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Self-Bill Carrier Detailed (Guardian 01/26/2020)
Employee SSN Last Name First Name Office Location Eligibility Department Divisions Group Life AD&D Employee Volume Group Life AD&D Employee Premium Group Long Term Disability Volume Group Long Term Disability Premium Group Short Term Disability Volume Group Short Term Disability Premium Total Monthly Premium
$50,000.00 $7.50 $4,900.00 $17.15 $1,131.00 $26.01 $50.66
111-22-3359 Allen Elissa Maryland Full Time Production Online Services $50,000.00 $7.50 $3,000.00 $10.50 $692.00 $15.92 $33.92
111-22-4585 Carlson Adaline California Full Time Production Handheld Devices $50,000.00 $7.50 $3,000.00 $10.50 $692.00 $15.92 $33.92
111-22-4150 Carver Alonso California Full Time Sales Online Services $50,000.00 $7.50 $4,450.00 $15.57 $1,027.00 $23.62 $46.69
111-22-3695 Cohen Ace California Full Time Production Handheld Devices $50,000.00 $7.50 $3,000.00 $10.50 $692.00 $15.92 $33.92
111-22-4895 Contreras Allyson California Full Time Engineering Packing & Printing $10,000.00 $1.50 $945.00 $3.31 $623.00 $14.33 $19.14
249-20-2222 Evans Sam California Full Time $50,000.00 $7.50 $3,120.00 $10.92 $720.00 $16.56 $34.98
111-22-4293 Finch Aaden California Full Time Production Handheld Devices $50,000.00 $7.50 $3,000.00 $10.50 $692.00 $15.92 $33.92
843-65-2874 Graves Hilary California Full Time Customer Support Online Services, Handheld Devices $22,500.00 $3.38 $1,050.00 $3.67 $692.00 $15.92 $22.97
111-22-4317 Guthrie Achilles California Full Time Production Handheld Devices $50,000.00 $7.50 $3,000.00 $10.50 $692.00 $15.92 $33.92
268-41-2388 Hallaway James $50,000.00 $7.50 $7,500.00 $26.25 $1,500.00 $34.50 $68.25
987-24-8932 Hammy Alex $10,000.00 $1.50 $1,575.00 $5.51 $1,038.00 $23.87 $30.88
938-49-8374 Harley Quin $50,000.00 $7.50 $1,248.00 $4.37 $288.00 $6.62 $18.49
938-74-9847 Harris Ellen California Full Time Engineering Online Services $50,000.00 $7.50 $8,000.00 $28.00 $1,500.00 $34.50 $70.00
890-03-8279 Hill Jessica Maryland $50,000.00 $7.50 $2,600.00 $9.10 $600.00 $13.80 $30.40

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