HEAD|76d6deb6-d3db-43f3-9846-f9de2e58dd5f|ACA Automation
EEID|200000014|200000014|LUISITO||PELLERIN|M|06/13/1970
OFFR|200000014|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE|Employee|Y|133.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Five|EE|Employee|Y|133.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000014|Qualifying Event - Admin Change|02/01/2016|BSGPThree+OLD|BSG plan Three Plus|1|1|133.00|232.00|02/01/2016||||||||08/08/2016|200000014
DEPI|200000014|200000035|200000035|GRACE-ANN||REMOLLINO|Natural child|N|02/02/2011|M|02/01/2016||A|200000014
EEID|200000010|200000010|SALVAIN||ALEXANDRE|M|06/18/1954
OFFR|200000010|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE+Family|Employee + Family|Y|130.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + CH|Employee + 1|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|130.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|Employee + Child|Employee + Child|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|130.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|130.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|130.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|130.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|130.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Five|EE|Employee|Y|130.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000010|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|1|1|130.00|230.00|01/01/2016||||||||08/08/2016|200000010
EEID|100000013|100000013|LAURA||TUNNERO|M|08/07/1979
OFFR|100000013|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Y|89.15|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|140.00|760.00|Y|Y|YES|YES|Y|95.00|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Five|EE|Employee|Y|140.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|100000013|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2016||||||||08/05/2016|100000013
EEID|200000018|200000018|ALICE||SHIRLEY|M|10/04/1959
OFFR|200000018|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|135.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|135.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|135.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|135.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|135.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|135.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Five|EE|Employee|Y|135.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000018|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|3|3|135.00|240.00|01/01/2016||||||||08/08/2016|200000018
DEPI|200000018|200000032|200000032|MATTHEW||CATTAFI|Spouse|Y|01/01/1987|F|01/01/2016||A|200000018
DEPI|200000018|200000038|200000038|NASIMA||SARWAR|Natural child|N|02/02/2011|M|01/01/2016||A|200000018
EEID|200000000|200000000|KERRI||AVILES|M|04/08/1986
OFFR|200000000|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Y|89.15|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|140.00|760.00|Y|Y|YES|YES|Y|95.00|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Five|EE|Employee|Y|140.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000000|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2016||||||||08/05/2016|200000000
EEID|200000023|200000023|BENITA||MORALES|M|07/11/1957
OFFR|200000023|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Y|89.15|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|140.00|760.00|Y|Y|YES|YES|Y|95.00|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Five|EE|Employee|Y|140.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000023|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2016||||||||08/08/2016|200000023
EEID|200000016|200000016|ZORIC||PROSKUROVSKY|M|07/04/1986
OFFR|200000016|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|122.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|122.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|122.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|122.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|122.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|122.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|122.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|122.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|122.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|122.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|122.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|122.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Five|EE|Employee|Y|122.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000016|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|1|1|122.00|248.00|01/01/2016||||||||08/08/2016|200000016
DEPI|200000016|200000030|200000030|SHEENLY||SINDICO|Spouse|Y|01/01/1987|F|01/01/2016||A|200000016
EEID|200000009|200000009|JOSEPH||BILAND|M|11/12/1981
OFFR|200000009|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/09/2016 12:00:00.00 AM
ELIG|200000009|Qualifying Event - Admin Change||BSG Plan Four|EE|Employee|Y|50.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000009|Qualifying Event - Admin Change||BSG Plan Four|EE+Family|Employee + Family|Y|50.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000009|Qualifying Event - Admin Change||BSG Plan Four|EE + CH|Employee + 1|Y|50.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000009|Qualifying Event - Admin Change||BSG Plan Four|EE + SP|Employee + Spouse|Y|50.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000009|Qualifying Event - Admin Change||BSG Plan Five|EE|Employee|Y|50.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000009|Qualifying Event - Admin Change|02/01/2016||BSG Plan Five|1|1|50.00|150.00|01/01/2016||||||||08/09/2016|200000009
EEID|200000015|200000015|Gail||MIGALBIN|M|10/20/1984
OFFR|200000015|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE|Employee|Y|133.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Five|EE|Employee|Y|133.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000015|Qualifying Event - Admin Change|02/01/2016|BSGPThree+OLD|BSG plan Three Plus|1|1|133.00|232.00|02/01/2016||||||||08/08/2016|200000015
DEPI|200000015|200000036|200000036|PATRICIA||CHASE|Natural child|N|02/02/2011|M|02/01/2016||A|200000015
EEID|200000024|200000024|BENITB||MORALEB|M|07/11/1957
OFFR|200000024|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Y|89.15|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|140.00|760.00|Y|Y|YES|YES|Y|95.00|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Five|EE|Employee|Y|140.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000024|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2016||||||||08/08/2016|200000024
EEID|200000022|200000022|ROMANITA||DEBONO|M|10/17/1952
OFFR|200000022|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE|Employee|Y|133.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG Plan Five|EE|Employee|Y|133.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000022|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|1|1|133.00|232.00|01/01/2016||||||||08/08/2016|200000022
DEPI|200000022|200000040|200000040|KIRAT||WALIA|Natural child|N|02/02/2011|M|01/01/2016||A|200000022
EEID|100000029|100000029|JEFFERY||MALARAN|M|10/18/1970
OFFR|100000029|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/09/2016 12:00:00.00 AM
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Y|64.71|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|120.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|120.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|120.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE|Employee|Y|120.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|120.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|120.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|120.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Five|EE|Employee|Y|120.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|100000029|Qualifying Event - Admin Change|01/01/2016|BSGPlanTwo_OLD|BSG plan Two|1|1|120.00|220.00|01/01/2016||||||||08/09/2016|100000029
EEID|200000003|200000003|YANIRDA||MEJIA|M|02/17/1985
OFFR|200000003|Qualifying Event - Add New Child|Qualifying Event - Add New Child|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|133.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|133.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|133.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|133.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|133.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG Plan Five|EE|Employee|Y|133.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000003|Qualifying Event - Add New Child|02/01/2016|BSGPlanThre_OLD|BSG plan Three|1|1|133.00|232.00|02/01/2016||||||||08/08/2016|200000003
DEPI|200000003|200000025|200000025|BAKTHA||KUMAR|Natural child|N|05/05/2012|M|02/01/2016||A|200000003
EEID|100000006|100000006|LISA||MORALES|M|12/10/1974
OFFR|100000006|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|0.00|10.00|Y|Y|YES|YES|Y|100.00|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|10.00|Y|Y|YES|YES|Y|100.00|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|10.00|Y|Y|YES|YES|Y|100.00|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|10.00|Y|Y|YES|YES|Y|100.00|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Five|EE|Employee|Y|0.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|100000006|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|1|1|0.00|0.00|01/01/2016||||||||08/05/2016|100000006
EEID|100000004|100000004|ANN-TERESA||CUSENZA|M|07/26/1954
OFFR|100000004|||||||
ELIG|100000004||OptOut_OLD|BSG plan one|EE|Employee|Y|0.00|1150.00|Y|Y|YES|YES|Y|89.15|Y|
ELIG|100000004||OptOut_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|100000004||OptOut_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|100000004||OptOut_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|100000004||OptOut_OLD|BSG plan one|Employee + Child|Employee + Child|Y|0.00|760.00|Y|Y|YES|YES|Y|95.00|Y|
ELIG|100000004||OptOut_OLD|BSG Plan Four|EE|Employee|Y|0.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|100000004||OptOut_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|0.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000004||OptOut_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|0.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000004||OptOut_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|0.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000004||OptOut_OLD|BSG Plan Five|EE|Employee|Y|0.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|100000004|||OptOut_OLD|Opt Out|1|1|0.00|0.00|01/01/2016||||||||08/05/2016|100000004
EEID|100000005|100000005|DANIELLE||DEBONO|M|03/24/1988
OFFR|100000005|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
OFFR|100000005|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/02/2016|02/02/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|125.00|220.00|Y|Y|YES|YES|Y|64.71|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|125.00|220.00|Y|Y|YES|YES|Y|64.71|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE|Employee|Y|125.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE|Employee|Y|125.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|125.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|125.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|125.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|125.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|125.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|125.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Five|EE|Employee|Y|125.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG Plan Five|EE|Employee|Y|125.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|100000005|Qualifying Event - Admin Change|02/01/2016|BSGPlanTwo_OLD|BSG plan Two|1|1|125.00|225.00|01/01/2016||||||||08/05/2016|100000005
COVG|100000005|Qualifying Event - Admin Change|02/02/2016|BSGPlanTwo_OLD|BSG plan Two|1|1|125.00|225.00|01/01/2016||||||||08/05/2016|100000005
DEPI|100000005|110000005|110000005|SP||Sp|Spouse|Y|01/01/1986|F|01/01/2016||A|100000005
EEID|100000001|100000001|STEPHEN||SHIRLEY|M|02/27/1987
OFFR|100000001|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|135.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|135.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|135.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|135.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|135.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|135.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|135.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|135.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Five|EE|Employee|Y|135.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|100000001|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|3|3|135.00|235.00|01/01/2016||||||||08/05/2016|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
EEID|200000034|200000034|BENITB||MORALEB|M|07/11/1957
OFFR|200000034|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Y|89.15|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|140.00|1167.50|Y|Y|YES|YES|Y|89.12|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|140.00|760.00|Y|Y|YES|YES|Y|95.00|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE|Employee|Y|140.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|140.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG Plan Five|EE|Employee|Y|140.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000034|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2016||||||||08/08/2016|200000034
EEID|200000039|200000039|TOMEKA||SWOPE|M|07/11/1957
OFFR|200000039|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/16/2016|01/16/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|130.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|130.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|130.00|240.00|Y|Y|YES|YES|Y|64.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|130.00|248.00|Y|Y|YES|YES|Y|67.03|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|130.00|232.00|Y|Y|YES|YES|Y|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE+Family|Employee + Family|Y|130.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + CH|Employee + 1|Y|130.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|130.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG Plan Five|EE|Employee|Y|130.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000039|Qualifying Event - Admin Change|01/16/2016|BSGPlanThre_OLD|BSG plan Three|1|1|130.00|230.00|01/16/2016||||||||08/08/2016|200000039
EEID|200000007|200000007|Anirudha|O|Dev|M|01/01/1985
OFFR|200000007|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/09/2016 12:00:00.00 AM
ELIG|200000007|Qualifying Event - Admin Change||BSG Plan Four|EE|Employee|Y|75.00|410.00|Y|Y|YES|YES|Y|63.08|Y|
ELIG|200000007|Qualifying Event - Admin Change||BSG Plan Four|EE+Family|Employee + Family|Y|75.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000007|Qualifying Event - Admin Change||BSG Plan Four|EE + CH|Employee + 1|Y|75.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000007|Qualifying Event - Admin Change||BSG Plan Four|EE + SP|Employee + Spouse|Y|75.00|420.00|Y|Y|YES|YES|Y|62.69|Y|
ELIG|200000007|Qualifying Event - Admin Change||BSG Plan Five|EE|Employee|Y|75.00|150.00|Y|Y|YES|YES|Y|75.00|Y|
COVG|200000007|Qualifying Event - Admin Change|01/01/2016||BSG Plan Five|1|1|75.00|170.00|01/01/2016||||||||08/09/2016|200000007
DEPI|200000007|200000048|200000048|Sam||Dev|Natural child|N|01/01/2012|M|01/01/2016||A|200000007
FOOT|20