HomeMy WebLinkAboutInv# 2024-00001266 - FLORIDA MUNICIPAL INSURANCE TRUST - 12/26/2024PREMIUMS ADJUSTMENTS TOTAL
Medical UHC Plan 2 Employee + 1 39 $56,310.15 $0.00 $56,310.15
Medical UHC Plan 2 Employee + Family 46 $101,918.98 $0.00 $101,918.98
Medical UHC Plan 2 Employee Only 88 $64,437.12 $732.24 $65,169.36
Medical UHC Plan 5 Employee + 1 0 $0.00 $0.00 $0.00
Medical UHC Plan 5 Employee + Family 1 $1,914.39 $0.00 $1,914.39
Medical UHC Plan 5 Employee Only 11 $6,959.48 $0.00 $6,959.48
-$732.24 -$732.24 refund for Cherie Sheley
$231,540.12 $0.00 $231,540.12
:$469,227.06
:-$237,687.04 Oct Paid
:$231,540.12 Nov Paid
:$0.00
:$463,080.14
Gen Date: 11-20-2024 $231,540.02
TERMED W/ADJ
DANIA BEACH Due Date: 12-01-2024
FMIT # FH0129
SUMMARY BILLING PAGE
COVERAGE
TOTAL DUE
BALANCE FORWARD
PAYMENTS
CURRENT PREMIUMS
ADJUSTMENTS
12/20/24