HEAD|76d6deb6-d3db-43f3-9846-f9de2e58dd5f|ACA Automation
EEID|200000014|200000014|LUISITO||PELLERIN|M|06/13/1970
OFFR|200000014|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 02:44:05.445 PM
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Yes|130.00|230.00|Y|Y|Y|Y|Y|63.89|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Yes|130.00|230.00|Y|Y|Y|N|Y|63.89|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Yes|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Yes|50.00|350.00|Y|Y|Y|Y|Y|87.50|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|No|75.00|175.00|Y|Y|Y|Y|Y|70.00|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|No|65.00|160.00|Y|Y|Y|Y|Y|71.11|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|No|60.00|175.00|Y|Y|Y|Y|Y|74.47|Y|
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|No|70.00|180.00|Y|Y|Y|Y|Y|72.00|Y|
COVG|200000014|Qualifying Event - Admin Change|02/01/2016|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 02:44:27.4427 PM
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|||||||
ELIG|200000010||||||NULL|||N|N|N|N|N||Y|
COVG|200000010|||BSGPThree+OLD|BSG plan Three Plus|EE|Employee|130.00|230.00|01/01/2016||||||||08/08/2016 02:22:25.2225 PM
EEID|100000013|100000013|LAURA||TUNNERO|M|08/07/1979
OFFR|100000013|||||||
ELIG|100000013||||||NULL|||N|N|N|N|N||Y|
COVG|100000013|||BSGPlanOne_OLD|BSG plan one|EE|Employee|140.00|1150.00|01/01/2016||||||||08/05/2016 03:21:33.2133 PM
EEID|200000018|200000018|ALICE||SHIRLEY|M|10/04/1959
OFFR|200000018|||||||
ELIG|200000018||||||NULL|||N|N|N|N|N||Y|
COVG|200000018|||BSGPlanThre_OLD|BSG plan Three|EE + F|Employee + Family|135.00|240.00|01/01/2016||||||||08/08/2016 03:23:34.2334 PM
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|||||||
ELIG|200000000||||||NULL|||N|N|N|N|N||Y|
COVG|200000000|||BSGPlanOne_OLD|BSG plan one|EE|Employee|140.00|1150.00|01/01/2016||||||||08/05/2016 11:39:18.3918 AM
EEID|200000023|200000023|BENITA||MORALES|M|07/11/1957
OFFR|200000023|||||||
ELIG|200000023||||||NULL|||N|N|N|N|N||Y|
COVG|200000023|||BSGPlanOne_OLD|BSG plan one|EE|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 04:06:34.634 PM
EEID|200000016|200000016|ZORIC||PROSKUROVSKY|M|07/04/1986
OFFR|200000016|||||||
ELIG|200000016||||||NULL|||N|N|N|N|N||Y|
COVG|200000016|||BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|122.00|248.00|01/01/2016||||||||08/08/2016 03:02:31.231 PM
DEPI|200000016|200000030|200000030|SHEENLY||SINDICO|Spouse|Y|01/01/1987|F|01/01/2016||A|200000016
EEID|200000015|200000015|Gail||MIGALBIN|M|10/20/1984
OFFR|200000015|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 02:52:00.520 PM
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Yes|130.00|230.00|Y|Y|Y|Y|Y|63.89|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Yes|130.00|230.00|Y|Y|Y|N|Y|63.89|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Yes|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Yes|50.00|350.00|Y|Y|Y|Y|Y|87.50|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|No|75.00|175.00|Y|Y|Y|Y|Y|70.00|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|No|65.00|160.00|Y|Y|Y|Y|Y|71.11|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|No|60.00|175.00|Y|Y|Y|Y|Y|74.47|Y|
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|No|70.00|180.00|Y|Y|Y|Y|Y|72.00|Y|
COVG|200000015|Qualifying Event - Admin Change|02/01/2016|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 02:53:00.530 PM
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|||||||
ELIG|200000024||||||NULL|||N|N|N|N|N||Y|
COVG|200000024|||BSGPlanOne_OLD|BSG plan one|EE|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 11:25:37.2537 AM
EEID|200000022|200000022|ROMANITA||DEBONO|M|10/17/1952
OFFR|200000022|||||||
ELIG|200000022||||||NULL|||N|N|N|N|N||Y|
COVG|200000022|||BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + Child|133.00|232.00|01/01/2016||||||||08/08/2016 03:57:03.573 PM
DEPI|200000022|200000040|200000040|KIRAT||WALIAAA|Natural child|N|02/02/2011|M|01/01/2016||A|200000022
EEID|100000029|100000029|JEFFERY||MALARAN|M|10/18/1970
OFFR|100000029|||||||
ELIG|100000029||||||NULL|||N|N|N|N|N||Y|
COVG|100000029|||BSGPlanTwo_OLD|BSG plan Two|EE|Employee|120.00|220.00|01/01/2016||||||||08/09/2016 12:45:57.4557 PM
EEID|200000003|200000003|YANIRDA||MEJIA|M|02/17/1985
OFFR|200000003|Qualifying Event - Add New Child|Qualifying Event - Add New Child|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 12:50:39.5039 PM
OFFR|200000003|Qualifying Event - Add New Child|Qualifying Event - Add New Child|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/18/2016 03:37:10.3710 PM
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Yes|130.00|230.00|Y|Y|Y|Y|Y|63.89|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Yes|130.00|230.00|Y|Y|Y|Y|Y|63.89|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Yes|130.00|230.00|Y|Y|Y|N|Y|63.89|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Yes|130.00|230.00|Y|Y|Y|N|Y|63.89|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|No|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|No|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|No|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Yes|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Yes|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Yes|50.00|350.00|Y|Y|Y|Y|Y|87.50|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Yes|50.00|350.00|Y|Y|Y|Y|Y|87.50|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|No|75.00|175.00|Y|Y|Y|Y|Y|70.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|No|75.00|175.00|Y|Y|Y|Y|Y|70.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|No|65.00|160.00|Y|Y|Y|Y|Y|71.11|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|No|65.00|160.00|Y|Y|Y|Y|Y|71.11|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|No|60.00|175.00|Y|Y|Y|Y|Y|74.47|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|No|60.00|175.00|Y|Y|Y|Y|Y|74.47|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|No|70.00|180.00|Y|Y|Y|Y|Y|72.00|Y|
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|No|70.00|180.00|Y|Y|Y|Y|Y|72.00|Y|
COVG|200000003|Qualifying Event - Add New Child|02/01/2016|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 01:49:51.4951 PM
COVG|200000003|Qualifying Event - Add New Child|02/01/2016|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 01:49:51.4951 PM
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|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 03:35:57.3557 PM
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE|Employee|Yes|140.00|1150.00|Y|Y|N|N|Y|89.15|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|No|142.50|1167.50|Y|Y|N|N|Y|89.12|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|No|142.50|1167.50|Y|Y|N|N|Y|89.12|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|No|142.50|1167.50|Y|Y|N|N|Y|89.12|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|No|40.00|760.00|Y|Y|N|N|Y|95.00|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Yes|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|No|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Yes|50.00|350.00|Y|Y|Y|Y|Y|87.50|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|No|75.00|175.00|Y|Y|Y|Y|Y|70.00|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|No|65.00|160.00|Y|Y|Y|Y|Y|71.11|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|No|60.00|175.00|Y|Y|Y|Y|Y|74.47|Y|
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|No|70.00|180.00|Y|Y|Y|Y|Y|72.00|Y|
COVG|200000020|Qualifying Event - Admin Change|02/01/2016|BSGPlanOne_OLD|BSG plan one|EE|Employee|140.00|1150.00|02/01/2016||||||||08/11/2016 04:56:46.5646 PM
EEID|100000006|100000006|LISA||MORALES|M|12/10/1974
OFFR|100000006|||||||
ELIG|100000006||||||NULL|||N|N|N|N|N||Y|
COVG|100000006|||BSGPlanOne_OLD|BSG plan one|EE|Employee|0.00|0.00|01/01/2016||||||||08/05/2016 03:00:03.03 PM
EEID|100000004|100000004|ANN-TERESA||CUSENZA|M|07/26/1954
OFFR|100000004|||||||
ELIG|100000004||||||NULL|||N|N|N|N|N||Y|
COVG|100000004|||OptOut_OLD|Opt Out|EE|Employee|0.00|0.00|01/01/2016||||||||08/05/2016 12:45:11.4511 PM
EEID|100000001|100000001|STEPHEN||SHIRLEY|M|02/27/1987
OFFR|100000001|||||||
ELIG|100000001||||||NULL|||N|N|N|N|N||Y|
COVG|100000001|||BSGPlanThre_OLD|BSG plan Three|EE + F|Employee + Family|135.00|235.00|01/01/2016||||||||08/05/2016 11:54:00.540 AM
DEPI|100000001|110000001|110000001|Sp||Sp|Spouse|Y|01/01/1985|F|01/01/2016||A|100000001
DEPI|100000001|120000001|120000001|Ch||Ch|Natural child|N|01/01/2010|M|01/01/2016||A|100000001
EEID|200000034|200000034|BENITB||MORALEB|M|07/11/1957
OFFR|200000034|||||||
ELIG|200000034||||||NULL|||N|N|N|N|N||Y|
COVG|200000034|||BSGPlanOne_OLD|BSG plan one|EE|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 02:32:27.3227 PM
EEID|200000039|200000039|TOMEKA||SWOPE|M|07/11/1957
OFFR|200000039|||||||
ELIG|200000039||||||NULL|||N|N|N|N|N||Y|
COVG|200000039|||BSGPlanThre_OLD|BSG plan Three|EE|Employee|130.00|230.00|01/16/2016||||||||08/08/2016 03:51:55.5155 PM
EEID|200000007|200000007|Anirudha|O|Dev|M|01/01/1985
OFFR|200000007|||||||
ELIG|200000007||||||NULL|||N|N|N|N|N||Y|
COVG|200000007|||BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + Child|75.00|170.00|01/01/2016||||||||08/09/2016 03:09:58.958 PM
DEPI|200000007|200000048|200000048|Sam||Dev|Natural child|N|01/01/2012|M|01/01/2016||A|200000007
EEID|100000200|100000200|AAA||AAA|M|01/01/1980
OFFR|100000200|||||||
ELIG|100000200||||||NULL|||N|N|N|N|N||Y|
COVG|100000200||||BSG Continuous enrollment|EE|Employee|0.00|0.00|01/01/2016||||||||08/17/2016 02:56:59.5659 PM
EEID|000000064|000000064|Sagar||Info|M|01/01/1980
OFFR|000000064|||||||
ELIG|000000064||||||NULL|||N|N|N|N|N||Y|
COVG|000000064|||BSGPlanOne_OLD|ACA 3769|EE + CH|Employee + Child|100.00|100.00|01/01/2016||||||||08/17/2016 02:49:27.4927 PM
DEPI|000000064|123565555|123565555|Test||Hspl|Natural child|N|01/01/2013|M|01/01/2016||A|000000064
EEID|000000065|000000065|RBS||Scotland|M|01/01/1987
OFFR|000000065|||||||
ELIG|000000065||||||NULL|||N|N|N|N|N||Y|
COVG|000000065|||BSGPlanOne_OLD|ACA 3769|EE + 1|Employee + 1|100.00|100.00|01/01/2016||||||||08/17/2016 03:07:08.78 PM
DEPI|000000065|||sadfsdf||sdfsdf|Natural child|N|01/01/2000|M|01/01/2016||A|000000065
DEPI|000000065|||fghfgh||fghfgh|Step child|N|01/01/2000|M|01/01/2016||A|000000065
DEPI|000000065|||asdasd||asd|Natural child|N|01/01/2000|M|01/01/2016||A|000000065
DEPI|000000065|||dsafsdf||sdfsdf|Natural child|N|01/01/2001|M|01/01/2016||A|000000065
DEPI|000000065|||vbnbvn||bnbvn|Natural child|N|01/01/2001|M|01/01/2016||A|000000065
DEPI|000000065|||bvbvn||fghgn|Natural child|N|02/01/2000|M|01/01/2016||A|000000065
DEPI|000000065|||rgf dfg||dfgdfg|Natural child|N|01/03/2000|M|01/01/2016||A|000000065
DEPI|000000065|||dfgdfg||dfgdfg|Natural child|N|01/01/2013|M|01/01/2016||A|000000065
DEPI|000000065|||Sadsad||asdsad|Natural child|N|01/01/2013|M|01/01/2016||A|000000065
DEPI|000000065|||sasa||zxcxzczxc|Natural child|N|01/01/2013|M|01/01/2016||A|000000065
DEPI|000000065|||xcxcv||xcvxcv|Natural child|N|01/01/2013|F|01/01/2016||A|000000065
EEID|100000072|100000072|Jon||Doe|M|01/01/1985
OFFR|100000072|||||||
ELIG|100000072||||||NULL|||N|N|N|N|N||Y|
COVG|100000072|||BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|250.00|420.00|01/15/2016||||||||08/18/2016 05:29:35.2935 PM
DEPI|100000072|||smith||Sp|Spouse|Y|08/01/1985|F|01/15/2016||A|100000072
FOOT|23