D. Martinez
Member M-06622 / Pacific Health Network / 2026. Notices, threshold events, filing records, reimbursement, and activity stay scoped to this member within the group.
Submission-level view for carrier, client, or internal status questions.
| Submission | Paid period | Requested | Reimbursed | Outstanding | Status |
|---|---|---|---|---|---|
| Submission 1 SL-2026-0145-F01 / Initial filing | Jan 1, 2026 to May 5, 2026 | $25,000 | $0 | $25,000 | Filed, awaiting carrier |
| Submission 2 SL-2026-0145-F02 / Supplemental filing | May 6, 2026 to May 5, 2026 | $0 | $0 | $0 | Watching |
| Total | $25,000 | $0 | $25,000 | ||
Current stop-loss position for this member in this group and policy year.
Sun Life Financial
filed-pending
No daily notice row
One member can have one 50% notice event and multiple independent filing records after spec is crossed.
Estimated from current paid claims against $175,000 specific deductible.
Member entered the year-end and pre-spec monitoring lane.
$200,000 paid against $175,000 deductible.
SL-2026-0145-F02, $0 new eligible paid against $500 threshold.
SL-2026-0145-F01, filed amount $25,000.
Daily notices are one-time carrier notices. Older rows remain here as audit history.
Each filing is separate. Subsequent filings compare new eligible paid claims against the configured filing creation threshold.
Initial filing applied the specific deductible and set the last filed cumulative paid amount for future filings.
Future treatment would open as a separate filing once new eligible paid claims meet the configured filing creation threshold.
Paid claim lines that feed notice percentages and filing packets.
| Date | Provider | Dx | Case | Amount |
|---|---|---|---|---|
| Apr 7, 2026 | Specialty Pharmacy | I50.43 | SL-2026-0145 | $32,000 |
| Mar 8, 2026 | Cleveland Clinic Outpatient | I50.43 | SL-2026-0145 | $44,000 |
| Jan 22, 2026 | Cleveland Clinic — Heart Center | I50.43 | SL-2026-0145 | $124,000 |
System, rep, carrier, notice, and filing events in one history.