Medical Stop Loss Accrued Carrier Fee Reconciliation Report Details

Effective

Policy effective date.

Contract

Contract number.

Policyholder

Policyholder name.

Policyholder state.

Report Period

Period of time covered by the report.

Gross Premium

Gross premium amount.

Percent of premium paid as a carrier fee.

Carrier Fee Accrued

Carrier fee owed as of the reporting period. Product of Gross Premium and %.

Disbursed

Amount of carrier fees paid out.

Closed

Documentation pending.

Due

Amount of carrier fees still to be paid as of the reporting period.