GetHired

Open Enrollment Elections(2019 Open Enrollment)

Employee SSN	Relationship	Last Name	First Name	Gender	Date of Birth	Martial Status	Tobacco User	Is Disabled	Home Street Address	City	State	Zip Code	Country	Mailing Address Same As Home Address	Phone	Email	Office Location	Eligibility	Department	Divisions	Employment Start Date	Employment Status	Enrollment Reason	Carrier/Provider	Product Type	Plan Name	Coverage Level	Enrollment Start Date	Enrollment End Date	Requested Benefit Amount	Approved Benefit Amount	Pending Benefit Amount	Employee Monthly Cost	Company Monthly Cost	Employee Per Pay Cost	Company Per Pay Cost	Employee Monthly Family Cost	Employee Per Pay Family Cost	Waived	Enrolled on Date	Enrolled By
111-22-4726	Employee	Adkins	Ada	Female	07/15/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1394@gmail.com	California	Full Time	Engineering	Packing & Printing	06/02/1999	Active	Open Enrollment	Anthem Blue Cross	Medical	Anthem Gold $1000 PPO	Employee	10/01/2019	01/01/2020				187.5	187.5	86.54	86.54			No		Kaylin Lewis
111-22-4726	Employee	Adkins	Ada	Female	07/15/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1394@gmail.com	California	Full Time	Engineering	Packing & Printing	06/02/1999	Active	Open Enrollment	ASIFlex	Dependent Care FSA	Flexible Spending Account - Dependent Care	Employee	10/01/2019	01/01/2020				16.67	0	7.14	0			No		Kaylin Lewis
111-22-4726	Employee	Adkins	Ada	Female	07/15/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1394@gmail.com	California	Full Time	Engineering	Packing & Printing	06/02/1999	Active	Open Enrollment	EyeMed	Vision	EyeMed Vision	Employee	10/01/2019	01/01/2020				7.5	7.5	3.46	3.46			No		Kaylin Lewis
111-22-4726	Employee	Adkins	Ada	Female	07/15/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1394@gmail.com	California	Full Time	Engineering	Packing & Printing	06/02/1999	Active	Open Enrollment	Delta Dental of Massachusetts	Dental	Delta Dental PPO	Employee	10/01/2019	01/01/2020				10	10	4.62	4.62			No		Kaylin Lewis
111-22-4739	Employee	Osborne	Amanda	Male	07/28/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1407@gmail.com	California	Full Time	Engineering	Packing & Printing	06/15/1999	Active	Open Enrollment	Anthem Blue Cross	Medical	Anthem Gold $1000 PPO	Employee	10/01/2019	01/01/2020				187.5	187.5	86.54	86.54			No	10/01/2019	Kaylin Lewis
111-22-4739	Employee	Osborne	Amanda	Male	07/28/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1407@gmail.com	California	Full Time	Engineering	Packing & Printing	06/15/1999	Active	Open Enrollment	Guardian	Group Short Term Disability	Guardian Group STD	Employee	10/01/2019	01/01/2024	692	692	0	0	15.92	0	7.35			No	10/01/2019	Kaylin Lewis
111-22-4739	Employee	Osborne	Amanda	Male	07/28/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1407@gmail.com	California	Full Time	Engineering	Packing & Printing	06/15/1999	Active	Open Enrollment	Delta Dental of Massachusetts	Dental	Delta Dental PPO	Employee	10/01/2019	01/01/2020				10	10	4.62	4.62			No	10/01/2019	Kaylin Lewis
111-22-4739	Employee	Osborne	Amanda	Male	07/28/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1407@gmail.com	California	Full Time	Engineering	Packing & Printing	06/15/1999	Active	Open Enrollment	EyeMed	Vision	EyeMed Vision	Employee	10/01/2019	01/01/2020				7.5	7.5	3.46	3.46			No	10/01/2019	Kaylin Lewis
111-22-4739	Employee	Osborne	Amanda	Male	07/28/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1407@gmail.com	California	Full Time	Engineering	Packing & Printing	06/15/1999	Active	Open Enrollment	Unum Group	Voluntary Life AD&D	2019 UNUM Voluntary Life/AD&D	Employee	10/01/2019	09/02/2020	430000	250000	180000	47.5	0	21.92	0	47.5	21.92	No	10/01/2019	Kaylin Lewis
111-22-4739	Employee	Osborne	Amanda	Male	07/28/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1407@gmail.com	California	Full Time	Engineering	Packing & Printing	06/15/1999	Active	Open Enrollment	Guardian	Group Life AD&D	Guardian Group Life/AD&D	Employee	10/01/2019	01/01/2024	50000	50000	0	0	7.5	0	3.46	0	0	No	10/01/2019	Kaylin Lewis
111-22-4739	Employee	Osborne	Amanda	Male	07/28/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1407@gmail.com	California	Full Time	Engineering	Packing & Printing	06/15/1999	Active	Open Enrollment	Guardian	Group Long Term Disability	Guardian Group LTD	Employee	10/01/2019	01/01/2024	3000	3000	0	0	10.5	0	4.85			No	10/01/2019	Kaylin Lewis
111-22-4833	Employee	Wilcox	Ariyah	Male	10/30/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1501@gmail.com	California	Full Time	Engineering	Packing & Printing	09/17/1999	Active	Open Enrollment	EyeMed	Vision	EyeMed Vision	Employee	10/01/2019	01/01/2020				7.5	7.5	3.46	3.46			No	10/01/2019	Kaylin Lewis
111-22-4833	Employee	Wilcox	Ariyah	Male	10/30/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1501@gmail.com	California	Full Time	Engineering	Packing & Printing	09/17/1999	Active	Open Enrollment	Guardian	Group Long Term Disability	Guardian Group LTD	Employee	10/01/2019	01/01/2024	3399	3399	0	0	11.9	0	5.49			No	10/01/2019	Kaylin Lewis
111-22-4833	Employee	Wilcox	Ariyah	Male	10/30/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1501@gmail.com	California	Full Time	Engineering	Packing & Printing	09/17/1999	Active	Open Enrollment	Delta Dental of Massachusetts	Dental	Delta Dental PPO	Employee	10/01/2019	01/01/2020				10	10	4.62	4.62			No	10/01/2019	Kaylin Lewis
111-22-4833	Employee	Wilcox	Ariyah	Male	10/30/1991	Married	No	No	650 Redwood Road	Oakland	CA	95004	US	Yes	789-980-0009	abc1501@gmail.com	California	Full Time	Engineering	Packing & Printing	09/17/1999	Active	Open Enrollment	Guardian	Group Life AD&D	Guardian Group Life/AD&D	Employee	10/01/2019	01/01/2024	50000	50000	0	0	7.5	0	3.46	0	0	No	10/01/2019	Kaylin Lewis