HEAD|76d6deb6-d3db-43f3-9846-f9de2e58dd5f|ACA Automation EEID|100000013|100000013|LAURA||TUNNERO|M|08/07/1979 OFFR|100000013| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|100000013|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|100000013| |BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013| |BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013| |BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013| |BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013| |BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013| |BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013| |BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013| |BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 COVG|100000013|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000013 EEID|200000000|200000000|KERRI||AVILES|M|04/08/1986 OFFR|200000000| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|200000000|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|200000000| |BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000| |BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000| |BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000| |BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000| |BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000| |BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000| |BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000| |BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000| |01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 COVG|200000000|Open Enrollment|01/01/2016||BSG plan one|1|1|140.00|1150.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|200000000 EEID|100000006|100000006|LISA||MORALES|M|12/10/1974 OFFR|100000006| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|100000006|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|100000006| |BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006| |BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006| |BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006| |BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006| |BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006| |BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006| |BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006| |BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006| |01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 COVG|100000006|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|10.00|01/01/2016||Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|01/01/2016|100000006 EEID|100000004|100000004|ANN-TERESA||CUSENZA|M|07/26/1954 OFFR|100000004| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|100000004|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|100000004| |OptOut_OLD|BSG plan one|EE|Employee|Y|0.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|OptOut_OLD|BSG plan one|EE|Employee|Y|0.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004| |OptOut_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|OptOut_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004| |OptOut_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|OptOut_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004| |OptOut_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|OptOut_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004| |OptOut_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004|Open Enrollment|OptOut_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004| |OptOut_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004|Open Enrollment|OptOut_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004| |OptOut_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004|Open Enrollment|OptOut_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004| |OptOut_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004|Open Enrollment|OptOut_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004| |01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 COVG|100000004|Open Enrollment|01/01/2016||Opt Out|1|1|0.00|0.00|01/01/2016||Yes|Yes|Yes|Opt Out|OptOut_OLD|OptOut_OLD|01/01/2016|100000004 EEID|100000005|100000005|DANIELLE||DEBONO|M|03/24/1988 OFFR|100000005| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|100000005|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|100000005| |BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|125.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|125.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005| |BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005| |BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005| |BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005| |BSGPlanTwo_OLD|BSG Plan Four|EE|Employee|Y|125.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG Plan Four|EE|Employee|Y|125.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005| |BSGPlanTwo_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|125.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|125.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005| |BSGPlanTwo_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|125.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|125.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005| |BSGPlanTwo_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|125.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|125.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005| |01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 COVG|100000005|Open Enrollment|01/01/2016||BSG plan Two|6|6|125.00|225.00|01/01/2016||Yes|Yes|Yes|BSG plan Two|BSGPlanTwo_OLD|BSGPlanTwo_OLD|01/01/2016|100000005 DEPI|100000005|110000005|110000005|SP||Sp|Spouse|Y|01/01/1986|F|01/01/2016||A|100000005 EEID|100000002|100000002|GINA||HUNTER|M|12/13/1968 OFFR|100000002| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|100000002|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|0.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|0.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|0.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|0.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|0.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|0.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|0.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|0.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|0.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|0.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|0.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|0.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|0.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|0.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002| |BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|0.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|0.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002| |BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002| |BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002| |BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002| |BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002| |01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 COVG|100000002|Open Enrollment|01/01/2016||BSG plan Three|3|3|0.00|0.00|01/01/2016|02/29/2016|Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|02/29/2016|100000002 DEPI|100000002|110000002|110000002|Sp||Sp|Spouse|Y|01/01/1987|F|01/01/2016|02/29/2016|A|100000002 DEPI|100000002|120000002|120000002|Ch||Ch|Natural child|N|01/01/2010|M|01/01/2016|02/29/2016|A|100000002 EEID|100000003|100000003|ROSALIND||APOSTOL|M|08/10/1960 OFFR|100000003| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|100000003|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|100000003| |BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|0.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|0.00|395.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003| |BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003| |BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003| |BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|403.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000003| |BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000003| |BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000003| |BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000003| |BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000003|Open Enrollment|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003| |01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 COVG|100000003|Open Enrollment|01/01/2016||BSG plan one|1|1|0.00|0.00|01/01/2016|03/31/2016|Yes|Yes|Yes|BSG plan one|BSGPlanOne_OLD|BSGPlanOne_OLD|03/31/2016|100000003 EEID|100000001|100000001|STEPHEN||SHIRLEY|M|02/27/1987 OFFR|100000001| | |01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 OFFR|100000001|Open Enrollment|Open Enrollment|01/01/2016|01/01/2016|01/01/2016|12/31/2016|12/01/2015 ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|135.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|135.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|135.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|135.00|235.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|135.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|135.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001| |BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|135.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|135.00|235.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001| |BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|135.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|135.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001| |BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|135.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|135.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001| |BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|135.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|135.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001| |BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|135.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|135.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001| |01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 COVG|100000001|Open Enrollment|01/01/2016||BSG plan Three|3|3|135.00|235.00|01/01/2016||Yes|Yes|Yes|BSG plan Three|BSGPlanThre_OLD|BSGPlanThre_OLD|01/01/2016|100000001 DEPI|100000001|110000001|110000001|Sp||Sp|Spouse|Y|01/01/1985|F|01/01/2016||A|100000001 DEPI|100000001|120000001|120000001|Ch||Ch|Natural child|N|01/01/2010|M|01/01/2016||A|100000001 FOOT|8