	04/22/2019	05/08/2019	30,000.00	20.55	0.00	0.00	30,020.55
1395430	68	04/15/2019	04/23/2019	05/01/2019	15,000.00	6.58	0.00	0.00	15,006.58
1403231	54	05/10/2019	05/30/2019	06/04/2019	30,000.00	20.55	0.00	0.00	30,020.55
1406775	77	06/09/2019	06/14/2019	07/25/2019	15,000.00	18.90	0.00	0.00	15,018.90
1408323	53	05/31/2019	06/21/2019	06/26/2019	30,000.00	21.37	0.00	0.00	30,021.37
1410360	72	06/16/2019	07/03/2019	08/30/2019	15,000.00	30.82	0.00	0.00	15,030.82
1414289	71	07/22/2019	07/24/2019	08/02/2019	15,000.00	4.52	0.00	0.00	15,004.52
1414409	61	07/24/2019	07/25/2019	08/14/2019	30,000.00	17.26	0.00	0.00	30,017.26
1420246	55	08/17/2019	08/27/2019	08/29/2019	30,000.00	9.86	0.00	0.00	30,009.86
1420761	56	08/05/2019	08/28/2019	09/03/2019	10,000.00	7.95	0.00	0.00	10,007.95
1420846	73	08/25/2019	08/27/2019	09/16/2019	30,000.00	18.08	0.00	0.00	30,018.08
1421194	61	07/26/2019	09/03/2019	09/03/2019	15,000.00	16.03	0.00	0.00	15,016.03
1421351	77	06/12/2019	08/28/2019	09/26/2019	15,000.00	43.56	0.00	0.00	15,043.56
1424821	67	09/13/2019	09/23/2019	10/01/2019	15,000.00	7.40	0.00	0.00	15,007.40
1431036	79	10/16/2019	10/22/2019	11/07/2019	15,000.00	9.04	0.00	0.00	15,009.04
1439654	52	11/29/2019	12/09/2019	12/17/2019	20,000.00	9.86	0.00	0.00	20,009.86
1443444	55	12/07/2019	12/20/2019	01/09/2020	30,000.00	27.12	0.00	0.00	30,127.12
1443847	56	12/24/2019	12/26/2019	01/06/2020	30,000.00	10.68	0.00	0.00	30,010.68
	31	Total Claims			650,000.00	565.40	0.00	0.00	650,565.40

Employee Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2019 through December 31, 2019 Death Claims

	Claim Number		Age at
Death		Date of
Death				Date Notice
Received					Date
Paid						Insurance
Amount Paid							Interest
Paid					Current
Reserve					Prior
Reserve					Incurred

Claims

	1331350	62	05/24/2018	05/31/2018	06/13/2019	$ 20,000.00	$ 1,265.75	$ 0.00	$ 20,000.00	$ 1,265.75
	1373215	53	01/02/2019	01/07/2019	01/22/2019	250,000.00	136.99	0.00	0.00	250,136.99
	1373468	62	12/18/2018	01/07/2019	10/16/2019	(160,000.00)	(188.50)	0.00	40,000.00	(200,188.50)
	1377008	63	01/22/2019	01/23/2019	02/07/2019	60,000.00	26.30	0.00	0.00	60,026.30
	1379868	59	02/04/2019	02/22/2019	03/05/2019	50,000.00	39.73	0.00	0.00	50,039.73
	1380950	67	02/06/2019	02/11/2019	03/20/2019	50,000.00	57.53	0.00	0.00	50,057.53
	1383042	61	01/26/2019	02/20/2019	03/19/2019	100,000.00	142.47	0.00	0.00	100,142.47
	1385243	67	01/08/2019	03/01/2019	03/19/2019	5,000.00	9.59	0.00	0.00	5,009.59
	1393709	69	04/06/2019	04/13/2019	05/20/2019	30,000.00	34.93	0.00	0.00	30,034.93
	1396502	65	04/20/2019	04/23/2019	05/15/2019	110,000.00	75.34	0.00	0.00	110,075.34
	1400603	65	05/11/2019	05/21/2019	06/19/2019	25,000.00	26.71	0.00	0.00	25,026.71
	1408089	62	06/20/2019	06/20/2019	07/02/2019	65,000.00	21.37	0.00	0.00	65,021.37
	1408300	60	06/09/2019	06/21/2019	07/26/2019	35,000.00	45.06	0.00	0.00	35,045.06
	1408412	67	06/20/2019	06/21/2019	07/12/2019	120,000.00	72.33	0.00	0.00	120,072.33
	1415013	69	07/26/2019	08/02/2019	09/06/2019	50,000.00	57.53	0.00	0.00	50,057.53
	1427707	65	09/15/2019	10/01/2019	10/16/2019	95,000.00	80.68	0.00	0.00	95,080.68
	1430236	66	10/15/2019	10/15/2019	11/11/2019	20,000.00	14.79	0.00	0.00	20,014.79
	1431191	64	10/14/2019	10/25/2019	11/05/2019	27,500.00	16.58	0.00	0.00	27,516.58
	1432707	49	10/10/2019	11/06/2019	12/02/2019	80,000.00	116.16	0.00	0.00	80,116.16
	1434864	65	11/03/2019	11/13/2019	11/25/2019	67,500.00	40.68	0.00	0.00	67,540.68
	1435307	63	11/06/2019	11/13/2019	11/27/2019	70,000.00	40.27	0.00	0.00	70,040.27
	1435734	67	11/11/2019	11/13/2019	12/10/2019	30,000.00	23.84	0.00	0.00	30,023.84
	1436031	69	11/14/2019	11/14/2019	12/05/2019	10,000.00	5.75	0.00	0.00	10,005.75
	1439428	63	11/24/2019	12/10/2019	12/20/2019	250,000.00	178.08	0.00	0.00	250,178.08
	1440039	67	11/29/2019	12/05/2019	12/26/2019	75,000.00	55.48	0.00	0.00	75,055.48
	1440737	67	10/15/2019	12/09/2019	01/17/2020	12,000.00	30.90	48,000.00	0.00	60,030.90
	1440988	65	12/09/2019	12/10/2019		0.00	0.00	30,000.00	0.00	30,000.00
	1441577	62	11/22/2019	11/26/2019	12/18/2019	40,000.00	28.49	0.00	0.00	40,028.49
	1443485	61	12/20/2019	12/23/2019	01/16/2020	100,000.00	73.97	0.00	0.00	100,073.97
	1443848	69	12/25/2019	12/26/2019	01/20/2020	40,000.00	28.49	0.00	0.00	40,028.49
Employee Voluntary Ported Claims Experience Policy Number: 34175

For the Period January 1, 2019 through December 31, 2019 Death Claims

	Claim Number		Age at
Death		Date of
Death				Date Notice
Received				Date
Paid					Insurance
Amount Paid						Interest
Paid				Current
Reserve				Prior
Reserve				Incurred

Claims

	1444358	68	12/01/2019	12/30/2019		$ 0.00		$ 0.00		$ 20,000.00		$ 0.00		$ 20,000.00
	D098454	59	01/22/2019	01/22/2019	02/20/2019	185,000.00		0.00		0.00		0.00		185,000.00 (A)
	32		Total Claims	$			1,912,000.00	$	2,557.29	$	98,000.00	$	60,000.00	$	1,952,557.29
(A) Accelerated Claim

Spouse Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2019 through December 31, 2019 Death Claims

	Claim Number				Age at
Death			Date of
Death			Date Notice
Received						Date
Paid						Insurance
Amount Paid					Interest
Paid				Current
Reserve					Prior
Reserve		Incurred

Claims

1379068	67	01/24/2019	02/01/2019	02/15/2019	$ 12,500.00	$ 7.53	$ 0.00	$ 0.00	$ 12,507.53
1380056	64	01/27/2019	02/19/2019	03/01/2019	10,000.00	9.04	0.00	0.00	10,009.04
1382572	58	02/17/2019	02/21/2019	03/11/2019	15,000.00	9.04	0.00	0.00	15,009.04
1382761	61	02/09/2019	02/19/2019	03/14/2019	25,000.00	22.60	0.00	0.00	25,022.60
1412348	66	07/11/2019	07/15/2019	07/29/2019	15,000.00	7.40	0.00	0.00	15,007.40
1416130	69	07/27/2019	08/02/2019	08/16/2019	25,000.00	13.70	0.00	0.00	25,013.70
1427700	64	09/16/2019	10/04/2019	10/21/2019	20,000.00	19.18	0.00	0.00	20,019.18
1430415	68	10/15/2019	10/17/2019	01/02/2020	10,000.00	21.64	0.00	0.00	10,021.64
	8	Total Claims			132,500.00	110.83	0.00	0.00	132,610.13

2020 Voluntary Term Life Employee Voluntary Term Life Insurance Claims Experience Policy Number: 34175 For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number		Age at
Death		Date of
Death				Date Notice
Received				Date
Paid					Insurance
Amount Paid							Interest
Paid				Current
Reserve						Prior
Reserve			Incurred

Claims

1415299	44	06/24/2019	07/30/2019	06/01/2020	$ 85,000.00	$ 0.00	$ 0.00	$ 85,000.00	$ 0.00
1431602	63	10/10/2019	10/29/2019	03/06/2020	100,000.00	405.48	0.00	100,000.00	405.48
1446333	63	12/07/2019	01/07/2020	02/27/2020	70,000.00	157.26	0.00	70,000.00	157.26
1448811	69	12/18/2019	01/29/2020	02/20/2020	115,000.00	201.64	0.00	115,000.00	201.64
1448814	62	01/03/2020	01/22/2020	02/04/2020	400,000.00	328.76	0.00	0.00	400,328.76
1449005	55	12/27/2019	01/29/2020	03/18/2020	195,000.00	438.08	0.00	195,000.00	438.08
1454495	60	02/10/2020	02/18/2020	02/25/2020	150,000.00	61.64	0.00	0.00	150,061.64
1455595	63	02/19/2020	02/21/2020	03/10/2020	20,000.00	10.96	0.00	0.00	20,010.96
1458080	71	03/02/2020	03/04/2020	08/27/2020	150,000.00	731.51	0.00	0.00	150,731.51
1459430	69	02/07/2020	03/11/2020	05/29/2020	20,000.00	42.19	0.00	0.00	20,042.19
1463007	73	03/28/2020	03/31/2020	06/11/2020	300,000.00	240.41	0.00	0.00	300,240.41
1465283	72	03/19/2020	04/20/2020	05/12/2020	25,000.00	36.99	0.00	0.00	25,036.99
1466892	65	04/15/2020	04/20/2020	05/12/2020	5,000.00	3.70	0.00	0.00	5,003.70
1467477	59	04/13/2020	04/24/2020	05/21/2020	95,000.00	578.06	0.00	0.00	95,578.06
1467586	72	03/19/2020	04/27/2020	05/12/2020	90,000.00	133.15	0.00	0.00	90,133.15
1468012	60	04/10/2020	04/22/2020	04/29/2020	200,000.00	104.11	0.00	0.00	200,104.11
1470613	55	03/19/2020	05/05/2020		0.00	0.00	65,000.00	0.00	65,000.00
1471154	64	04/27/2020	05/11/2020	05/13/2020	75,000.00	32.88	0.00	0.00	75,032.88
1476522	54	06/02/2020	06/10/2020	10/16/2020	200,000.00	745.21	0.00	0.00	200,745.21
1477671	38	05/11/2020	06/17/2020	06/29/2020	80,000.00	107.40	0.00	0.00	80,107.40
1479934	63	06/16/2020	06/30/2020	07/16/2020	55,000.00	45.21	0.00	0.00	55,045.21
1481827	40	06/07/2020	07/01/2020	07/23/2020	60,000.00	75.62	0.00	0.00	60,075.62
1481928	64	06/12/2020	07/01/2020	07/07/2020	75,000.00	51.37	0.00	0.00	75,051.37
1488753	59	07/08/2020	08/24/2020	09/04/2020	185,000.00	293.97	0.00	0.00	185,293.97
1488838	58	07/31/2020	08/05/2020	08/19/2020	50,000.00	26.03	0.00	0.00	50,026.03
1489411	63	07/27/2020	08/14/2020	09/21/2020	60,000.00	92.06	0.00	0.00	60,092.06
1490562	60	07/28/2020	08/12/2020	08/19/2020	255,000.00	153.70	0.00	0.00	255,153.70
1493930	55	08/24/2020	08/28/2020	12/22/2020	20,000.00	65.75	0.00	0.00	20,065.75
1494301	67	08/25/2020	08/31/2020	09/09/2020	60,000.00	24.66	0.00	0.00	60,024.66
1494696	48	08/17/2020	09/01/2020	01/12/2021	5,000.00	20.27	0.00	0.00	5,020.27
1495653	54	08/08/2020	09/08/2020		0.00	0.00	335,000.00	0.00	335,000.00
Employee Voluntary Term Life Insurance Claims Experience Policy Number: 34175

For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number		Age at
Death		Date of
Death					Date Notice
Received					Date
Paid						Insurance
Amount Paid								Interest
Paid					Current
Reserve							Prior
Reserve				Incurred

Claims

1497216 49		08/05/2020	09/15/2020	09/22/2020	$ 320,000.00	$ 420.82	$ 0.00	$ 0.00	$ 320,420.82
1497505 49		09/11/2020	09/23/2020	10/02/2020	110,000.00	63.28	0.00	0.00	110,063.28
1498071 63		08/15/2020	09/25/2020	10/12/2020	50,000.00	71.77	0.00	0.00	50,071.77
1498624 62		09/15/2020	09/28/2020	10/01/2020	90,000.00	39.45	0.00	0.00	90,039.45
1499800 53		09/13/2020	10/02/2020	10/05/2020	100,000.00	60.27	0.00	0.00	100,060.27
1503214 65		10/01/2020	10/13/2020	10/27/2020	125,000.00	89.04	0.00	0.00	125,089.04
1504484 47		10/16/2020	10/18/2020	11/03/2020	130,000.00	64.11	0.00	0.00	130,064.11
1504580 61		08/17/2020	10/19/2020	12/21/2020	170,000.00	586.85	0.00	0.00	170,586.85
1506303 49		10/14/2020	10/27/2020	11/30/2020	265,000.00	341.23	0.00	0.00	265,341.23
1508475 70		10/04/2020	11/05/2020	11/11/2020	180,000.00	187.40	0.00	0.00	180,187.40
1509868 45		10/16/2020	11/12/2020	12/04/2020	130,000.00	174.52	65,000.00	0.00	195,174.52
1512165 60		11/17/2020	11/24/2020	12/15/2020	115,000.00	55.98	0.00	0.00	115,055.98
1512941 64		11/07/2020	11/25/2020	12/22/2020	135,000.00	166.44	0.00	0.00	135,166.44
1515608 50		12/06/2020	12/08/2020	01/22/2021	30,000.00	23.84	0.00	0.00	30,023.84
1517230 52		12/11/2020	12/15/2020		0.00	0.00	105,000.00	0.00	105,000.00
1517302 61		12/04/2020	12/16/2020	12/17/2020	20,000.00	7.12	0.00	0.00	20,007.12
1523425 57		12/16/2020	01/09/2021	01/21/2021	140,000.00	138.08	0.00	0.00	140,138.08
1524430 68		12/04/2020	01/13/2021	01/22/2021	120,000.00	161.10	0.00	0.00	120,161.10
1524438 58		12/30/2020	01/13/2021		0.00	0.00	145,000.00	0.00	145,000.00
D109325 55		06/05/2020	06/05/2020	07/01/2020	205,000.00	0.00	0.00	0.00	205,000.00	(A)
	51	Total Claims			$ 5,635,000.00	$ 7,859.37	$ 715,000.00	$ 565,000.00	$ 5,792,859.37
(A) Accelerated Death Benefit

Spouse Voluntary Term Life Insurance Claims Experience Policy Number: 34175 For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number	Age at
Death		Date of
Death				Date Notice
Received			Date
Paid						Insurance
Amount Paid					Interest
Paid				Current
Reserve			Prior
Reserve		Incurred

Claims

1448259	64	01/19/2020	01/20/2020	02/28/2020	$ 15,000.00	$ 16.44	$ 0.00	$ 0.00	$ 15,016.44
1456678	57	02/15/2020	02/26/2020	03/03/2020	20,000.00	9.32	0.00	0.00	20,009.32
1457383	55	02/09/2020	03/05/2020	03/05/2020	30,000.00	20.55	0.00	0.00	30,020.55
1459031	61	03/05/2020	03/10/2020	04/07/2020	30,000.00	27.12	0.00	0.00	30,027.12
1460488	56	03/11/2020	03/23/2020	03/26/2020	30,000.00	12.33	0.00	0.00	30,012.33
1461257	61	02/08/2020	03/26/2020	03/26/2020	15,000.00	19.32	0.00	0.00	15,019.32
1461327	67	03/05/2020	03/30/2020	04/14/2020	5,000.00	5.48	0.00	0.00	5,005.48
1464602	61	02/11/2020	04/07/2020		0.00	0.00	30,000.00	0.00	30,000.00
1468081	67	02/20/2020	04/24/2020	04/28/2020	25,000.00	46.58	0.00	0.00	25,046.58
1468723	69	04/24/2020	05/06/2020	05/19/2020	15,000.00	10.27	0.00	0.00	15,010.27
1472260	73	04/26/2020	05/20/2020	06/19/2020	15,000.00	22.19	0.00	0.00	15,022.19
1472438	66	05/12/2020	05/14/2020	05/19/2020	30,000.00	5.75	0.00	0.00	30,005.75
1472478	63	04/15/2020	05/19/2020	05/20/2020	15,000.00	14.38	0.00	0.00	15,014.38
1480124	81	06/15/2020	06/22/2020	07/28/2020	15,000.00	17.67	0.00	0.00	15,017.67
1480951	59	05/01/2020	07/06/2020	07/06/2020	30,000.00	54.25	0.00	0.00	30,054.25
1482721	59	06/18/2020	07/16/2020	09/21/2020	30,000.00	78.08	0.00	0.00	30,078.08
1483835	50	06/01/2020	07/09/2020	07/16/2020	30,000.00	36.99	0.00	0.00	30,036.99
1484208	57	07/08/2020	07/14/2020	07/24/2020	15,000.00	6.58	0.00	0.00	15,006.58
1488926	58	08/04/2020	08/05/2020	08/20/2020	15,000.00	6.58	0.00	0.00	15,006.58
1490614	51	08/07/2020	08/13/2020	09/02/2020	30,000.00	21.37	0.00	0.00	30,021.37
1492214	52	08/11/2020	08/26/2020	09/09/2020	30,000.00	23.84	0.00	0.00	30,023.84
1497825	66	09/01/2020	09/17/2020	09/30/2020	15,000.00	11.92	0.00	0.00	15,011.92
1499527	63	09/24/2020	09/25/2020	10/06/2020	15,000.00	4.93	0.00	0.00	15,004.93
1502389	65	10/07/2020	10/09/2020	11/11/2020	25,000.00	23.97	0.00	0.00	25,023.97
1504916	70	10/11/2020	10/22/2020	11/05/2020	15,000.00	10.27	0.00	0.00	15,010.27
1505598	52	07/22/2020	10/30/2020	11/02/2020	10,000.00	28.22	0.00	0.00	10,028.22
1508950	50	11/07/2020	11/09/2020	12/23/2020	30,000.00	21.37	0.00	0.00	30,021.37
1509291	56	10/27/2020	11/10/2020	11/19/2020	30,000.00	18.90	0.00	0.00	30,018.90
1509330	87	09/15/2020	11/10/2020	12/29/2020	15,000.00	43.15	0.00	0.00	15,043.15
Spouse Voluntary Term Life Insurance Claims Experience Policy Number: 34175

For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number		Age at
Death			Date of
Death					Date Notice
Received				Date
Paid							Insurance
Amount Paid						Interest
Paid					Current
Reserve				Prior
Reserve		Incurred

Claims

1511178	67	11/16/2020	11/18/2020	12/21/2020	$ 15,000.00		$ 14.38		$ 0.00		$ 0.00		$ 15,014.38
1511272	49	08/31/2020	11/18/2020	12/21/2020	20,000.00		61.37		0.00		0.00		20,061.37
1512270	65	11/01/2020	11/23/2020	12/02/2020	15,000.00		12.74		0.00		0.00		15,012.74
1512308	70	11/04/2020	11/27/2020	12/28/2020	10,000.00		14.79		0.00		0.00		10,014.79
1516977	77	10/27/2020	12/14/2020	12/22/2020	15,000.00		23.01		0.00		0.00		15,023.01
1520264	53	11/28/2020	12/28/2020	01/05/2021	20,000.00		20.82		0.00		0.00		20,020.82
1524856	46	01/13/2020	01/20/2021		0.00		0.00		30,000.00		0.00		30,000.00
36		Total Claims	$			690,000.00	$	764.93	$	60,000.00	$	0.00	$	750,764.93

Voluntary Child Term Life Rider Claims Experience Policy Number: 34175 For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number		Age at
Death			Date of
Death					Date Notice
Received				Date
Paid							Insurance
Amount Paid						Interest
Paid					Current
Reserve				Prior
Reserve		Incurred

Claims

1470176	13	04/28/2020	05/05/2020	05/07/2020	$ 10,000.00		$ 2.47		$ 0.00		$ 0.00		$ 10,002.47
1497773	21	09/14/2020	09/17/2020	09/28/2020	10,000.00		3.84		0.00		0.00		10,003.84
1514349	21	11/12/2020	12/04/2020	12/23/2020	10,000.00		11.23		0.00		0.00		10,011.23
3		Total Claims	$			30,000.00	$	17.54	$	0.00	$	0.00	$	30,017.54

Employee Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number	Age at
Death		Date of
Death				Date Notice
Received			Date
Paid				Insurance
Amount Paid					Interest
Paid				Current
Reserve				Prior
Reserve		Incurred

Claims

1440737	67	10/15/2019	12/09/2019	01/06/2021	$ 48,000.00	$ 357.91	$ 0.00	$ 48,000.00	$ 357.91
1440988	65	12/09/2019	12/10/2019	02/05/2020	30,000.00	119.18	0.00	30,000.00	119.18
1444358	68	12/01/2019	12/30/2019	02/04/2020	20,000.00	35.62	0.00	20,000.00	35.62
1446310	67	01/03/2020	01/07/2020	01/27/2020	90,000.00	59.18	0.00	0.00	90,059.18
1446983	58	01/10/2020	01/13/2020	01/28/2020	45,000.00	133.15	0.00	0.00	45,133.15
1461118	60	02/29/2020	03/20/2020	05/12/2020	200,000.00	400.00	0.00	0.00	200,400.00
1462257	69	03/21/2020	03/27/2020	04/14/2020	45,000.00	29.59	0.00	0.00	45,029.59
1464030	58	03/07/2020	04/08/2020	04/28/2020	75,000.00	106.85	0.00	0.00	75,106.85
1466458	66	04/14/2020	04/15/2020	05/12/2020	150,000.00	115.07	0.00	0.00	150,115.07
1470711	69	04/30/2020	05/06/2020	05/29/2020	85,000.00	67.53	0.00	0.00	85,067.53
1473489	62	05/15/2020	05/26/2020	07/10/2020	50,000.00	76.71	0.00	0.00	50,076.71
1476205	66	05/29/2020	06/02/2020	06/23/2020	35,000.00	21.58	0.00	0.00	35,021.58
1476439	62	04/02/2020	06/04/2020	06/19/2020	90,000.00	192.33	0.00	0.00	90,192.33
1482820	64	07/04/2020	07/15/2020	09/04/2020	20,000.00	33.98	0.00	0.00	20,033.98
1485662	58	07/09/2020	07/20/2020	08/20/2020	75,000.00	86.30	0.00	0.00	75,086.30
1486570	69	07/09/2020	07/29/2020	08/13/2020	75,000.00	71.92	0.00	0.00	75,071.92
1490871	63	08/13/2020	08/13/2020	09/09/2020	15,000.00	11.10	0.00	0.00	15,011.10
1492074	69	08/19/2020	08/20/2020	09/03/2020	50,000.00	20.55	0.00	0.00	50,020.55
1493924	63	08/25/2020	08/28/2020	09/08/2020	45,000.00	17.26	0.00	0.00	45,017.26
1496806	69	09/13/2020	09/14/2020	09/29/2020	40,000.00	17.53	0.00	0.00	40,017.53
1500135	62	09/21/2020	09/28/2020	11/06/2020	50,000.00	63.01	0.00	0.00	50,063.01
1500595	63	09/29/2020	09/29/2020	10/29/2020	125,000.00	102.74	0.00	0.00	125,102.74
1501514	59	10/03/2020	10/06/2020	11/05/2020	55,000.00	49.72	0.00	0.00	55,049.72
1502296	67	09/09/2020	10/15/2020	10/27/2020	35,000.00	46.03	0.00	0.00	35,046.03
1503034	63	10/09/2020	10/13/2020	10/30/2020	100,000.00	57.53	0.00	0.00	100,057.53
1505868	69	10/11/2020	10/27/2020	11/09/2020	65,000.00	51.64	0.00	0.00	65,051.64
1507974	62	10/30/2020	11/11/2020	12/04/2020	32,500.00	31.16	0.00	0.00	32,531.16
1510051	59	11/11/2020	11/18/2020	12/01/2020	100,000.00	54.79	0.00	0.00	100,054.79
1511993	64	11/19/2020	11/30/2020	01/04/2021	50,000.00	63.01	0.00	0.00	50,063.01
1518182	65	12/09/2020	12/17/2020	01/19/2021	105,000.00	117.95	0.00	0.00	105,117.95
Employee Voluntary Ported Claims Experience Policy Number: 34175

For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number	Age at
Death		Date of
Death				Date Notice
Received			Date
Paid				Insurance
Amount Paid					Interest
Paid				Current
Reserve				Prior
Reserve		Incurred

Claims

1520184	62	11/20/2020	12/28/2020	01/07/2021	$ 30,000.00		$ 39.45		$ 0.00		$ 0.00		$ 30,039.45
1521003	66	12/17/2020	01/07/2021	01/21/2021	40,000.00		38.36		0.00		0.00		40,038.36
1523219	59	12/03/2020	01/08/2021		0.00		0.00		170,000.00		0.00		170,000.00
1523229	64	07/07/2020	01/11/2021		0.00		0.00		60,000.00		0.00		60,000.00
34		Total Claims	$			2,070,500.00	$	2,688.73	$	230,000.00	$	98,000.00	$	2,205,188.73

Spouse Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2020 through December 31, 2020 Death Claims

	Claim Number		Age at
Death			Date of
Death					Date Notice
Received				Date
Paid						Insurance
Amount Paid							Interest
Paid					Current
Reserve				Prior
Reserve		Incurred

Claims

1469402	59		04/15/2020	05/04/2020	06/05/2020	$ 25,000.00	$ 34.93	$ 0.00	$ 0.00	$ 25,034.93
1485684	57		06/26/2020	07/21/2020	08/07/2020	30,000.00	34.52	0.00	0.00	30,034.52
1492270	69		08/17/2020	08/25/2020	09/14/2020	15,000.00	11.51	0.00	0.00	15,011.51
1509488	70		11/05/2020	11/10/2020	12/04/2020	15,000.00	11.92	0.00	0.00	15,011.92
1512107	69		11/18/2020	11/24/2020	01/11/2021	20,000.00	26.02	0.00	0.00	20,026.02
1513112	58		11/26/2020	11/30/2020	12/23/2020	7,500.00	5.55	0.00	0.00	7,505.55
1517817	67		12/01/2020	12/16/2020		0.00	0.00	15,000.00	0.00	15,000.00
D111165	65		09/11/2020	09/11/2020	11/19/2020	30,000.00	0.00	0.00	0.00	30,000.00 (A)
		8	Total Claims			$ 142,500.00	$ 124.45	$ 15,000.00	$ 0.00	$ 157,624.45
(A) Accelerated Claim

2021 Voluntary Term Life Employee Voluntary Term Life Insurance Claims Experience Policy Number: 34175 For the Period January 1, 2021 through December 31, 2021 Estimate

	Death Claims
	Claim Number		Age at
Death		Date of
Death					Date Notice
Received							Date
Paid							Insurance
Amount Paid							Interest
Paid				Current
Reserve							Prior
Reserve						Incurred

Claims

1470613	55	03/19/2020	05/05/2020	04/22/2021	$	65,000.00	$	710.88	$	0.00	$	65,000.00	$	710.88
1495653	54	08/08/2020	09/08/2020			0.00		0.00		335,000.00		335,000.00		0.00
1509868	45	10/16/2020	11/12/2020	07/09/2021		65,000.00		473.70		0.00		65,000.00		473.70
1517230	52	12/11/2020	12/15/2020	07/07/2021		105,000.00		598.36		0.00		105,000.00		598.36
1524434	76	01/01/2021	01/13/2021	03/15/2021		120,000.00		240.00		0.00		0.00		120,240.00
1524438	58	12/30/2020	01/13/2021	03/02/2021		145,000.00		246.30		0.00		145,000.00		246.30
1526451	63	12/31/2020	02/03/2021	04/21/2021		20,000.00		60.82		0.00		0.00		20,060.82
1526660	67	01/03/2021	01/22/2021	01/27/2021		120,000.00		78.90		0.00		0.00		120,078.90
1529371	39	01/09/2021	03/03/2021	03/04/2021		30,000.00		44.38		0.00		0.00		30,044.38
1530296	59	01/19/2021	02/03/2021	03/22/2021		170,000.00		204.01		0.00		0.00		170,204.01
1530473	47	01/03/2021	02/03/2021	03/15/2021		130,000.00		252.88		0.00		0.00		130,252.88
1530696	54	12/30/2020	02/05/2021	03/02/2021		225,000.00		382.19		0.00		0.00		225,382.19
1532055	57	12/22/2020	02/10/2021	10/14/2021		5,000.00		40.55		0.00		0.00		5,040.55
1532964	59	01/14/2021	02/18/2021	03/04/2021		100,000.00		134.25		0.00		0.00		100,134.25
1533053	70	02/11/2021	02/15/2021	03/02/2021		60,000.00		31.24		0.00		0.00		60,031.24
1535077	59	10/25/2020	02/23/2021	05/10/2021		40,000.00		215.89		0.00		0.00		40,215.89
1535639	68	02/11/2021	02/26/2021	03/01/2021		60,000.00		29.59		0.00		0.00		60,029.59
1537195	64	02/14/2021	03/02/2021	03/15/2021		245,000.00		194.66		0.00		0.00		245,194.66
1538561	53	02/15/2021	03/08/2021	03/16/2021		500,000.00		397.26		0.00		0.00		500,397.26
1541593	63	02/23/2021	03/26/2021	03/31/2021		105,000.00		103.56		0.00		0.00		105,103.56
1545979	55	03/24/2021	04/06/2021	04/26/2021		30,000.00		27.12		0.00		0.00		30,027.12
1546576	54	04/04/2021	04/09/2021	04/23/2021		50,000.00		26.03		0.00		0.00		50,026.03
1547750	59	04/03/2021	04/13/2021	04/22/2021		150,000.00		78.08		0.00		0.00		150,078.08
1549812	61	04/20/2021	04/22/2021	05/18/2021		50,000.00		38.36		0.00		0.00		50,038.36
1553044	59	05/04/2021	05/10/2021	05/26/2021		35,000.00		21.10		0.00		0.00		35,021.10
1555005	55	05/15/2021	05/18/2021	06/11/2021		60,000.00		44.38		0.00		0.00		60,044.38
1557092	25	05/06/2021	06/07/2021	06/08/2021		5,000.00		4.52		0.00		0.00		5,004.52
1560252	66	06/02/2021	06/23/2021	06/24/2021		460,000.00		277.26		0.00		0.00		460,277.26
1560446	54	06/13/2021	06/15/2021	08/23/2021		234,000.00		455.18		0.00		0.00		234,455.18
1564459	60	06/26/2021	07/02/2021	08/02/2021	$ 250,000.00		$ 253.42		$ 0.00		$ 0.00		$ 250,253.42
1566546	50	01/29/2021	07/15/2021	09/22/2021	110,000.00		711.23		0.00		0.00		110,711.23
1573001	68	08/08/2021	08/18/2021	09/02/2021	155,000.00		106.16		0.00		0.00		155,106.16
1580274	59	09/19/2021	09/21/2021	10/14/2021	200,000.00		136.98		0.00		0.00		200,136.98
1580644	66	09/03/2021	09/29/2021	09/29/2021	65,000.00		46.30		0.00		0.00		65,046.30
1581314	63	09/13/2021	10/04/2021	10/27/2021	30,000.00		36.16		0.00		0.00		30,036.16
1582793	51	09/30/2021	10/01/2021	10/22/2021	230,000.00		138.63		0.00		0.00		230,138.63
1584001	64	10/04/2021	10/13/2021	11/04/2021	10,000.00		8.50		0.00		0.00		10,008.50
1585528	65	10/06/2021	10/21/2021	11/02/2021	20,000.00		14.79		0.00		0.00		20,014.79
1585971	62	10/05/2021	10/22/2021	11/01/2021	60,000.00		44.38		0.00		0.00		60,044.38
1586784	56	08/17/2021	10/20/2021	12/06/2021	125,000.00		380.14		0.00		0.00		125,380.14
1587477	28	09/23/2021	10/22/2021	11/02/2021	100,000.00		109.59		0.00		0.00		100,109.59
1589815	58	10/20/2021	11/02/2021	11/23/2021	200,000.00		186.30		0.00		0.00		200,186.30
1591001	62	11/07/2021	11/08/2021	12/17/2021	20,000.00		21.92		0.00		0.00		20,021.92
1591401	60	11/01/2021	11/10/2021		0.00		0.00		60,000.00		0.00		60,000.00
1592387	56	05/22/2021	11/22/2021		0.00		0.00		65,000.00		0.00		65,000.00
1593212	61	11/14/2021	11/17/2021		0.00		0.00		345,000.00		0.00		345,000.00
1595108	75	11/16/2021	12/06/2021	12/09/2021	100,000.00		63.01		0.00		0.00		100,063.01
1598226	68	10/25/2021	12/10/2021		0.00		0.00		25,000.00		0.00		25,000.00
1600946	57	12/17/2021	12/27/2021		0.00		0.00		105,000.00		0.00		105,000.00
1601278	70	12/08/2021	12/28/2021		0.00		0.00		200,000.00		0.00		200,000.00
D115821	44	04/12/2021	04/12/2021	08/05/2021	130,000.00		0.00		0.00		0.00		130,000.00		(A)
D116883	53	05/13/2021	05/27/2021	07/27/2021	20,000.00		0.00		0.00		0.00		20,000.00		(A)
					$ 5,209,000.00		$ 7,668.96		$ 1,135,000.00		$ 715,000.00		$ 5,636,668.96
											IBNR		$ 572,331
	52	Total Claims											$ 6,208,999.96
(A) Accelerated Claim

Spouse Voluntary Term Life Insurance Claims Experience Policy Number: 34175 For the Period January 1, 2021 through December 31, 2021 Estimate

	Death Claims
	Claim Number	Age at
Death			Date of
Death					Date Notice
Received				Date
Paid							Insurance
Amount Paid						Interest
Paid		Current
Reserve						Prior
Reserve			Incurred

Claims

1464602	61	02/11/2020	04/07/2020	12/30/2021	$	0.00	$	0.00	$	6,210.48	$	30,000.00	$	(23,789.52)
1524227	66	11/03/2020	04/15/2021	04/20/2021		15,000.00		69.04		0.00		0.00		15,069.04
1524616	69	01/05/2021	01/14/2021	02/08/2021		15,000.00		13.97		0.00		0.00		15,013.97
1524856	46	01/13/2020	01/20/2021	04/05/2021		30,000.00		368.64		0.00		30,000.00		368.64
1526009	64	01/16/2021	01/20/2021	02/08/2021		15,000.00		9.45		0.00		0.00		15,009.45
1529483	56	01/19/2021	02/01/2021	02/18/2021		15,000.00		12.33		0.00		0.00		15,012.33
1529589	61	01/11/2021	02/02/2021	02/09/2021		30,000.00		23.84		0.00		0.00		30,023.84
1529642	61	01/12/2021	02/02/2021	02/15/2021		30,000.00		27.95		0.00		0.00		30,027.95
1534390	66	01/28/2021	02/18/2021	03/02/2021		15,000.00		13.56		0.00		0.00		15,013.56
1536217	65	02/02/2021	02/26/2021	03/02/2021		15,000.00		11.51		0.00		0.00		15,011.51
1541265	62	03/11/2021	03/24/2021	04/01/2021		30,000.00		17.26		0.00		0.00		30,017.26
1542089	63	03/19/2021	03/19/2021			0.00		0.00		15,000.00		0.00		15,000.00
1542862	79	03/06/2021	03/23/2021	04/05/2021		10,000.00		8.22		0.00		0.00		10,008.22
1544971	53	03/14/2021	04/06/2021	04/07/2021		30,000.00		19.73		0.00		0.00		30,019.73
1547354	82	02/16/2021	04/13/2021	04/22/2021		10,000.00		17.81		0.00		0.00		10,017.81
1548811	50	03/26/2021	04/20/2021	04/23/2021		30,000.00		23.01		0.00		0.00		30,023.01
1551232	65	03/17/2021	04/29/2021	05/12/2021		25,000.00		38.36		0.00		0.00		25,038.36
1553943	57	05/07/2021	05/12/2021	07/06/2021		15,000.00		24.66		0.00		0.00		15,024.66
1555015	72	05/18/2021	05/18/2021	06/03/2021		10,000.00		4.38		0.00		0.00		10,004.38
1556191	57	05/09/2021	05/25/2021	08/10/2021		30,000.00		76.44		0.00		0.00		30,076.44
1559849	62	06/14/2021	06/14/2021	07/19/2021		15,000.00		14.38		0.00		0.00		15,014.38
1562371	70	06/21/2021	06/22/2021	07/07/2021		15,000.00		6.58		0.00		0.00		15,006.58
1565420	83	07/01/2021	07/19/2021	08/10/2021		15,000.00		16.44		0.00		0.00		15,016.44
1570507	69	07/13/2021	08/12/2021	08/12/2021		15,000.00		12.33		0.00		0.00		15,012.33
1572542	68	08/14/2021	08/16/2021	09/08/2021		30,000.00		20.55		0.00		0.00		30,020.55
1573630	72	08/19/2021	08/23/2021	09/29/2021		10,000.00		11.23		0.00		0.00		10,011.23
1582182	48	09/25/2021	10/05/2021	12/15/2021		30,000.00		66.58		0.00		0.00		30,066.58
1582532	66	09/13/2021	09/30/2021	10/08/2021		25,000.00		17.12		0.00		0.00		25,017.12
1584359	69	09/25/2021	10/08/2021	12/06/2021		15,000.00		29.59		0.00		0.00		15,029.59
1586786	35	08/17/2021	10/28/2021	12/07/2021	$	30,000.00	$	92.06	$	0.00	$	0.00	$	30,092.06
1588620	62	10/24/2021	10/26/2021	11/24/2021		30,000.00		25.48		0.00		0.00		30,025.48
1591004	48	11/06/2021	11/08/2021	11/24/2021		30,000.00		14.79		0.00		0.00		30,014.79
1593616	56	11/17/2021	11/18/2021	12/16/2021		30,000.00		23.84		0.00		0.00		30,023.84
1594049	48	09/12/2021	11/23/2021	12/13/2021		30,000.00		75.62		0.00		0.00		30,075.62
1594141	63	11/18/2021	12/01/2021	12/13/2021		20,000.00		13.70		0.00		0.00		20,013.70
1594706	59	10/16/2021	11/24/2021			0.00		0.00		30,000.00		0.00		30,000.00
1595828	55	11/29/2021	12/02/2021	12/23/2021		30,000.00		19.73		0.00		0.00		30,019.73
					$	740,000.00	$	1,240.18	$	51,210.48	$	60,000.00	$	732,450.66
												IBNR	$	46,808
	37	Total Claims											$	779,258.66

Employee Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2021 through December 31, 2021 Estimate

	Death Claims
	Claim Number		Age at
Death		Date of
Death					Date Notice
Received							Date
Paid								Insurance
Amount Paid						Interest
Paid				Current
Reserve						Prior
Reserve						Incurred

Claims

1518784	57	11/30/2020	03/04/2021	07/09/2021	$	205,000.00	$	673.13	$	0.00	$	0.00	$	205,673.13
1523219	59	12/03/2020	01/08/2021	04/01/2021		170,000.00		554.24		0.00		170,000.00		554.24
1523229	64	07/07/2020	01/11/2021	03/03/2021		60,000.00		392.88		0.00		60,000.00		392.88
1523312	69	01/08/2021	01/15/2021	03/16/2021		100,000.00		183.56		0.00		0.00		100,183.56
1539543	69	03/09/2021	03/10/2021	04/19/2021		35,000.00		13.42		0.00		0.00		35,013.42
1543642	65	03/24/2021	04/02/2021	05/24/2021		60,000.00		100.28		0.00		0.00		60,100.28
1550727	68	04/24/2021	04/27/2021	05/17/2021		225,000.00		141.78		0.00		0.00		225,141.78
1564238	63	06/07/2021	07/22/2021	09/21/2021		40,000.00		104.11		0.00		0.00		40,104.11
1566066	69	07/12/2021	07/14/2021	08/11/2021		25,000.00		18.15		0.00		0.00		25,018.15
1568063	55	07/20/2021	07/30/2021	08/13/2021		25,000.00		16.44		0.00		0.00		25,016.44
1575756	68	08/24/2021	08/31/2021	09/17/2021		130,000.00		85.48		0.00		0.00		130,085.48
1576956	59	08/08/2021	09/03/2021	10/14/2021		30,000.00		55.07		0.00		0.00		30,055.07
1578418	66	09/13/2021	09/14/2021	10/22/2021		100,000.00		106.85		0.00		0.00		100,106.85
1580936	61	09/15/2021	09/24/2021			0.00		0.00		95,000.00		0.00		95,000.00
1581864	64	09/14/2021	09/29/2021	10/28/2021		50,000.00		60.27		0.00		0.00		50,060.27
1583985	65	10/05/2021	10/07/2021	10/28/2021		100,000.00		63.01		0.00		0.00		100,063.01
1592194	67	11/10/2021	11/12/2021	12/16/2021		40,000.00		39.45		0.00		0.00		40,039.45
1600181	70	12/14/2021	12/22/2021			0.00		0.00		30,000.00		0.00		30,000.00
1601219	70	12/23/2021	12/28/2021			0.00		0.00		20,000.00		0.00		20,000.00
					$	1,395,000.00	$	2,608.12	$	145,000.00	$	230,000.00	$	1,312,608.12
												IBNR	$	99,093
	19	Total Claims											$	1,411,701.12

Spouse Voluntary Ported Claims Experience Policy Number: 34175 For the Period January 1, 2021 through December 31, 2021 Estimate

	Death Claims
		Claim Number		Age at
Death			Date of
Death						Date Notice
Received								Date
Paid								Insurance
Amount Paid								Interest
Paid					Current
Reserve							Prior
Reserve							Incurred

Claims

1517817	67	12/01/2020	12/16/2020	03/09/2021	$ 15,000.00	$ 40.27	$ 0.00	$ 15,000.00	$ 40.27
1538650	67	03/07/2021	03/12/2021	07/16/2021	5,000.00	17.95	0.00	0.00	5,017.95
1546885	66	04/05/2021	04/16/2021	04/28/2021	30,000.00	18.90	0.00	0.00	30,018.90
1557110	68	05/21/2021	06/01/2021	07/07/2021	30,000.00	38.63	0.00	0.00	30,038.63
1564685	51	07/02/2021	07/14/2021	07/22/2021	15,000.00	8.22	0.00	0.00	15,008.22
1564968	51	06/21/2021	07/07/2021	07/29/2021	25,000.00	26.03	0.00	0.00	25,026.03
1568881	68	07/18/2021	08/03/2021	08/24/2021	25,000.00	25.34	0.00	0.00	25,025.34
1571236	66	08/04/2021	08/11/2021	09/28/2021	15,000.00	22.60	0.00	0.00	15,022.60
1580114	70	09/11/2021	09/27/2021	11/03/2021	10,000.00	14.52	0.00	0.00	10,014.52
1580917	65	09/04/2021	09/24/2021	10/11/2021	15,000.00	15.21	0.00	0.00	15,015.21
1581947	62	09/23/2021	10/07/2021	11/01/2021	10,000.00	10.68	0.00	0.00	10,010.68
1582655	67	09/25/2021	10/07/2021	11/11/2021	15,000.00	19.32	0.00	0.00	15,019.32
1583689	69	09/29/2021	10/06/2021	10/19/2021	20,000.00	10.96	0.00	0.00	20,010.96
1587255	67	09/09/2021	10/21/2021	11/18/2021	15,000.00	28.77	0.00	0.00	15,028.77
1595052	66	11/21/2021	12/09/2021		0.00	0.00	15,000.00	0.00	15,000.00
1596798	63	09/17/2021	12/06/2021		0.00	0.00	15,000.00	0.00	15,000.00
1597085	51	11/28/2021	12/07/2021		0.00	0.00	15,000.00	0.00	15,000.00
D116957	65	07/01/2020	06/01/2021	07/21/2021	20,000.00	0.00	0.00	0.00	20,000.00	(A)
					$ 265,000.00	$ 297.40	$ 45,000.00	$ 15,000.00	$ 295,297.40
								IBNR	$ 10,986
	18	Total Claims							$ 306,283.40
(A) Accelerated Claim

Voluntary Child Rider…

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File details come from the government source that posted it. Updated Aug 21, 2026.