SubscriberId	448736
First Name
Last Name
Middle Name
Gender
BirthDate
Marital Status
Address 1
Address 2
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State
Zip Code
HomePhone
email

                   

Id	BenefitType	Plan	CoverageLevel	SubscriberPremium	BillingPremium	Volume	OriginalEffectiveDate	ChangeEffectiveDate	TerminationDate	TerminationReasonId
2505161	medical	HMO	EE	11.97	25.93	113.68	2012-05-23	2011-09-17