HEAD|1234567890123456|Company ABC
EEID||200000008|IRIS||CARSON|M|07/24/1983
OFFR|200000008|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000008|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|0.00|0.00|01/01/2016|02/29/2016||||02/29/2016||
DEPI|200000008|200000008|200000027|SARAH||SHERIDAN|Natural child|N|01/01/2011|Male|01/01/2016|02/29/2016|Active|200000008|
EEID||200000017|ADRIANA||NAVARRETE|M|12/23/1976
OFFR|200000017|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000017|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|0.00|0.00|01/01/2016|02/29/2016||||02/29/2016||
DEPI||200000017|200000031|CARLA||CALERO|Spouse|Y|01/01/1987|Female|01/01/2016|02/29/2016|Active|200000017|
EEID||200000014|LUISITO||PELLERIN|M|06/13/1970
OFFR|200000014|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000014|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|0.00|0.00|01/01/2016|||||01/01/2016||
EEID||200000013|AMIHAN||CRUZ|M|11/20/1959
OFFR|200000013|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000013|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|0.00|0.00|01/01/2016|03/31/2016||||03/31/2016||
EEID||200000010|SALVAIN||ALEXANDRE|M|06/18/1954
OFFR|200000010|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000010|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016|||||01/01/2016||
EEID||100000013|LAURA||TUNNERO|M|08/07/1979
OFFR|100000013|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|Employee|Employee|Y|95.00|395.00|Yes|Yes|Y||Yes|80.61|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Family|Employee + Family|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + 1|Employee + 1|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Spouse|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|105.00|95.00|Yes|Yes|Y||Yes|47.50|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|100000013|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|||||01/01/2016||
EEID||200000018|ALICE||SHIRLEY|M|10/04/1959
OFFR|200000018|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000018|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|135.00|240.00|01/01/2016|||||01/01/2016||
DEPI||200000018|200000032|MATTHEW||CATTAFI|Spouse|Y|01/01/1987|Female|01/01/2016||Active|200000018|
DEPI|200000018|200000018|200000038|NASIMA||SARWAR|Natural child|N|02/02/2011|Male|01/01/2016||Active|200000018|
EEID||200000000|KERRI||AVILES|M|04/08/1986
OFFR|200000000|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|Employee|Employee|Y|95.00|395.00|Yes|Yes|Y||Yes|80.61|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Family|Employee + Family|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + 1|Employee + 1|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Spouse|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|105.00|95.00|Yes|Yes|Y||Yes|47.50|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000000|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|||||01/01/2016||
EEID||200000016|ZORIC||PROSKUROVSKY|M|07/04/1986
OFFR|200000016|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000016|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|122.00|248.00|01/01/2016|||||01/01/2016||
DEPI||200000016|200000030|SHEENLY||SINDICO|Spouse|Y|01/01/1987|Female|01/01/2016||Active|200000016|
EEID||200000001|DANISSE||SALOMON|M|05/14/1963
OFFR|200000001|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee|Employee|Y|95.00|395.00|Yes|Yes|Y||Yes|80.61|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Family|Employee + Family|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + 1|Employee + 1|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Spouse|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|105.00|95.00|Yes|Yes|Y||Yes|47.50|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000001|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|0.00|0.00|01/01/2016|02/29/2016||||02/29/2016||
EEID||200000015|Gail||MIGALBIN|M|10/20/1984
OFFR|200000015|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000015|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|0.00|0.00|01/01/2016|||||01/01/2016||
EEID||200000024|BENITB||MORALEB|M|07/11/1957
OFFR|200000024|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|Employee|Employee|Y|95.00|395.00|Yes|Yes|Y||Yes|80.61|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Family|Employee + Family|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + 1|Employee + 1|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Spouse|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|105.00|95.00|Yes|Yes|Y||Yes|47.50|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000024|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|||||01/01/2016||
EEID||200000022|ROMANITA||DEBONO|M|10/17/1952
OFFR|200000022|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000022|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|01/01/2016|||||01/01/2016||
DEPI|200000022|200000022|200000040|KIRAT||WALIA|Natural child|N|02/02/2011|Male|01/01/2016||Active|200000022|
EEID||200000021|SARAH||CUSENZA|M|07/18/1975
OFFR|200000021|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee|Employee|Y|95.00|395.00|Yes|Yes|Y||Yes|80.61|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Family|Employee + Family|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + 1|Employee + 1|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Spouse|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|105.00|95.00|Yes|Yes|Y||Yes|47.50|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000021|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|0.00|0.00|01/01/2016|03/01/2016||||03/01/2016||
EEID||100000030|PAUL||TUNNERO|M|08/07/1979
OFFR|100000030|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|100000030|Qualifying Event - Admin Change|01/01/2016|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|0.00|0.00|01/01/2016|04/01/2016||||04/01/2016||
EEID||200000003|YANIRDA||MEJIA|M|02/17/1985
OFFR|200000003|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000003|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|0.00|0.00|01/01/2016|||||01/01/2016||
EEID||200000004|BAMBI||ALANIS|M|05/09/1979
OFFR|200000004|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000004|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|0.00|0.00|01/01/2016|02/29/2016||||02/29/2016||
EEID||100000004|ANN-TERESA||CUSENZA|M|07/26/1954
OFFR|100000004|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee|Employee|Y|95.00|395.00|Yes|Yes|Y||Yes|80.61|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Family|Employee + Family|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + 1|Employee + 1|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Spouse|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|105.00|95.00|Yes|Yes|Y||Yes|47.50|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|100000004|Qualifying Event - Admin Change|01/01/2016|OptOut_OLD|Opt Out|Employee|Employee|0.00|0.00|01/01/2016|||||01/01/2016||
EEID||100000005|DANIELLE||DEBONO|M|03/24/1988
OFFR|100000005|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|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|Employee|Employee|Y|120.00|220.00|Yes|Yes|Y||Yes|64.71|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|Employee + Family|Employee + Family|Y|125.00|225.00|Yes|Yes|Y||Yes|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|Employee + 1|Employee + 1|Y|125.00|225.00|Yes|Yes|Y||Yes|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|Employee + Spouse|Employee + Spouse|Y|125.00|225.00|Yes|Yes|Y||Yes|64.29|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|100000005|Qualifying Event - Admin Change|01/01/2016|BSGPlanTwo_OLD|BSG plan Two|Employee + Spouse|Employee + Spouse|125.00|225.00|01/01/2016|||||01/01/2016||
DEPI||100000005|110000005|SP||Sp|Spouse|Y|01/01/1986|Female|01/01/2016||Active|100000005|
EEID||100000002|GINA||HUNTER|M|12/13/1968
OFFR|100000002|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|100000002|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|0.00|0.00|01/01/2016|02/29/2016||||02/29/2016||
DEPI||100000002|110000002|Sp||Sp|Spouse|Y|01/01/1987|Female|01/01/2016|02/29/2016|Active|100000002|
DEPI|100000002|100000002|120000002|Ch||Ch|Natural child|N|01/01/2010|Male|01/01/2016|02/29/2016|Active|100000002|
EEID||100000003|ROSALIND||APOSTOL|M|08/10/1960
OFFR|100000003|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 12:00:00.00 AM
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee|Employee|Y|95.00|395.00|Yes|Yes|Y||Yes|80.61|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Family|Employee + Family|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + 1|Employee + 1|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Spouse|Y|97.00|403.00|Yes|Yes|Y||Yes|80.60|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|105.00|95.00|Yes|Yes|Y||Yes|47.50|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|100000003|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|0.00|0.00|01/01/2016|03/31/2016||||03/31/2016||
EEID||100000001|STEPHEN||SHIRLEY|M|02/27/1987
OFFR|100000001|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|100000001|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|135.00|235.00|01/01/2016|||||01/01/2016||
DEPI||100000001|110000001|Sp||Sp|Spouse|Y|01/01/1985|Female|01/01/2016||Active|100000001|
DEPI|100000001|100000001|120000001|Ch||Ch|Natural child|N|01/01/2010|Male|01/01/2016||Active|100000001|
EEID||200000039|TOMEKA||SWOPE|M|07/11/1957
OFFR|200000039|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 12:00:00.00 AM
OFFR|200000039|Qualifying Event - Admin Event|Qualifying Event - Admin Event|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|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|Y|100.00|300.00|Yes|Yes|Y||Yes|75.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Family|Employee + Family|Y|135.00|240.00|Yes|Yes|Y||Yes|64.00|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + 1|Employee + 1|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Spouse|Y|122.00|248.00|Yes|Yes|Y||Yes|67.03|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Yes|Yes|Y||Yes|63.56|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|Y|240.00|410.00|Yes|Yes|Y||Yes|63.08|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Family|Employee + Family|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + 1|Employee + 1|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Employee + Spouse|Employee + Spouse|Y|250.00|420.00|Yes|Yes|Y||Yes|62.69|Y|
COVG|200000039|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|130.00|230.00|01/16/2016|||||01/16/2016||
COVG|200000039|Qualifying Event - Admin Change|01/16/2016|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|130.00|230.00|01/16/2016|||||01/16/2016||
FOOT|23