L. Fernandez
Member M-12678 / 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-2026-0183-F01 / Initial filing | Jan 1, 2026 to May 25, 2026 | $51,000 | $0 | $51,000 | Draft |
| Total | $51,000 | $0 | $51,000 | ||
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.
$226,000 paid against $175,000 deductible.
SL-2026-0183-F01, draft amount $51,000.
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 |
|---|---|---|---|---|
| May 7, 2026 | Optum Specialty Pharmacy | I50.43 | SL-2026-0183 | $36,160 |
| Apr 7, 2026 | Cedars-Sinai Outpatient | I50.43 | SL-2026-0183 | $49,720 |
| Feb 21, 2026 | Cedars-Sinai — Smidt Heart Institute | I50.43 | SL-2026-0183 | $140,120 |
System, rep, carrier, notice, and filing events in one history.