Subscriber

SubscriberId 449800  
First Name  
Last Name  
Middle Name  
Gender  
BirthDate  
Marital Status  
Address 1  
Address 2  
City  
State  
Zip Code  
HomePhone  
email  

                   

Coverages

Id BenefitType Plan CoverageLevel SubscriberPremium BillingPremium Volume OriginalEffectiveDate ChangeEffectiveDate TerminationDate TerminationReasonId
2505162 medical HMO EE+Dependent 14.94 32.37 32.14 2013-06-27 2011-06-07