L Distribution Report AWS
Accounts Payable by G/L Distribution Report G/L Date Range 12/12/17 - 12/12/17
Vendor Invoice No. Invoice Description Status Held Reason Invoice Date Due Date FUND 850 - EMPLOYEE HEALTH BENEFITS DEPT OR SOURCE 698 - MEDICAL / DENTAL INSURANCE Object Code 500.2021 - Employee Benefit Payments Premium Term Life / AD&D 12412 - TEX ASSOC OF COUNTIES HEALTH 94537201712 DECEMBER 2017 Open 11/17/2017 12/12/2017 BENEFITS POOL Object Code 500.2021 - Employee Benefit Payments Premium Term Life / AD&D Totals Object Code 500.2022 - Employee Benefit Payments TAC Benefit Pool Costs 12412 - TEX ASSOC OF COUNTIES HEALTH 94537201712 DECEMBER 2017 Open 11/17/2017 12/12/2017 BENEFITS POOL Object Code 500.2022 - Employee Benefit Payments TAC Benefit Pool Costs Totals Object Code 500.2029 - Employee Benefit Payments Medical Claims / Prescriptions 10168 - CAREMARK 52009211 11/1/17-11/15/17 RX Open 11/16/2017 12/12/2017 Object Code 500.2029 - Employee Benefit Payments Medical Claims / Prescriptions Totals Object Code 500.2037 - Employee Benefit Payments Prescription Card Admin Fee 10168 - CAREMARK 52020713 11/1/17-11/30/17 RX Open 12/01/2017 12/12/2017 FEES Object Code 500.2037 - Employee Benefit Payments Prescription Card Admin Fee Totals Object Code 500.2038 - Employee Benefit Payments Cobra / Hippa Fees 12892 - WAGE WORKS 1117-DR5078 NOVEMBER 2017 Open 11/01/2017 12/12/2017 Object Code 500.2038 - Employee Benefit Payments Cobra / Hippa Fees Totals DEPT OR SOURCE 698 - MEDICAL / DENTAL INSURANCE Totals FUND 850 - EMPLOYEE HEALTH BENEFITS Totals Grand Totals
Run by Audrey McDougal on 12/06/2017 01:18:28 PM
G/L Date
Received Date Payment Date
12/12/2017 12/06/2017
Invoice Amount
1,378.64
Invoice Transactions 1 12/12/2017 12/06/2017
$1,378.64 83,795.27
Invoice Transactions 1
$83,795.27
12/12/2017 11/16/2017 Invoice Transactions 1
61,263.27 $61,263.27
12/12/2017 12/01/2017
39.88
Invoice Transactions 1 12/12/2017 12/06/2017 Invoice Transactions Invoice Transactions Invoice Transactions Invoice Transactions
1 5 5 5
$39.88 601.96 $601.96 $147,079.02 $147,079.02 $147,079.02
Page 1 of 1
TEXAS ASSOCIATION OF COUNTIES P.O. Box 2131 AUSTIN, TEXAS 78768 800-456-5974 HEALTH & EMPLOYEE BENEFITS POOL ASO BILLING CLAIMS INVOICE SUMMARY For Period 11/27/2017 Thru 11/30/2017 Bill to: GUADALUPE COUNTY - 94537 Ms. Audrey McDougal 212 W Nolte St Seguin, TX 78155-6136
Invoice #: 2019612 Invoice Date: 12/6/2017 Bank Draft Date: Pending Approval
Invoice (claims) total for 11/27/2017 - 11/30/2017: BSBC Vendor Fee Nov 2017: BCBS Vendor Credit:
Nov2017
Total:
Please email Stacey Jones at [email protected] with invoice approval.
$65,246.39 $745.46 -$8.74
$65,983.11
If you have any questions regarding this ASO billing, please contact Stacey Jones or Lisa Linenberger in the HEBP Department at (800) 456-5974.
Vendor Invoice No. Invoice Description Status Held Reason Invoice Date Due Date FUND 850 - EMPLOYEE HEALTH BENEFITS DEPT OR SOURCE 698 - MEDICAL / DENTAL INSURANCE Object Code 500.2021 - Employee Benefit Payments Premium Term Life / AD&D 12412 - TEX ASSOC OF COUNTIES HEALTH 94537201712 DECEMBER 2017 Open 11/17/2017 12/12/2017 BENEFITS POOL Object Code 500.2021 - Employee Benefit Payments Premium Term Life / AD&D Totals Object Code 500.2022 - Employee Benefit Payments TAC Benefit Pool Costs 12412 - TEX ASSOC OF COUNTIES HEALTH 94537201712 DECEMBER 2017 Open 11/17/2017 12/12/2017 BENEFITS POOL Object Code 500.2022 - Employee Benefit Payments TAC Benefit Pool Costs Totals Object Code 500.2029 - Employee Benefit Payments Medical Claims / Prescriptions 10168 - CAREMARK 52009211 11/1/17-11/15/17 RX Open 11/16/2017 12/12/2017 Object Code 500.2029 - Employee Benefit Payments Medical Claims / Prescriptions Totals Object Code 500.2037 - Employee Benefit Payments Prescription Card Admin Fee 10168 - CAREMARK 52020713 11/1/17-11/30/17 RX Open 12/01/2017 12/12/2017 FEES Object Code 500.2037 - Employee Benefit Payments Prescription Card Admin Fee Totals Object Code 500.2038 - Employee Benefit Payments Cobra / Hippa Fees 12892 - WAGE WORKS 1117-DR5078 NOVEMBER 2017 Open 11/01/2017 12/12/2017 Object Code 500.2038 - Employee Benefit Payments Cobra / Hippa Fees Totals DEPT OR SOURCE 698 - MEDICAL / DENTAL INSURANCE Totals FUND 850 - EMPLOYEE HEALTH BENEFITS Totals Grand Totals
Run by Audrey McDougal on 12/06/2017 01:18:28 PM
G/L Date
Received Date Payment Date
12/12/2017 12/06/2017
Invoice Amount
1,378.64
Invoice Transactions 1 12/12/2017 12/06/2017
$1,378.64 83,795.27
Invoice Transactions 1
$83,795.27
12/12/2017 11/16/2017 Invoice Transactions 1
61,263.27 $61,263.27
12/12/2017 12/01/2017
39.88
Invoice Transactions 1 12/12/2017 12/06/2017 Invoice Transactions Invoice Transactions Invoice Transactions Invoice Transactions
1 5 5 5
$39.88 601.96 $601.96 $147,079.02 $147,079.02 $147,079.02
Page 1 of 1
TEXAS ASSOCIATION OF COUNTIES P.O. Box 2131 AUSTIN, TEXAS 78768 800-456-5974 HEALTH & EMPLOYEE BENEFITS POOL ASO BILLING CLAIMS INVOICE SUMMARY For Period 11/27/2017 Thru 11/30/2017 Bill to: GUADALUPE COUNTY - 94537 Ms. Audrey McDougal 212 W Nolte St Seguin, TX 78155-6136
Invoice #: 2019612 Invoice Date: 12/6/2017 Bank Draft Date: Pending Approval
Invoice (claims) total for 11/27/2017 - 11/30/2017: BSBC Vendor Fee Nov 2017: BCBS Vendor Credit:
Nov2017
Total:
Please email Stacey Jones at [email protected] with invoice approval.
$65,246.39 $745.46 -$8.74
$65,983.11
If you have any questions regarding this ASO billing, please contact Stacey Jones or Lisa Linenberger in the HEBP Department at (800) 456-5974.
