N. Ito
Member M-06701 / 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-2026-0160-F01 / Initial filing | Jan 1, 2026 to May 18, 2026 | $3,000 | $0 | $3,000 | Draft |
| Total | $3,000 | $0 | $3,000 | ||
Current stop-loss position for this member in this group and policy year.
Sun Life Financial
gathering-docs
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.
$178,000 paid against $175,000 deductible.
SL-2026-0160-F01, draft amount $3,000.
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.
Paid claim lines that feed notice percentages and filing packets.
| Date | Provider | Dx | Case | Amount |
|---|---|---|---|---|
| Apr 14, 2026 | Pediatrix Medical Group | P07.25 | SL-2026-0160 | $21,360 |
| Feb 28, 2026 | Texas Children's Imaging | P07.25 | SL-2026-0160 | $28,480 |
| Feb 13, 2026 | Texas Children's Hospital — NICU | P07.25 | SL-2026-0160 | $128,160 |
System, rep, carrier, notice, and filing events in one history.
Member confirmed no other coverage; need attestation in writing per carrier requirements
Insurance discovery API flagged possible secondary coverage through spouse plan — manual verification required
Requested confirmation of spouse coverage status via member portal