AmeraStop-Loss
Member stop-loss workspace

G. Kumar

Member M-07891 / Pacific Health Network / 2026. Notices, threshold events, filing records, reimbursement, and activity stay scoped to this member within the group.

Open active filing
% of spec
117%
$204,000 paid
Spec deductible
$175,000
NICU
Filing records
1
1 open or draft
Outstanding
$0
$0 reimbursed
Printable filing summary

Submission-level view for carrier, client, or internal status questions.

SubmissionPaid periodRequestedReimbursedOutstandingStatus
Submission 1
SL-2026-0168-F01 / Initial filing
Jan 1, 2026 to May 27, 2026$29,000$0$29,000Draft
Total$29,000$0$29,000
Member summary

Current stop-loss position for this member in this group and policy year.

Group
Pacific Health Network

Sun Life Financial

Owner
Sarah Park

ready-to-file

Highest diagnosis
NICU
Case management
Not marked open

No daily notice row

Threshold timeline

One member can have one 50% notice event and multiple independent filing records after spec is crossed.

50% threshold crossed
Apr 15, 2026

Estimated from current paid claims against $175,000 specific deductible.

75% watch reached
May 1, 2026

Member entered the year-end and pre-spec monitoring lane.

Specific deductible crossed
May 15, 2026

$204,000 paid against $175,000 deductible.

Initial filing staged
May 27, 2026

SL-2026-0168-F01, draft amount $29,000.

50% notices

Daily notices are one-time carrier notices. Older rows remain here as audit history.

No 50% notice rows for this member.
Claim ledger

Paid claim lines that feed notice percentages and filing packets.

DateProviderDxCaseAmount
Apr 20, 2026Pediatrix Medical GroupP07.25SL-2026-0168$24,480
Mar 6, 2026Texas Children's ImagingP07.25SL-2026-0168$32,640
Feb 19, 2026Texas Children's Hospital — NICUP07.25SL-2026-0168$146,880