HEAD|1234567890123456|Company ABC
EEID|200000008|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 02:12:17.910000 PM
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
COVG|200000008|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|01/01/2016|02/29/2016|N|||08/08/2016 02:18:20.000000 PM|200000008|
DEPI|200000008|200000027|200000027|SARAH||SHERIDAN|Natural child|N|01/01/2011|Male|01/01/2016|02/29/2016|A|200000008|
EEID|200000017|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 03:05:10.480000 PM
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
COVG|200000017|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Spouse|122.00|248.00|01/01/2016|02/29/2016|N|||08/08/2016 03:14:22.000000 PM|200000017|
DEPI|200000017|200000031|200000031|CARLA||CALERO|Spouse|Y|01/01/1987|Female|01/01/2016|02/29/2016|A|200000017|
EEID|200000014|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 02:40:58.007000 PM
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
COVG|200000014|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016||N|||08/08/2016 02:44:27.000000 PM|200000014|
EEID|200000013|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 02:35:21.200000 PM
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
COVG|200000013|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016|03/31/2016|N|||08/08/2016 02:37:15.000000 PM|200000013|
EEID|200000010|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 02:21:44.330000 PM
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
COVG|200000010|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016||N|||08/08/2016 02:22:25.000000 PM|200000010|
EEID|100000013|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 03:20:45.953000 PM
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
COVG|100000013|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||N|||08/05/2016 03:21:33.000000 PM|100000013|
EEID|200000018|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 03:18:08.563000 PM
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
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||N|||08/08/2016 03:23:34.000000 PM|200000018|
DEPI|200000018|200000032|200000032|MATTHEW||CATTAFI|Spouse|Y|01/01/1987|Female|01/01/2016||A|200000018|
DEPI|200000018|200000038|200000038|NASIMA||SARWAR|Natural child|N|02/02/2011|Male|01/01/2016||A|200000018|
EEID|200000000|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 11:38:28.860000 AM
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000000|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||N|||08/05/2016 11:39:18.000000 AM|200000000|
EEID|200000023|200000023|BENITA||MORALES|M|07/11/1957
OFFR|200000023|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 04:00:15.120000 PM
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000023|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|11/16/2016|N|||08/08/2016 04:06:34.000000 PM|200000023|
EEID|200000016|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 02:55:48.383000 PM
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
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||N|||08/08/2016 03:02:31.000000 PM|200000016|
DEPI|200000016|200000030|200000030|SHEENLY||SINDICO|Spouse|Y|01/01/1987|Female|01/01/2016||A|200000016|
EEID|200000001|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 10:44:06.550000 AM
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000001|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|02/29/2016|N|||08/08/2016 11:51:13.000000 AM|200000001|
EEID|200000009|200000009|JOSEPH||BILAND|M|11/12/1981
OFFR|200000009|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/12/2016 04:51:07.773000 PM
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000009|Qualifying Event - Admin Change|01/01/2016|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|240.00|410.00|01/01/2016||N|||08/12/2016 04:51:39.000000 PM|200000009|
EEID|200000015|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 02:46:51.217000 PM
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000015|Qualifying Event - Admin Change|01/01/2016|BSGPThree+OLD|BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016||N|||08/08/2016 02:53:00.000000 PM|200000015|
EEID|200000024|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 11:25:19.333000 AM
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000024|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||N|||08/08/2016 11:25:37.000000 AM|200000024|
EEID|200000022|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 03:56:19.363000 PM
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
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||N|||08/08/2016 03:57:03.000000 PM|200000022|
DEPI|200000022|200000040|200000040|KIRAT||WALIA|Natural child|N|02/02/2011|Male|01/01/2016||A|200000022|
EEID|200000021|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 03:40:43.390000 PM
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000021|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000021|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|03/01/2016|N|||08/08/2016 03:41:49.000000 PM|200000021|
EEID|100000030|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 07:15:25.937000 PM
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000030|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|100000030|Qualifying Event - Admin Change|01/01/2016|BSGPlanFour+OLD|BSG Plan Four|Employee|Employee|240.00|410.00|01/01/2016|04/01/2016|N|||08/08/2016 07:19:29.000000 PM|100000030|
EEID|200000003|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 12:31:40.007000 PM
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000003|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|130.00|230.00|01/01/2016||N|||08/08/2016 01:49:51.000000 PM|200000003|
EEID|200000004|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 01:54:13.847000 PM
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000004|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|130.00|230.00|01/01/2016|02/29/2016|N|||08/08/2016 01:59:45.000000 PM|200000004|
EEID|100000004|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 12:44:39.280000 PM
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|100000004|Qualifying Event - Admin Change|01/01/2016|OptOut_OLD|Opt Out|Employee|Employee|0.00|0.00|01/01/2016||Y|||08/05/2016 12:45:11.000000 PM|100000004|
EEID|100000005|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 12:52:33.017000 PM
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|Y|Employee|Employee|120.00|220.00|Y|Y|N|Y|Y|64.71|Y|N
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|N|Employee + Family|Employee + Family|125.00|225.00|Y|Y|N|Y|Y|64.29|Y|N
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|N|Employee + 1|Employee + 1|125.00|225.00|Y|Y|N|Y|Y|64.29|Y|N
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|N|Employee + Spouse|Employee + Spouse|125.00|225.00|Y|Y|N|Y|Y|64.29|Y|N
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
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||N|||08/05/2016 02:06:58.000000 PM|100000005|
DEPI|100000005|110000005|110000005|SP||Sp|Spouse|Y|01/01/1986|Female|01/01/2016||A|100000005|
EEID|100000002|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 12:01:43.727000 PM
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|100000002|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee + Family|Employee + Family|135.00|235.00|01/01/2016|02/29/2016|N|||08/05/2016 12:13:01.000000 PM|100000002|
DEPI|100000002|110000002|110000002|Sp||Sp|Spouse|Y|01/01/1987|Female|01/01/2016|02/29/2016|A|100000002|
DEPI|100000002|120000002|120000002|Ch||Ch|Natural child|N|01/01/2010|Male|01/01/2016|02/29/2016|A|100000002|
EEID|100000003|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 12:17:02.503000 PM
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000003|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|100000003|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|03/31/2016|N|||08/05/2016 12:26:18.000000 PM|100000003|
EEID|100000001|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 11:39:22.993000 AM
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
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||N|||08/05/2016 11:54:00.000000 AM|100000001|
DEPI|100000001|110000001|110000001|Sp||Sp|Spouse|Y|01/01/1985|Female|01/01/2016||A|100000001|
DEPI|100000001|120000001|120000001|Ch||Ch|Natural child|N|01/01/2010|Male|01/01/2016||A|100000001|
EEID|200000034|200000034|BENITB||MORALEB|M|07/11/1957
OFFR|200000034|Qualifying Event - Admin Event|Qualifying Event - Admin Event|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 02:32:05.960000 PM
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|Y|Employee|Employee|140.00|1150.00|Y|Y|||Y|89.15|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Family|Employee + Family|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + 1|Employee + 1|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Spouse|Employee + Spouse|142.50|1167.50|Y|Y|||Y|89.12|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanOne_OLD|BSG plan one|N|Employee + Child|Employee + Child|40.00|760.00|Y|Y|||Y|95.00|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000034|Qualifying Event - Admin Change|01/01/2016|BSGPlanOne_OLD|BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016|11/16/2016|N|||08/08/2016 02:32:27.000000 PM|200000034|
EEID|200000039|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 03:49:43.737000 PM
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 03:51:19.700000 PM
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Y|Employee|Employee|100.00|300.00|Y|Y|Y|Y|Y|75.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|Y|Y|64.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|Y|Y|67.03|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|Y|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Y|Employee|Employee|100.00|300.00|Y|Y|Y|N|Y|75.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Family|Employee + Family|135.00|240.00|Y|Y|Y|N|Y|64.00|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + 1|Employee + 1|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Spouse|Employee + Spouse|122.00|248.00|Y|Y|Y|N|Y|67.03|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|N|Employee + Child|Employee + Child|133.00|232.00|Y|Y|Y|N|Y|63.56|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|Y|Employee|Employee|240.00|410.00|Y|Y|Y|Y|Y|63.08|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Family|Employee + Family|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + 1|Employee + 1|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|N|Employee + Spouse|Employee + Spouse|250.00|420.00|Y|Y|Y|Y|Y|62.69|Y|N
COVG|200000039|Qualifying Event - Admin Change|01/01/2016|BSGPlanThre_OLD|BSG plan Three|Employee|Employee|0.00|0.00|01/16/2016||N|||08/08/2016 03:51:55.000000 PM|200000039|
FOOT|26