Employee ID Employee SSN Member Type Member SSN DOB Month Index Tax Year Month Value EIN 300000174 300000174 Ch 300000191 01/01/2015 03 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 04 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 05 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 06 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 07 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 08 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 09 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 10 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 11 2016 1 123456799 300000174 300000174 Ch 300000191 01/01/2015 12 2016 1 123456799