HEAD|76d6deb6-d3db-43f3-9846-f9de2e58dd5f|ACA Automation
EEID|200000002|200000002|AARON||CRANE|M|11/29/1981
OFFR|200000002|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|02/06/2017 12:04:48.097000 PM
ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|1150.00|Y|Y|YES|YES|Y|81.56|Y||
ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000002|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Y|95.00|Y||
ELIG|200000002|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000002|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000002|Open Enrollment|01/01/2017||BSG Continuous enrollment|1|1|0.00|0.00|01/01/2017|||||N|||2017-02-06 12:04:48|200000002
EEID|200000017|200000017|ADRIANA||NAVARRETE|M|12/23/1976
OFFR|200000017|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000017|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000017|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000017|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000017|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000017|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|1|1|130.00|230.00|01/01/2017|||||N|||2016-08-08 15:14:22|200000017
EEID|200000014|200000014|LUISITO||PELLERIN|M|06/13/1970
OFFR|200000014|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000014|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000014|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000014|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000014|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000014|Open Enrollment|01/01/2017|BSGPThree+OLD|BSG plan Three Plus|1|1|133.00|232.00|01/01/2017|||||N|||2016-08-08 14:44:27|200000014
DEPI|200000014|200000035|200000035|GRACE-ANN||REMOLLINO|Natural child|N|02/02/2011|M|A|200000014|
EEID|200000013|200000013|AMIHAN||CRUZ|M|11/20/1959
OFFR|200000013|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000013|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000013|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000013|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000013|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000013|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000013|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000013|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000013|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000013|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000013|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000013|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000013|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000013|Open Enrollment|01/01/2017|BSGPThree+OLD|BSG plan Three Plus|1|1|130.00|230.00|01/01/2017|||||N|||2016-08-22 14:14:01|200000013
EEID|200000010|200000010|SALVAIN||ALEXANDRE|M|06/18/1954
OFFR|200000010|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000010|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000010|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000010|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000010|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000010|Open Enrollment|01/01/2017|BSGPThree+OLD|BSG plan Three Plus|1|1|130.00|230.00|01/01/2017|||||N|||2016-08-08 14:22:25|200000010
EEID|100000013|100000013|LAURA||TUNNERO|M|08/07/1979
OFFR|100000013|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|1150.00|Y|Y|YES|YES|Y|81.56|Y||
ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000013|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Y|95.00|Y||
ELIG|100000013|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000013|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000013|Open Enrollment|01/01/2017|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2017|||||N|||2016-08-05 15:21:33|100000013
EEID|200000018|200000018|ALICE||SHIRLEY|M|10/04/1959
OFFR|200000018|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000018|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000018|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000018|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000018|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000018|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|3|3|135.00|240.00|01/01/2017|||||N|||2016-11-03 12:32:17|200000018
DEPI|200000018|200000032|200000032|MATTHEW||CATTAFI|Spouse|Y|01/01/1987|F|01/01/2017||A|200000018
DEPI|200000018|200000038|200000038|NASIMA||Sarawar Mam|Natural child|N|02/02/2011|M|A|200000018|
EEID|200000000|200000000|KERRI||AVILES|M|04/08/1986
OFFR|200000000|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|1150.00|Y|Y|YES|YES|Y|81.56|Y||
ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000000|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Y|95.00|Y||
ELIG|200000000|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000000|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000000|Open Enrollment|01/01/2017|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2017|||||N|||2016-08-05 11:39:18|200000000
EEID|200000016|200000016|ZORIC||PROSKUROVSKY|M|07/04/1986
OFFR|200000016|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000016|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000016|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000016|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000016|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000016|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|1|1|122.00|248.00|01/01/2017|||||N|||2016-08-08 15:02:31|200000016
DEPI|200000016|200000030|200000030|SHEENLY||SINDICO|Spouse|Y|01/01/1987|F|01/01/2017||A|200000016
EEID|200000001|200000001|DANISSE||SALOMON|M|05/14/1963
OFFR|200000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|130.00|220.00|Y|Y|YES|YES|Y|62.86|Y||
ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|200000001|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|200000001|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000001|Open Enrollment|01/01/2017|BSGPlanTwo_OLD|BSG plan Two|1|1|120.00|220.00|01/01/2017|||||N|||2016-08-08 11:51:13|200000001
EEID|200000009|200000009|JOSEPH||BILAND|M|11/12/1981
OFFR|200000009|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|200000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|200000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|200000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|200000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|200000009|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000009|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000009|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|150.00|01/01/2017|||||N|||2016-08-09 16:26:30|200000009
EEID|200000015|200000015|Gail||MIGALBIN|M|10/20/1984
OFFR|200000015|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000015|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000015|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000015|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000015|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000015|Open Enrollment|01/01/2017|BSGPThree+OLD|BSG plan Three Plus|1|1|133.00|232.00|01/01/2017|||||N|||2016-08-08 14:53:00|200000015
DEPI|200000015|200000036|200000036|PATRICIA||CHASE|Natural child|N|02/02/2011|M|A|200000015|
EEID|200000024|200000024|BENITB||MORALEB|M|07/11/1957
OFFR|200000024|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|1150.00|Y|Y|YES|YES|Y|81.56|Y||
ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|200000024|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Y|95.00|Y||
ELIG|200000024|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000024|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000024|Open Enrollment|01/01/2017|BSGPlanOne_OLD|BSG plan one|1|1|140.00|1150.00|01/01/2017|||||N|||2016-08-08 11:25:37|200000024
EEID|100000027|100000027|STEVE||ZAEH|M|02/21/1953
OFFR|100000027|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000027|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000027|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000027|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000027|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-09 17:03:11|100000027
EEID|100000024|100000024|BARBARA||FORSTER|M|10/25/1951
OFFR|100000024|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000024|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000024|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000024|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000024|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-22 17:41:21|100000024
EEID|100000025|100000025|LUTCHIE||CARIAGA|M|11/12/1977
OFFR|100000025|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000025|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000025|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000025|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000025|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000025|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000025|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000025|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|250.00|420.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-22 17:57:30|100000025
DEPI|100000025|110000025|110000025|Sp||Sp|Spouse|Y|01/01/1985|F|01/01/2017||A|100000025
EEID|100000021|100000021|CAROL||ZIESING|M|04/15/1940
OFFR|100000021|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/27/2017 05:26:12.477000 PM
ELIG|100000021|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|130.00|220.00|Y|Y|YES|YES|Y|62.86|Y||
ELIG|100000021|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000021|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000021|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000021|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000021|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000021|Re-hire Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|200000022|200000022|ROMANITA||DEBONO|M|10/17/1952
OFFR|200000022|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000022|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000022|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000022|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000022|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000022|Open Enrollment|01/01/2017|BSGPThree+OLD|BSG plan Three Plus|1|1|133.00|232.00|01/01/2017|||||N|||2016-08-08 15:57:03|200000022
DEPI|200000022|200000040|200000040|KIRAT||WALIBAA|Natural child|N|02/02/2011|M|A|200000022|
EEID|100000028|100000028|GARY||RICE|M|05/01/1955
OFFR|100000028|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|1150.00|Y|Y|YES|YES|Y|81.56|Y||
ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000028|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Y|95.00|Y||
ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000028|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000028|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000028|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000028|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|3|3|250.00|420.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-09 16:46:44|100000028
DEPI|100000028|110000028|110000028|Sp||Sp|Spouse|Y|01/01/1980|F|01/01/2017||A|100000028
DEPI|100000028|120000028|120000028|Ch||Ch|Natural child|N|01/01/2010|M|A|100000028|
EEID|100000029|100000029|JEFFERY||MALARAN|M|10/18/1970
OFFR|100000029|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|130.00|220.00|Y|Y|YES|YES|Y|62.86|Y||
ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000029|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000029|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000029|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000029|Open Enrollment|01/01/2017|BSGPlanTwo_OLD|BSG plan Two|1|1|120.00|220.00|01/01/2017|||||N|||2016-08-09 12:45:57|100000029
EEID|100000030|100000030|PAUL||TUNNERO|M|08/07/1979
OFFR|100000030|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000030|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000030|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000030|Open Enrollment|01/01/2017|OptOut_OLD|Opt Out|1|1|0.00|0.00|01/01/2017|||||Y|06|Unknown|2016-08-09 11:04:28|100000030
EEID|200000003|200000003|YANIRDA||MEJIA|M|02/17/1985
OFFR|200000003|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000003|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000003|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000003|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000003|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000003|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|1|1|133.00|232.00|01/01/2017|||||N|||2016-08-08 13:49:51|200000003
DEPI|200000003|200000025|200000025|BAKTHA||KUMAR|Natural child|N|05/05/2012|M|A|200000003|
EEID|200000004|200000004|BAMBI||ALANIS|M|05/09/1979
OFFR|200000004|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000004|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000004|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000004|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000004|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000004|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|3|3|135.00|240.00|01/01/2017|||||N|||2016-08-08 13:59:45|200000004
DEPI|200000004|200000033|200000033|Neeta||ALANIS|Spouse|Y|01/01/1987|F|01/01/2017||A|200000004
DEPI|200000004|200000026|200000026|TERESA||WRIGHT|Natural child|N|04/23/2013|M|A|200000004|
EEID|100000006|100000006|LISA||MORALES|M|12/10/1974
OFFR|100000006|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|10.00|Y|Y|YES|YES|Y|7.14|Y||
ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|0.00|10.00|Y|Y|YES|YES|Y|100.00|Y||
ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|0.00|10.00|Y|Y|YES|YES|Y|100.00|Y||
ELIG|100000006|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|0.00|10.00|Y|Y|YES|YES|Y|100.00|Y||
ELIG|100000006|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000006|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000006|Open Enrollment|01/01/2017|BSGPlanOne_OLD|BSG plan one|1|1|0.00|10.00|01/01/2017|||||N|||2016-08-05 15:00:03|100000006
EEID|100000004|100000004|ANN-TERESA||CUSENZA|M|07/26/1954
OFFR|100000004|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|1150.00|Y|Y|YES|YES|Y|81.56|Y||
ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000004|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Y|95.00|Y||
ELIG|100000004|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000004|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000004|Open Enrollment|01/01/2017|OptOut_OLD|Opt Out|1|1|0.00|0.00|01/01/2017|||||Y|06|Unknown|2016-08-05 12:45:11|100000004
EEID|100000005|100000005|DANIELLE||DEBONO|M|03/24/1988
OFFR|100000005|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|130.00|220.00|Y|Y|YES|YES|Y|62.86|Y||
ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000005|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000005|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000005|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000005|Open Enrollment|01/01/2017|BSGPlanTwo_OLD|BSG plan Two|1|1|125.00|225.00|01/01/2017|||||N|||2016-08-05 14:06:58|100000005
DEPI|100000005|110000005|110000005|SP||Sp|Spouse|Y|01/01/1986|F|01/01/2017||A|100000005
EEID|100000002|100000002|GINA||HUNTER|M|12/13/1968
OFFR|100000002|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|100000002|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|100000002|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000002|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000002|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000002|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|1|1|130.00|230.00|01/01/2017|||||N|||2016-08-05 12:13:01|100000002
EEID|100000001|100000001|STEPHEN||SHIRLEY|M|02/27/1987
OFFR|100000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|100000001|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|100000001|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|100000001|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000001|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|3|3|135.00|235.00|01/01/2017|||||N|||2016-08-05 11:54:00|100000001
DEPI|100000001|110000001|110000001|Sp||Sp|Spouse|Y|01/01/1985|F|01/01/2017||A|100000001
DEPI|100000001|120000001|120000001|Ch||Ch|Natural child|N|01/01/2010|M|A|100000001|
EEID|100000015|100000015|MARY||FOURTE|M|11/16/1975
OFFR|100000015|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000015|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE|Employee|Y|130.00|1150.00|Y|Y|YES|YES|Y|81.56|Y||
ELIG|100000015|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE+Family|Employee + Family|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000015|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + CH|Employee + 1|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000015|Open Enrollment|BSGPlanOne_OLD|BSG plan one|EE + SP|Employee + Spouse|Y|142.50|1167.50|Y|Y|YES|YES|Y|89.12|Y||
ELIG|100000015|Open Enrollment|BSGPlanOne_OLD|BSG plan one|Employee + Child|Employee + Child|Y|40.00|760.00|Y|Y|YES|YES|Y|95.00|Y||
ELIG|100000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000015|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000015|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000015|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000015|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-22 16:59:42|100000015
EEID|100000037|100000037|Jhon||Doe|M|01/01/1980
OFFR|100000037|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000037|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000037|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000037|Open Enrollment|01/01/2017|OptOut_OLD|Opt Out|1|1|0.00|0.00|01/01/2017|||||Y|06|Unknown|2016-08-05 15:30:37|100000037
EEID|200000039|200000039|TOMEKA||SWOPE|M|07/11/1957
OFFR|200000039|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000039|Open Enrollment|BSGPlanThre_OLD|BSG plan Three|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE|Employee|Y|130.00|230.00|Y|Y|YES|YES|Y|63.89|Y||
ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE+Family|Employee + Family|Y|135.00|240.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + CH|Employee + 1|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|EE + SP|Employee + Spouse|Y|122.00|248.00|Y|Y|YES|YES|Y|67.03|Y||
ELIG|200000039|Open Enrollment|BSGPThree+OLD|BSG plan Three Plus|Employee + Child|Employee + Child|Y|133.00|232.00|Y|Y|YES|YES|Y|63.56|Y||
ELIG|200000039|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000039|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000039|Open Enrollment|01/01/2017|BSGPlanThre_OLD|BSG plan Three|1|1|130.00|230.00|01/01/2017|||||N|||2016-08-08 15:51:55|200000039
EEID|100000038|100000038|STEPHEN||Joe|M|01/01/1980
OFFR|100000038|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|130.00|220.00|Y|Y|YES|YES|Y|62.86|Y||
ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000038|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000038|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000038|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000038|Open Enrollment|01/01/2017|BSGPlanTwo_OLD|BSG plan Two|1|1|120.00|220.00|01/01/2017|||||N|||2016-08-08 16:55:10|100000038
EEID|100000039|100000039|smith||Joes|M|01/01/1980
OFFR|100000039|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|130.00|220.00|Y|Y|YES|YES|Y|62.86|Y||
ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000039|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|100000039|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000039|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000039|Open Enrollment|01/01/2017|BSGPlanTwo_OLD|BSG plan Two|1|1|120.00|220.00|01/01/2017|||||N|||2016-08-08 19:00:15|100000039
EEID|200000007|200000007|Anirudha|O|Dev|M|01/01/1985
OFFR|200000007|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000007|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|200000007|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|200000007|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|200000007|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|200000007|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|200000007|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000007|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000007|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|75.00|170.00|01/01/2017|||||N|||2016-08-09 15:09:58|200000007
DEPI|200000007|200000048|200000048|Sam||Dev|Natural child|N|01/01/2012|M|A|200000007|
EEID|100000040|100000040|Test||Hspl|M|01/01/1980
OFFR|100000040|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000040|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000040|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000040|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|000000058|000000058|a||a|M|01/01/1980
OFFR|000000058|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|02/06/2017 11:47:59.790000 AM
ELIG|000000058|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000058|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000058|Open Enrollment|01/01/2017||ACA plan for 7220|1|1|0.00|0.00|01/01/2017|||||ACA plan for 7220|ACA plan for 7220|ACA plan for 7220|2017-02-06 11:47:59|000000058
EEID|000000059|000000059|aa||aa|M|01/01/1980
OFFR|000000059|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|000000059|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000059|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|000000059|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|100000200|100000200|AAA||AAA|M|01/01/1980
OFFR|100000200|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000200|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000200|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000200|Open Enrollment|01/01/2017||BSG Continuous enrollment|1|1|0.00|0.00|01/01/2017|||||N|||2016-08-17 14:56:59|100000200
EEID|000000064|000000064|Sagar||Info|M|01/01/1980
OFFR|000000064|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000064|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|000000064|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000064|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000064|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2016-08-17 14:49:27|000000064
DEPI|000000064|123565555|123565555|Test||Hspl|Natural child|N|01/01/2013|M|A|000000064|
EEID|000000065|000000065|RBS||Scotland|M|01/01/1987
OFFR|000000065|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000065|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|000000065|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000065|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000065|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2016-08-17 15:07:08|000000065
DEPI|000000065|||sadfsdf||sdfsdf|Natural child|N|01/01/2000|M|A|000000065|
DEPI|000000065|||fghfgh||fghfgh|Step child|N|01/01/2000|M|A|000000065|
DEPI|000000065|||asdasd||asd|Natural child|N|01/01/2000|M|A|000000065|
DEPI|000000065|||dsafsdf||sdfsdf|Natural child|N|01/01/2001|M|A|000000065|
DEPI|000000065|||vbnbvn||bnbvn|Natural child|N|01/01/2001|M|A|000000065|
DEPI|000000065|||bvbvn||fghgn|Natural child|N|02/01/2000|M|A|000000065|
DEPI|000000065|||rgf dfg||dfgdfg|Natural child|N|01/03/2000|M|A|000000065|
DEPI|000000065|||dfgdfg||dfgdfg|Natural child|N|01/01/2013|M|A|000000065|
DEPI|000000065|||Sadsad||asdsad|Natural child|N|01/01/2013|M|A|000000065|
DEPI|000000065|||sasa||zxcxzczxc|Natural child|N|01/01/2013|M|A|000000065|
DEPI|000000065|||xcxcv||xcvxcv|Natural child|N|01/01/2013|F|A|000000065|
EEID|100000070|100000070|JOHN||WAIVE|M|01/01/1984
OFFR|100000070|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000070|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000070|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 01:03:40.277000 PM
EEID|100000071|100000071|Jon||Doe|F|01/01/1984
OFFR|100000071|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000071|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000071|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000071|Open Enrollment|01/01/2017|OptOut_OLD|Opt Out|1|1|0.00|0.00|01/01/2017|||||Y|06|Unknown|2016-08-18 16:34:49|100000071
EEID|100000072|100000072|Jon||Doe|M|01/01/1985
OFFR|100000072|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000072|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000072|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000072|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000072|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|250.00|420.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-18 17:29:35|100000072
DEPI|100000072|||smith||Sp|Spouse|Y|08/01/1985|F|01/01/2017||A|100000072
EEID|100000073|100000073|CCC||CCC|M|01/01/1980
OFFR|100000073|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000073|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000073|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000073|New Hire Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|100000074|100000074|Jon||Doe|F|01/01/1980
OFFR|100000074|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000074|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000074|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000074|Qualifying Event - Other chnages|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|100000075|100000075|Jon||Doe|M|01/01/1980
OFFR|100000075|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000075|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|100000075|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|100000075|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|100000075|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|100000075|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|100000075|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000075|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000075|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|150.00|01/01/2017|||||N|||2016-08-19 12:46:10|100000075
EEID|100000076|100000076|Jon||Test|M|01/01/1980
OFFR|100000076|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000076|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000076|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000076|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000076|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000076|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000076|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000076|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-19 14:49:00|100000076
EEID|100000077|100000077|Jon||Doe|M|01/01/1980
OFFR|100000077|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000077|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000077|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000077|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000077|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-08-19 15:12:43|100000077
EEID|100000079|100000079|Jon||Doe|F|01/01/1985
OFFR|100000079|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000079|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000079|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000079|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|100000080|100000080|Jon||Doe|M|01/01/1984
OFFR|100000080|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000080|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000080|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000080|New Hire Enrollment|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 01:03:40.277000 PM
EEID|100000082|100000082|Jon||Doe|M|01/01/1980
OFFR|100000082|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000082|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000082|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000082|New Hire Enrollment|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 01:03:40.277000 PM
EEID|200000008|200000008|Mahendra||Mungase|M|01/01/1987
OFFR|200000008|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000008|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|200000008|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|200000008|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|200000008|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|200000008|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|200000008|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000008|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000008|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|350.00|01/01/2017|||||N|||2016-08-22 16:41:36|200000008
EEID|900000000|900000000|Mark||Warner|M|01/01/1980
OFFR|900000000|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|900000000|Open Enrollment|||EE|Employee|Y|100.00|200.00|Y|Y|YES|YES|Y|66.67|Y||
ELIG|900000000|Open Enrollment|||EE+Family|Employee + Family|Y|200.00|300.00|Y|Y|YES|YES|Y|60.00|Y||
ELIG|900000000|Open Enrollment|||EE + SP|Employee + Spouse|Y|150.00|250.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|900000000|Open Enrollment|||Employee + Child|Employee + Child|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|900000000|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|900000000|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|900000000|Open Enrollment|01/01/2017||Cigna PPO-Demo|1|1|100.00|200.00|01/01/2017|||||Cigna PPO-Demo|Cigna PPO-Demo|Cigna PPO-Demo|2016-08-31 11:53:18|900000000
EEID|200000040|200000040|Anirudha||Joshi|M|01/01/1987
OFFR|200000040|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000040|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|200000040|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|200000040|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|200000040|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|200000040|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|200000040|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000040|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000040|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|350.00|01/01/2017|||||N|||2016-08-31 11:19:21|200000040
EEID|200000060|200000060|Sagar||Powale|M|01/01/1987
OFFR|200000060|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|200000060|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE|Employee|Y|130.00|220.00|Y|Y|YES|YES|Y|62.86|Y||
ELIG|200000060|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE+Family|Employee + Family|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|200000060|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + CH|Employee + 1|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|200000060|Open Enrollment|BSGPlanTwo_OLD|BSG plan Two|EE + SP|Employee + Spouse|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|200000060|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|200000060|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|200000060|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|200000060|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|200000060|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|200000060|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000060|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|200000060|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|350.00|01/01/2017|||||N|||2016-08-31 13:26:19|200000060
EEID|900000005|900000005|Brett||Lee|M|03/02/1983
OFFR|900000005|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|900000005|Open Enrollment|||EE|Employee|Y|100.00|200.00|Y|Y|YES|YES|Y|66.67|Y||
ELIG|900000005|Open Enrollment|||EE+Family|Employee + Family|Y|200.00|300.00|Y|Y|YES|YES|Y|60.00|Y||
ELIG|900000005|Open Enrollment|||EE + SP|Employee + Spouse|Y|150.00|250.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|900000005|Open Enrollment|||Employee + Child|Employee + Child|Y|125.00|225.00|Y|Y|YES|YES|Y|64.29|Y||
ELIG|900000005|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|900000005|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|900000005|Open Enrollment|01/01/2017||Cigna PPO-Demo|1|1|100.00|200.00|01/01/2017|||||Cigna PPO-Demo|Cigna PPO-Demo|Cigna PPO-Demo|2016-11-09 14:57:26|900000005
EEID|300000011|300000011|MELBA||MALARAN|M|12/12/1985
OFFR|300000011|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|300000011|Open Enrollment|TANGO_002||EE|Employee|Y|110.00|200.00|Y|Y|YES|YES|Y|64.52|Y||
ELIG|300000011|Open Enrollment|TANGO_002||EE+Family|Employee + Family|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000011|Open Enrollment|TANGO_002||EE + CH|Employee + 1|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000011|Open Enrollment|TANGO_002||EE + SP|Employee + Spouse|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000011|Open Enrollment|TANGO_002||Employee + Child|Employee + Child|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000011|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000011|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000011|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000011|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000011|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|300000011|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000010|300000010|RICHARD||RICE|M|12/12/1985
OFFR|300000010|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|300000010|Open Enrollment|TANGO_002||EE|Employee|Y|110.00|200.00|Y|Y|YES|YES|Y|64.52|Y||
ELIG|300000010|Open Enrollment|TANGO_002||EE+Family|Employee + Family|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000010|Open Enrollment|TANGO_002||EE + CH|Employee + 1|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000010|Open Enrollment|TANGO_002||EE + SP|Employee + Spouse|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000010|Open Enrollment|TANGO_002||Employee + Child|Employee + Child|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000010|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000010|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000010|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000010|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000010|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|300000010|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000012|300000012|LAURA||TUNNERO|M|12/12/1985
OFFR|300000012|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|300000012|Open Enrollment|TANGO_002||EE|Employee|Y|110.00|200.00|Y|Y|YES|YES|Y|64.52|Y||
ELIG|300000012|Open Enrollment|TANGO_002||EE+Family|Employee + Family|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000012|Open Enrollment|TANGO_002||EE + CH|Employee + 1|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000012|Open Enrollment|TANGO_002||EE + SP|Employee + Spouse|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000012|Open Enrollment|TANGO_002||Employee + Child|Employee + Child|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000012|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000012|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000012|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000012|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000012|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|300000012|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000021|300000021|ELMA||BUENVENIDA|M|12/12/1985
OFFR|300000021|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000021|Open Enrollment|||EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Y|64.71|Y||
ELIG|300000021|Open Enrollment|||EE+Family|Employee + Family|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000021|Open Enrollment|||EE + CH|Employee + 1|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000021|Open Enrollment|||EE + SP|Employee + Spouse|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000021|Open Enrollment|||Employee + Child|Employee + Child|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000021|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000021|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000021|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000021|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000021|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000021|Open Enrollment|01/01/2017||TANGO Plan Three|1|1|120.00|220.00|01/01/2017|||||TANGO Plan Three|TANGO Plan Three|TANGO Plan Three|2016-09-16 13:46:56|300000021
EEID|300000020|300000020|CAROL||ZIESING|M|12/12/1985
OFFR|300000020|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000020|Open Enrollment|||EE|Employee|Y|120.00|220.00|Y|Y|YES|YES|Y|64.71|Y||
ELIG|300000020|Open Enrollment|||EE+Family|Employee + Family|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000020|Open Enrollment|||EE + CH|Employee + 1|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000020|Open Enrollment|||EE + SP|Employee + Spouse|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000020|Open Enrollment|||Employee + Child|Employee + Child|Y|110.00|240.00|Y|Y|YES|YES|Y|68.57|Y||
ELIG|300000020|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000020|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000020|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000020|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000020|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000020|Open Enrollment|01/01/2017||TANGO Plan Three|1|1|120.00|220.00|01/01/2017|||||TANGO Plan Three|TANGO Plan Three|TANGO Plan Three|2016-09-16 11:47:08|300000020
EEID|300000009|300000009|DOLASNoTestabcaa||ZAEH|M|12/12/1985
OFFR|300000009|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000009|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000009|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000009|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000009|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000009|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000009|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000009|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000009|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000009|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000009|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000009|Open Enrollment|01/01/2017|TANGO_001|TANGO Plan One|1|1|85.00|165.00|01/01/2017|||||TANGO Plan One|TANGO Plan One|TANGO Plan One|2016-09-14 16:09:09|300000009
EEID|300000000|300000000|STEPHEN|DDD|SHIRLEY|M|12/12/1985
OFFR|300000000|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000000|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000000|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000000|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000000|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000000|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000000|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000000|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000000|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000000|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000000|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000000|Open Enrollment|01/01/2017|OptOutTango_1|Opt Out Tango Medical Plan|1|1|0.00|340.00|01/01/2017|||||Opt Out Tango Medical Plan|Opt Out Tango Medical Plan|Opt Out Tango Medical Plan|2016-09-13 09:45:11|300000000
DEPI|300000000|||Sam||Shirley|Natural child|N|01/01/2015|M|A|300000000|
EEID|300000003|300000003|ANN-TERESA||CUSENZA|M|12/12/1985
OFFR|300000003|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000003|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000003|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000003|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000003|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000003|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000003|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000003|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000003|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000003|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000003|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000003|Open Enrollment|01/01/2017|TANGO_001|TANGO Plan One|1|1|60.00|140.00|01/01/2017|||||TANGO Plan One|TANGO Plan One|TANGO Plan One|2016-09-13 10:22:35|300000003
EEID|300000005|300000005|LISA||MORALES|M|12/12/1985
OFFR|300000005|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000005|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000005|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000005|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000005|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000005|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000005|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000005|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000005|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000005|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000005|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000005|Open Enrollment|01/01/2017|TANGO_006|TANGO Plan Six|1|1|140.00|240.00|01/01/2017|||||TANGO Plan Six|TANGO Plan Six|TANGO Plan Six|2016-09-13 13:50:08|300000005
EEID|300000004|300000004|DANIELLE||DEBONO|M|12/12/1985
OFFR|300000004|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000004|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000004|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000004|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000004|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000004|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000004|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000004|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000004|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000004|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000004|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000004|Open Enrollment|01/01/2017|TANGO_001|TANGO Plan One|1|1|60.00|140.00|01/01/2017|||||TANGO Plan One|TANGO Plan One|TANGO Plan One|2016-09-13 11:07:20|300000004
EEID|300000007|300000007|IRIS||DURAN|M|12/12/1985
OFFR|300000007|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000007|Open Enrollment|TANGO_002||EE|Employee|Y|110.00|200.00|Y|Y|YES|YES|Y|64.52|Y||
ELIG|300000007|Open Enrollment|TANGO_002||EE+Family|Employee + Family|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000007|Open Enrollment|TANGO_002||EE + CH|Employee + 1|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000007|Open Enrollment|TANGO_002||EE + SP|Employee + Spouse|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000007|Open Enrollment|TANGO_002||Employee + Child|Employee + Child|Y|120.00|200.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000007|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000007|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000007|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000007|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000007|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000007|Open Enrollment|01/01/2017|TANGO_006|TANGO Plan Six|1|1|140.00|240.00|01/01/2017|||||TANGO Plan Six|TANGO Plan Six|TANGO Plan Six|2016-09-14 10:39:36|300000007
EEID|300000006|300000006|LASHARON||TUBBS|M|12/12/1985
OFFR|300000006|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000006|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000006|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000006|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000006|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000006|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000006|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000006|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000006|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000006|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000006|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000006|Open Enrollment|01/01/2017|TANGO_001|TANGO Plan One|1|1|60.00|140.00|01/01/2017|||||TANGO Plan One|TANGO Plan One|TANGO Plan One|2016-09-13 16:35:47|300000006
EEID|300000001|300000001|GINA||HUNTER|M|12/12/1985
OFFR|300000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000001|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000001|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000001|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000001|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000001|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000001|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000001|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000001|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000001|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000001|Open Enrollment|01/01/2017|TANGO_001|TANGO Plan One|1|1|60.00|140.00|01/01/2017|||||TANGO Plan One|TANGO Plan One|TANGO Plan One|2016-09-12 16:39:12|300000001
EEID|300000053|300000053|Tim||Potter|M|01/01/1987
OFFR|300000053|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|300000053|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|300000053|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|300000053|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|300000053|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|300000053|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|300000053|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|300000053|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|300000053|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|300000053|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000053|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|300000053|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|400000001|400000001|CAROL||WEHLISCH|M|12/04/1988
OFFR|400000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|400000001|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|400000001|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|400000001|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|400000001|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|400000001|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|400000001|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|400000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|400000001|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|350.00|01/01/2017|||||N|||2016-09-19 12:53:32|400000001
EEID|400000003|400000003|SHANNON||COLLINS|M|08/07/1978
OFFR|400000003|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|400000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|400000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|400000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|400000003|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|400000003|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|400000003|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|400000003|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-09-20 11:21:37|400000003
EEID|400000011|400000011|JACKIE||DRAZEN|F|05/04/1980
OFFR|400000011|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|400000011|Open Enrollment||Basic Life and AD&D for PT Grandfathered MSH Employees|EE|Employee|Y|0.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|400000011|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|400000011|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|400000011|Open Enrollment|01/01/2017||WT-4369 NO Rate|1|1|0.00|0.00|01/01/2017|||||WT-4369 NO Rate|WT-4369 NO Rate|WT-4369 NO Rate|2016-09-22 17:40:59|400000011
EEID|400000012|400000012|ANTHONY||BAECHLE|M|05/04/1980
OFFR|400000012|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|400000012|Open Enrollment|||EE|Employee|Y|0.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|400000012|Open Enrollment|||EE+Family|Employee + Family|Y|0.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|400000012|Open Enrollment|||EE + CH|Employee + 1|Y|0.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|400000012|Open Enrollment|||EE + SP|Employee + Spouse|Y|0.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|400000012|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|400000012|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|400000012|Open Enrollment|01/01/2017||WT-4369 Rate mapped from Other Class|1|1|0.00|0.00|01/01/2017|||||WT-4369 Rate mapped from Other Class|WT-4369 Rate mapped from Other Class|WT-4369 Rate mapped from Other Class|2016-09-22 17:41:28|400000012
EEID|600000001|600000001|Test||Waived New|M|03/09/1984
OFFR|600000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|600000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|600000001|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|600000004|600000004|Test||WaiveEMP|M|10/07/1986
OFFR|600000004|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|600000004|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|600000004|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|600000005|600000005|Check||Waive EMP|M|01/01/1985
OFFR|600000005|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|600000005|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|600000005|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|500000001|500000001|AdrianAdrianAdrianAdrianAdrianAdrianAdrianAdrianAd|AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA|BrunettBrunettBrunettBruneBrunettttBrunettBrunettB|M|05/04/1980
OFFR|500000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|03/16/2017 12:29:32.617000 PM
ELIG|500000001|Open Enrollment|||EE|Employee|Y|130.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|500000001|Open Enrollment||Employee Assistance Program|EE|Employee|Y|130.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|500000001|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|500000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|500000001|Open Enrollment|01/01/2017||ACA Plan 1|1|1|0.00|0.00|01/01/2017|||||ACA Plan 1|ACA Plan 1|ACA Plan 1|2017-03-16 12:29:32|500000001
EEID|300000085|300000085|DAVIAA||DAVIAA|M|12/12/1985
OFFR|300000085|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000085|Open Enrollment||2014 Dependent Care FSA|EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000085|Open Enrollment||2014 Dependent Care FSA|EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000085|Open Enrollment||2014 Dependent Care FSA|EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000085|Open Enrollment||2014 Dependent Care FSA|EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000085|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000085|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000085|Open Enrollment|01/01/2017||WT-2691 Class AA|1|1|90.00|200.00|01/01/2017|||||WT-2691 Class AA|WT-2691 Class AA|WT-2691 Class AA|2016-10-18 10:29:13|300000085
EEID|100000041|100000041|Smith||Joes|M|01/01/1980
OFFR|100000041|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|100000041|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|100000041|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000041|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000041|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|100000041|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000041|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|100000041|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-10-17 12:48:52|100000041
EEID|300000035|300000035|DAVIF||DAVIF|M|12/12/1985
OFFR|300000035|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000035|Open Enrollment|||EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000035|Open Enrollment|||EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000035|Open Enrollment|||EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000035|Open Enrollment|||EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000035|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000035|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000035|Open Enrollment|01/01/2017||WT-2691 Class AB|1|1|0.00|0.00|01/01/2017|||||WT-2691 Class AB|WT-2691 Class AB|WT-2691 Class AB|2016-10-18 12:11:19|300000035
DEPI|300000035|||Sagar||Davif|Natural child|N|01/01/2014|M|A|300000035|
EEID|100000042|100000042|Smith||Testrom|M|01/01/2015
OFFR|100000042|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|100000042|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000042|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000042|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000047|300000047|DAVIM||DAVIM|M|12/12/1985
OFFR|300000047|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000047|Open Enrollment||Group Long Term Disability Class 1|EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000047|Open Enrollment||Group Long Term Disability Class 1|EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000047|Open Enrollment||Group Long Term Disability Class 1|EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000047|Open Enrollment||Group Long Term Disability Class 1|EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000047|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000047|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000047|Open Enrollment|01/01/2017||WT-2691 Class AD|1|1|90.00|200.00|01/01/2017|||||WT-2691 Class AD|WT-2691 Class AD|WT-2691 Class AD|2016-10-20 10:43:25|300000047
EEID|600000012|600000012|One||waive|M|01/01/1985
OFFR|600000012|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|600000012|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|600000012|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000040|300000040|DAVIK||DAVIK|M|12/12/1985
OFFR|300000040|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000040|Open Enrollment||2014 Health Care FSA|EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000040|Open Enrollment||2014 Health Care FSA|EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000040|Open Enrollment||2014 Health Care FSA|EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000040|Open Enrollment||2014 Health Care FSA|EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000040|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000040|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000040|Open Enrollment|01/01/2017||WT-2691 Class AC|1|1|90.00|200.00|01/01/2017|||||WT-2691 Class AC|WT-2691 Class AC|WT-2691 Class AC|2016-10-18 17:09:27|300000040
EEID|300000041|300000041|DAVIM||DAVIMQ|M|12/12/1985
OFFR|300000041|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000041|Open Enrollment||2014 Health Care FSA|EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000041|Open Enrollment||2014 Health Care FSA|EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000041|Open Enrollment||2014 Health Care FSA|EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000041|Open Enrollment||2014 Health Care FSA|EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000041|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000041|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000041|Open Enrollment|01/01/2017||WT-2691 Class AC|1|1|90.00|200.00|01/01/2017|||||WT-2691 Class AC|WT-2691 Class AC|WT-2691 Class AC|2016-10-18 17:10:05|300000041
EEID|300000042|300000042|DAVIM||DAVIM|M|12/12/1985
OFFR|300000042|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000042|Open Enrollment||2014 Health Care FSA|EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000042|Open Enrollment||2014 Health Care FSA|EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000042|Open Enrollment||2014 Health Care FSA|EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000042|Open Enrollment||2014 Health Care FSA|EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000042|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000042|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000042|Open Enrollment|01/01/2017||WT-2691 Class AC|1|1|90.00|200.00|01/01/2017|||||WT-2691 Class AC|WT-2691 Class AC|WT-2691 Class AC|2016-10-18 17:10:35|300000042
EEID|300000043|300000043|DAVIM||DAVIM|M|12/12/1985
OFFR|300000043|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000043|Open Enrollment||2014 Health Care FSA|EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000043|Open Enrollment||2014 Health Care FSA|EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000043|Open Enrollment||2014 Health Care FSA|EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000043|Open Enrollment||2014 Health Care FSA|EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000043|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000043|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000043|Open Enrollment|01/01/2017||WT-2691 Class AC|1|1|90.00|200.00|01/01/2017|||||WT-2691 Class AC|WT-2691 Class AC|WT-2691 Class AC|2016-10-18 17:11:02|300000043
EEID|300000044|300000044|DAVIM||DAVIM|M|12/12/1985
OFFR|300000044|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000044|Open Enrollment||2014 Health Care FSA|EE|Employee|Y|90.00|200.00|Y|Y|YES|YES|Y|68.97|Y||
ELIG|300000044|Open Enrollment||2014 Health Care FSA|EE+Family|Employee + Family|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000044|Open Enrollment||2014 Health Care FSA|EE + CH|Employee + 1|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000044|Open Enrollment||2014 Health Care FSA|EE + SP|Employee + Spouse|Y|92.00|208.00|Y|Y|YES|YES|Y|69.33|Y||
ELIG|300000044|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000044|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000044|Open Enrollment|01/01/2017||WT-2691 Class AC|1|1|90.00|200.00|01/01/2017|||||WT-2691 Class AC|WT-2691 Class AC|WT-2691 Class AC|2016-10-18 17:11:45|300000044
EEID|200000041|200000041|Shivayyy||Shinde|M|01/01/1987
OFFR|200000041|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|200000041|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000041|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|200000041|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|100000045|100000045|Swatia||James|M|01/01/1982
OFFR|100000045|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|100000045|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|100000045|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|100000045|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 01:03:40.277000 PM
EEID|300000104|300000104|DAVIM||DAVIM|M|12/12/1985
OFFR|300000104|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000104|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE|Employee|Y|130.00|410.00|Y|Y|YES|YES|Y|61.19|Y||
ELIG|300000104|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE+Family|Employee + Family|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|300000104|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + CH|Employee + 1|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|300000104|Open Enrollment|BSGPlanFour+OLD|BSG Plan Four|EE + SP|Employee + Spouse|Y|250.00|420.00|Y|Y|YES|YES|Y|62.69|Y||
ELIG|300000104|Open Enrollment||Voluntary STD Option 2|EE|Employee|Y|90.00|150.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000104|Open Enrollment||Voluntary STD Option 2|EE+Family|Employee + Family|Y|125.00|175.00|Y|Y|YES|YES|Y|58.33|Y||
ELIG|300000104|Open Enrollment||Voluntary STD Option 2|EE + CH|Employee + 1|Y|130.00|180.00|Y|Y|YES|YES|Y|58.06|Y||
ELIG|300000104|Open Enrollment||Voluntary STD Option 2|EE + SP|Employee + Spouse|Y|115.00|200.00|Y|Y|YES|YES|Y|63.49|Y||
ELIG|300000104|Open Enrollment||Voluntary STD Option 2|Employee + Child|Employee + Child|Y|140.00|180.00|Y|Y|YES|YES|Y|56.25|Y||
ELIG|300000104|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000104|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000104|Open Enrollment|01/01/2017|BSGPlanFour+OLD|BSG Plan Four|1|1|240.00|410.00|01/01/2017|||||BSG Plan Four|BSG Plan Four|BSG Plan Four|2016-10-26 14:07:40|300000104
EEID|300000105|300000105|DAVIM||DAVIM|M|12/12/1985
OFFR|300000105|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000105|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|300000105|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|300000105|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|300000105|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|300000105|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|300000105|Open Enrollment||Voluntary STD Option 2|EE|Employee|Y|90.00|150.00|Y|Y|YES|YES|Y|62.50|Y||
ELIG|300000105|Open Enrollment||Voluntary STD Option 2|EE+Family|Employee + Family|Y|125.00|175.00|Y|Y|YES|YES|Y|58.33|Y||
ELIG|300000105|Open Enrollment||Voluntary STD Option 2|EE + CH|Employee + 1|Y|130.00|180.00|Y|Y|YES|YES|Y|58.06|Y||
ELIG|300000105|Open Enrollment||Voluntary STD Option 2|EE + SP|Employee + Spouse|Y|115.00|200.00|Y|Y|YES|YES|Y|63.49|Y||
ELIG|300000105|Open Enrollment||Voluntary STD Option 2|Employee + Child|Employee + Child|Y|140.00|180.00|Y|Y|YES|YES|Y|56.25|Y||
ELIG|300000105|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000105|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000105|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|70.00|180.00|01/01/2017|||||N|||2016-12-06 10:59:53|300000105
DEPI|300000105|100080000|100080000|Sp||Sp|Natural child|N|01/01/2011|M|A|300000105|
EEID|300000116|300000116|STEPHEN||SHIRLEY|M|12/12/1985
OFFR|300000116|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000116|Open Enrollment||COBRA PPO Base Plan|EE|Employee|Y|30.00|120.00|Y|Y|YES|YES|Y|80.00|Y||
ELIG|300000116|Open Enrollment||COBRA PPO Base Plan|EE+Family|Employee + Family|Y|50.00|100.00|Y|Y|YES|YES|Y|66.67|Y||
ELIG|300000116|Open Enrollment||COBRA PPO Base Plan|EE + CH|Employee + 1|Y|50.00|100.00|Y|Y|YES|YES|Y|66.67|Y||
ELIG|300000116|Open Enrollment||COBRA PPO Base Plan|EE + SP|Employee + Spouse|Y|50.00|100.00|Y|Y|YES|YES|Y|66.67|Y||
ELIG|300000116|Open Enrollment||COBRA PPO Base Plan|Employee + Child|Employee + Child|Y|50.00|100.00|Y|Y|YES|YES|Y|66.67|Y||
ELIG|300000116|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000116|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000116|Open Enrollment|01/01/2017||WT-5810 TANGO AA|1|1|50.00|100.00|01/01/2017|||||WT-5810 TANGO AA|WT-5810 TANGO AA|WT-5810 TANGO AA|2016-10-28 17:50:30|300000116
EEID|300000136|300000136|CAROL||ZIESING|M|12/12/1985
OFFR|300000136|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000136|Open Enrollment||COBRA Ameritas Dental High Plan|EE|Employee|Y|50.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000136|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000136|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000136|Open Enrollment|01/01/2017||WT-5810 TANGO CC|1|1|0.00|0.00|01/01/2017|||||WT-5810 TANGO CC|WT-5810 TANGO CC|WT-5810 TANGO CC|2016-10-28 17:34:45|300000136
EEID|000000043|000000043|Rash||Mann|M|01/01/1980
OFFR|000000043|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000043|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000043|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000043|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000043|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000043|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000043|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000043|Open Enrollment|01/01/2017||ACA new changes code 1J|1|1|95.00|205.00|01/01/2017|||||ACA new changes code 1J|ACA new changes code 1J|ACA new changes code 1J|2016-11-04 17:52:08|000000043
DEPI|000000043|000000044|000000044|Ramandeep||Mann|Spouse|Y|01/01/1984|F|01/01/2017||A|000000043
EEID|000000000|000000000|smith||Jhonson|M|01/01/1980
OFFR|000000000|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000000|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000000|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000000|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000000|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000000|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000000|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000000|Open Enrollment|01/01/2017||ACA new changes code 1J|1|1|95.00|205.00|01/01/2017|||||ACA new changes code 1J|ACA new changes code 1J|ACA new changes code 1J|2016-11-03 15:08:16|000000000
DEPI|000000000|||sam||Sp|Spouse|Y|01/01/1985|F|01/01/2017||A|000000000
EEID|000000001|000000001|Jimmy||Donald|M|01/01/1980
OFFR|000000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000001|Open Enrollment|||EE|Employee|Y|130.00|170.00|Y|Y|YES|YES|Y|56.67|Y||
ELIG|000000001|Open Enrollment|||||Y|95.00|255.00|Y|Y|YES|YES|Y|72.86|Y||
ELIG|000000001|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000001|Open Enrollment|01/01/2017||ACA new changes code 1K|1|1|95.00|255.00|01/01/2017|||||ACA new changes code 1K|ACA new changes code 1K|ACA new changes code 1K|2016-11-03 15:45:24|000000001
DEPI|000000001|||Simi||Jen|Spouse|Y|01/01/1985|F|01/01/2017||A|000000001
DEPI|000000001|||Ramy||Donald|Natural child|N|01/01/2009|F|A|000000001|
DEPI|000000001|||Sami||Donald|Natural child|N|01/01/2010|M|A|000000001|
EEID|000000002|000000002|Simmy||Ray|M|01/01/1985
OFFR|000000002|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|05/15/2017 01:03:40.277000 PM
ELIG|000000002|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000002|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000002|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000002|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000002|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000002|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|000000002|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|000000003|000000003|Sanny||Som|M|01/01/1980
OFFR|000000003|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000003|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000003|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000003|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000003|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000003|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000003|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000003|Open Enrollment|01/01/2017||ACA new changes code 1J|1|1|95.00|205.00|01/01/2017|||||ACA new changes code 1J|ACA new changes code 1J|ACA new changes code 1J|2016-11-04 12:00:27|000000003
DEPI|000000003|||Sommy||Ali|Spouse|Y|01/01/1983|F|01/01/2017||A|000000003
EEID|000000006|000000006|Rony||Rom|M|01/01/1981
OFFR|000000006|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000006|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000006|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000006|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000006|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000006|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000006|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000006|Open Enrollment|01/01/2017||ACA new changes code 1J|1|1|95.00|205.00|01/01/2017|||||ACA new changes code 1J|ACA new changes code 1J|ACA new changes code 1J|2016-11-04 12:18:02|000000006
DEPI|000000006|||Sonam||Rom|Spouse|Y|01/01/1980|F|01/01/2017||A|000000006
EEID|000000007|000000007|Jon||Doe|M|01/01/1980
OFFR|000000007|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000007|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000007|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000007|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000007|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000007|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000007|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000007|Open Enrollment|01/01/2017||ACA new changes code 1J|1|1|90.00|160.00|01/01/2017|||||ACA new changes code 1J|ACA new changes code 1J|ACA new changes code 1J|2016-11-04 14:12:57|000000007
EEID|000000009|000000009|Ronny||Spout|M|01/01/1980
OFFR|000000009|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|000000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|000000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|000000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|000000009|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|000000009|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000009|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000009|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000009|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000009|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000009|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000009|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|350.00|01/01/2017|||||N|||2016-11-04 15:09:27|000000009
EEID|000000011|000000011|Jam||Sakura|M|01/01/1980
OFFR|000000011|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|000000011|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE|Employee|Y|125.00|160.00|Y|Y|YES|YES|Y|56.14|Y||
ELIG|000000011|Open Enrollment||COBRA Ameritas Dental Wellness Plan|EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000011|Open Enrollment|||EE|Employee|Y|90.00|160.00|Y|Y|YES|YES|Y|64.00|Y||
ELIG|000000011|Open Enrollment|||EE + SP|Employee + Spouse|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|000000011|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000011|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|000000011|Open Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|011111114|011111114|Sam||Sunny|M|01/01/1985
OFFR|011111114|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|05/15/2017 01:03:40.277000 PM
ELIG|011111114|Open Enrollment||COBRA Superior Vision Plan|EE|Employee|Y|0.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|011111114|Open Enrollment||COBRA Superior Vision Plan|EE + SP|Employee + Spouse|Y|0.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|011111114|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|011111114|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|011111114|Open Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|999999999|999999999|TEST|T|HSPL|M|01/01/1985
OFFR|999999999|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|999999999|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE|Employee|Y|250.00|350.00|Y|Y|YES|YES|Y|41.18|Y||
ELIG|999999999|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE+Family|Employee + Family|Y|75.00|175.00|Y|Y|YES|YES|Y|70.00|Y||
ELIG|999999999|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + CH|Employee + 1|Y|65.00|160.00|Y|Y|YES|YES|Y|71.11|Y||
ELIG|999999999|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|EE + SP|Employee + Spouse|Y|60.00|175.00|Y|Y|YES|YES|Y|74.47|Y||
ELIG|999999999|Open Enrollment|BSGPlanFive_OLD|BSG Plan Five|Employee + Child|Employee + Child|Y|70.00|180.00|Y|Y|YES|YES|Y|72.00|Y||
ELIG|999999999|Open Enrollment|TANGO_001||EE|Employee|Y|85.00|165.00|Y|Y|YES|YES|Y|66.00|Y||
ELIG|999999999|Open Enrollment|TANGO_001||EE+Family|Employee + Family|Y|180.00|180.00|Y|Y|YES|YES|Y|50.00|Y||
ELIG|999999999|Open Enrollment|TANGO_001||EE + CH|Employee + 1|Y|100.00|210.00|Y|Y|YES|YES|Y|67.74|Y||
ELIG|999999999|Open Enrollment|TANGO_001||EE + SP|Employee + Spouse|Y|105.00|215.00|Y|Y|YES|YES|Y|67.19|Y||
ELIG|999999999|Open Enrollment|TANGO_001||Employee + Child|Employee + Child|Y|95.00|205.00|Y|Y|YES|YES|Y|68.33|Y||
ELIG|999999999|Open Enrollment|TANGO_005|TANGO Plan Five|EE|Employee|Y|280.00|480.00|Y|Y|YES|YES|Y|63.16|Y||
ELIG|999999999|Open Enrollment|TANGO_005|TANGO Plan Five|EE+Family|Employee + Family|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|TANGO_005|TANGO Plan Five|EE + CH|Employee + 1|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|TANGO_005|TANGO Plan Five|EE + SP|Employee + Spouse|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|TANGO_005|TANGO Plan Five|Employee + Child|Employee + Child|Y|320.00|460.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE|Employee|Y|45.00|240.00|Y|Y|YES|YES|Y|84.21|Y||
ELIG|999999999|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE+Family|Employee + Family|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + CH|Employee + 1|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|EE + SP|Employee + Spouse|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|TANGO_006|Basic Life and AD&D for Physicians|Employee + Child|Employee + Child|Y|160.00|230.00|Y|Y|YES|YES|Y|58.97|Y||
ELIG|999999999|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|999999999|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|999999999|Open Enrollment|01/01/2017|BSGPlanFive_OLD|BSG Plan Five|1|1|50.00|350.00|01/01/2017|||||N|||2016-12-08 11:06:20|999999999
EEID|000000022|000000022|Bob||Test|F|01/01/1982
OFFR|000000022|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|05/15/2017 02:14:43.823000 PM
ELIG|000000022|Open Enrollment||COBRA Superior Vision Plan|EE|Employee|Y|0.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|000000022|Open Enrollment||COBRA Superior Vision Plan|EE + SP|Employee + Spouse|Y|0.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|000000022|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000022|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|000000022|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 02:14:43.823000 PM
EEID|000000050|000000050|HERR||Two|M|01/01/1980
OFFR|000000050|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000050|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000050|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000050|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000050|Open Enrollment|01/01/2017||XML Verification|1|1|0.00|0.00|01/01/2017|||||XML Verification|XML Verification|XML Verification|2016-12-08 13:13:50|000000050
EEID|000000051|000000051|HERR||Three|M|01/01/1980
OFFR|000000051|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000051|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000051|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000051|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000051|Open Enrollment|01/01/2017||XML Verification|1|1|0.00|0.00|01/01/2017|||||XML Verification|XML Verification|XML Verification|2016-12-08 13:14:50|000000051
EEID|000000052|000000052|HERR||Four|F|01/01/1980
OFFR|000000052|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000052|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000052|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000052|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000052|Open Enrollment|01/01/2017||XML Verification|1|1|0.00|0.00|01/01/2017|||||XML Verification|XML Verification|XML Verification|2016-12-08 13:15:44|000000052
EEID|000000053|000000053|HERR||Five|M|01/01/1980
OFFR|000000053|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000053|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000053|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000053|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000053|Open Enrollment|01/01/2017||XML Verification|1|1|0.00|0.00|01/01/2017|||||XML Verification|XML Verification|XML Verification|2016-12-08 13:16:22|000000053
EEID|000000055|000000055|Jam||Jimmy|F|01/01/1980
OFFR|000000055|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|000000055|Open Enrollment|||EE|Employee|Y|97.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000055|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000000055|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|000000055|Open Enrollment|01/01/2017||xmlreplacement|1|1|0.00|0.00|01/01/2017|||||xmlreplacement|xmlreplacement|xmlreplacement|2016-12-09 15:27:07|000000055
EEID|900001234|900001234|Laurel||Lance|F|07/06/1984
OFFR|900001234|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|900001234|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|900001234|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|900001234|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 01:03:40.277000 PM
EEID|900012345|900012345|Sara||Lance|F|10/20/1987
OFFR|900012345|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|900012345|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|900012345|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|900012345|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 01:03:40.277000 PM
EEID|300000156|300000156|Ani||Dev|M|01/01/1985
OFFR|300000156|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000156|Open Enrollment|||EE|Employee|Y|22.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|300000156|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000156|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000156|Open Enrollment|01/01/2017||WT_7061_A|1|1|0.00|0.00|01/01/2017|||||WT_7061_A|WT_7061_A|WT_7061_A|2016-12-21 13:58:21|300000156
EEID|300000157|300000157|Venky||Pujari|M|01/01/1987
OFFR|300000157|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000157|Open Enrollment|||EE|Employee|Y|0.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|300000157|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000157|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000157|Open Enrollment|01/01/2017||WT_7061_B|1|1|0.00|0.00|01/01/2017|||||WT_7061_B|WT_7061_B|WT_7061_B|2016-12-21 16:54:47|300000157
EEID|000111111|000111111|Alka||James|M|01/01/1980
OFFR|000111111|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|000111111|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000111111|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|000111111|Open Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|000111112|000111112|Anu||Anny|M|01/01/1980
OFFR|000111112|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|000111112|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000111112|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|000111112|New Hire Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|000111113|000111113|Renu||Roy|F|01/01/1980
OFFR|000111113|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|000111113|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|000111113|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|000111113|New Hire Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000169|300000169|Tome||Vary|M|01/01/1985
OFFR|300000169|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000169|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000169|Open Enrollment|||EE|Employee|Y|0.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|300000169|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000169|Open Enrollment|01/01/2017||WT_7061_G|1|1|0.00|0.00|01/01/2017|||||WT_7061_G|WT_7061_G|WT_7061_G|2016-12-26 17:29:06|300000169
EEID|300000172|300000172|Sahim||Tom|M|01/01/1985
OFFR|300000172|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000172|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000172|Open Enrollment|||EE|Employee|Y|40.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|300000172|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000172|Open Enrollment|01/01/2017||WT_7061_N|1|1|0.00|0.00|01/01/2017|||||WT_7061_N|WT_7061_N|WT_7061_N|2016-12-22 19:35:17|300000172
EEID|999999981|999999981|TEST||HSPL|M|01/01/1985
OFFR|999999981|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|999999981|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|999999981|Open Enrollment|||EE|Employee|Y|120.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|999999981|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|999999981|Open Enrollment|01/01/2017||DEMO|1|1|0.00|0.00|01/01/2017|||||DEMO|DEMO|DEMO|2016-12-22 18:23:40|999999981
EEID|999999983|999999983|TESTW||HSPL|M|01/01/1985
OFFR|999999983|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|999999983|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|999999983|Open Enrollment|||EE|Employee|Y|120.00|0.00|Y|Y|YES|YES|N|0.00|Y||
ELIG|999999983|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|999999983|Open Enrollment|01/01/2017||DEMO|1|1|0.00|0.00|01/01/2017|||||DEMO|DEMO|DEMO|2016-12-22 18:33:16|999999983
EEID|300000174|300000174|ZhangNan||Zhu|M|01/01/2015
OFFR|300000174|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000174|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000174|Open Enrollment|||EE|Employee|Y|50.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000174|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000174|Open Enrollment|01/01/2017||WT_4579|1|1|0.00|0.00|01/01/2017|||||WT_4579|WT_4579|WT_4579|2016-12-27 15:24:55|300000174
DEPI|300000174|300000191|300000191|Oscar||Zhu|Natural child|N|01/01/2015|M|A|300000174|
EEID|200000061|200000061|ELLIOTT||BROWN|M|05/04/1980
OFFR|200000061|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|200000061|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000061|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|200000061|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|New Reason|05/15/2017 01:03:40.277000 PM
EEID|200000062|200000062|TODD||KELLY|M|05/04/1980
OFFR|200000062|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 05:00:07.407000 PM
ELIG|200000062|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|200000062|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|200000062|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000180|300000180|Jhon||Zumi|M|01/01/1980
OFFR|300000180|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/01/2017 08:46:23.950000 AM
ELIG|300000180|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000180|Open Enrollment|||EE|Employee|Y|50.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000180|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000180|Open Enrollment|01/01/2017||WT_4579|1|1|0.00|0.00|01/01/2017|||||WT_4579|WT_4579|WT_4579|2016-12-29 12:59:07|300000180
EEID|300000183|300000183|Michael||Lercel|M|01/01/1985
OFFR|300000183|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|300000183|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000183|Open Enrollment||Accident Insurance|EE|Employee|Y|25.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000183|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|300000183|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|300000184|300000184|MATT||HAINES|M|01/01/1985
OFFR|300000184|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/13/2017 04:59:53.813000 PM
ELIG|300000184|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000184|Open Enrollment||Accident Insurance|EE|Employee|Y|25.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000184|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|300000184|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|210000000|210000000|Pop||pinto|M|01/01/1985
OFFR|210000000|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|02/02/2017 02:21:52.313000 PM
ELIG|210000000|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|210000000|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|210000000|Open Enrollment|01/01/2017||ACA plan for 7220|1|1|0.00|0.00|01/01/2017|||||ACA plan for 7220|ACA plan for 7220|ACA plan for 7220|2017-02-02 14:21:52|210000000
EEID|111000001|111000001|samual||Jack|M|01/01/1980
OFFR|111000001|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/23/2017 03:30:24.497000 PM
ELIG|111000001|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|111000001|Open Enrollment||Universal Employee Life|EE|Employee|Y|90.00|310.00|Y|Y|YES|YES|Y|77.50|Y||
ELIG|111000001|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|111000001|Open Enrollment|01/01/2017||ACA-7697|1|1|150.00|150.00|01/01/2017|||||ACA-7697|ACA-7697|ACA-7697|2017-01-23 15:30:24|111000001
EEID|111000002|111000002|Sany||Jhonson|M|01/01/1980
OFFR|111000002|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/23/2017 03:57:37.460000 PM
ELIG|111000002|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|111000002|Open Enrollment||Universal Employee Life|EE|Employee|Y|90.00|310.00|Y|Y|YES|YES|Y|77.50|Y||
ELIG|111000002|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|111000002|Open Enrollment|01/01/2017||ACA-7697|1|1|100.00|150.00|01/01/2017|||||ACA-7697|ACA-7697|ACA-7697|2017-01-23 15:57:37|111000002
EEID|111000003|111000003|Sanu||Test|M|01/01/1980
OFFR|111000003|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|01/23/2017 04:42:51.647000 PM
ELIG|111000003|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|111000003|Open Enrollment||Universal Employee Life|EE|Employee|Y|90.00|310.00|Y|Y|YES|YES|Y|77.50|Y||
ELIG|111000003|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|111000003|Open Enrollment|01/01/2017||ACA-7697|1|1|200.00|200.00|01/01/2017|||||ACA-7697|ACA-7697|ACA-7697|2017-01-23 16:42:51|111000003
EEID|888888888|888888888|Jam||One|M|01/01/1980
OFFR|888888888|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|02/06/2017 07:31:16.753000 PM
ELIG|888888888|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|888888888|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|888888888|Open Enrollment|01/01/2017||ACA plan for 7220|1|1|0.00|0.00|01/01/2017|||||ACA plan for 7220|ACA plan for 7220|ACA plan for 7220|2017-02-06 19:31:16|888888888
DEPI|888888888|123123123|123123123|Sp||Sp|Spouse|Y|01/01/1983|F|01/01/2017||A|888888888
EEID|111000007|111000007|Jam||Two|M|01/01/1981
OFFR|111000007|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|02/06/2017 02:24:41.660000 PM
ELIG|111000007|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|111000007|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|111000007|Open Enrollment|01/01/2017||ACA plan for 7220|1|1|0.00|0.00|01/01/2017|||||ACA plan for 7220|ACA plan for 7220|ACA plan for 7220|2017-02-06 14:24:41|111000007
EEID|220000000|220000000|Ramsy||Andrew|M|01/01/1980
OFFR|220000000|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|05/15/2017 01:03:40.277000 PM
ELIG|220000000|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|220000000|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|220000000|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|010101010|010101010|Sami|AVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV|JonsonJonsonJonsonJonsonJonsonJonsonJonsonJonsonJo|M|01/01/1980
OFFR|010101010|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|02/14/2017 05:58:53.547000 PM
ELIG|010101010|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|010101010|Open Enrollment||2015 Health Care FSA|EE|Employee|Y|96.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|010101010|Open Enrollment|01/01/2017||ACA 8056|3|3|0.00|0.00|01/01/2017|||||ACA 8056|ACA 8056|ACA 8056|2017-02-14 17:58:53|010101010
DEPI|010101010|||SPSPSPSPSPSPSPSPSPSPSPSPSPSPSPSPSPSPPSPSPPPPPPPPPP|AASASSASAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA|ASASASASASASAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA|Spouse|Y|01/01/1984|F|01/01/2017||A|010101010
DEPI|010101010|||CHHHHHHHHHHHHHHHHHHHHHCCCCCCCCCCCCCCCCCCCCCCCCCCCC|as|AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA|Natural child|N|01/01/2015|M|A|010101010|
EEID|124124124|124124124|Correction||Employeeone|M|01/01/1980
OFFR|124124124|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/18/2017 03:45:31.813000 PM
ELIG|124124124|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|NO|NO|Y|0.00|Y||
COVG|124124124|Open Enrollment|01/01/2017||testForEuro|1|1|0.00|0.00|01/01/2017|||||testForEuro|testForEuro|testForEuro|2017-04-18 15:45:31|124124124
EEID|126126126|126126126|Andrew||Notchy|M|01/01/1984
OFFR|126126126|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/18/2017 04:04:08.127000 PM
ELIG|126126126|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|NO|NO|Y|0.00|Y||
COVG|126126126|Open Enrollment|01/01/2017||testForEuro|1|1|0.00|0.00|01/01/2017|||||testForEuro|testForEuro|testForEuro|2017-04-18 16:04:08|126126126
EEID|300000999|300000999|ZhangNan||Zhu|M|01/01/1985
OFFR|300000999|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/24/2017 02:49:40.827000 PM
ELIG|300000999|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000999|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000999|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000999|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2017-04-24 14:49:40|300000999
EEID|300000998|300000998|Anita||Fumar-Pici|M|01/01/1985
OFFR|300000998|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/24/2017 04:28:07.980000 PM
ELIG|300000998|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000998|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000998|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000998|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2017-04-24 16:28:07|300000998
EEID|300000997|300000997|Paula||Henriques|M|01/01/1985
OFFR|300000997|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/24/2017 05:16:03.730000 PM
ELIG|300000997|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000997|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000997|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000997|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2017-04-24 17:16:03|300000997
EEID|300000996|300000996|Jonathan||Glick|M|01/01/1985
OFFR|300000996|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/24/2017 06:06:12.490000 PM
ELIG|300000996|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|NO|NO|Y|0.00|Y||
COVG|300000996|Open Enrollment|01/01/2017||testForEuro|1|1|0.00|0.00|01/01/2017|||||testForEuro|testForEuro|testForEuro|2017-04-24 18:06:12|300000996
EEID|300000994|300000994|Guohong||Zhang|M|01/01/1985
OFFR|300000994|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/25/2017 11:34:59.870000 AM
ELIG|300000994|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000994|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000994|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000994|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2017-04-25 11:34:59|300000994
EEID|300000993|300000993|James||James|M|01/01/1985
OFFR|300000993|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/25/2017 11:35:35.373000 AM
ELIG|300000993|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000993|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000993|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000993|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2017-04-25 11:35:35|300000993
EEID|300000992|300000992|Mark||Hazel|M|01/01/1985
OFFR|300000992|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/25/2017 11:36:24.083000 AM
ELIG|300000992|Open Enrollment|BSGPlanOne_OLD|Waive Ameritas Dental Plan|EE|Employee|Y|150.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
ELIG|300000992|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|300000992|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|300000992|Open Enrollment|01/01/2017|BSGPlanOne_OLD|ACA 3769|1|1|0.00|0.00|01/01/2017|||||ACA 3769|ACA 3769|ACA 3769|2017-04-25 11:36:24|300000992
EEID|131131131|131131131|test||Hspl|M|01/01/1980
OFFR|131131131|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|04/27/2017 05:24:53.560000 PM
ELIG|131131131|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|131131131|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|131131131|Open Enrollment|01/01/2017||BSG Continuous enrollment|1|1|0.00|0.00|01/01/2017|||||N|||2017-04-27 17:24:53|131131131
EEID|133133133|133133133|Jhony||Sam|M|01/01/1980
OFFR|133133133|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|05/15/2017 01:03:40.277000 PM
ELIG|133133133|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|133133133|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|133133133|Open Enrollment|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|134134134|134134134|test||one|M|01/01/1980
OFFR|134134134|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|05/15/2017 01:03:40.277000 PM
ELIG|134134134|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|134134134|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
WAIVE|134134134|Qualifying Event - Admin Change|01/01/2017|01/01/2017||YES|Reason One|05/15/2017 01:03:40.277000 PM
EEID|148148148|148148148|asa||asas|M|01/01/1985
OFFR|148148148|Open Enrollment|Open Enrollment|01/01/2017|01/01/2017|01/01/2017|12/31/2017|05/30/2017 05:12:16.410000 PM
ELIG|148148148|Open Enrollment|||EE|Employee|Y|100.00|0.00|Y|N|YES|YES|Y|0.00|Y||
ELIG|148148148|Open Enrollment||Child Supplemental Life|EE|Employee|Y|90.00|0.00|Y|Y|YES|YES|Y|0.00|Y||
COVG|148148148|Open Enrollment|01/01/2017||BSG Continuous enrollment|1|1|0.00|0.00|01/01/2017|||||N|||2017-05-30 17:12:16|148148148
FOOT|0