Eligibility Census
By Group CodeReport Date: 01/01/2004
  Eligibility as of: 01/01/2003
  Paid Claims: 01/01/2003 - 01/01/2003
 
 

M

Claims		 Enrollee

F

Claims

M

Claims		 Spouse

F

Claims

M

Claims		 Dependent

F

Claims
Group: 99999
Benefit Type: %
 
ACTIVE
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 32 $.00 19 $.00
20-29 10 $.00 9 $.00 2 $.00 0 $.00 2 $.00 2 $.00
30-39 13 $.00 20 $.00 5 $.00 6 $.00 0 $.00 0 $.00
40-49 19 $.00 17 $.00 3 $.00 4 $.00 0 $.00 0 $.00
50-59 9 $.00 12 $.00 3 $.00 4 $.00 0 $.00 0 $.00
60-64 1 $.00 8 $.00 3 $.00 0 $.00 0 $.00 0 $.00
65+ 1 $.00 6 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 53 $.00 72 $.00 16 $.00 14 $.00 34 $.00 21 $.00
 
COVERAGE
Employee 38 $.00 49 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Spouse 6 $.00 5 $.00 5 $.00 6 $.00 0 $.00 0 $.00
Emp.+Child(ren) 1 $.00 6 $.00 0 $.00 0 $.00 10 $.00 6 $.00
Family 8 $.00 12 $.00 11 $.00 8 $.00 24 $.00 15 $.00
 
Total COVERAGE 53 $.00 72 $.00 16 $.00 14 $.00 34 $.00 21 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
COBRA
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
20-29 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
30-39 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
40-49 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
50-59 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
60-64 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
65+ 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
COVERAGE
Employee 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Spouse 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Child(ren) 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Family 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total COVERAGE 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
INACTIVE
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 1 $.00 0 $.00
20-29 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
30-39 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
40-49 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
50-59 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
60-64 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
65+ 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
 
COVERAGE
Employee 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
Emp.+Spouse 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Child(ren) 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Family 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total COVERAGE 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
TERM
 
AGE
0-19 0 $.00 1 $.00 0 $.00 0 $.00 26 $.00 18 $.00
20-29 13 $.00 14 $.00 1 $.00 3 $.00 7 $.00 7 $.00
30-39 13 $.00 9 $.00 5 $.00 3 $.00 1 $.00 0 $.00
40-49 5 $.00 15 $.00 4 $.00 1 $.00 0 $.00 0 $.00
50-59 2 $.00 8 $.00 7 $.00 1 $.00 0 $.00 0 $.00
60-64 0 $.00 3 $.00 3 $.00 2 $.00 0 $.00 0 $.00
65+ 1 $.00 5 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 34 $.00 55 $.00 20 $.00 10 $.00 34 $.00 25 $.00
 
COVERAGE
Employee 29 $.00 44 $.00 8 $.00 7 $.00 18 $.00 14 $.00
Emp.+Spouse 1 $.00 2 $.00 2 $.00 1 $.00 1 $.00 0 $.00
Emp.+Child(ren) 2 $.00 1 $.00 1 $.00 0 $.00 5 $.00 3 $.00
Family 2 $.00 8 $.00 9 $.00 2 $.00 10 $.00 8 $.00
 
Total COVERAGE 34 $.00 55 $.00 20 $.00 10 $.00 34 $.00 25 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
TOTAL
 
AGE
0-19 0 $.00 1 $.00 0 $.00 0 $.00 59 $.00 37 $.00
20-29 23 $.00 23 $.00 3 $.00 3 $.00 9 $.00 9 $.00
30-39 26 $.00 29 $.00 10 $.00 9 $.00 1 $.00 0 $.00
40-49 24 $.00 33 $.00 7 $.00 5 $.00 0 $.00 0 $.00
50-59 11 $.00 20 $.00 10 $.00 5 $.00 0 $.00 0 $.00
60-64 1 $.00 12 $.00 6 $.00 2 $.00 0 $.00 0 $.00
65+ 2 $.00 11 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 87 $.00 129 $.00 36 $.00 24 $.00 69 $.00 46 $.00
 
COVERAGE
Employee 67 $.00 95 $.00 8 $.00 7 $.00 19 $.00 14 $.00
Emp.+Spouse 7 $.00 7 $.00 7 $.00 7 $.00 1 $.00 0 $.00
Emp.+Child(ren) 3 $.00 7 $.00 1 $.00 0 $.00 15 $.00 9 $.00
Family 10 $.00 20 $.00 20 $.00 10 $.00 34 $.00 23 $.00
 
Total COVERAGE 87 $.00 129 $.00 36 $.00 24 $.00 69 $.00 46 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
Total Benefit Type % 87 $.00 129 $.00 36 $.00 24 $.00 69 $.00 46 $.00
 
Benefit Type: M
 
ACTIVE
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 32 $2,848.24 19 $588.78
20-29 10 $343.68 9 $5,090.50 2 $.00 0 $.00 2 $.00 2 $.00
30-39 13 $398.32 20 $850.94 5 $75.00 6 $854.50 0 $.00 0 $.00
40-49 19 $254.80 17 $943.33 3 $.00 4 $4,039.84 0 $.00 0 $.00
50-59 9 $522.22 12 $2,140.09 3 $.00 4 $202.55 0 $.00 0 $.00
60-64 1 $.00 8 $.00 3 $441.22 0 $.00 0 $.00 0 $.00
65+ 1 $.00 5 $102.32 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 53 $1,519.02 71 $9,127.18 16 $516.22 14 $5,096.89 34 $2,848.24 21 $588.78
 
COVERAGE
Employee 38 $526.68 48 $3,195.92 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Spouse 6 $447.00 5 $588.66 5 $441.22 6 $141.00 0 $.00 0 $.00
Emp.+Child(ren) 1 $75.22 6 $3,501.85 0 $.00 0 $.00 10 $2,474.26 6 $.00
Family 8 $470.12 12 $1,840.75 11 $75.00 8 $4,955.89 24 $373.98 15 $588.78
 
Total COVERAGE 53 $1,519.02 71 $9,127.18 16 $516.22 14 $5,096.89 34 $2,848.24 21 $588.78
 
Avg Paid Per Enrollee $158.84
Avg Paid Per Member $94.24
 
 
COBRA
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
20-29 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
30-39 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
40-49 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
50-59 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
60-64 0 $.00 1 $709.55 0 $.00 0 $.00 0 $.00 0 $.00
65+ 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 0 $.00 1 $709.55 0 $.00 0 $.00 0 $.00 0 $.00
 
COVERAGE
Employee 0 $.00 1 $709.55 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Spouse 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Child(ren) 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Family 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total COVERAGE 0 $.00 1 $709.55 0 $.00 0 $.00 0 $.00 0 $.00
 
Avg Paid Per Enrollee $709.55
Avg Paid Per Member $709.55
 
 
INACTIVE
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 1 $.00 0 $.00
20-29 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
30-39 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
40-49 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
50-59 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
60-64 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
65+ 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
 
COVERAGE
Employee 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
Emp.+Spouse 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Child(ren) 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Family 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total COVERAGE 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
TERM
 
AGE
0-19 0 $.00 1 $.00 0 $.00 0 $.00 26 $.00 18 $.00
20-29 13 $.00 14 $.00 1 $.00 3 $.00 7 $.00 7 $.00
30-39 13 $.00 9 $.00 5 $.00 3 $.00 1 $.00 0 $.00
40-49 5 $.00 15 $.00 4 $.00 1 $.00 0 $.00 0 $.00
50-59 2 $.00 8 $.00 7 $.00 1 $.00 0 $.00 0 $.00
60-64 0 $.00 3 $.00 3 $.00 2 $26,959.66 0 $.00 0 $.00
65+ 1 $.00 5 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 34 $.00 55 $.00 20 $.00 10 $26,959.66 34 $.00 25 $.00
 
COVERAGE
Employee 29 $.00 44 $.00 8 $.00 7 $26,959.66 18 $.00 14 $.00
Emp.+Spouse 1 $.00 2 $.00 2 $.00 1 $.00 1 $.00 0 $.00
Emp.+Child(ren) 2 $.00 1 $.00 1 $.00 0 $.00 5 $.00 3 $.00
Family 2 $.00 8 $.00 9 $.00 2 $.00 10 $.00 8 $.00
 
Total COVERAGE 34 $.00 55 $.00 20 $.00 10 $26,959.66 34 $.00 25 $.00
 
Avg Paid Per Enrollee $302.92
Avg Paid Per Member $151.46
 
 
TOTAL
 
AGE
0-19 0 $.00 1 $.00 0 $.00 0 $.00 59 $2,848.24 37 $588.78
20-29 23 $343.68 23 $5,090.50 3 $.00 3 $.00 9 $.00 9 $.00
30-39 26 $398.32 29 $850.94 10 $75.00 9 $854.50 1 $.00 0 $.00
40-49 24 $254.80 33 $943.33 7 $.00 5 $4,039.84 0 $.00 0 $.00
50-59 11 $522.22 20 $2,140.09 10 $.00 5 $202.55 0 $.00 0 $.00
60-64 1 $.00 12 $709.55 6 $441.22 2 $26,959.66 0 $.00 0 $.00
65+ 2 $.00 10 $102.32 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 87 $1,519.02 128 $9,836.73 36 $516.22 24 $32,056.55 69 $2,848.24 46 $588.78
 
COVERAGE
Employee 67 $526.68 94 $3,905.47 8 $.00 7 $26,959.66 19 $.00 14 $.00
Emp.+Spouse 7 $447.00 7 $588.66 7 $441.22 7 $141.00 1 $.00 0 $.00
Emp.+Child(ren) 3 $75.22 7 $3,501.85 1 $.00 0 $.00 15 $2,474.26 9 $.00
Family 10 $470.12 20 $1,840.75 20 $75.00 10 $4,955.89 34 $373.98 23 $588.78
 
Total COVERAGE 87 $1,519.02 128 $9,836.73 36 $516.22 24 $32,056.55 69 $2,848.24 46 $588.78
 
Avg Paid Per Enrollee $220.30
Avg Paid Per Member $121.45
 
Total Benefit Type M 87 $1,519.02 128 $9,836.73 36 $516.22 24 $32,056.55 69 $2,848.24 46 $588.78
 
Benefit Type: Z
 
ACTIVE
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 32 $.00 19 $.00
20-29 10 $.00 9 $.00 2 $.00 0 $.00 2 $.00 2 $.00
30-39 13 $.00 20 $.00 5 $.00 6 $.00 0 $.00 0 $.00
40-49 19 $.00 17 $.00 3 $.00 4 $.00 0 $.00 0 $.00
50-59 9 $.00 12 $.00 3 $.00 4 $.00 0 $.00 0 $.00
60-64 1 $.00 8 $.00 3 $.00 0 $.00 0 $.00 0 $.00
65+ 1 $.00 6 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 53 $.00 72 $.00 16 $.00 14 $.00 34 $.00 21 $.00
 
COVERAGE
Employee 38 $.00 49 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Spouse 6 $.00 5 $.00 5 $.00 6 $.00 0 $.00 0 $.00
Emp.+Child(ren) 1 $.00 6 $.00 0 $.00 0 $.00 10 $.00 6 $.00
Family 8 $.00 12 $.00 11 $.00 8 $.00 24 $.00 15 $.00
 
Total COVERAGE 53 $.00 72 $.00 16 $.00 14 $.00 34 $.00 21 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
>COBRA
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
20-29 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
30-39 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
40-49 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
50-59 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
60-64 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
65+ 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
COVERAGE
Employee 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Spouse 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Child(ren) 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Family 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total COVERAGE 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
INACTIVE
 
AGE
0-19 0 $.00 0 $.00 0 $.00 0 $.00 1 $.00 0 $.00
20-29 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
30-39 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
40-49 0 $.00 1 $.00 0 $.00 0 $.00 0 $.00 0 $.00
50-59 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
60-64 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
65+ 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
 
COVERAGE
Employee 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
Emp.+Spouse 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Emp.+Child(ren) 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Family 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total COVERAGE 0 $.00 1 $.00 0 $.00 0 $.00 1 $.00 0 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
TERM
 
AGE
0-19 0 $.00 1 $.00 0 $.00 0 $.00 26 $.00 18 $.00
20-29 13 $.00 14 $.00 1 $.00 3 $.00 7 $.00 7 $.00
30-39 13 $.00 9 $.00 5 $.00 3 $.00 1 $.00 0 $.00
40-49 5 $.00 15 $.00 4 $.00 1 $.00 0 $.00 0 $.00
50-59 2 $.00 8 $.00 7 $.00 1 $.00 0 $.00 0 $.00
60-64 0 $.00 3 $.00 3 $.00 2 $.00 0 $.00 0 $.00
65+ 1 $.00 5 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 34 $.00 55 $.00 20 $.00 10 $.00 34 $.00 25 $.00
 
COVERAGE
Employee 29 $.00 44 $.00 8 $.00 7 $.00 18 $.00 14 $.00
Emp.+Spouse 1 $.00 2 $.00 2 $.00 1 $.00 1 $.00 0 $.00
Emp.+Child(ren) 2 $.00 1 $.00 1 $.00 0 $.00 5 $.00 3 $.00
Family 2 $.00 8 $.00 9 $.00 2 $.00 10 $.00 8 $.00
 
Total COVERAGE 34 $.00 55 $.00 20 $.00 10 $.00 34 $.00 25 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
 
TOTAL
 
AGE
0-19 0 $.00 1 $.00 0 $.00 0 $.00 59 $.00 37 $.00
20-29 23 $.00 23 $.00 3 $.00 3 $.00 9 $.00 9 $.00
30-39 26 $.00 29 $.00 10 $.00 9 $.00 1 $.00 0 $.00
40-49 24 $.00 33 $.00 7 $.00 5 $.00 0 $.00 0 $.00
50-59 11 $.00 20 $.00 10 $.00 5 $.00 0 $.00 0 $.00
60-64 1 $.00 12 $.00 6 $.00 2 $.00 0 $.00 0 $.00
65+ 2 $.00 11 $.00 0 $.00 0 $.00 0 $.00 0 $.00
Unknown 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00 0 $.00
 
Total AGE 87 $.00 129 $.00 36 $.00 24 $.00 69 $.00 46 $.00
 
COVERAGE
Employee 67 $.00 95 $.00 8 $.00 7 $.00 19 $.00 14 $.00
Emp.+Spouse 7 $.00 7 $.00 7 $.00 7 $.00 1 $.00 0 $.00
Emp.+Child(ren) 3 $.00 7 $.00 1 $.00 0 $.00 15 $.00 9 $.00
Family 10 $.00 20 $.00 20 $.00 10 $.00 34 $.00 23 $.00
 
Total COVERAGE 87 $.00 129 $.00 36 $.00 24 $.00 69 $.00 46 $.00
 
Avg Paid Per Enrollee $.00
Avg Paid Per Member $.00
 
Total Benefit Type Z 87 $.00 129 $.00 36 $.00 24 $.00 69 $.00 46 $.00
 
Total Group 99999 261 $1,519.02 386 $9,836.73 108 $516.22 72 $32,056.55 207 $2,848.24 138 $588.78
 
* Report Total * 261 $1,519.02 386 $9,836.73 108 $516.22 72 $32,056.55 207 $2,848.24 138 $588.78
 
Uncategorized Claims Total $17,562.82
 
Eligibility Census
Requestor: John Employer
Report Date: 01/01/2004
Sort fields: Selected values:
Group 99999
Coverage: ALL
Status: ALL
Benefit Type(s): ALL
Include Terms? Yes
Eligibility As of: 01/01/2003
From Age: 0
To Age: 150
Paid Claims From: 01/01/2003 To: 01/01/2003