Spreadsheet: 872949d1719404681-2-worksheets-need-to-compare-billing-options-benefits-billing-vs-billed_test
Sheet: DD Billing

EE ID | Coverage Description (invoice) | Plan Type from Prism | Adjust Reason | Original Effective | Adjust Effective | Credits | Debits | Current Fees(invoice) | [NAME]
H06464 | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | January
H06464 | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
H06464 | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | February
H06464 | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | May
H06464 | Emp and 1+ Dep | FAMILY |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | April
Y12095 | Emp Only | EE | Term | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | -33.92 | 0 | 0 | May
N05270 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | January
N05270 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
N05270 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
N05270 | Emp Only | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | May
W11013 | EMPLOYEE + SPOUSE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
W11013 | EMPLOYEE +SPOUSE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
W11013 | EMPLOYEE + SPOUSE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
W11013 | Emp and Sp | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | May
U07963 | Emp Only | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 33.92 | May
U07963 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
U07963 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
U07963 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | Emp Only | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | Emp and 1+ Dep | FAM |  | 2014-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2014-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2014-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2014-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2014-07-01 00:00:00 |  | 0 | 0 | 157.78 | May
[NAME] | Emp and 1+ Dep | FAMILY |  | 2014-07-01 00:00:00 |  | 0 | 0 | 157.78 | April
N04358 | EMPLOYEE | EE |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
N04358 | EMPLOYEE | EE |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
N04358 | EMPLOYEE | EE |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
N04358 | EMPLOYEE | EE |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
N04358 | Emp Only | EE |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | May
N04358 | EMPLOYEE | EMPLOYEE |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | April
T08202 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
T08202 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
T08202 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
T08202 | Emp Only | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | May
L07788 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
L07788 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
L07788 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
L07788 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
L07788 | Emp Only | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | May
L07788 | EMPLOYEE | EMPLOYEE |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | April
[NAME] | EMPLOYEE | EE |  | 2017-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | EE |  | 2017-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | EE |  | 2017-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | Emp Only | EE |  | 2017-11-01 00:00:00 |  | 0 | 0 | 48.81 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2017-11-01 00:00:00 |  | 0 | 0 | 48.81 | April
[NAME] | EMPLOYEE | EE |  | 2017-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
T11682 | EMPLOYEE | #N/A | Add | 2023-12-01 00:00:00 | 2023-12-01 00:00:00 | 0 | 48.81 | 48.81 | March
T11682 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
T11682 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
T11682 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
T11682 | Emp Only | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | May
T11682 | EMPLOYEE | EMPLOYEE |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | April
I10641 | EMPLOYEE + SPOUSE | ES |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
I10641 | EMPLOYEE +SPOUSE | ES |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
I10641 | EMPLOYEE + SPOUSE | ES |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
I10641 | EMPLOYEE + SPOUSE | ES |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
I10641 | Emp and Sp | ES |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | May
I10641 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | April
C04995 | EMPLOYEE + SPOUSE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 42.67 | March
C04995 | EMPLOYEE +SPOUSE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 42.67 | March
C04995 | EMPLOYEE + SPOUSE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 42.67 | March
C04995 | Emp and Sp | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 42.67 | May
C04995 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-12-01 00:00:00 |  | 0 | 0 | 42.67 | April
C04995 | EMPLOYEE + SPOUSE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 42.67 | March
L06540 | EMPLOYEE + SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
U12115 | EMPLOYEE | EE | Add | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | 0 | 0 | 22.89 | March
U12115 | Emp Only | EE |  | 2024-04-01 00:00:00 |  | 0 | 0 | 22.89 | May
U12115 | EMPLOYEE | EMPLOYEE | Add | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | 0 | 0 | 22.89 | April
T12018 | EMPLOYEE | EE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 0 | 48.81 | March
T12018 | EMPLOYEE | EE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
T12018 | Emp Only | EE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 48.81 | May
T12018 | EMPLOYEE | EMPLOYEE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 48.81 | April
K04187 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
K04187 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
K04187 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
K04187 | EMPLOYEE | EMPLOYEE | Term | 2023-05-01 00:00:00 | 2024-02-29 00:00:00 | -57.85 | 0 | 0 | April
[NAME] | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | Emp Only | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | April
C12099 | EMPLOYEE | EE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 0 | 33.92 | March
C12099 | Emp Only | EE | Term | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | -67.84 | 0 | 0 | May
S05105 | EMPLOYEE | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
S05105 | EMPLOYEE | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
S05105 | EMPLOYEE | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
S05105 | Emp Only | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
B04970 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
B04970 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
B04970 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
B04970 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
B04970 | Emp Only | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 48.81 | May
B04970 | EMPLOYEE | EMPLOYEE |  | 2021-07-01 00:00:00 |  | 0 | 0 | 48.81 | April
L04188 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
L04188 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
L04188 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
L04188 | Emp Only | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
E11957 | EMPLOYEE | #N/A | Add | 2023-11-01 00:00:00 | 2023-11-01 00:00:00 | 0 | 67.84 | 33.92 | March
E11957 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
E11957 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
E11957 | Emp Only | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | May
#N/A | Emp and 1+ Dep | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 157.78 | April
P03039 | EMPLOYEE | EE |  | 2020-07-02 00:00:00 |  | 0 | 0 | 48.81 | March
P03039 | EMPLOYEE | EE |  | 2020-07-02 00:00:00 |  | 0 | 0 | 48.81 | March
P03039 | EMPLOYEE | EE |  | 2020-07-02 00:00:00 |  | 0 | 0 | 48.81 | March
P03039 | EMPLOYEE | EE |  | 2020-07-02 00:00:00 |  | 0 | 0 | 48.81 | March
P03039 | Emp Only | EE |  | 2020-07-02 00:00:00 |  | 0 | 0 | 48.81 | May
P03039 | EMPLOYEE | EMPLOYEE |  | 2020-07-02 00:00:00 |  | 0 | 0 | 48.81 | April
A05545 | EMPLOYEE + CHILDREN (2 OR MORE) | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
A05545 | EMPLOYEE + CHILDren (2 OR MORE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
A05545 | EMPLOYEE + CHILDren (2 OR MORE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
A05545 | Emp and Children | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
A05545 | Emp and Children | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | May
A05545 | EMPLOYEE + CHILDren (2 OR MORE | EMPLOYEE + CHILDREN (2 OR MORE) |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | April
X05542 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05542 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05542 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05542 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05542 | Emp Only | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
X05542 | EMPLOYEE | EMPLOYEE |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
W05541 | Emp and 1+ Dep | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
W05541 | Emp and 1+ Dep | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
W05541 | Emp and 1+ Dep | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | May
W05541 | Emp and 1+ Dep | FAMILY |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | April
U05539 | EMPLOYEE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
U05539 | EMPLOYEE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
U05539 | EMPLOYEE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
U05539 | EMPLOYEE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
U05539 | Emp Only | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 48.81 | May
U05539 | EMPLOYEE | EMPLOYEE |  | 2020-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
W05541 | Emp and 1+ Dep | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
W05541 | Emp and 1+ Dep | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 157.78 | March
I05025 | EMPLOYEE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
I05025 | EMPLOYEE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
I05025 | EMPLOYEE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
I05025 | Emp Only | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 33.92 | May
J04354 | EMPLOYEE | EE |  | 2019-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
J04354 | EMPLOYEE | EE |  | 2019-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
J04354 | EMPLOYEE | EE |  | 2019-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
J04354 | EMPLOYEE | EE |  | 2019-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
J04354 | Emp Only | EE |  | 2019-02-01 00:00:00 |  | 0 | 0 | 57.85 | May
J04354 | EMPLOYEE | EMPLOYEE |  | 2019-02-01 00:00:00 |  | 0 | 0 | 57.85 | April
N06998 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 48.81 | 48.81 | March
N06998 | EMPLOYEE | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
N06998 | Emp Only | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | May
N06998 | EMPLOYEE | EMPLOYEE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
W12141 | Emp Only | EE |  | 2024-04-01 00:00:00 |  | 0 | 0 | 33.92 | May
S10841 | EMPLOYEE + SPOUSE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
S10841 | EMPLOYEE +SPOUSE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
S10841 | EMPLOYEE + SPOUSE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
S10841 | Emp and Sp | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | May
Y10559 | EMPLOYEE | EE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y10559 | EMPLOYEE | EE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y10559 | EMPLOYEE | EE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y10559 | EMPLOYEE | EE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y10559 | EMPLOYEE | EMPLOYEE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | April
Y10559 | Emp Only | EE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | May
L00348 | EMPLOYEE | #N/A |  | 2010-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00348 | EMPLOYEE | #N/A |  | 2010-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00348 | EMPLOYEE | #N/A |  | 2010-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00348 | EMPLOYEE | #N/A |  | 2010-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00348 | Emp Only | #N/A | Term | 2010-04-01 00:00:00 | 2024-02-29 00:00:00 | -115.7 | 0 | 0 | May
L00348 | EMPLOYEE | EMPLOYEE |  | 2010-04-01 00:00:00 |  | 0 | 0 | 57.85 | April
D08596 | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
D08596 | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
D08596 | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
D08596 | Emp Only | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 33.92 | May
G11575 | EMPLOYEE | #N/A | Add | 2023-12-01 00:00:00 | 2023-12-01 00:00:00 | 0 | 33.92 | 33.92 | March
G11575 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
G11575 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
G11575 | Emp Only | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 33.92 | May
G09079 | EMPLOYEE + CHILD | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
G09079 | EMPLOYEE +CHILD | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
G09079 | EMPLOYEE + CHILD | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
G09079 | Emp and 1 Dep | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | May
S05537 | EMPLOYEE + SPOUSE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
S05537 | EMPLOYEE +SPOUSE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
S05537 | EMPLOYEE + SPOUSE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
S05537 | EMPLOYEE + SPOUSE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
S05537 | Emp and Sp | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 83.95 | May
S05537 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2020-02-01 00:00:00 |  | 0 | 0 | 83.95 | April
S04697 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
S04697 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
S04697 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
S04697 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
S04697 | Emp Only | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | May
S04697 | EMPLOYEE | EMPLOYEE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | April
E05789 | EMPLOYEE | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
E05789 | EMPLOYEE | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
E05789 | EMPLOYEE | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
E05789 | Emp Only | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | EMPLOYEE +SPOUSE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | EMPLOYEE + SPOUSE | EMPLOYEE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 83.95 | April
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
[NAME] | EMPLOYEE +SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
[NAME] | Emp and Sp | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | May
[NAME] | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | April
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
P09495 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
P09495 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
P09495 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
P09495 | Emp Only | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
Y05351 | EMPLOYEE + SPOUSE | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Y05351 | EMPLOYEE + SPOUSE | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Y05351 | EMPLOYEE +SPOUSE | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Y05351 | EMPLOYEE + SPOUSE | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Y05351 | Emp and Sp | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | May
Y05351 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | April
R07288 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
R07288 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
R07288 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
R07288 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
R07288 | Emp Only | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 48.81 | May
R07288 | EMPLOYEE | EMPLOYEE |  | 2021-08-01 00:00:00 |  | 0 | 0 | 48.81 | April
A04081 | EMPLOYEE + SPOUSE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
A04081 | EMPLOYEE +SPOUSE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
A04081 | EMPLOYEE + SPOUSE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
A04081 | Emp and Sp | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 83.95 | May
A04081 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 83.95 | April
A04081 | EMPLOYEE + SPOUSE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
V11972 | EMPLOYEE | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 22.89 | March
V11972 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 22.89 | 22.89 | March
V11972 | EMPLOYEE | EMPLOYEE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 22.89 | April
V11972 | Emp Only | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 22.89 | May
R09280 | EMPLOYEE + SPOUSE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
R09280 | EMPLOYEE +SPOUSE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
R09280 | EMPLOYEE + SPOUSE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
R09280 | EMPLOYEE + SPOUSE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
R09280 | Emp and Sp | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 83.95 | May
R09280 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2022-10-01 00:00:00 |  | 0 | 0 | 83.95 | April
W00453 | Emp and 1+ Dep | #N/A |  | 2009-05-01 00:00:00 |  | 0 | 0 | 191.95 | March
W00453 | Emp and 1+ Dep | #N/A |  | 2009-05-01 00:00:00 |  | 0 | 0 | 191.95 | March
W00453 | Emp and 1+ Dep | #N/A |  | 2009-05-01 00:00:00 |  | 0 | 0 | 191.95 | March
W00453 | Emp and 1+ Dep | #N/A |  | 2009-05-01 00:00:00 |  | 0 | 0 | 191.95 | March
W00453 | Emp and 1+ Dep | #N/A |  | 2009-05-01 00:00:00 |  | 0 | 0 | 191.95 | May
W00453 | Emp and 1+ Dep | FAMILY |  | 2009-05-01 00:00:00 |  | 0 | 0 | 191.95 | April
V09572 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
V09572 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
V09572 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
V09572 | Emp Only | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | EMPLOYEE | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | Emp Only | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 33.92 | May
Y04703 | EMPLOYEE + SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 42.67 | March
Y04703 | EMPLOYEE +SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 42.67 | March
Y04703 | EMPLOYEE + SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 42.67 | March
Y04703 | EMPLOYEE + SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 42.67 | March
Y04703 | Emp and Sp | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 42.67 | May
Y04703 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 42.67 | April
H04160 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
H04160 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
H04160 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
H04160 | Emp Only | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
X05278 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05278 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05278 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05278 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
X05278 | Emp Only | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 48.81 | May
X05278 | EMPLOYEE | EMPLOYEE |  | 2022-04-01 00:00:00 |  | 0 | 0 | 48.81 | April
I01137 | EMPLOYEE + SPOUSE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 83.95 | March
I01137 | EMPLOYEE +SPOUSE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 83.95 | March
I01137 | EMPLOYEE + SPOUSE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 83.95 | March
I01137 | EMPLOYEE + SPOUSE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 83.95 | March
I01137 | Emp and Sp | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 83.95 | May
I01137 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2015-03-01 00:00:00 |  | 0 | 0 | 83.95 | April
U04507 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
U04507 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
U04507 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
U04507 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
U04507 | Emp Only | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | May
U04507 | EMPLOYEE | EMPLOYEE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | April
U01747 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 138.89 | March
U01747 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 138.89 | March
U01747 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 138.89 | May
U01747 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 138.89 | March
X04006 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
X04006 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
X04006 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
X04006 | Emp Only | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | May
X02926 | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
X02926 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X02926 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X02926 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X02926 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X02926 | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
[NAME] | EMPLOYEE | #N/A |  | 2020-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2020-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2020-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2020-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | Emp Only | #N/A |  | 2020-08-01 00:00:00 |  | 0 | 0 | 48.81 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2020-08-01 00:00:00 |  | 0 | 0 | 48.81 | April
G07639 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
G07639 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
L04500 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
L04500 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
L04500 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
L04500 | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
L04500 | Emp Only | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | May
L04500 | EMPLOYEE | EMPLOYEE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | April
W09237 | EMPLOYEE | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
W09237 | EMPLOYEE | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
W09237 | EMPLOYEE | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
W09237 | EMPLOYEE | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
W09237 | Emp Only | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 22.89 | May
W09237 | EMPLOYEE | EMPLOYEE |  | 2022-11-01 00:00:00 |  | 0 | 0 | 22.89 | April
W07101 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07101 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07101 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07101 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07101 | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | May
W07101 | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | April
T06618 | EMPLOYEE | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
T06618 | EMPLOYEE | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
T06618 | EMPLOYEE | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
N00734 | Emp and 1+ Dep | #N/A |  | 2009-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
N00734 | Emp and 1+ Dep | #N/A |  | 2009-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
N00734 | Emp and 1+ Dep | #N/A |  | 2009-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
N00734 | Emp and 1+ Dep | #N/A |  | 2009-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
N00734 | Emp and 1+ Dep | #N/A |  | 2009-10-01 00:00:00 |  | 0 | 0 | 191.95 | May
N00734 | Emp and 1+ Dep | FAMILY |  | 2009-10-01 00:00:00 |  | 0 | 0 | 191.95 | April
[NAME] | EMPLOYEE | #N/A |  | 2017-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2017-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2017-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2017-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | Emp Only | #N/A |  | 2017-02-01 00:00:00 |  | 0 | 0 | 48.81 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2017-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
I08649 | EMPLOYEE | EE |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
I08649 | EMPLOYEE | EE |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
I08649 | EMPLOYEE | EE |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
I08649 | Emp Only | EE |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | May
N07766 | EMPLOYEE | EE |  | 2021-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
N07766 | EMPLOYEE | EE |  | 2021-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
N07766 | EMPLOYEE | EE |  | 2021-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
N07766 | Emp Only | EE |  | 2021-12-01 00:00:00 |  | 0 | 0 | 33.92 | May
C00243 | EMPLOYEE | #N/A |  | 2005-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
C00243 | EMPLOYEE | #N/A |  | 2005-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
C00243 | EMPLOYEE | #N/A |  | 2005-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
C00243 | Emp Only | #N/A |  | 2005-07-01 00:00:00 |  | 0 | 0 | 33.92 | May
C10563 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
C10563 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
C10563 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
C10563 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
C10563 | Emp Only | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | May
C10563 | EMPLOYEE | EMPLOYEE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | April
X04390 | EMPLOYEE + CHILD | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
X04390 | EMPLOYEE +CHILD | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
X04390 | EMPLOYEE + CHILD | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
X04390 | Emp and 1 Dep | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 60.32 | May
X03718 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
X03718 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
X03718 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
X03718 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
X03718 | Emp and 1+ Dep | #N/A |  | 2018-09-01 00:00:00 |  | 0 | 0 | 157.78 | May
X03718 | Emp and 1+ Dep | FAMILY |  | 2018-09-01 00:00:00 |  | 0 | 0 | 157.78 | April
I10905 | EMPLOYEE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 57.85 | March
I10905 | EMPLOYEE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 57.85 | March
I10905 | EMPLOYEE | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 57.85 | March
I10905 | EMPLOYEE | EMPLOYEE | Term | 2023-06-01 00:00:00 | 2024-02-29 00:00:00 | -57.85 | 0 | 0 | April
#N/A | Emp and 1+ Dep | #N/A | Coverage Change | 2020-08-01 00:00:00 | 2023-04-01 00:00:00 | -158.37 | 0 | 0 | April
#N/A | EMPLOYEE + CHILDren (2 OR MORE | #N/A | Coverage Change Change | 2020-08-01 00:00:00 | 2023-11-01 00:00:00 | 0 | 315.56 | 0 | April
#N/A | EMPLOYEE + CHILDren (2 OR MORE | #N/A | Term | 2020-08-01 00:00:00 | 2023-12-31 00:00:00 | -473.34 | 0 | 0 | April
#N/A | EMPLOYEE + SPOUSE | #N/A | Coverage Change | 2020-08-01 00:00:00 | 2023-04-01 00:00:00 | 0 | 84.26 | 0 | April
#N/A | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 57.85 | April
Y11999 | EMPLOYEE +SPOUSE | ES |  | 2024-02-01 00:00:00 |  | 0 | 0 | 60.32 | March
Y11999 | EMPLOYEE + SPOUSE | ES | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 0 | 60.32 | March
Y11999 | Emp and Sp | ES |  | 2024-02-01 00:00:00 |  | 0 | 0 | 60.32 | May
[NAME] | Emp and 1+ Dep | FAM |  | 2016-05-01 00:00:00 |  | 0 | 0 | 116.75 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2016-05-01 00:00:00 |  | 0 | 0 | 116.75 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2016-05-01 00:00:00 |  | 0 | 0 | 116.75 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2016-05-01 00:00:00 |  | 0 | 0 | 116.75 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2016-05-01 00:00:00 |  | 0 | 0 | 116.75 | May
[NAME] | Emp and 1+ Dep | FAMILY |  | 2016-05-01 00:00:00 |  | 0 | 0 | 116.75 | April
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-09-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-09-01 00:00:00 |  | 0 | 0 | 157.78 | May
[NAME] | Emp and 1+ Dep | FAMILY |  | 2022-09-01 00:00:00 |  | 0 | 0 | 157.78 | April
U01939 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
U01939 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
U01939 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
U01915 | Emp Only | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | May
T11874 | Emp Only | EE | Add | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | 0 | 33.92 | 33.92 | May
X07630 | EMPLOYEE + CHILD | #N/A | Coverage Change | 2022-12-01 00:00:00 | 2023-11-01 00:00:00 | 0 | 167.9 | 83.95 | March
X07630 | EMPLOYEE | #N/A | Coverage Change | 2022-12-01 00:00:00 | 2023-11-01 00:00:00 | -97.62 | 0 | 0 | March
X07630 | EMPLOYEE +CHILD | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 83.95 | March
X07630 | EMPLOYEE + CHILD | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 83.95 | March
X07630 | EMPLOYEE + CHILD | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 83.95 | March
X07630 | Emp and 1 Dep | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 83.95 | May
X07630 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2022-12-01 00:00:00 |  | 0 | 0 | 83.95 | April
A00529 | EMPLOYEE + SPOUSE | ES |  | 2017-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A00529 | EMPLOYEE +SPOUSE | ES |  | 2017-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A00529 | EMPLOYEE + SPOUSE | ES |  | 2017-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A00529 | EMPLOYEE + SPOUSE | ES |  | 2017-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A00529 | Emp and Sp | ES |  | 2017-08-01 00:00:00 |  | 0 | 0 | 83.95 | May
A00529 | EMPLOYEE + SPOUSE | FAMILY |  | 2017-08-01 00:00:00 |  | 0 | 0 | 83.95 | April
G03703 | EMPLOYEE + SPOUSE | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
G03703 | EMPLOYEE +SPOUSE | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
G03703 | EMPLOYEE + SPOUSE | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
G03703 | EMPLOYEE + SPOUSE | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
G03703 | Emp and Sp | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 83.95 | May
G03703 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2018-08-01 00:00:00 |  | 0 | 0 | 83.95 | April
M04957 | EMPLOYEE +SPOUSE | ES |  | 2024-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
M04957 | EMPLOYEE + SPOUSE | ES | Add | 2024-01-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 60.32 | 60.32 | March
M04957 | Emp and Sp | ES |  | 2024-01-01 00:00:00 |  | 0 | 0 | 60.32 | May
Z00216 | EMPLOYEE | #N/A |  | 2016-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z00216 | EMPLOYEE | #N/A |  | 2016-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z00216 | EMPLOYEE | #N/A |  | 2016-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z00216 | EMPLOYEE | #N/A |  | 2016-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z00216 | Emp Only | #N/A |  | 2016-05-01 00:00:00 |  | 0 | 0 | 22.89 | May
Z00216 | EMPLOYEE | EMPLOYEE |  | 2016-05-01 00:00:00 |  | 0 | 0 | 22.89 | April
C04659 | Emp and 1+ Dep | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
C04659 | Emp and 1+ Dep | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
C04659 | Emp and 1+ Dep | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
C04659 | Emp and 1+ Dep | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
C04659 | Emp and 1+ Dep | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 157.78 | May
C04659 | Emp and 1+ Dep | FAMILY |  | 2019-08-01 00:00:00 |  | 0 | 0 | 157.78 | April
[NAME] | EMPLOYEE | #N/A |  | 2021-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | Emp Only | #N/A |  | 2021-02-01 00:00:00 |  | 0 | 0 | 48.81 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2021-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
S05969 | EMPLOYEE + SPOUSE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 42.67 | March
S05969 | Emp and Sp | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 42.67 | May
S05969 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2020-11-01 00:00:00 |  | 0 | 0 | 42.67 | April
H06560 | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
H06560 | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
H06560 | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
H06560 | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
H06560 | Emp Only | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 22.89 | May
H06560 | EMPLOYEE | EMPLOYEE |  | 2021-05-01 00:00:00 |  | 0 | 0 | 22.89 | April
V00956 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
V00956 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
V00956 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
V00956 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
V00956 | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
V00956 | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
F08358 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
F08358 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
F08358 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
F08358 | Emp Only | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | May
#N/A | Emp and 1+ Dep | #N/A |  | 2008-12-01 00:00:00 |  | 0 | 0 | 191.95 | April
I04521 | EMPLOYEE | EE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
I04521 | EMPLOYEE | EE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
I04521 | EMPLOYEE | EE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
I04521 | EMPLOYEE | EE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
I04521 | Emp Only | EE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | May
I04521 | EMPLOYEE | EMPLOYEE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 57.85 | April
H10760 | EMPLOYEE | EE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
H10760 | EMPLOYEE | EE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
H10760 | EMPLOYEE | EE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
H10760 | EMPLOYEE | EE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
H10760 | Emp Only | EE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 22.89 | May
H10760 | EMPLOYEE | EMPLOYEE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 22.89 | April
B04154 | EMPLOYEE + SPOUSE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
B04154 | EMPLOYEE +SPOUSE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
B04154 | EMPLOYEE + SPOUSE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
B04154 | EMPLOYEE + SPOUSE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
B04154 | Emp and Sp | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 83.95 | May
B04154 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-01-01 00:00:00 |  | 0 | 0 | 83.95 | April
[NAME] | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | Emp Only | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 22.89 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2022-10-01 00:00:00 |  | 0 | 0 | 22.89 | April
F04350 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
F04350 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
F04350 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
F04350 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
F04350 | Emp Only | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
F04350 | EMPLOYEE | EMPLOYEE |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
A11161 | EMPLOYEE + SPOUSE | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
A11161 | EMPLOYEE +SPOUSE | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
A11161 | EMPLOYEE + SPOUSE | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
B08930 | EMPLOYEE + SPOUSE | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 83.95 | March
B08930 | EMPLOYEE +CHILD | EC | Coverage Change | 2022-09-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 83.95 | 83.95 | March
B08930 | EMPLOYEE +SPOUSE | EC | Coverage Change | 2022-09-01 00:00:00 | 2024-02-01 00:00:00 | -83.95 | 0 | 0 | March
B08930 | EMPLOYEE + CHILD | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 83.95 | March
B08930 | EMPLOYEE + SPOUSE | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 83.95 | March
B08930 | Emp and 1 Dep | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 83.95 | May
B08930 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2022-09-01 00:00:00 |  | 0 | 0 | 83.95 | April
Z10944 | EMPLOYEE | EE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z10944 | EMPLOYEE | EE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z10944 | EMPLOYEE | EE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z10944 | EMPLOYEE | EE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z10944 | Emp Only | EE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | May
Z10944 | EMPLOYEE | EMPLOYEE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | April
U08419 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
U08419 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
U08419 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
U08419 | Emp Only | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
Z01536 | EMPLOYEE + CHILD | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 99.91 | March
Z01536 | EMPLOYEE +CHILD | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 99.91 | March
Z01536 | Emp and 1 Dep | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 99.91 | March
Z01536 | EMPLOYEE + CHILD | EMPLOYEE + CHILD | Term | 2022-12-01 00:00:00 | 2024-02-29 00:00:00 | -99.91 | 0 | 0 | April
V05420 | EMPLOYEE + SPOUSE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 60.32 | March
V05420 | EMPLOYEE +SPOUSE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 60.32 | March
V05420 | EMPLOYEE + SPOUSE | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 60.32 | March
V05420 | Emp and Sp | #N/A |  | 2020-02-01 00:00:00 |  | 0 | 0 | 60.32 | May
K03611 | EMPLOYEE | #N/A |  | 2018-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
K03611 | EMPLOYEE | #N/A |  | 2018-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
K03611 | EMPLOYEE | #N/A |  | 2018-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
K03611 | Emp Only | #N/A |  | 2018-04-01 00:00:00 |  | 0 | 0 | 33.92 | May
T05274 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
T05274 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
T05274 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
T05274 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
T05274 | Emp Only | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 57.85 | May
T05274 | EMPLOYEE | EMPLOYEE |  | 2022-05-01 00:00:00 |  | 0 | 0 | 57.85 | April
H07976 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
H07976 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
H07976 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
H07976 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
H07976 | Emp Only | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | May
H07976 | EMPLOYEE | EMPLOYEE |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | April
G07183 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
G07183 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
G07183 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
G07183 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
G07183 | Emp Only | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | May
G07183 | EMPLOYEE | EMPLOYEE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | April
W11805 | EMPLOYEE | #N/A | Add | 2023-12-01 00:00:00 | 2023-12-01 00:00:00 | 0 | 57.85 | 57.85 | March
W11805 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 57.85 | March
W11805 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 57.85 | March
W11805 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 57.85 | March
W11805 | Emp Only | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 57.85 | May
W11805 | EMPLOYEE | EMPLOYEE |  | 2023-12-01 00:00:00 |  | 0 | 0 | 57.85 | April
Z12168 | Emp and 1 Dep | EC | Add | 2024-05-01 00:00:00 | 2024-05-01 00:00:00 | 0 | 0 | 60.32 | May
P09111 | Emp and 1+ Dep | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
P09111 | Emp and 1+ Dep | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
P09111 | Emp and 1+ Dep | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
P09111 | Emp and 1+ Dep | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
P09111 | Emp and 1+ Dep | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 191.95 | May
P09111 | Emp and 1+ Dep | FAMILY |  | 2022-10-01 00:00:00 |  | 0 | 0 | 191.95 | April
J03226 | Emp and 1+ Dep | EE | Add | 2023-12-01 00:00:00 | 2023-12-01 00:00:00 | 0 | 138.89 | 138.89 | March
J03226 | EMPLOYEE | EE |  | 2023-12-01 00:00:00 |  | 0 | 0 | 33.92 | March
J03226 | Emp and 1+ Dep | EE | Coverage Change | 2023-12-01 00:00:00 | 2024-01-01 00:00:00 | -138.89 | 0 | 0 | March
J03226 | EMPLOYEE | EE | Coverage Change | 2023-12-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 33.92 | 33.92 | March
J03226 | Emp Only | EE |  | 2023-12-01 00:00:00 |  | 0 | 0 | 33.92 | May
K11987 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 48.81 | 48.81 | March
K11987 | EMPLOYEE | EMPLOYEE | Term | 2024-02-01 00:00:00 | 2024-02-29 00:00:00 | -48.81 | 0 | 0 | April
T11490 | Emp and 1+ Dep | FAM | Add | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | 0 | 157.78 | 157.78 | May
Y05735 | EMPLOYEE | #N/A |  | 2021-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y05735 | EMPLOYEE | #N/A |  | 2021-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y05735 | EMPLOYEE | #N/A |  | 2021-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y05735 | EMPLOYEE | #N/A |  | 2021-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y05735 | Emp Only | #N/A |  | 2021-04-01 00:00:00 |  | 0 | 0 | 48.81 | May
Y05735 | EMPLOYEE | EMPLOYEE |  | 2021-04-01 00:00:00 |  | 0 | 0 | 48.81 | April
W04509 | EMPLOYEE + SPOUSE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 42.67 | March
W04509 | EMPLOYEE +SPOUSE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 42.67 | March
W04509 | EMPLOYEE + SPOUSE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 42.67 | March
W04509 | EMPLOYEE + SPOUSE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 42.67 | March
W04509 | Emp and Sp | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 42.67 | May
W04509 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-05-01 00:00:00 |  | 0 | 0 | 42.67 | April
U08635 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
U08635 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
U08635 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
U08635 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
U08635 | Emp Only | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 57.85 | May
U08635 | EMPLOYEE | EMPLOYEE |  | 2022-08-01 00:00:00 |  | 0 | 0 | 57.85 | April
#N/A | EMPLOYEE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
B01634 | EMPLOYEE | #N/A |  | 2023-05-22 00:00:00 |  | 0 | 0 | 48.81 | March
B01634 | EMPLOYEE | #N/A |  | 2023-05-22 00:00:00 |  | 0 | 0 | 48.81 | March
E00773 | Emp and 1+ Dep | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 191.95 | March
E00773 | Emp and 1+ Dep | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 191.95 | March
E00773 | Emp and 1+ Dep | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 191.95 | March
E00773 | Emp and 1+ Dep | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 191.95 | March
E00773 | Emp and 1+ Dep | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 191.95 | May
E00773 | Emp and 1+ Dep | FAMILY |  | 2015-03-01 00:00:00 |  | 0 | 0 | 191.95 | April
J08242 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
J08242 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
J08242 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
J08242 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
J08242 | Emp Only | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
J08242 | EMPLOYEE | EMPLOYEE |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
E10757 | EMPLOYEE | EE |  | 2023-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
E10757 | Emp Only | EE | Add | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | 0 | 22.89 | 22.89 | May
K04979 | EMPLOYEE + SPOUSE | #N/A |  | 2019-11-01 00:00:00 |  | 0 | 0 | 42.67 | March
K04979 | EMPLOYEE + SPOUSE | #N/A |  | 2019-11-01 00:00:00 |  | 0 | 0 | 42.67 | March
P00783 | EMPLOYEE + SPOUSE | ES |  | 2023-11-01 00:00:00 |  | 0 | 0 | 60.32 | March
P00783 | EMPLOYEE +SPOUSE | ES |  | 2023-11-01 00:00:00 |  | 0 | 0 | 60.32 | March
P00783 | EMPLOYEE + SPOUSE | ES |  | 2023-11-01 00:00:00 |  | 0 | 0 | 60.32 | March
P00783 | Emp and Sp | ES |  | 2023-11-01 00:00:00 |  | 0 | 0 | 60.32 | May
X04078 | Emp and 1+ Dep | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
X04078 | Emp and 1+ Dep | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
X04078 | Emp and 1+ Dep | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
X04078 | Emp and 1+ Dep | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 157.78 | May
X04078 | Emp and 1+ Dep | FAMILY |  | 2019-07-01 00:00:00 |  | 0 | 0 | 157.78 | April
X04078 | Emp and 1+ Dep | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
N01478 | EMPLOYEE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
N01478 | EMPLOYEE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
N01478 | EMPLOYEE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
N01478 | EMPLOYEE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
N01478 | Emp Only | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 48.81 | May
N01478 | EMPLOYEE | EMPLOYEE |  | 2019-08-01 00:00:00 |  | 0 | 0 | 48.81 | April
H04088 | EMPLOYEE + SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 83.95 | March
H04088 | EMPLOYEE +SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 83.95 | March
H04088 | EMPLOYEE + SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 83.95 | March
H04088 | EMPLOYEE + SPOUSE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 83.95 | March
H04088 | Emp and Sp | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 83.95 | May
H04088 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 83.95 | April
F00822 | EMPLOYEE + SPOUSE | #N/A |  | 2014-10-01 00:00:00 |  | 0 | 0 | 99.91 | March
F00822 | EMPLOYEE +SPOUSE | #N/A |  | 2014-10-01 00:00:00 |  | 0 | 0 | 99.91 | March
F00822 | EMPLOYEE + SPOUSE | #N/A |  | 2014-10-01 00:00:00 |  | 0 | 0 | 99.91 | March
F00822 | EMPLOYEE + SPOUSE | #N/A |  | 2014-10-01 00:00:00 |  | 0 | 0 | 99.91 | March
F00822 | Emp and Sp | #N/A |  | 2014-10-01 00:00:00 |  | 0 | 0 | 99.91 | May
F00822 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2014-10-01 00:00:00 |  | 0 | 0 | 99.91 | April
D08116 | EMPLOYEE | #N/A |  | 2023-01-31 00:00:00 |  | 0 | 0 | 33.92 | March
D08116 | EMPLOYEE | #N/A |  | 2023-01-31 00:00:00 |  | 0 | 0 | 33.92 | March
D08116 | EMPLOYEE | #N/A |  | 2023-01-31 00:00:00 |  | 0 | 0 | 33.92 | March
D08116 | Emp Only | #N/A |  | 2023-01-31 00:00:00 |  | 0 | 0 | 33.92 | May
J04882 | EMPLOYEE | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
J04882 | EMPLOYEE | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
J04882 | EMPLOYEE | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
J04882 | Emp Only | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | May
M04741 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
M04741 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
M04741 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
M04741 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
M04741 | Emp Only | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | May
M04741 | EMPLOYEE | EMPLOYEE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 48.81 | April
[NAME] | Emp Only | EE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 33.92 | May
H06920 | EMPLOYEE | #N/A |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
H06920 | EMPLOYEE | #N/A |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
H06920 | EMPLOYEE | #N/A |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
H06920 | Emp Only | #N/A |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | May
#N/A | EMPLOYEE | #N/A |  | 2019-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
#N/A | Emp and 1+ Dep | #N/A |  | 2007-04-01 00:00:00 |  | 0 | 0 | 157.78 | April
J07978 | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
J07978 | EMPLOYEE +SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
J07978 | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
J07978 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE | Term | 2022-01-01 00:00:00 | 2024-02-29 00:00:00 | -83.95 | 0 | 0 | April
M10117 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
M10117 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
M10117 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
M10117 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
M10117 | Emp Only | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 48.81 | May
M10117 | EMPLOYEE | EMPLOYEE |  | 2023-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
E12101 | Emp and 1+ Dep | FAM |  | 2024-04-01 00:00:00 |  | 0 | 0 | 138.89 | May
Y04007 | EMPLOYEE | #N/A |  | 2018-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04007 | EMPLOYEE | #N/A |  | 2018-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04007 | EMPLOYEE | #N/A |  | 2018-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04007 | EMPLOYEE | #N/A |  | 2018-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04007 | Emp Only | #N/A |  | 2018-10-01 00:00:00 |  | 0 | 0 | 57.85 | May
Y04007 | EMPLOYEE | EMPLOYEE |  | 2018-10-01 00:00:00 |  | 0 | 0 | 57.85 | April
R12088 | Emp Only | EE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 33.92 | May
N04598 | EMPLOYEE + CHILD | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
N04598 | EMPLOYEE +CHILD | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
N04598 | EMPLOYEE + CHILD | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
N04598 | Emp and 1 Dep | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 60.32 | May
D07828 | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
D07828 | EMPLOYEE +SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
D07828 | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
D07828 | Emp and Sp | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | May
[NAME] | EMPLOYEE | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | Emp Only | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 33.92 | May
E04157 | Emp and 1+ Dep | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
E04157 | Emp and 1+ Dep | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
E04157 | Emp and 1+ Dep | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
E04157 | Emp and 1+ Dep | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 138.89 | May
M04165 | EMPLOYEE + SPOUSE | ES |  | 2019-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
M04165 | EMPLOYEE +SPOUSE | ES |  | 2019-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
M04165 | EMPLOYEE + SPOUSE | ES |  | 2019-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
M04165 | EMPLOYEE + SPOUSE | ES |  | 2019-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
M04165 | Emp and Sp | ES |  | 2019-01-01 00:00:00 |  | 0 | 0 | 60.32 | May
M04165 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-01-01 00:00:00 |  | 0 | 0 | 60.32 | April
D08092 | EMPLOYEE | #N/A | Term | 2023-05-01 00:00:00 | 2024-03-31 00:00:00 | 0 | 0 | 0 | March
D08092 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
D08092 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
D08092 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 22.89 | March
D08092 | EMPLOYEE | EMPLOYEE | Term | 2023-05-01 00:00:00 | 2024-03-31 00:00:00 | 0 | 0 | 0 | April
G11359 | EMPLOYEE + CHILD | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 99.91 | March
G11359 | EMPLOYEE +CHILD | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 99.91 | March
G11359 | EMPLOYEE + CHILD | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 99.91 | March
G11359 | Emp and 1 Dep | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 99.91 | March
G11359 | Emp and 1 Dep | #N/A |  | 2023-09-01 00:00:00 |  | 0 | 0 | 99.91 | May
G11359 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2023-09-01 00:00:00 |  | 0 | 0 | 99.91 | April
[NAME] | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | Emp Only | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 22.89 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2021-08-01 00:00:00 |  | 0 | 0 | 22.89 | April
[NAME] | Emp and 1+ Dep | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 157.78 | May
[NAME] | Emp and 1+ Dep | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 157.78 | April
[NAME] | EMPLOYEE + CHILD | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 60.32 | March
[NAME] | EMPLOYEE + CHILD | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 60.32 | March
[NAME] | EMPLOYEE +CHILD | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 60.32 | March
[NAME] | EMPLOYEE + CHILD | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 60.32 | March
[NAME] | Emp and 1 Dep | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 60.32 | May
[NAME] | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2023-03-01 00:00:00 |  | 0 | 0 | 60.32 | April
F00750 | EMPLOYEE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
F00750 | EMPLOYEE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
F00750 | EMPLOYEE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
F00750 | EMPLOYEE | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
F00750 | Emp Only | #N/A |  | 2015-03-01 00:00:00 |  | 0 | 0 | 48.81 | May
F00750 | EMPLOYEE | EMPLOYEE |  | 2015-03-01 00:00:00 |  | 0 | 0 | 48.81 | April
W04653 | EMPLOYEE + CHILDREN (2 OR MORE) | EC |  | 2020-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
W04653 | EMPLOYEE +CHILD | EC |  | 2020-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
W04653 | EMPLOYEE + CHILD | EC |  | 2020-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
W04653 | Emp and 1 Dep | EC | Coverage Change | 2020-01-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 0 | 60.32 | March
W04653 | Emp and 1 Dep | EC |  | 2020-01-01 00:00:00 |  | 0 | 0 | 60.32 | May
W04653 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2020-01-01 00:00:00 |  | 0 | 0 | 60.32 | April
R04696 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 22.89 | 22.89 | March
R04696 | EMPLOYEE | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 22.89 | March
R04696 | Emp Only | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 22.89 | May
R04696 | EMPLOYEE | EMPLOYEE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 22.89 | April
Y04175 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04175 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04175 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04175 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
Y04175 | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | May
Y04175 | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | April
Z03240 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
B06338 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
B06338 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
B06338 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
B06338 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
B06338 | Emp Only | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 22.89 | May
B06338 | EMPLOYEE | EMPLOYEE |  | 2021-03-01 00:00:00 |  | 0 | 0 | 22.89 | April
T08370 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
T08370 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
T08370 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
T08370 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
T08370 | Emp Only | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 33.92 | May
T08370 | EMPLOYEE | EMPLOYEE |  | 2022-06-01 00:00:00 |  | 0 | 0 | 33.92 | April
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | May
[NAME] | Emp and 1+ Dep | FAMILY |  | 2022-07-01 00:00:00 |  | 0 | 0 | 157.78 | April
L09804 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
L09804 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
L09804 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
L09804 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
L09804 | Emp Only | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | May
L09804 | EMPLOYEE | EMPLOYEE |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | April
Z06120 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z06120 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z06120 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z06120 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z06120 | Emp Only | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | May
Z06120 | EMPLOYEE | EMPLOYEE |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | April
Z09360 | EMPLOYEE | #N/A | Term | 2022-12-01 00:00:00 | 2023-12-31 00:00:00 | 0 | 0 | 0 | March
X00526 | EMPLOYEE + SPOUSE | #N/A |  | 2018-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
X00526 | EMPLOYEE +SPOUSE | #N/A |  | 2018-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
X00526 | EMPLOYEE + SPOUSE | #N/A |  | 2018-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
X00526 | EMPLOYEE + SPOUSE | #N/A |  | 2018-02-01 00:00:00 |  | 0 | 0 | 83.95 | March
X00526 | Emp and Sp | #N/A |  | 2018-02-01 00:00:00 |  | 0 | 0 | 83.95 | May
X00526 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2018-02-01 00:00:00 |  | 0 | 0 | 83.95 | April
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 191.95 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 191.95 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 191.95 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 191.95 | March
[NAME] | Emp and 1+ Dep | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 191.95 | May
[NAME] | Emp and 1+ Dep | FAMILY |  | 2022-01-01 00:00:00 |  | 0 | 0 | 191.95 | April
Z00696 | EMPLOYEE | EE | Add | 2024-01-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 97.62 | 48.81 | March
Z00696 | EMPLOYEE | EE |  | 2024-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z00696 | Emp Only | EE |  | 2024-01-01 00:00:00 |  | 0 | 0 | 48.81 | May
Z00696 | EMPLOYEE | EMPLOYEE |  | 2024-01-01 00:00:00 |  | 0 | 0 | 48.81 | April
R08176 | EMPLOYEE + CHILDREN (2 OR MORE) | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 157.78 | March
R08176 | EMPLOYEE + CHILDren (2 OR MORE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 157.78 | March
R08176 | EMPLOYEE + CHILDren (2 OR MORE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 157.78 | March
R08176 | Emp and Children | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 157.78 | March
R08176 | Emp and Children | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 157.78 | May
R08176 | EMPLOYEE + CHILDren (2 OR MORE | EMPLOYEE + CHILDREN (2 OR MORE) |  | 2023-03-01 00:00:00 |  | 0 | 0 | 157.78 | April
Z00408 | EMPLOYEE + CHILD | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Z00408 | EMPLOYEE +CHILD | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Z00408 | EMPLOYEE + CHILD | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Z00408 | EMPLOYEE + CHILD | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
Z00408 | Emp and 1 Dep | #N/A |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | May
Z00408 | EMPLOYEE + CHILD | EMPLOYEE |  | 2020-01-01 00:00:00 |  | 0 | 0 | 83.95 | April
T06546 | EMPLOYEE + SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
T06546 | EMPLOYEE +SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
T06546 | EMPLOYEE + SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
T06546 | EMPLOYEE + SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
T06546 | Emp and Sp | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 83.95 | May
T06546 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2021-05-01 00:00:00 |  | 0 | 0 | 83.95 | April
E07517 | Emp and 1+ Dep | FAM |  | 2021-12-01 00:00:00 |  | 0 | 0 | 191.95 | March
E07517 | Emp and 1+ Dep | FAM |  | 2021-12-01 00:00:00 |  | 0 | 0 | 191.95 | March
E07517 | Emp and 1+ Dep | FAM |  | 2021-12-01 00:00:00 |  | 0 | 0 | 191.95 | March
E07517 | Emp and 1+ Dep | FAM |  | 2021-12-01 00:00:00 |  | 0 | 0 | 191.95 | March
E07517 | Emp and 1+ Dep | FAM |  | 2021-12-01 00:00:00 |  | 0 | 0 | 191.95 | May
E07517 | Emp and 1+ Dep | FAMILY |  | 2021-12-01 00:00:00 |  | 0 | 0 | 191.95 | April
T05322 | EMPLOYEE + SPOUSE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
T05322 | EMPLOYEE + SPOUSE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
T05322 | EMPLOYEE +SPOUSE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
T05322 | EMPLOYEE + SPOUSE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | March
T05322 | Emp and Sp | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | May
T05322 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 60.32 | April
W04701 | EMPLOYEE | EE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
W04701 | EMPLOYEE | EE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
W04701 | EMPLOYEE | EE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
W04701 | EMPLOYEE | EE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
W04701 | Emp Only | EE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | May
W04701 | EMPLOYEE | EMPLOYEE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | April
[NAME] | Emp and 1+ Dep | FAM |  | 2022-05-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2022-05-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2022-05-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2022-05-01 00:00:00 |  | 0 | 0 | 157.78 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2022-05-01 00:00:00 |  | 0 | 0 | 157.78 | May
[NAME] | Emp and 1+ Dep | FAMILY |  | 2022-05-01 00:00:00 |  | 0 | 0 | 157.78 | April
V00404 | EMPLOYEE + SPOUSE | ES | Coverage Change | 2021-03-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 0 | 99.91 | March
V00404 | EMPLOYEE + SPOUSE | ES | Coverage Change | 2021-03-01 00:00:00 | 2023-12-31 00:00:00 | -99.91 | 0 | 0 | March
K00467 | EMPLOYEE | #N/A |  | 2012-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
K00467 | EMPLOYEE | #N/A |  | 2012-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
K00467 | EMPLOYEE | #N/A |  | 2012-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
K00467 | EMPLOYEE | #N/A |  | 2012-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
K00467 | Emp Only | #N/A |  | 2012-04-01 00:00:00 |  | 0 | 0 | 48.81 | May
K00467 | EMPLOYEE | EMPLOYEE |  | 2012-04-01 00:00:00 |  | 0 | 0 | 48.81 | April
F09366 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
F09366 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
F09366 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
F09366 | EMPLOYEE | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
F09366 | Emp Only | #N/A |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | May
F09366 | EMPLOYEE | EMPLOYEE |  | 2023-02-01 00:00:00 |  | 0 | 0 | 33.92 | April
I11481 | EMPLOYEE | EE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11481 | EMPLOYEE | EE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11481 | EMPLOYEE | EE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11481 | EMPLOYEE | EE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11481 | Emp Only | EE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | May
I11481 | EMPLOYEE | EMPLOYEE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | April
Y11951 | EMPLOYEE | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y11951 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 48.81 | 48.81 | March
Y11951 | Emp Only | EE | Term | 2024-02-01 00:00:00 | 2024-03-31 00:00:00 | -48.81 | 0 | 0 | May
Y11951 | EMPLOYEE | EMPLOYEE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
V00788 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 138.89 | March
V00788 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 138.89 | March
V00788 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 138.89 | March
V00788 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 138.89 | March
V00788 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 138.89 | May
V00788 | Emp and 1+ Dep | FAMILY |  | 2014-08-01 00:00:00 |  | 0 | 0 | 138.89 | April
[NAME] | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | Emp Only | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | April
#N/A | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 57.85 | April
H01640 | EMPLOYEE + CHILD | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
H01640 | EMPLOYEE +CHILD | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
H01640 | EMPLOYEE + CHILD | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
H01640 | Emp and 1 Dep | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | March
H01640 | Emp and 1 Dep | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | May
H01640 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2023-05-01 00:00:00 |  | 0 | 0 | 83.95 | April
I06537 | EMPLOYEE + SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
I06537 | EMPLOYEE +SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
I06537 | EMPLOYEE + SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
I06537 | EMPLOYEE + SPOUSE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
I06537 | Emp and Sp | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 60.32 | May
I06537 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2021-05-01 00:00:00 |  | 0 | 0 | 60.32 | April
P04887 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
P04887 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
P04887 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
P04887 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
P04887 | Emp Only | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | May
P04887 | EMPLOYEE | EMPLOYEE |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | April
F00774 | Emp and 1+ Dep | #N/A |  | 2015-06-01 00:00:00 |  | 0 | 0 | 191.95 | March
F00774 | Emp and 1+ Dep | #N/A |  | 2015-06-01 00:00:00 |  | 0 | 0 | 191.95 | March
F00774 | Emp and 1+ Dep | #N/A |  | 2015-06-01 00:00:00 |  | 0 | 0 | 191.95 | March
F00774 | Emp and 1+ Dep | #N/A |  | 2015-06-01 00:00:00 |  | 0 | 0 | 191.95 | March
F00774 | Emp and 1+ Dep | #N/A |  | 2015-06-01 00:00:00 |  | 0 | 0 | 191.95 | May
F00774 | Emp and 1+ Dep | FAMILY |  | 2015-06-01 00:00:00 |  | 0 | 0 | 191.95 | April
[NAME] | EMPLOYEE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | Emp Only | #N/A |  | 2022-02-01 00:00:00 |  | 0 | 0 | 48.81 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
U00811 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 191.95 | March
U00811 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 191.95 | March
U00811 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 191.95 | March
U00811 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 191.95 | March
U00811 | Emp and 1+ Dep | FAM |  | 2014-08-01 00:00:00 |  | 0 | 0 | 191.95 | May
U00811 | Emp and 1+ Dep | FAMILY |  | 2014-08-01 00:00:00 |  | 0 | 0 | 191.95 | April
#N/A | Emp and 1+ Dep | #N/A |  | 2009-03-01 00:00:00 |  | 0 | 0 | 191.95 | April
W07485 | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
W07485 | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
W07485 | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
W07485 | EMPLOYEE | #N/A | Term | 2021-11-01 00:00:00 | 2024-02-29 00:00:00 | -48.81 | 0 | 0 | April
H10616 | EMPLOYEE | #N/A | Add | 2023-12-01 00:00:00 | 2023-12-01 00:00:00 | 0 | 48.81 | 48.81 | March
H10616 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
H10616 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
H10616 | EMPLOYEE | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
H10616 | Emp Only | #N/A |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | May
H10616 | EMPLOYEE | EMPLOYEE |  | 2023-12-01 00:00:00 |  | 0 | 0 | 48.81 | April
#N/A | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | April
M07837 | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
M07837 | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
M07837 | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
M07837 | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
M07837 | Emp Only | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 33.92 | May
M07837 | EMPLOYEE | EMPLOYEE |  | 2021-11-01 00:00:00 |  | 0 | 0 | 33.92 | April
E09485 | EMPLOYEE | EE |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
E09485 | EMPLOYEE | EE |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
E09485 | EMPLOYEE | EE |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
E09485 | EMPLOYEE | EE |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
E09485 | Emp Only | EE |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | May
E09485 | EMPLOYEE | EMPLOYEE |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | April
R03232 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
R03232 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
R03232 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
R03232 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
R03232 | Emp Only | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | May
R03232 | EMPLOYEE | EMPLOYEE |  | 2022-05-01 00:00:00 |  | 0 | 0 | 33.92 | April
V07964 | EMPLOYEE + CHILD | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 42.67 | March
V07964 | EMPLOYEE + CHILD | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 42.67 | March
V07964 | EMPLOYEE +CHILD | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 42.67 | March
V07964 | EMPLOYEE + CHILD | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 42.67 | March
V07964 | EMPLOYEE + CHILD | EMPLOYEE + SPOUSE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 42.67 | April
V07964 | Emp and 1 Dep | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 42.67 | May
V11924 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 33.92 | 33.92 | March
V11924 | EMPLOYEE | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
V11924 | Emp Only | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 33.92 | May
V11924 | EMPLOYEE | EMPLOYEE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 33.92 | April
A11977 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 33.92 | 33.92 | March
A11977 | EMPLOYEE | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 33.92 | March
A11977 | Emp Only | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 33.92 | May
A11977 | EMPLOYEE | EMPLOYEE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 33.92 | April
V00812 | EMPLOYEE | #N/A |  | 2014-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
M11077 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
M11077 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
M11077 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
M11077 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 57.85 | March
M11077 | Emp Only | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 57.85 | May
M11077 | EMPLOYEE | EMPLOYEE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 57.85 | April
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | EMPLOYEE +SPOUSE | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | EMPLOYEE + SPOUSE | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 83.95 | March
[NAME] | Emp and Sp | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 83.95 | May
[NAME] | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2018-06-01 00:00:00 |  | 0 | 0 | 83.95 | April
I11121 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11121 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11121 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11121 | EMPLOYEE | #N/A |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
I11121 | EMPLOYEE | EMPLOYEE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 33.92 | April
[NAME] | EMPLOYEE | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | Emp Only | EE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2020-10-01 00:00:00 |  | 0 | 0 | 33.92 | April
R12136 | EMPLOYEE | #N/A | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 67.84 | 33.92 | March
R12136 | Emp Only | #N/A |  | 2024-02-01 00:00:00 |  | 0 | 0 | 33.92 | May
R12136 | EMPLOYEE | #N/A | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 67.84 | 33.92 | April
X07966 | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
X07966 | EMPLOYEE +SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
X07966 | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
X07966 | EMPLOYEE + SPOUSE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | March
X07966 | Emp and Sp | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | May
X07966 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2022-01-01 00:00:00 |  | 0 | 0 | 99.91 | April
T11010 | Emp and 1+ Dep | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 191.95 | March
T11010 | Emp and 1+ Dep | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 191.95 | March
T11010 | Emp and 1+ Dep | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 191.95 | March
T11010 | Emp and 1+ Dep | FAMILY | Term | 2023-07-01 00:00:00 | 2024-02-29 00:00:00 | -191.95 | 0 | 0 | April
R02464 | EMPLOYEE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
R02464 | EMPLOYEE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
R02464 | EMPLOYEE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
R02464 | EMPLOYEE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
R02464 | Emp Only | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 48.81 | May
R02464 | EMPLOYEE | EMPLOYEE |  | 2020-11-01 00:00:00 |  | 0 | 0 | 48.81 | April
R11968 | EMPLOYEE +CHILD | EC |  | 2024-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
R11968 | EMPLOYEE + CHILD | EC |  | 2024-01-01 00:00:00 |  | 0 | 0 | 83.95 | March
R11968 | Emp and 1 Dep | EC | Add | 2024-01-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 83.95 | 83.95 | March
R11968 | Emp and 1 Dep | EC |  | 2024-01-01 00:00:00 |  | 0 | 0 | 83.95 | May
R11968 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2024-01-01 00:00:00 |  | 0 | 0 | 83.95 | April
Y09335 | Emp and 1+ Dep | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y09335 | Emp and 1+ Dep | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y09335 | Emp and 1+ Dep | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y09335 | Emp and 1+ Dep | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y09335 | Emp and 1+ Dep | #N/A |  | 2022-11-01 00:00:00 |  | 0 | 0 | 157.78 | May
Y09335 | Emp and 1+ Dep | FAMILY |  | 2022-11-01 00:00:00 |  | 0 | 0 | 157.78 | April
H08864 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
H08864 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
H08864 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
H08864 | EMPLOYEE | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
H08864 | Emp Only | #N/A |  | 2022-08-01 00:00:00 |  | 0 | 0 | 33.92 | May
H08864 | EMPLOYEE | EMPLOYEE |  | 2022-08-01 00:00:00 |  | 0 | 0 | 33.92 | April
Z01056 | Emp and 1+ Dep | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
G05911 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
G05911 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
G05911 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
G05911 | EmpOnty | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
G05911 | Emp Only | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 48.81 | May
G05911 | EMPLOYEE | EMPLOYEE |  | 2021-01-01 00:00:00 |  | 0 | 0 | 48.81 | April
M07885 | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
M07885 | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
M07885 | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
M07885 | EMPLOYEE | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | March
M07885 | Emp Only | #N/A |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | May
M07885 | EMPLOYEE | EMPLOYEE |  | 2021-12-01 00:00:00 |  | 0 | 0 | 22.89 | April
M05221 | EMPLOYEE | EE |  | 2020-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
M05221 | EMPLOYEE | EE |  | 2020-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
M05221 | EMPLOYEE | EE |  | 2020-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
M05221 | EMPLOYEE | EE |  | 2020-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
M05221 | Emp Only | EE |  | 2020-03-01 00:00:00 |  | 0 | 0 | 22.89 | May
M05221 | EMPLOYEE | EMPLOYEE |  | 2020-03-01 00:00:00 |  | 0 | 0 | 22.89 | April
X10630 | EMPLOYEE | EE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X10630 | EMPLOYEE | EE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X10630 | EMPLOYEE | EE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X10630 | EMPLOYEE | EE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
X10630 | Emp Only | EE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
X10630 | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
#N/A | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | April
V05252 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
V05252 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
V05252 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
V05252 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | March
V05252 | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | May
V05252 | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 57.85 | April
W08205 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
W08205 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
W08205 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
W08205 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
W08205 | Emp Only | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
W08205 | EMPLOYEE | EMPLOYEE |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
W09501 | EMPLOYEE | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
W09501 | EMPLOYEE | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
W09501 | EMPLOYEE | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
W09501 | EMPLOYEE | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
W09501 | Emp Only | #N/A |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | May
W09501 | EMPLOYEE | EMPLOYEE |  | 2022-12-01 00:00:00 |  | 0 | 0 | 48.81 | April
D11020 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
D11020 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
D11020 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
D11020 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
D11020 | Emp Only | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | May
D11020 | EMPLOYEE | EMPLOYEE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 48.81 | April
R07888 | EMPLOYEE + SPOUSE | ES | Coverage Change | 2022-01-01 00:00:00 | 2023-12-31 00:00:00 | 0 | 0 | 60.32 | March
R07888 | EMPLOYEE +SPOUSE | ES |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
R07888 | EMPLOYEE + SPOUSE | ES |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
R07888 | EMPLOYEE + SPOUSE | ES |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | March
R07888 | Emp and Sp | ES |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | May
R07888 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2022-01-01 00:00:00 |  | 0 | 0 | 60.32 | April
P04647 | EMPLOYEE + SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
P04647 | EMPLOYEE +SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
P04647 | EMPLOYEE + SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
P04647 | EMPLOYEE + SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
P04647 | Emp and Sp | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | May
P04647 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | April
L02028 | Emp and 1+ Dep | #N/A |  | 2016-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
L02028 | Emp and 1+ Dep | #N/A |  | 2016-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
L02028 | Emp and 1+ Dep | #N/A |  | 2016-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
L02028 | Emp and 1+ Dep | #N/A |  | 2016-10-01 00:00:00 |  | 0 | 0 | 191.95 | March
L02028 | Emp and 1+ Dep | #N/A |  | 2016-10-01 00:00:00 |  | 0 | 0 | 191.95 | May
L02028 | Emp and 1+ Dep | FAMILY |  | 2016-10-01 00:00:00 |  | 0 | 0 | 191.95 | April
M02029 | EMPLOYEE + CHILD | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 83.95 | March
M02029 | EMPLOYEE +CHILD | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 83.95 | March
M02029 | EMPLOYEE + CHILD | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 83.95 | March
M02029 | EMPLOYEE + CHILD | #N/A |  | 11101/2020 |  | 0 | 0 | 83.95 | March
M02029 | Emp and 1 Dep | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 83.95 | May
M02029 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2020-11-01 00:00:00 |  | 0 | 0 | 83.95 | April
P11991 | EMPLOYEE | EE | Add | 2024-01-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 115.7 | 57.85 | March
P11991 | EMPLOYEE | EE |  | 2024-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
P11991 | Emp Only | EE |  | 2024-01-01 00:00:00 |  | 0 | 0 | 57.85 | May
P11991 | EMPLOYEE | EMPLOYEE |  | 2024-01-01 00:00:00 |  | 0 | 0 | 57.85 | April
#N/A | Emp and 1+ Dep | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 191.95 | April
[NAME] | Emp and 1+ Dep | FAM | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 116.75 | 116.75 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2024-02-01 00:00:00 |  | 0 | 0 | 116.75 | March
[NAME] | Emp and 1+ Dep | FAM |  | 2024-02-01 00:00:00 |  | 0 | 0 | 116.75 | May
[NAME] | Emp and 1+ Dep | FAMILY |  | 2024-02-01 00:00:00 |  | 0 | 0 | 116.75 | April
Y11327 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y11327 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y11327 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y11327 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 157.78 | March
Y11327 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 157.78 | May
Y11327 | Emp and 1+ Dep | FAMILY |  | 2023-07-01 00:00:00 |  | 0 | 0 | 157.78 | April
R08992 | EMPLOYEE | EE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 22.89 | 22.89 | March
R08992 | Emp Only | EE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 22.89 | May
R08992 | EMPLOYEE | EMPLOYEE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 22.89 | 22.89 | April
M09805 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
M09805 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
M09805 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
M09805 | EMPLOYEE | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | March
M09805 | Emp Only | #N/A |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | May
M09805 | EMPLOYEE | EMPLOYEE |  | 2023-03-01 00:00:00 |  | 0 | 0 | 48.81 | April
Z11064 | EMPLOYEE | EE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z11064 | EMPLOYEE | EE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z11064 | EMPLOYEE | EE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z11064 | EMPLOYEE | EE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 22.89 | March
Z11064 | Emp Only | EE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 22.89 | May
Z11064 | EMPLOYEE | EMPLOYEE |  | 2023-08-01 00:00:00 |  | 0 | 0 | 22.89 | April
E08213 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
E08213 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
E08213 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
E08213 | EMPLOYEE | #N/A |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
E08213 | Emp Only | #N/A | Term | 2022-05-01 00:00:00 | 2024-03-31 00:00:00 | -48.81 | 0 | 0 | May
E08213 | EMPLOYEE | EMPLOYEE |  | 2022-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
[NAME] | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | Emp Only | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2022-04-01 00:00:00 |  | 0 | 0 | 22.89 | April
T03402 | EMPLOYEE | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
T03402 | EMPLOYEE | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
T03402 | EMPLOYEE | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
T03402 | EMPLOYEE | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
T03402 | Emp Only | #N/A |  | 2020-07-01 00:00:00 |  | 0 | 0 | 22.89 | May
T03402 | EMPLOYEE | EMPLOYEE |  | 2020-07-01 00:00:00 |  | 0 | 0 | 22.89 | April
B04874 | EMPLOYEE | #N/A |  | 2019-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
B04874 | EMPLOYEE | #N/A |  | 2019-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
B04874 | EMPLOYEE | #N/A |  | 2019-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
B04874 | EMPLOYEE | #N/A |  | 2019-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
B04874 | Emp Only | #N/A |  | 2019-09-01 00:00:00 |  | 0 | 0 | 33.92 | May
B04874 | EMPLOYEE | EMPLOYEE |  | 2019-09-01 00:00:00 |  | 0 | 0 | 33.92 | April
[NAME] | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 22.89 | March
[NAME] | Emp Only | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 22.89 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 22.89 | April
#N/A | EMPLOYEE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 57.85 | April
V04364 | EMPLOYEE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
V04364 | EMPLOYEE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
V04364 | EMPLOYEE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
V04364 | EMPLOYEE | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 48.81 | March
V04364 | Emp Only | #N/A |  | 2019-12-01 00:00:00 |  | 0 | 0 | 48.81 | May
V04364 | EMPLOYEE | EMPLOYEE |  | 2019-12-01 00:00:00 |  | 0 | 0 | 48.81 | April
U03955 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
U03955 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
U03955 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
U03955 | EMPLOYEE | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
U03955 | Emp Only | #N/A |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
U03955 | EMPLOYEE | EMPLOYEE |  | 2019-01-01 00:00:00 |  | 0 | 0 | 33.92 | April
G09199 | EMPLOYEE | EE |  | 2022-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
G09199 | EMPLOYEE | EE |  | 2022-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
G09199 | EMPLOYEE | EE |  | 2022-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
G09199 | EMPLOYEE | EE |  | 2022-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
G09199 | Emp Only | EE |  | 2022-11-01 00:00:00 |  | 0 | 0 | 33.92 | May
G09199 | EMPLOYEE | EMPLOYEE |  | 2022-11-01 00:00:00 |  | 0 | 0 | 33.92 | April
W11517 | Emp and 1+ Dep | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
W11517 | Emp and 1+ Dep | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
W11517 | Emp and 1+ Dep | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
W11517 | Emp and 1+ Dep | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 157.78 | March
W11517 | Emp and 1+ Dep | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 157.78 | May
W11517 | Emp and 1+ Dep | FAMILY |  | 2023-11-01 00:00:00 |  | 0 | 0 | 157.78 | April
F08142 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
F08142 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
F08142 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
F08142 | EMPLOYEE | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | March
F08142 | Emp Only | #N/A |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | May
F08142 | EMPLOYEE | EMPLOYEE |  | 2022-04-01 00:00:00 |  | 0 | 0 | 33.92 | April
I06993 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
I06993 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
I06993 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
I06993 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
I06993 | Emp Only | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | May
I06993 | EMPLOYEE | EMPLOYEE |  | 2021-07-01 00:00:00 |  | 0 | 0 | 33.92 | April
H00248 | EMPLOYEE | #N/A |  | 2008-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
H00248 | EMPLOYEE | #N/A |  | 2008-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
H00248 | EMPLOYEE | #N/A |  | 2008-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
H00248 | EMPLOYEE | #N/A |  | 2008-04-01 00:00:00 |  | 0 | 0 | 48.81 | March
H00248 | Emp Only | #N/A |  | 2008-04-01 00:00:00 |  | 0 | 0 | 48.81 | May
H00248 | EMPLOYEE | EMPLOYEE |  | 2008-04-01 00:00:00 |  | 0 | 0 | 48.81 | April
S07505 | EMPLOYEE + CHILD | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
S07505 | EMPLOYEE +CHILD | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
S07505 | EMPLOYEE + CHILD | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
S07505 | Emp and 1 Dep | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | March
S07505 | Emp and 1 Dep | EC |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | May
S07505 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2022-09-01 00:00:00 |  | 0 | 0 | 60.32 | April
P10743 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
P10743 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
P10743 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
P10743 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
P10743 | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | May
P10743 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | April
P08103 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
P08103 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
P08103 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
P08103 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
P08103 | Emp Only | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 57.85 | May
P08103 | EMPLOYEE | EMPLOYEE |  | 2022-03-01 00:00:00 |  | 0 | 0 | 57.85 | April
G10615 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
G10615 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
G10615 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
G10615 | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | March
G10615 | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | May
G10615 | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 48.81 | April
C07947 | EMPLOYEE | EE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
C07947 | EMPLOYEE | EE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
C07947 | EMPLOYEE | EE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
C07947 | EMPLOYEE | EE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 57.85 | March
C07947 | Emp Only | EE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 57.85 | May
C07947 | EMPLOYEE | EMPLOYEE |  | 2022-02-01 00:00:00 |  | 0 | 0 | 57.85 | April
B03674 | Emp and 1+ Dep | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
B03674 | Emp and 1+ Dep | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
B03674 | Emp and 1+ Dep | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
B03674 | Emp and 1+ Dep | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 157.78 | March
B03674 | Emp and 1+ Dep | #N/A |  | 2018-08-01 00:00:00 |  | 0 | 0 | 157.78 | May
B03674 | Emp and 1+ Dep | FAMILY |  | 2018-08-01 00:00:00 |  | 0 | 0 | 157.78 | April
B07922 | EMPLOYEE | ES |  | 2022-03-01 00:00:00 |  | 0 | 0 | 33.92 | March
B07922 | EMPLOYEE | ES |  | 2022-03-01 00:00:00 |  | 0 | 0 | 33.92 | March
B07922 | EMPLOYEE | ES |  | 2022-03-01 00:00:00 |  | 0 | 0 | 33.92 | March
B07922 | EMPLOYEE | ES |  | 2022-03-01 00:00:00 |  | 0 | 0 | 33.92 | March
B07922 | Emp Only | ES |  | 2022-03-01 00:00:00 |  | 0 | 0 | 33.92 | May
B07922 | EMPLOYEE | EMPLOYEE |  | 2022-03-01 00:00:00 |  | 0 | 0 | 33.92 | April
#N/A | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | April
L00828 | EMPLOYEE | #N/A |  | 2014-09-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00828 | EMPLOYEE | #N/A |  | 2014-09-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00828 | EMPLOYEE | #N/A |  | 2014-09-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00828 | EMPLOYEE | #N/A |  | 2014-09-01 00:00:00 |  | 0 | 0 | 57.85 | March
L00828 | Emp Only | #N/A |  | 2014-09-01 00:00:00 |  | 0 | 0 | 57.85 | May
L00828 | EMPLOYEE | EMPLOYEE |  | 2014-09-01 00:00:00 |  | 0 | 0 | 57.85 | April
H07568 | EMPLOYEE + SPOUSE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 99.91 | March
H07568 | EMPLOYEE +SPOUSE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 99.91 | March
H07568 | EMPLOYEE + SPOUSE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 99.91 | March
H07568 | EMPLOYEE + SPOUSE | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 99.91 | March
H07568 | Emp and Sp | #N/A |  | 2021-11-01 00:00:00 |  | 0 | 0 | 99.91 | May
H07568 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2021-11-01 00:00:00 |  | 0 | 0 | 99.91 | April
A07969 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A07969 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A07969 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A07969 | EMPLOYEE | EMPLOYEE |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | April
A07969 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A07969 | Emp Only | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
T00546 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
T00546 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
T00546 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
T00546 | EMPLOYEE | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 22.89 | March
T00546 | Emp Only | #N/A |  | 2022-06-01 00:00:00 |  | 0 | 0 | 22.89 | May
T00546 | EMPLOYEE | EMPLOYEE |  | 2022-06-01 00:00:00 |  | 0 | 0 | 22.89 | April
F09486 | Emp and 1+ Dep | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
F09486 | Emp and 1+ Dep | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
F09486 | Emp and 1+ Dep | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
F09486 | Emp and 1+ Dep | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 138.89 | March
F09486 | Emp and 1+ Dep | #N/A | Term | 2023-01-01 00:00:00 | 2024-03-31 00:00:00 | -138.89 | 0 | 0 | May
F09486 | Emp and 1+ Dep | FAMILY |  | 2023-01-01 00:00:00 |  | 0 | 0 | 138.89 | April
#N/A | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 22.89 | April
[NAME] | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | Emp Only | #N/A |  | 2022-07-01 00:00:00 |  | 0 | 0 | 48.81 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2022-07-01 00:00:00 |  | 0 | 0 | 48.81 | April
T12186 | EMPLOYEE | EE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 48.81 | 48.81 | March
T12186 | Emp Only | EE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 48.81 | May
T12186 | EMPLOYEE | EMPLOYEE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 48.81 | 48.81 | April
M00397 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
M00397 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
M00397 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
M00397 | EMPLOYEE | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 57.85 | March
M00397 | Emp Only | #N/A |  | 2021-03-01 00:00:00 |  | 0 | 0 | 57.85 | May
M00397 | EMPLOYEE | EMPLOYEE |  | 2021-03-01 00:00:00 |  | 0 | 0 | 57.85 | April
A04681 | EMPLOYEE + SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A04681 | EMPLOYEE +SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A04681 | EMPLOYEE + SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A04681 | EMPLOYEE + SPOUSE | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | March
A04681 | Emp and Sp | #N/A |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | May
A04681 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-08-01 00:00:00 |  | 0 | 0 | 83.95 | April
K03539 | Emp and 1+ Dep | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 116.75 | March
K03539 | Emp and 1+ Dep | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 116.75 | March
K03539 | Emp and 1+ Dep | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 116.75 | March
K03539 | Emp and 1+ Dep | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 116.75 | March
K03539 | Emp and 1+ Dep | #N/A |  | 2018-06-01 00:00:00 |  | 0 | 0 | 116.75 | May
K03539 | Emp and 1+ Dep | FAMILY |  | 2018-06-01 00:00:00 |  | 0 | 0 | 116.75 | April
E04085 | EMPLOYEE | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
E04085 | EMPLOYEE | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
E04085 | EMPLOYEE | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
E04085 | EMPLOYEE | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
E04085 | Emp Only | EE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | May
E04085 | EMPLOYEE | EMPLOYEE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 48.81 | April
C03675 | EMPLOYEE + CHILD | #N/A |  | 2018-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
C03675 | EMPLOYEE +CHILD | #N/A |  | 2018-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
C03675 | EMPLOYEE + CHILD | #N/A |  | 2018-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
C03675 | Emp and 1 Dep | #N/A |  | 2018-05-01 00:00:00 |  | 0 | 0 | 60.32 | March
C03675 | Emp and 1 Dep | #N/A |  | 2018-05-01 00:00:00 |  | 0 | 0 | 60.32 | May
C03675 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2018-05-01 00:00:00 |  | 0 | 0 | 60.32 | April
L04068 | Emp and 1+ Dep | FAM |  | 2020-11-01 00:00:00 |  | 0 | 0 | 191.95 | March
L04068 | Emp and 1+ Dep | FAM |  | 2020-11-01 00:00:00 |  | 0 | 0 | 191.95 | March
L04068 | Emp and 1+ Dep | FAM |  | 2020-11-01 00:00:00 |  | 0 | 0 | 191.95 | March
L04068 | Emp and 1+ Dep | FAM |  | 2020-11-01 00:00:00 |  | 0 | 0 | 191.95 | March
L04068 | Emp and 1+ Dep | FAM |  | 2020-11-01 00:00:00 |  | 0 | 0 | 191.95 | May
L04068 | Emp and 1+ Dep | FAMILY |  | 2020-11-01 00:00:00 |  | 0 | 0 | 191.95 | April
[NAME] | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | Emp Only | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | April
W07317 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07317 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07317 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07317 | EMPLOYEE | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | March
W07317 | Emp Only | EE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | May
W07317 | EMPLOYEE | EMPLOYEE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 57.85 | April
#N/A | EMPLOYEE + CHILD | #N/A |  | 2018-05-01 00:00:00 |  | 0 | 0 | 83.95 | April
#N/A | EMPLOYEE + CHILD | #N/A |  | 2007-04-01 00:00:00 |  | 0 | 0 | 83.95 | April
H00776 | EMPLOYEE | #N/A |  | 2014-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
H00776 | EMPLOYEE | #N/A |  | 2014-08-01 00:00:00 |  | 0 | 0 | 48.81 | March
G04855 | EMPLOYEE + SPOUSE | #N/A |  | 2019-11-01 00:00:00 |  | 0 | 0 | 60.32 | March
G04855 | EMPLOYEE +SPOUSE | #N/A |  | 2019-11-01 00:00:00 |  | 0 | 0 | 60.32 | March
G04855 | EMPLOYEE + SPOUSE | #N/A |  | 2019-11-01 00:00:00 |  | 0 | 0 | 60.32 | March
G04855 | EMPLOYEE + SPOUSE | #N/A |  | 2019-11-01 00:00:00 |  | 0 | 0 | 60.32 | March
G04855 | Emp and Sp | #N/A |  | 2019-11-01 00:00:00 |  | 0 | 0 | 60.32 | May
G04855 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2019-11-01 00:00:00 |  | 0 | 0 | 60.32 | April
B00554 | EMPLOYEE + SPOUSE | #N/A |  | 2013-09-01 00:00:00 |  | 0 | 0 | 83.95 | March
B00554 | EMPLOYEE +SPOUSE | #N/A |  | 2013-09-01 00:00:00 |  | 0 | 0 | 83.95 | March
B00554 | EMPLOYEE + SPOUSE | #N/A |  | 2013-09-01 00:00:00 |  | 0 | 0 | 83.95 | March
B00554 | EMPLOYEE + SPOUSE | #N/A |  | 2013-09-01 00:00:00 |  | 0 | 0 | 83.95 | March
B00554 | Emp and Sp | #N/A |  | 2013-09-01 00:00:00 |  | 0 | 0 | 83.95 | May
B00554 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2013-09-01 00:00:00 |  | 0 | 0 | 83.95 | April
K11027 | EMPLOYEE + CHILDREN (2 OR MORE) | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
K11027 | EMPLOYEE + CHILDren (2 OR MORE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
K11027 | EMPLOYEE + CHILDren (2 OR MORE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
K11027 | Emp and Children | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
K11027 | Emp and Children | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | May
K11027 | EMPLOYEE + CHILDren (2 OR MORE | EMPLOYEE + CHILDREN (2 OR MORE) |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | April
L08100 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
L08100 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
L08100 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
L08100 | EMPLOYEE | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 22.89 | March
L08100 | Emp Only | #N/A |  | 2022-03-01 00:00:00 |  | 0 | 0 | 22.89 | May
L08100 | EMPLOYEE | EMPLOYEE |  | 2022-03-01 00:00:00 |  | 0 | 0 | 22.89 | April
M00733 | Emp and 1+ Dep | FAM |  | 2012-09-01 00:00:00 |  | 0 | 0 | 191.95 | March
M00733 | Emp and 1+ Dep | FAM |  | 2012-09-01 00:00:00 |  | 0 | 0 | 191.95 | March
M00733 | Emp and 1+ Dep | FAM |  | 2012-09-01 00:00:00 |  | 0 | 0 | 191.95 | March
M00733 | Emp and 1+ Dep | FAM |  | 2012-09-01 00:00:00 |  | 0 | 0 | 191.95 | March
M00733 | Emp and 1+ Dep | FAM |  | 2012-09-01 00:00:00 |  | 0 | 0 | 191.95 | May
M00733 | Emp and 1+ Dep | FAMILY |  | 2012-09-01 00:00:00 |  | 0 | 0 | 191.95 | April
S05969 | EMPLOYEE + SPOUSE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 42.67 | March
S05969 | EMPLOYEE +SPOUSE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 42.67 | March
S05969 | EMPLOYEE + SPOUSE | #N/A |  | 2020-11-01 00:00:00 |  | 0 | 0 | 42.67 | March
[NAME] | EMPLOYEE + CHILD | EE |  | 2021-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
[NAME] | EMPLOYEE | EE |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | EE |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | EE | Coverage Change | 2021-06-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 0 | 33.92 | March
[NAME] | Emp Only | EE |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2021-06-01 00:00:00 |  | 0 | 0 | 33.92 | April
D11932 | EMPLOYEE | EE | Add | 2024-01-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 22.89 | 22.89 | March
J10546 | EMPLOYEE + SPOUSE | ES |  | 2023-04-01 00:00:00 |  | 0 | 0 | 99.91 | March
J10546 | EMPLOYEE +SPOUSE | ES |  | 2023-04-01 00:00:00 |  | 0 | 0 | 99.91 | March
J10546 | EMPLOYEE + SPOUSE | ES |  | 2023-04-01 00:00:00 |  | 0 | 0 | 99.91 | March
J10546 | EMPLOYEE + SPOUSE | ES |  | 2023-04-01 00:00:00 |  | 0 | 0 | 99.91 | March
J10546 | Emp and Sp | ES |  | 2023-04-01 00:00:00 |  | 0 | 0 | 99.91 | May
J10546 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 99.91 | April
A12145 | EMPLOYEE | EE | Add | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | 0 | 0 | 22.89 | March
A12145 | Emp Only | EE |  | 2024-04-01 00:00:00 |  | 0 | 0 | 22.89 | May
A12145 | EMPLOYEE | EMPLOYEE | Add | 2024-04-01 00:00:00 | 2024-04-01 00:00:00 | 0 | 0 | 22.89 | April
T10554 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
T10554 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
T10554 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
T10554 | EMPLOYEE | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | March
T10554 | Emp Only | #N/A |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | May
T10554 | EMPLOYEE | EMPLOYEE |  | 2023-04-01 00:00:00 |  | 0 | 0 | 57.85 | April
J11986 | Emp and 1+ Dep | FAM |  | 2024-01-01 00:00:00 |  | 0 | 0 | 157.78 | March
J11986 | Emp and 1+ Dep | FAM |  | 2024-01-01 00:00:00 |  | 0 | 0 | 157.78 | March
J11986 | Emp and 1+ Dep | FAM | Add | 2024-01-01 00:00:00 | 2024-01-01 00:00:00 | 0 | 157.78 | 157.78 | March
J11986 | Emp and 1+ Dep | FAM |  | 2024-01-01 00:00:00 |  | 0 | 0 | 157.78 | May
J11986 | Emp and 1+ Dep | FAMILY |  | 2024-01-01 00:00:00 |  | 0 | 0 | 157.78 | April
V11492 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
V11492 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | March
V11492 | EMPLOYEE | #N/A | Add | 2023-11-01 00:00:00 | 2023-11-01 00:00:00 | 0 | 101.76 | 33.92 | March
V11492 | Emp Only | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | May
V11492 | EMPLOYEE | EMPLOYEE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 33.92 | April
W07965 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
W07965 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
W07965 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
W07965 | Emp Only | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
W07965 | EMPLOYEE | EMPLOYEE |  | 2022-01-01 00:00:00 |  | 0 | 0 | 33.92 | April
G07015 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
G07015 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
G07015 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
G07015 | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 33.92 | March
G07015 | Emp Only | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 33.92 | May
G07015 | EMPLOYEE | EMPLOYEE |  | 2021-08-01 00:00:00 |  | 0 | 0 | 33.92 | April
W06069 | Emp and 1+ Dep | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 157.78 | March
W06069 | Emp and 1+ Dep | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 157.78 | March
W06069 | Emp and 1+ Dep | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 157.78 | March
W06069 | Emp and 1+ Dep | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 157.78 | March
W06069 | Emp and 1+ Dep | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 157.78 | May
W06069 | Emp and 1+ Dep | FAMILY |  | 2021-01-01 00:00:00 |  | 0 | 0 | 157.78 | April
L04668 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
L04668 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
L04668 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
L04668 | EMPLOYEE | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | March
L04668 | Emp Only | #N/A |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | May
L04668 | EMPLOYEE | EMPLOYEE |  | 2019-07-01 00:00:00 |  | 0 | 0 | 33.92 | April
B07970 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
B07970 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
B07970 | EMPLOYEE | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | March
B07970 | Emp Only | #N/A |  | 2022-01-01 00:00:00 |  | 0 | 0 | 57.85 | May
F07158 | EMPLOYEE | #N/A |  | 2023-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
F07158 | EMPLOYEE | EMPLOYEE |  | 2023-10-01 00:00:00 |  | 0 | 0 | 48.81 | April
[NAME] | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | EMPLOYEE | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
[NAME] | Emp Only | #N/A |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | May
[NAME] | EMPLOYEE | EMPLOYEE |  | 2023-05-01 00:00:00 |  | 0 | 0 | 33.92 | April
F07158 | EMPLOYEE | #N/A |  | 2023-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
F07158 | EMPLOYEE | #N/A |  | 2023-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
F07158 | EMPLOYEE | #N/A |  | 2023-10-01 00:00:00 |  | 0 | 0 | 48.81 | March
F07158 | Emp Only | #N/A |  | 2023-10-01 00:00:00 |  | 0 | 0 | 48.81 | May
D00820 | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
D00820 | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
D00820 | EMPLOYEE | #N/A |  | 2021-05-01 00:00:00 |  | 0 | 0 | 33.92 | March
D00820 | EMPLOYEE | EMPLOYEE | Term | 2021-05-01 00:00:00 | 2024-02-29 00:00:00 | -33.92 | 0 | 0 | April
A11521 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
A11521 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
A11521 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
A11521 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
A11521 | Emp Only | #N/A | Term | 2023-11-01 00:00:00 | 2024-03-31 00:00:00 | -48.81 | 0 | 0 | May
A11521 | EMPLOYEE | EMPLOYEE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | April
L07620 | EMPLOYEE | ES |  | 2021-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
L07620 | EMPLOYEE | ES |  | 2021-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
L07620 | EMPLOYEE | ES |  | 2021-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
L07620 | EMPLOYEE | ES |  | 2021-09-01 00:00:00 |  | 0 | 0 | 33.92 | March
L07620 | Emp Only | ES |  | 2021-09-01 00:00:00 |  | 0 | 0 | 33.92 | May
L07620 | EMPLOYEE | EMPLOYEE |  | 2021-09-01 00:00:00 |  | 0 | 0 | 33.92 | April
Y11519 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y11519 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y11519 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y11519 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
Y11519 | Emp Only | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | May
Y11519 | EMPLOYEE | EMPLOYEE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | April
C09339 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
C09339 | EMPLOYEE | EMPLOYEE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | April
K04811 | EMPLOYEE | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
K04811 | EMPLOYEE | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
K04811 | EMPLOYEE | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
K04811 | EMPLOYEE | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 22.89 | March
K04811 | Emp Only | #N/A |  | 2019-10-01 00:00:00 |  | 0 | 0 | 22.89 | May
K04811 | EMPLOYEE | EMPLOYEE |  | 2019-10-01 00:00:00 |  | 0 | 0 | 22.89 | April
C09339 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
C09339 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
C09339 | EMPLOYEE | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | March
C09339 | Emp Only | #N/A |  | 2023-01-01 00:00:00 |  | 0 | 0 | 48.81 | May
F05598 | EMPLOYEE | #N/A |  | 2020-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
F05598 | EMPLOYEE | #N/A |  | 2020-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
F05598 | EMPLOYEE | #N/A |  | 2020-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
F05598 | EMPLOYEE | #N/A |  | 2020-04-01 00:00:00 |  | 0 | 0 | 22.89 | March
F05598 | Emp Only | #N/A |  | 2020-04-01 00:00:00 |  | 0 | 0 | 22.89 | May
F05598 | EMPLOYEE | EMPLOYEE |  | 2020-04-01 00:00:00 |  | 0 | 0 | 22.89 | April
#N/A | EMPLOYEE | #N/A |  | 2021-08-01 00:00:00 |  | 0 | 0 | 33.92 | April
S11009 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
S11009 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
S11009 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
S11009 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | March
S11009 | Emp and 1+ Dep | FAM |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | May
S11009 | Emp and 1+ Dep | FAMILY |  | 2023-07-01 00:00:00 |  | 0 | 0 | 138.89 | April
B11450 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
B11450 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
B11450 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
B11450 | EMPLOYEE | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | March
B11450 | Emp Only | #N/A |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | May
B11450 | EMPLOYEE | EMPLOYEE |  | 2023-11-01 00:00:00 |  | 0 | 0 | 48.81 | April
V09308 | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
V09308 | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
V09308 | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
V09308 | EMPLOYEE | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | March
V09308 | Emp Only | #N/A |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | May
V09308 | EMPLOYEE | EMPLOYEE |  | 2022-10-01 00:00:00 |  | 0 | 0 | 33.92 | April
Z04464 | EMPLOYEE | #N/A |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z04464 | EMPLOYEE | #N/A |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z04464 | EMPLOYEE | #N/A |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z04464 | EMPLOYEE | #N/A |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | March
Z04464 | Emp Only | #N/A |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | May
Z04464 | EMPLOYEE | EMPLOYEE |  | 2019-06-01 00:00:00 |  | 0 | 0 | 48.81 | April
I07113 | EMPLOYEE + SPOUSE | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
I07113 | EMPLOYEE +SPOUSE | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
I07113 | EMPLOYEE + SPOUSE | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
I07113 | EMPLOYEE + SPOUSE | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 83.95 | March
I07113 | Emp and Sp | #N/A |  | 2021-10-01 00:00:00 |  | 0 | 0 | 83.95 | May
I07113 | EMPLOYEE + SPOUSE | EMPLOYEE + SPOUSE |  | 2021-10-01 00:00:00 |  | 0 | 0 | 83.95 | April
S11801 | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 57.85 | 57.85 | March
S11801 | Emp Only | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 57.85 | May
[NAME] | Emp Only | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | May
[NAME] | EMPLOYEE | EE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | March
[NAME] | EMPLOYEE | EE | Add | 2024-02-01 00:00:00 | 2024-02-01 00:00:00 | 0 | 48.81 | 48.81 | March
[NAME] | EMPLOYEE | EMPLOYEE |  | 2024-02-01 00:00:00 |  | 0 | 0 | 48.81 | April
Y00215 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
Y00215 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
Y00215 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
Y00215 | EMPLOYEE | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
Y00215 | Emp Only | #N/A |  | 2023-07-01 00:00:00 |  | 0 | 0 | 22.89 | May
Y00215 | EMPLOYEE | EMPLOYEE |  | 2023-07-01 00:00:00 |  | 0 | 0 | 22.89 | April
M07813 | EMPLOYEE + SPOUSE | ES |  | 2021-12-01 00:00:00 |  | 0 | 0 | 99.91 | March
M07813 | EMPLOYEE +SPOUSE | ES |  | 2021-12-01 00:00:00 |  | 0 | 0 | 99.91 | March
M07813 | EMPLOYEE + SPOUSE | ES |  | 2021-12-01 00:00:00 |  | 0 | 0 | 99.91 | March
M07813 | Emp and Sp | ES |  | 2021-12-01 00:00:00 |  | 0 | 0 | 99.91 | May
A09313 | EMPLOYEE | EE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A09313 | EMPLOYEE | EE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A09313 | EMPLOYEE | EE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A09313 | EMPLOYEE | EE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | March
A09313 | Emp Only | EE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | May
A09313 | EMPLOYEE | EMPLOYEE |  | 2023-01-01 00:00:00 |  | 0 | 0 | 33.92 | April
E12077 | EMPLOYEE | EE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 22.89 | 22.89 | March
E12077 | Emp Only | EE |  | 2024-03-01 00:00:00 |  | 0 | 0 | 22.89 | May
E12077 | EMPLOYEE | EMPLOYEE | Add | 2024-03-01 00:00:00 | 2024-03-01 00:00:00 | 0 | 22.89 | 22.89 | April
W05709 | EMPLOYEE + CHILD | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
W05709 | EMPLOYEE + CHILD | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
W05709 | EMPLOYEE +CHILD | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
W05709 | EMPLOYEE + CHILD | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | March
W05709 | Emp and 1 Dep | #N/A |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | May
W05709 | EMPLOYEE + CHILD | EMPLOYEE + CHILD |  | 2023-06-01 00:00:00 |  | 0 | 0 | 60.32 | April
R07120 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
R07120 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
R07120 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
R07120 | EMPLOYEE | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | March
R07120 | Emp Only | #N/A |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | May
R07120 | EMPLOYEE | EMPLOYEE |  | 2021-07-01 00:00:00 |  | 0 | 0 | 22.89 | April
M06133 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
M06133 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
M06133 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
M06133 | EMPLOYEE | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | March
M06133 | Emp Only | #N/A |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | May
M06133 | EMPLOYEE | EMPLOYEE |  | 2021-01-01 00:00:00 |  | 0 | 0 | 22.89 | April
X00766 | EMPLOYEE + CHILDREN (2 OR MORE) | #N/A |  | 2012-11-01 00:00:00 |  | 0 | 0 | 191.95 | March
X00766 | EMPLOYEE + CHILDren (2 OR MORE | #N/A |  | 2012-11-01 00:00:00 |  | 0 | 0 | 191.95 | March
X00766 | Emp and Children | #N/A |  | 2012-11-01 00:00:00 |  | 0 | 0 | 191.95 | February
X00766 | Emp and Children | #N/A |  | 2012-11-01 00:00:00 |  | 0 | 0 | 191.95 | May