HEAD|76d6deb6-d3db-43f3-9846-f9de2e58dd5f|ACA Automation
EEID|200000002|200000002|AARON||CRANE|M|11/29/1981
OFFR|200000002|Qualifying Event - QE- Future date|Qualifying Event - QE- Future date|03/01/2016|03/01/2016|01/01/2016|12/31/2016|08/05/2016 12:54:34.5434 PM
ELIG|200000002|Qualifying Event - QE- Future date|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|Qualifying Event - QE- Future date|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|Qualifying Event - QE- Future date|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|Qualifying Event - QE- Future date|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|Qualifying Event - QE- Future date|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|Qualifying Event - QE- Future date|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000002|Qualifying Event - QE- Future date|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000002|Qualifying Event - QE- Future date|03/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|03/01/2016||||||||08/05/2016 12:54:34.5434 PM|200000002
EEID|200000008|200000008|IRIS||CARSON|M|07/24/1983
OFFR|200000008|Qualifying Event - Admin Change|Qualifying Event - Admin Change|03/01/2016|03/01/2016|01/01/2016|12/31/2016|08/22/2016 12:59:18.5918 PM
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000008|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|200000008|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|200000008|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|200000008|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000008|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000008|Qualifying Event - Admin Change|03/01/2016||BSG plan Three Plus|Employee|Employee|130.00|230.00|03/01/2016||||||||08/22/2016 12:59:18.5918 PM|200000008
EEID|200000017|200000017|ADRIANA||NAVARRETE|M|12/23/1976
OFFR|200000017|Qualifying Event - Admin Change|Qualifying Event - Admin Change|03/01/2016|03/01/2016|01/01/2016|12/31/2016|08/08/2016 03:14:22.1422 PM
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000017|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|200000017|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|200000017|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|200000017|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000017|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000017|Qualifying Event - Admin Change|03/01/2016||BSG plan Three|Employee|Employee|130.00|230.00|03/01/2016||||||||08/08/2016 03:14:22.1422 PM|200000017
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 02:44:27.4427 PM
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000014|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|200000014|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|200000014|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|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000014|Qualifying Event - Admin Change|02/01/2016||BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 02:44:27.4427 PM|200000014
DEPI|200000014|200000035|200000035|GRACE-ANN||REMOLLINO|Natural child|N|02/02/2011|M|02/01/2016||A|200000014
EEID|200000013|200000013|AMIHAN||CRUZ|M|11/20/1959
OFFR|200000013|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/22/2016 02:14:01.141 PM
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000013|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|200000013|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|200000013|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|200000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000013|Qualifying Event - Admin Change|01/01/2016||BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016||||||||08/22/2016 02:14:01.141 PM|200000013
EEID|200000010|200000010|SALVAIN||ALEXANDRE|M|06/18/1954
OFFR|200000010|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 02:22:25.2225 PM
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000010|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|200000010|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|200000010|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|200000010|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000010|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000010|Qualifying Event - Admin Change|01/01/2016||BSG plan Three Plus|Employee|Employee|130.00|230.00|01/01/2016||||||||08/08/2016 02:22:25.2225 PM|200000010
EEID|100000013|100000013|LAURA||TUNNERO|M|08/07/1979
OFFR|100000013|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 03:21:33.2133 PM
ELIG|100000013|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000013|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|100000013|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|100000013|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|100000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000013|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000013|Qualifying Event - Admin Change|01/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/05/2016 03:21:33.2133 PM|100000013
EEID|200000018|200000018|ALICE||SHIRLEY|M|10/04/1959
OFFR|200000018|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 03:23:34.2334 PM
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000018|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|200000018|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|200000018|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|200000018|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000018|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000018|Qualifying Event - Admin Change|01/01/2016||BSG plan Three|Employee + Family|Employee + Family|135.00|240.00|01/01/2016||||||||08/08/2016 03:23:34.2334 PM|200000018
DEPI|200000018|200000032|200000032|MATTHEW||CATTAFI|Spouse|Y|01/01/1987|F|01/01/2016||A|200000018
DEPI|200000018|200000038|200000038|NASIMA||SARWAR|Natural child|N|02/02/2011|M|01/01/2016||A|200000018
EEID|200000000|200000000|KERRI||AVILES|M|04/08/1986
OFFR|200000000|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 11:39:18.3918 AM
ELIG|200000000|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000000|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|200000000|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|200000000|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|200000000|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000000|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000000|Qualifying Event - Admin Change|01/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/05/2016 11:39:18.3918 AM|200000000
EEID|200000023|200000023|BENITA||MORALES|M|07/11/1957
OFFR|200000023|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 04:06:34.634 PM
ELIG|200000023|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000023|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|200000023|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|200000023|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|200000023|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000023|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000023|Qualifying Event - Admin Change|01/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 04:06:34.634 PM|200000023
EEID|200000016|200000016|ZORIC||PROSKUROVSKY|M|07/04/1986
OFFR|200000016|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 03:02:31.231 PM
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000016|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|200000016|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|200000016|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|200000016|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000016|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000016|Qualifying Event - Admin Change|01/01/2016||BSG plan Three|Employee + Spouse|Employee + Spouse|122.00|248.00|01/01/2016||||||||08/08/2016 03:02:31.231 PM|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|Qualifying Event - Admin Change|Qualifying Event - Admin Change|03/01/2016|03/01/2016|01/01/2016|12/31/2016|08/08/2016 11:51:13.5113 AM
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | 
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000001|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|200000001|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|200000001|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|200000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000001|Qualifying Event - Admin Change|03/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|03/01/2016||||||||08/08/2016 11:51:13.5113 AM|200000001
EEID|200000009|200000009|JOSEPH||BILAND|M|11/12/1981
OFFR|200000009|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/09/2016 04:26:30.2630 PM
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000009|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|200000009|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|200000009|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|200000009|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000009|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000009|Qualifying Event - Admin Change|01/01/2016||BSG Plan Five|Employee|Employee|50.00|150.00|01/01/2016||||||||08/09/2016 04:26:30.2630 PM|200000009
EEID|200000015|200000015|Gail||MIGALBIN|M|10/20/1984
OFFR|200000015|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 02:53:00.530 PM
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000015|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|200000015|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|200000015|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|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000015|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000015|Qualifying Event - Admin Change|02/01/2016||BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 02:53:00.530 PM|200000015
DEPI|200000015|200000036|200000036|PATRICIA||CHASE|Natural child|N|02/02/2011|M|02/01/2016||A|200000015
EEID|200000024|200000024|BENITB||MORALEB|M|07/11/1957
OFFR|200000024|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 11:25:37.2537 AM
ELIG|200000024|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000024|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|200000024|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|200000024|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|200000024|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000024|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000024|Qualifying Event - Admin Change|01/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 11:25:37.2537 AM|200000024
EEID|100000027|100000027|STEVE||ZAEH|M|02/21/1953
OFFR|100000027|Qualifying Event - Admin Change|Qualifying Event - Admin Change|03/02/2016|03/02/2016|01/01/2016|12/31/2016|08/09/2016 05:03:11.311 PM
ELIG|100000027|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000027|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|100000027|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|100000027|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|100000027|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000027|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000027|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000027|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000027|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000027|Qualifying Event - Admin Change|03/02/2016||BSG Plan Four|Employee|Employee|240.00|410.00|03/02/2016||||||||08/09/2016 05:03:11.311 PM|100000027
EEID|200000022|200000022|ROMANITA||DEBONO|M|10/17/1952
OFFR|200000022|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 03:57:03.573 PM
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000022|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|200000022|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|200000022|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|200000022|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000022|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000022|Qualifying Event - Admin Change|01/01/2016||BSG plan Three Plus|Employee + Child|Employee + Child|133.00|232.00|01/01/2016||||||||08/08/2016 03:57:03.573 PM|200000022
DEPI|200000022|200000040|200000040|KIRAT||WALIAAA|Natural child|N|02/02/2011|M|01/01/2016||A|200000022
EEID|100000028|100000028|GARY||RICE|M|05/01/1955
OFFR|100000028|Qualifying Event - Admin Change|Qualifying Event - Admin Change|03/02/2016|03/02/2016|01/01/2016|12/31/2016|08/09/2016 04:46:44.4644 PM
ELIG|100000028|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000028|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|100000028|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|100000028|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|100000028|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000028|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000028|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000028|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000028|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000028|Qualifying Event - Admin Change|03/02/2016||BSG Plan Four|Employee + Family|Employee + Family|250.00|420.00|03/02/2016||||||||08/09/2016 04:46:44.4644 PM|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|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/09/2016 12:45:57.4557 PM
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000029|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|100000029|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|100000029|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|100000029|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000029|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000029|Qualifying Event - Admin Change|01/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|01/01/2016||||||||08/09/2016 12:45:57.4557 PM|100000029
EEID|200000003|200000003|YANIRDA||MEJIA|M|02/17/1985
OFFR|200000003|Qualifying Event - Add New Child|Qualifying Event - Add New Child|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/08/2016 01:49:51.4951 PM
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000003|Qualifying Event - Add New Child|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000003|Qualifying Event - Add New Child|02/01/2016||BSG plan Three|Employee + Child|Employee + Child|133.00|232.00|02/01/2016||||||||08/08/2016 01:49:51.4951 PM|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|Qualifying Event - Admin Change|Qualifying Event - Admin Change|02/01/2016|02/01/2016|01/01/2016|12/31/2016|08/11/2016 04:56:46.5646 PM
ELIG|200000020|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000020|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|200000020|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|200000020|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|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000020|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000020|Qualifying Event - Admin Change|02/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|02/01/2016||||||||08/11/2016 04:56:46.5646 PM|200000020
EEID|200000004|200000004|BAMBI||ALANIS|M|05/09/1979
OFFR|200000004|Qualifying Event - Admin Change|Qualifying Event - Admin Change|03/01/2016|03/01/2016|01/01/2016|12/31/2016|08/08/2016 01:59:45.5945 PM
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000004|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|200000004|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|200000004|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|200000004|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000004|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000004|Qualifying Event - Admin Change|03/01/2016||BSG plan Three|Employee + Family|Employee + Family|135.00|240.00|03/01/2016||||||||08/08/2016 01:59:45.5945 PM|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
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|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|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|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|Qualifying Event - Admin Change|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|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|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|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000006|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000006|Qualifying Event - Admin Change|08/01/2016||BSG plan one|Employee|Employee|0.00|10.00|01/01/2016||||||||08/05/2016 03:00:03.03 PM|100000006
EEID|100000004|100000004|ANN-TERESA||CUSENZA|M|07/26/1954
OFFR|100000004|||||||
ELIG|100000004||||||Y|||N|N|YES|YES||0||
COVG|100000004||||Opt Out|Employee|Employee|0.00|0.00|01/01/2016||||||||08/05/2016 12:45:11.4511 PM|100000004
EEID|100000005|100000005|DANIELLE||DEBONO|M|03/24/1988
OFFR|100000005|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 02:06:58.658 PM
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000005|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|100000005|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|100000005|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|100000005|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000005|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000005|Qualifying Event - Admin Change|01/01/2016||BSG plan Two|Employee + Spouse|Employee + Spouse|125.00|225.00|01/01/2016||||||||08/05/2016 02:06:58.658 PM|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|Qualifying Event - Admin Change|Qualifying Event - Admin Change|03/01/2016|03/01/2016|01/01/2016|12/31/2016|08/05/2016 12:13:01.131 PM
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000002|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|100000002|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|100000002|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|100000002|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000002|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000002|Qualifying Event - Admin Change|03/01/2016||BSG plan Three|Employee|Employee|130.00|230.00|03/01/2016||||||||08/05/2016 12:13:01.131 PM|100000002
EEID|100000001|100000001|STEPHEN||SHIRLEY|M|02/27/1987
OFFR|100000001|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/05/2016 11:54:00.540 AM
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000001|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|100000001|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|100000001|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|100000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000001|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000001|Qualifying Event - Admin Change|01/01/2016||BSG plan Three|Employee + Family|Employee + Family|135.00|235.00|01/01/2016||||||||08/05/2016 11:54:00.540 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|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/09/2016 02:58:27.5827 PM
ELIG|100000014|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000014|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|100000014|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|100000014|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|100000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000014|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000014|Qualifying Event - Admin Change|01/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/09/2016 02:58:27.5827 PM|100000014
EEID|100000037|100000037|Jhon||Doe|M|01/01/1980
OFFR|100000037|New Hire Enrollment|New Hire Enrollment|08/04/2016|08/04/2016|01/01/2016|12/31/2016|08/04/2016 12:00:00.00 AM
ELIG|100000037|New Hire Enrollment|||||Y|||N|N|YES|YES||0||
COVG|100000037|New Hire Enrollment|08/04/2016||Opt Out|Employee|Employee|0.00|0.00|08/04/2016||||||||08/05/2016 03:30:37.3037 PM|100000037
EEID|200000034|200000034|BENITB||MORALEB|M|07/11/1957
OFFR|200000034|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/08/2016 02:32:27.3227 PM
ELIG|200000034|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|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|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000034|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|200000034|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|200000034|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|200000034|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000034|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000034|Qualifying Event - Admin Change|01/01/2016||BSG plan one|Employee|Employee|140.00|1150.00|01/01/2016||||||||08/08/2016 02:32:27.3227 PM|200000034
EEID|200000039|200000039|TOMEKA||SWOPE|M|07/11/1957
OFFR|200000039|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/16/2016|01/16/2016|01/01/2016|12/31/2016|08/08/2016 03:51:55.5155 PM
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanThre_OLD|BSG plan Three|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|70| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPThree+OLD|BSG plan Three Plus|Employee + Spouse|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Yes|80| | 
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000039|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|200000039|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|200000039|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|200000039|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000039|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000039|Qualifying Event - Admin Change|01/16/2016||BSG plan Three|Employee|Employee|130.00|230.00|01/16/2016||||||||08/08/2016 03:51:55.5155 PM|200000039
EEID|100000038|100000038|STEPHEN||Joe|M|01/01/1980
OFFR|100000038|New Hire Enrollment|New Hire Enrollment|08/07/2016|08/07/2016|01/01/2016|12/31/2016|08/07/2016 12:00:00.00 AM
ELIG|100000038|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000038|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000038|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000038|New Hire Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Yes|75| | 
ELIG|100000038|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000038|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000038|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000038|New Hire Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000038|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000038|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000038|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000038|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000038|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000038|New Hire Enrollment|08/07/2016||BSG plan Two|Employee|Employee|120.00|220.00|08/01/2016||||||||08/08/2016 04:55:10.5510 PM|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
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|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|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|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|New Hire 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|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|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|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000039|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000039|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000039|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000039|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000039|New Hire Enrollment|08/01/2016||BSG plan Two|Employee|Employee|120.00|220.00|08/01/2016||||||||08/08/2016 07:00:15.015 PM|100000039
EEID|200000007|200000007|Anirudha|O|Dev|M|01/01/1985
OFFR|200000007|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/01/2016|01/01/2016|01/01/2016|12/31/2016|08/09/2016 03:09:58.958 PM
ELIG|200000007|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|200000007|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|200000007|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|200000007|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|200000007|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000007|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000007|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000007|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|200000007|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|200000007|Qualifying Event - Admin Change|01/01/2016||BSG Plan Five|Employee + Child|Employee + Child|75.00|170.00|01/01/2016||||||||08/09/2016 03:09:58.958 PM|200000007
DEPI|200000007|200000048|200000048|Sam||Dev|Natural child|N|01/01/2012|M|01/01/2016||A|200000007
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
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|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|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|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|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000071|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000071|Qualifying Event - Admin Change|08/17/2016||Opt Out|Employee|Employee|0.00|0.00|08/17/2016||||||||08/18/2016 04:34:49.3449 PM|100000071
EEID|100000072|100000072|Jon||Doe|M|01/01/1985
OFFR|100000072|Qualifying Event - Admin Change|Qualifying Event - Admin Change|01/15/2016|01/15/2016|01/01/2016|12/31/2016|08/18/2016 05:29:35.2935 PM
ELIG|100000072|Qualifying Event - Admin Change|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|240.00|410.00|Y|Y|YES|YES|Yes|50| | 
ELIG|100000072|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|100000072|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|100000072|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|100000072|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000072|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000072|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000072|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000072|Qualifying Event - Admin Change|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000072|Qualifying Event - Admin Change|01/15/2016||BSG Plan Four|Employee + Spouse|Employee + Spouse|250.00|420.00|01/15/2016||||||||08/18/2016 05:29:35.2935 PM|100000072
DEPI|100000072|||smith||Sp|Spouse|Y|08/01/1985|F|01/15/2016||A|100000072
EEID|100000075|100000075|Jon||Doe|M|01/01/1980
OFFR|100000075|New Hire Enrollment|New Hire Enrollment|08/15/2016|08/15/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM
ELIG|100000075|New Hire Enrollment|||||Y|||N|N|YES|YES||0||
COVG|100000075|New Hire Enrollment|08/15/2016||BSG Plan Five|Employee|Employee|50.00|150.00|08/15/2016||||||||08/19/2016 12:46:10.4610 PM|100000075
EEID|100000076|100000076|Jon||Test|M|01/01/1980
OFFR|100000076|New Hire Enrollment|New Hire Enrollment|08/15/2016|08/15/2016|01/01/2016|12/31/2016|08/15/2016 12:00:00.00 AM
ELIG|100000076|New Hire Enrollment|||||Y|||N|N|YES|YES||0||
COVG|100000076|New Hire Enrollment|08/15/2016||BSG Plan Four|Employee|Employee|240.00|410.00|08/15/2016||||||||08/19/2016 02:49:00.490 PM|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
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|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|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|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|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE|Employee|Y|50.00|350.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000077|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000077|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000077|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
ELIG|100000077|New Hire Enrollment|BSGPlanFive_OLD|1. Ameritas Dental Low|Employee + Spouse|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Yes|1. Ameritas Dental Low|1. Ameritas Dental Low|1. Ameritas Dental Low
COVG|100000077|New Hire Enrollment|08/01/2016||BSG Plan Four|Employee|Employee|240.00|410.00|08/01/2016||||||||08/19/2016 03:12:43.1243 PM|100000077
FOOT|39