SubscriberId	518266
First Name
Last Name
Middle Name
Gender
BirthDate
Marital Status
Address 1
Address 2
City
State
Zip Code
HomePhone
email

                   

Id	BenefitType	Plan	CoverageLevel	SubscriberPremium	BillingPremium	Volume	OriginalEffectiveDate	ChangeEffectiveDate	TerminationDate	TerminationReasonId
2505164	medical	Medical - PPO Base Plan	EE+Family	27.13	58.78	49.86	2011-07-25	2012-03-18