HEAD|76d6deb6-d3db-43f3-9846-f9de2e58dd5f|ACA Automation EEID|200000002|200000002|AARON||CRANE|M|11/29/1981 OFFR|200000002|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000002|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|03/01/2016||||||||08/05/2016 12:00:00.00 AM|200000002 EEID|200000008|200000008|IRIS||CARSON|M|07/24/1983 OFFR|200000008|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000008|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000008|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000008|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000008|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000008|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000008|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000008|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000008|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000008|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000008|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000008|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000008|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000008|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000008|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000008|Open Enrollment|08/01/2016||BSG plan Three Plus|Employee|Employee|130.00|230.00|03/01/2016||||||||08/08/2016 12:00:00.00 AM|200000008 EEID|200000017|200000017|ADRIANA||NAVARRETE|M|12/23/1976 OFFR|200000017|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000017|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000017|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000017|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000017|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000017|Open Enrollment|08/01/2016||BSG plan Three|Employee|Employee|130.00|230.00|03/01/2016||||||||08/08/2016 12:00:00.00 AM|200000017 EEID|200000014|200000014|LUISITO||PELLERIN|M|06/13/1970 OFFR|200000014|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000014|Open Enrollment|08/01/2016||BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 12:00:00.00 AM|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|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000010|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000010|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000010|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000010|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000010|Open Enrollment|08/01/2016||BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016||||||||08/08/2016 12:00:00.00 AM|200000010 EEID|100000013|100000013|LAURA||TUNNERO|M|08/07/1979 OFFR|100000013|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000013|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000013|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000013|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/05/2016 12:00:00.00 AM|100000013 EEID|200000018|200000018|ALICE||SHIRLEY|M|10/04/1959 OFFR|200000018|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000018|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000018|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000018|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000018|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000018|Open Enrollment|08/01/2016||BSG plan Three|Employee + Family|Employee + Family|135.00|240.00|01/01/2016||||||||08/08/2016 12:00:00.00 AM|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|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000000|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000000|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000000|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/05/2016 12:00:00.00 AM|200000000 EEID|200000023|200000023|BENITA||MORALES|M|07/11/1957 OFFR|200000023|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000023|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000023|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000023|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000023|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000023|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000023|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000023|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000023|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000023|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000023|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 12:00:00.00 AM|200000023 EEID|200000016|200000016|ZORIC||PROSKUROVSKY|M|07/04/1986 OFFR|200000016|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000016|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000016|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000016|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000016|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000016|Open Enrollment|08/01/2016||BSG plan Three|Employee + Spouse|Employee + Spouse|122.00|248.00|01/01/2016||||||||08/08/2016 12:00:00.00 AM|200000016 DEPI|200000016|200000030|200000030|SHEENLY||SINDICO|Spouse|Y|01/01/1987|F|01/01/2016||A|200000016 EEID|200000001|200000001|DANISSE||SALOMON|M|05/14/1963 OFFR|200000001|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|200000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000001|Open Enrollment|08/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|03/01/2016||||||||08/08/2016 12:00:00.00 AM|200000001 EEID|200000015|200000015|Gail||MIGALBIN|M|10/20/1984 OFFR|200000015|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000015|Open Enrollment|08/01/2016||BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 12:00:00.00 AM|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|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000024|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 12:00:00.00 AM|200000024 EEID|100000027|100000027|STEVE||ZAEH|M|02/21/1953 OFFR|100000027|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000027|Open Enrollment|08/01/2016||BSG Plan Four|Employee|Employee|240.00|410.00|03/02/2016||||||||08/09/2016 12:00:00.00 AM|100000027 EEID|200000022|200000022|ROMANITA||DEBONO|M|10/17/1952 OFFR|200000022|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000022|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000022|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000022|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000022|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000022|Open Enrollment|08/01/2016||BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|01/01/2016||||||||08/08/2016 12:00:00.00 AM|200000022 DEPI|200000022|200000040|200000040|KIRAT||WALIA|Natural child|N|02/02/2011|M|01/01/2016||A|200000022 EEID|100000028|100000028|GARY||RICE|M|05/01/1955 OFFR|100000028|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000028|Open Enrollment|08/01/2016||BSG Plan Four|Employee + Family|Employee + Family|250.00|420.00|03/02/2016||||||||08/09/2016 12:00:00.00 AM|100000028 DEPI|100000028|110000028|110000028|Sp||Sp|Spouse|Y|01/01/1980|F|03/02/2016||A|100000028 DEPI|100000028|120000028|120000028|Ch||Ch|Natural child|N|01/01/2010|M|03/02/2016||A|100000028 EEID|100000029|100000029|JEFFERY||MALARAN|M|10/18/1970 OFFR|100000029|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000029|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000029|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000029|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000029|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000029|Open Enrollment|08/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|01/01/2016||||||||08/09/2016 12:00:00.00 AM|100000029 EEID|200000003|200000003|YANIRDA||MEJIA|M|02/17/1985 OFFR|200000003|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000003|Open Enrollment|08/01/2016||BSG plan Three|Employee + Child|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 12:00:00.00 AM|200000003 DEPI|200000003|200000025|200000025|BAKTHA||KUMAR|Natural child|N|05/05/2012|M|02/01/2016||A|200000003 EEID|200000020|200000020|ADRIENNE||APOSTOL|M|12/13/1970 OFFR|200000020|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000020|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000020|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000020|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000020|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000020|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000020|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000020|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000020|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000020|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000020|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|02/01/2016||||||||08/11/2016 12:00:00.00 AM|200000020 EEID|200000004|200000004|BAMBI||ALANIS|M|05/09/1979 OFFR|200000004|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000004|Open Enrollment|08/01/2016||BSG plan Three|Employee + Family|Employee + Family|135.00|240.00|03/01/2016||||||||08/08/2016 12:00:00.00 AM|200000004 DEPI|200000004|200000033|200000033|Neeta||ALANIS|Spouse|Y|01/01/1987|F|03/01/2016||A|200000004 DEPI|200000004|200000026|200000026|TERESA||WRIGHT|Natural child|N|04/23/2013|M|03/01/2016||A|200000004 EEID|100000006|100000006|LISA||MORALES|M|12/10/1974 OFFR|100000006|Qualifying Event - Admin Change|Qualifying Event - Admin Change|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/05/2016 02:36:47.3647 PM OFFR|100000006|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 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|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|10.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000006|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000006|Qualifying Event - Admin Change|08/01/2016||BSG plan one|Employee|Employee|0.00|10.00|01/01/2016||||||||08/05/2016 12:00:00.00 AM|100000006 COVG|100000006|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|0.00|10.00|01/01/2016||||||||08/05/2016 12:00:00.00 AM|100000006 EEID|100000004|100000004|ANN-TERESA||CUSENZA|M|07/26/1954 OFFR|100000004|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000004|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000004|Open Enrollment|08/01/2016||Opt Out|Employee|Employee|0.00|0.00|01/01/2016||||||||08/05/2016 12:00:00.00 AM|100000004 EEID|100000005|100000005|DANIELLE||DEBONO|M|03/24/1988 OFFR|100000005|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000005|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000005|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000005|Open Enrollment|08/01/2016||BSG plan Two|Employee + Spouse|Employee + Spouse|125.00|225.00|01/01/2016||||||||08/05/2016 12:00:00.00 AM|100000005 DEPI|100000005|110000005|110000005|SP||Sp|Spouse|Y|01/01/1986|F|01/01/2016||A|100000005 EEID|100000002|100000002|GINA||HUNTER|M|12/13/1968 OFFR|100000002|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|100000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000002|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000002|Open Enrollment|08/01/2016||BSG plan Three|Employee|Employee|130.00|230.00|03/01/2016||||||||08/05/2016 12:00:00.00 AM|100000002 EEID|100000001|100000001|STEPHEN||SHIRLEY|M|02/27/1987 OFFR|100000001|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|100000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000001|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000001|Open Enrollment|08/01/2016||BSG plan Three|Employee + Family|Employee + Family|135.00|235.00|01/01/2016||||||||08/05/2016 12:00:00.00 AM|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|100000014|100000014|MELINA||PINEDA|M|10/31/1985 OFFR|100000014|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000014|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000014|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000014|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000014|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000014|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|100000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000014|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000014|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/09/2016 12:00:00.00 AM|100000014 EEID|100000037|100000037|Jhon||Doe|M|01/01/1980 OFFR|100000037|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000037|Open Enrollment|||||Y|||N|N|YES|YES||0|| COVG|100000037|Open Enrollment|08/01/2016||Opt Out|Employee|Employee|0.00|0.00|08/04/2016||||||||08/05/2016 12:00:00.00 AM|100000037 EEID|200000034|200000034|BENITB||MORALEB|M|07/11/1957 OFFR|200000034|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000034|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|140.00|1150.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000034|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000034|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000034|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000034|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Spouse|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Yes|60|2015 PPO Buy-Up Plan|2015 PPO Buy-Up Plan ELIG|200000034|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000034|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000034|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000034|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000034|Open Enrollment|08/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 12:00:00.00 AM|200000034 EEID|200000039|200000039|TOMEKA||SWOPE|M|07/11/1957 OFFR|200000039|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | ELIG|200000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|200000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|200000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|200000039|Open Enrollment|08/01/2016||BSG plan Three|Employee|Employee|130.00|230.00|01/16/2016||||||||08/08/2016 12:00:00.00 AM|200000039 EEID|100000038|100000038|STEPHEN||Joe|M|01/01/1980 OFFR|100000038|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000038|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000038|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000038|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000038|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000038|Open Enrollment|08/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|08/01/2016||||||||08/08/2016 12:00:00.00 AM|100000038 EEID|100000039|100000039|smith||Joes|M|01/01/1980 OFFR|100000039|New Hire Enrollment|New Hire Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/01/2016 12:00:00.00 AM OFFR|100000039|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000039|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | ELIG|100000039|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000039|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000039|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000039|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000039|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000039|New Hire Enrollment|08/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|08/01/2016||||||||08/08/2016 12:00:00.00 AM|100000039 COVG|100000039|Open Enrollment|08/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|08/01/2016||||||||08/08/2016 12:00:00.00 AM|100000039 EEID|100000071|100000071|Jon||Doe|F|01/01/1984 OFFR|100000071|Qualifying Event - Admin Change|Qualifying Event - Admin Change|08/17/2016|08/17/2016|01/01/2016|12/31/2016|08/18/2016 04:22:59.2259 PM OFFR|100000071|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000071|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000071|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000071|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000071|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000071|Qualifying Event - Admin Change|08/17/2016||Opt Out|Employee|Employee|0.00|0.00|08/17/2016||||||||08/18/2016 12:00:00.00 AM|100000071 COVG|100000071|Open Enrollment|08/01/2016||Opt Out|Employee|Employee|0.00|0.00|08/17/2016||||||||08/18/2016 12:00:00.00 AM|100000071 EEID|100000072|100000072|Jon||Doe|M|01/01/1985 OFFR|100000072|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000072|Open Enrollment|08/01/2016||BSG Plan Four|Employee + Spouse|Employee + Spouse|250.00|420.00|01/15/2016||||||||08/18/2016 12:00:00.00 AM|100000072 DEPI|100000072|||smith||Sp|Spouse|Y|08/01/1985|F|01/15/2016||A|100000072 EEID|100000076|100000076|Jon||Test|M|01/01/1980 OFFR|100000076|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000076|Open Enrollment|||||N|||N|N|NO|NO||0|| COVG|100000076|Open Enrollment|08/01/2016||BSG Plan Four|Employee|Employee|240.00|410.00|08/15/2016||||||||08/19/2016 12:00:00.00 AM|100000076 EEID|100000077|100000077|Jon||Doe|M|01/01/1980 OFFR|100000077|New Hire Enrollment|New Hire Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/01/2016 12:00:00.00 AM OFFR|100000077|Open Enrollment|Open Enrollment|08/01/2016|08/01/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM ELIG|100000077|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | ELIG|100000077|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000077|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000077|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | COVG|100000077|New Hire Enrollment|08/01/2016||BSG Plan Four|Employee|Employee|240.00|410.00|08/01/2016||||||||08/19/2016 12:00:00.00 AM|100000077 COVG|100000077|Open Enrollment|08/01/2016||BSG Plan Four|Employee|Employee|240.00|410.00|08/01/2016||||||||08/19/2016 12:00:00.00 AM|100000077 FOOT|35