Stop Loss Concepts, Inc. RFP Checklist

Stop Loss Concepts, Inc. Carrier
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MONTH CENSUS CLAIMS ATT PT REIMB

SINGLE FAMILY

Jan-01 $ 0.00 $ 0.00

Feb-01 $ 0.00 $ 0.00

Mar-01 $ 0.00 $ 0.00

Apr-01 $ 0.00 $ 0.00

May-01 $ 0.00 $ 0.00

Jul-01 $ 0.00 $ 0.00

Aug-01 $ 0.00 $ 0.00

Sep-01 $ 0.00 $ 0.00

Oct-01 $ 0.00 $ 0.00

Nov-01 $ 0.00 $ 0.00

Dec-01 $ 0.00 $ 0.00

Jun-01 $ 0.00 $ 0.00

TOTALS $ 0.00 $ 0.00 $ 0.00

REQUESTED REIMB. $ 0.00
==============
$ 0.00

ADJUSTED ATTACHMENT % #DIV/0!

MONTH	CENSUS		CLAIMS	ATT PT	REIMB
MONTH	SINGLE	FAMILY	CLAIMS	ATT PT	REIMB
Jan-01				$ 0.00	$ 0.00
Feb-01				$ 0.00	$ 0.00
Mar-01				$ 0.00	$ 0.00
Apr-01				$ 0.00	$ 0.00
May-01				$ 0.00	$ 0.00
Jul-01				$ 0.00	$ 0.00
Aug-01				$ 0.00	$ 0.00
Sep-01				$ 0.00	$ 0.00
Oct-01				$ 0.00	$ 0.00
Nov-01				$ 0.00	$ 0.00
Dec-01				$ 0.00	$ 0.00
Jun-01				$ 0.00	$ 0.00
TOTALS			$ 0.00	$ 0.00	$ 0.00

REQUESTED REIMB.			$ 0.00 ============== $ 0.00
ADJUSTED ATTACHMENT %				#DIV/0!