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XYZ Enterprises
Status:
Prospect
Case Information
New Business
Case Notes & Messages
Case History
Case History
The following list contains a history of activity for this case.
1 to 15 of 15
ID
Date/Time
User
Action
8388
06/09/2015 11:23:51 AM
Broker, Bob
Enrollment 8388 Opened to Employees, Closes 06/10/2015
8388
06/09/2015 11:23:37 AM
Broker, Bob
Enrollment 8388 Closed to Employees
8388
06/09/2015 11:23:37 AM
Broker, Bob
Enrollment 8388 Rates Generated
8388
06/09/2015 11:23:26 AM
Broker, Bob
Enrollment 8388 Status Updated from Enrolling to Enrollment Review
8388
06/09/2015 11:18:49 AM
Broker, Bob
Enrollment 8388 Status Updated from Applying to Enrolling
8388
06/09/2015 11:18:40 AM
Broker, Bob
Enrollment 8388 Opened to Employees, Closes 06/09/2015
8388
06/09/2015 11:14:33 AM
Broker, Bob
Enrollment 8388 Employer Application Submitted
8388
06/09/2015 11:08:54 AM
Broker, Bob
Enrollment 8388 Started
8387
06/09/2015 11:08:53 AM
Broker, Bob
Quote 8387 Status Updated from Quoting to Enrollment
8387
06/09/2015 11:08:09 AM
Broker, Bob
Quote 8387 Proposal Recipients - rmehta@connecture.com
8387
06/09/2015 11:08:09 AM
Broker, Bob
Quote 8387 Proposal Generated
8387
06/09/2015 11:08:09 AM
Broker, Bob
Quote 8387 Locked
8387
06/09/2015 11:05:04 AM
Broker, Bob
Quote 8387 Created
--
06/09/2015 11:05:04 AM
Broker, Bob
Case Owner Assigned - Broker, Bob, Broker
--
06/09/2015 11:05:04 AM
Broker, Bob
Case Created
1 to 15 of 15
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Employee Information:
First Name
Last Name
Birth Date
*
Age (As of Effective Date)
*
Smoker
Yes
No
Smoking Cessation
Yes
No
*
Gender
Female
Male
*
Employment Status
Active
COBRA
Out Of Area
Yes
No
Coverage Type
Employee Only
Employee + Spouse
Employee + Child
Family
No Coverage
Email Address
Date of Hire
# Hours Worked
Commissions Employee
No
Yes
1099
No
Yes
Employee Dependent Information
Birth Date
Age (As of Effective Date)
*
Smoker
Yes
No
Smoking Cessation
Yes
No
*
Gender
Female
Male
*
Relationship
Spouse
Child
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