LTD Claim Status
As of: mm/dd/yyyy
Contract: 123456 - Admin Unit: MISS - Status: ACTIVE
Member
SSN Claim Number		 Benefits
Start		 Approved
Through		 Status Reason
BOB FRANKLIN
xxx-00-1111 / 00010001		 mm/dd/yyyy    
LINDA JONES
xxx-00-2222 / 00020002		 mm/dd/yyyy    
JOHN SMITH
xxx-00-3333 / 00030003		 mm/dd/yyyy    
Contract: 123456 - Admin Unit: MISS - Status: CLOSED
Member
SSN Claim Number		 Benefits
Start		 Approved
Through		 Status Reason
HOWARD DAVIS
xxx-00-4444 / 00040004		 mm/dd/yyyy mm/dd/yyyy RETURNED TO WORK
PAT THOMPSON
xxx-00-5555 / 00050005		 mm/dd/yyyy mm/dd/yyyy END OF BENEFIT PERIOD