AmeraStop-Loss
Member stop-loss workspace

N. Ali

Member M-09920 / 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
111%
$195,000 paid
Spec deductible
$175,000
Spinal Surgery
Filing records
1
1 open or draft
Outstanding
$20,000
$0 reimbursed
Printable filing summary

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

SubmissionPaid periodRequestedReimbursedOutstandingStatus
Submission 1
SL-2026-0177-F01 / Initial filing
Jan 1, 2026 to May 19, 2026$20,000$0$20,000Filed, awaiting carrier
Total$20,000$0$20,000
Member summary

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

Group
Pacific Health Network

Sun Life Financial

Owner
David Nguyen

filed-pending

Highest diagnosis
Spinal Surgery
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 7, 2026

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

75% watch reached
Apr 23, 2026

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

Specific deductible crossed
May 7, 2026

$195,000 paid against $175,000 deductible.

Initial filing submitted
May 19, 2026

SL-2026-0177-F01, filed amount $20,000.

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 22, 2026Specialty PharmacyM48.062SL-2026-0177$31,200
Mar 23, 2026HSS OutpatientM48.062SL-2026-0177$42,900
Feb 6, 2026Hospital for Special Surgery — SpineM48.062SL-2026-0177$120,900