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ABC Company View Group Information GROUP NUMBER : 123456 Change Group
Report For Member: ACTIVE; ALL; 04/25/2022; ALL; ALL;
Self | 02860122200
Product
Medical
Status
ACTIVE
Continuation
No
Eff Date
02/01/2022
End Date
Bill Group ID
101
Population
Plan ID
17633947
Self | 21964388700
04/01/2022
04/30/2022
1030902
Self | 46281738300
102
Spouse | 46281738301
Child | 15543262201
03/28/2022
05/02/2022
12719897
Self | 78809613900
03/23/2022
05/31/2022
17633948
Child | 78477419803
Child | 46281738302
Child | 58419334102
12/01/2021
1031203
Self | 58419334100
Self | 68104870000
Spouse | 15543262202
Child | 21964388701
Self | 66564916100
Spouse | 58419334101
Spouse | 69107959001
Self | 69107959000
Self | 15543262200
Child | 32275843802
Child | 02860122202
03/25/2022
