Termination History
| Request ID: 2144 | Status: COMPLETE |
| Request Date: 2019-02-12 | Status Date: 2019-02-12 |
| Member Name: PAUL RICHARDS | Member ID: 09571258101 |
| Employer ID: DATAPG | Termination Date: 2016-04-11 |
| Contract Record ID: 27963261701 | Term Reason: null |
| Comments: |
|
| Request ID: 2144 | Status: COMPLETE |
| Request Date: 2019-02-12 | Status Date: 2019-02-12 |
| Member Name: PAUL RICHARDS | Member ID: 09571258101 |
| Employer ID: DATAPG | Termination Date: 2016-04-11 |
| Contract Record ID: 27963261701 | Term Reason: null |
| Comments: |
|
| Request ID: 2281 | Status: COMPLETE |
| Request Date: 2019-02-13 | Status Date: 2019-02-13 |
| Member Name: SHARI SELL | Member ID: 51742258601 |
| Employer ID: DATAPG | Termination Date: 2012-06-06 |
| Contract Record ID: 81744104701 | Term Reason: null |
| Comments: |
|
| Request ID: 2281 | Status: COMPLETE |
| Request Date: 2019-02-13 | Status Date: 2019-02-13 |
| Member Name: SHARI SELL | Member ID: 51742258601 |
| Employer ID: DATAPG | Termination Date: 2012-06-06 |
| Contract Record ID: 81744104701 | Term Reason: null |
| Comments: |
|
| Request ID: 2381 | Status: COMPLETE |
| Request Date: 2019-02-15 | Status Date: 2019-02-15 |
| Member Name: ANNIE FURMAN SAWYERS | Member ID: 23181678601 |
| Employer ID: CNT | Termination Date: 2016-07-31 |
| Contract Record ID: 88908168001 | Term Reason: null |
| Comments: Gayle was promoted to full time management and is no longer eligible for the MEC plan as of 8/1/16 as she is eligible for the regular health insurance. |
|
| Request ID: 2381 | Status: COMPLETE |
| Request Date: 2019-02-15 | Status Date: 2019-02-15 |
| Member Name: ANNIE FURMAN SAWYERS | Member ID: 23181678601 |
| Employer ID: CNT | Termination Date: 2016-07-31 |
| Contract Record ID: 88908168001 | Term Reason: null |
| Comments: |
|
| Request ID: 2591 | Status: COMPLETE |
| Request Date: 2019-02-22 | Status Date: 2019-02-22 |
| Member Name: SAMANTHA WADE | Member ID: 26839843201 |
| Employer ID: CNT | Termination Date: 2016-07-01 |
| Contract Record ID: 67578545101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 2591 | Status: COMPLETE |
| Request Date: 2019-02-22 | Status Date: 2019-02-22 |
| Member Name: SAMANTHA WADE | Member ID: 26839843201 |
| Employer ID: CNT | Termination Date: 2016-07-01 |
| Contract Record ID: 67578545101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 2862 | Status: COMPLETE |
| Request Date: 2019-03-01 | Status Date: 2019-03-01 |
| Member Name: JOHN ALLEN | Member ID: 02852098601 |
| Employer ID: DATAPG | Termination Date: 2016-08-01 |
| Contract Record ID: 24280374001 | Term Reason: TERMINATION |
| Comments: please term eff. 8-1-16 |
|
| Request ID: 2862 | Status: COMPLETE |
| Request Date: 2019-03-01 | Status Date: 2019-03-01 |
| Member Name: JOHN ALLEN | Member ID: 02852098601 |
| Employer ID: DATAPG | Termination Date: 2016-08-01 |
| Contract Record ID: 24280374001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3102 | Status: COMPLETE |
| Request Date: 2016-08-09 | Status Date: 2016-08-09 |
| Member Name: RAUL C CAMPUZANO | Member ID: 88286020701 |
| Employer ID: ENF | Termination Date: 2016-06-01 |
| Contract Record ID: 88286020701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3102 | Status: COMPLETE |
| Request Date: 2016-08-09 | Status Date: 2016-08-09 |
| Member Name: RAUL C CAMPUZANO | Member ID: 88286020701 |
| Employer ID: ENF | Termination Date: 2016-06-01 |
| Contract Record ID: 88286020701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3522 | Status: COMPLETE |
| Request Date: 2019-03-20 | Status Date: 2019-03-20 |
| Member Name: ANTHONY LAZZARO | Member ID: 68494959901 |
| Employer ID: DATAPG | Termination Date: 2016-09-30 |
| Contract Record ID: 27285855201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3522 | Status: COMPLETE |
| Request Date: 2019-03-20 | Status Date: 2019-03-20 |
| Member Name: ANTHONY LAZZARO | Member ID: 68494959901 |
| Employer ID: DATAPG | Termination Date: 2016-09-30 |
| Contract Record ID: 27285855201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3651 | Status: COMPLETE |
| Request Date: 2016-09-27 | Status Date: 2016-09-27 |
| Member Name: ARTURO MARTINEZ-CORTES | Member ID: 83257843801 |
| Employer ID: ENF | Termination Date: 2016-07-01 |
| Contract Record ID: 83257843801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3866 | Status: COMPLETE |
| Request Date: 2019-03-25 | Status Date: 2019-03-25 |
| Member Name: BONNIE RAMOS | Member ID: 51105861901 |
| Employer ID: DATAPG | Termination Date: 2016-05-23 |
| Contract Record ID: 72769504601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3866 | Status: COMPLETE |
| Request Date: 2019-03-25 | Status Date: 2019-03-25 |
| Member Name: BONNIE RAMOS | Member ID: 51105861901 |
| Employer ID: DATAPG | Termination Date: 2016-05-23 |
| Contract Record ID: 72769504601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3868 | Status: COMPLETE |
| Request Date: 2019-03-25 | Status Date: 2019-03-25 |
| Member Name: SOFIA ELLIS | Member ID: 14340503901 |
| Employer ID: DATAPG | Termination Date: 2016-07-22 |
| Contract Record ID: 54299179001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 3868 | Status: COMPLETE |
| Request Date: 2019-03-25 | Status Date: 2019-03-25 |
| Member Name: SOFIA ELLIS | Member ID: 14340503901 |
| Employer ID: DATAPG | Termination Date: 2016-07-22 |
| Contract Record ID: 54299179001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 5122 | Status: COMPLETE |
| Request Date: 2016-12-06 | Status Date: 2016-12-06 |
| Member Name: CRISTINA A GUZMAN ESTEVEZ | Member ID: 25407183801 |
| Employer ID: ENF | Termination Date: 2016-11-22 |
| Contract Record ID: 25407183801 | Term Reason: TERMINATION |
| Comments: Member needs MES HP3 ID cards |
|
| Request ID: 5122 | Status: COMPLETE |
| Request Date: 2016-12-06 | Status Date: 2016-12-06 |
| Member Name: CRISTINA A GUZMAN ESTEVEZ | Member ID: 25407183801 |
| Employer ID: ENF | Termination Date: 2016-11-22 |
| Contract Record ID: 25407183801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 5142 | Status: COMPLETE |
| Request Date: 2016-12-06 | Status Date: 2016-12-06 |
| Member Name: EMELIA LOPEZ SIXTO | Member ID: 00333062801 |
| Employer ID: ENF | Termination Date: 2016-07-23 |
| Contract Record ID: 00333062801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 5142 | Status: COMPLETE |
| Request Date: 2016-12-06 | Status Date: 2016-12-06 |
| Member Name: EMELIA LOPEZ SIXTO | Member ID: 00333062801 |
| Employer ID: ENF | Termination Date: 2016-07-23 |
| Contract Record ID: 00333062801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 5203 | Status: COMPLETE |
| Request Date: 2016-12-07 | Status Date: 2016-12-07 |
| Member Name: TAUVE A BEGAYE | Member ID: 19264264701 |
| Employer ID: NNEBP | Termination Date: 2019-03-30 |
| Contract Record ID: 91385072301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 5203 | Status: COMPLETE |
| Request Date: 2016-12-07 | Status Date: 2016-12-07 |
| Member Name: TAUVE A BEGAYE | Member ID: 19264264701 |
| Employer ID: NNEBP | Termination Date: 2019-03-30 |
| Contract Record ID: 91385072301 | Term Reason: VOLUNTARY |
| Comments: member lost id card about 2 months ago |
|
| Request ID: 5362 | Status: COMPLETE |
| Request Date: 2019-04-10 | Status Date: 2019-04-10 |
| Member Name: MICHAEL BRESSLER | Member ID: 09546164101 |
| Employer ID: DATAPG | Termination Date: 2017-01-31 |
| Contract Record ID: 03591556601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 5362 | Status: COMPLETE |
| Request Date: 2019-04-10 | Status Date: 2019-04-10 |
| Member Name: MICHAEL BRESSLER | Member ID: 09546164101 |
| Employer ID: DATAPG | Termination Date: 2017-01-31 |
| Contract Record ID: 03591556601 | Term Reason: TERMINATION |
| Comments: Member needs HSP3 ID card |
|
| Request ID: 6303 | Status: COMPLETE |
| Request Date: 2019-04-23 | Status Date: 2019-04-23 |
| Member Name: KEVIN BARCELON | Member ID: 28074794301 |
| Employer ID: DATAPG | Termination Date: 2016-09-23 |
| Contract Record ID: 13303416601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 6303 | Status: COMPLETE |
| Request Date: 2019-04-23 | Status Date: 2019-04-23 |
| Member Name: KEVIN BARCELON | Member ID: 28074794301 |
| Employer ID: DATAPG | Termination Date: 2016-09-23 |
| Contract Record ID: 13303416601 | Term Reason: VOLUNTARY |
| Comments: Member needs HSP3 ID card |
|
| Request ID: 6321 | Status: COMPLETE |
| Request Date: 2019-04-23 | Status Date: 2019-04-23 |
| Member Name: CYNTHIA TRUSZAK | Member ID: 19083316801 |
| Employer ID: DATAPG | Termination Date: 2016-08-22 |
| Contract Record ID: 06747901901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 6321 | Status: COMPLETE |
| Request Date: 2019-04-23 | Status Date: 2019-04-23 |
| Member Name: CYNTHIA TRUSZAK | Member ID: 19083316801 |
| Employer ID: DATAPG | Termination Date: 2016-08-22 |
| Contract Record ID: 06747901901 | Term Reason: VOLUNTARY |
| Comments: PLEASE RESEND ID CARDS |
|
| Request ID: 6850 | Status: COMPLETE |
| Request Date: 2019-04-30 | Status Date: 2019-04-30 |
| Member Name: ALEXANDER BLANCO | Member ID: 93427823001 |
| Employer ID: DATAPG | Termination Date: 2017-03-31 |
| Contract Record ID: 33967390901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 6850 | Status: COMPLETE |
| Request Date: 2019-04-30 | Status Date: 2019-04-30 |
| Member Name: ALEXANDER BLANCO | Member ID: 93427823001 |
| Employer ID: DATAPG | Termination Date: 2017-03-31 |
| Contract Record ID: 33967390901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7663 | Status: COMPLETE |
| Request Date: 2019-05-14 | Status Date: 2019-05-14 |
| Member Name: EDEN ELYSE BITSOI | Member ID: 47981739803 |
| Employer ID: NNEBP | Termination Date: 2017-03-27 |
| Contract Record ID: 70499453001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7668 | Status: COMPLETE |
| Request Date: 2019-05-14 | Status Date: 2019-05-14 |
| Member Name: EDEN ELYSE BITSOI | Member ID: 47981739803 |
| Employer ID: NNEBP | Termination Date: 2017-06-02 |
| Contract Record ID: 57307360801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7669 | Status: COMPLETE |
| Request Date: 2019-05-14 | Status Date: 2019-05-14 |
| Member Name: JOSE REYES | Member ID: 23911464301 |
| Employer ID: JAZXP | Termination Date: 2017-02-11 |
| Contract Record ID: 98978703501 | Term Reason: TERMINATION |
| Comments: Please send ID Card to address on file. Thank you. |
|
| Request ID: 7669 | Status: COMPLETE |
| Request Date: 2019-05-14 | Status Date: 2019-05-14 |
| Member Name: JOSE REYES | Member ID: 23911464301 |
| Employer ID: JAZXP | Termination Date: 2017-02-11 |
| Contract Record ID: 98978703501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7691 | Status: COMPLETE |
| Request Date: 2019-05-15 | Status Date: 2019-05-15 |
| Member Name: SYLVIA E NEZ | Member ID: 55296996901 |
| Employer ID: NNEBP | Termination Date: 2016-11-21 |
| Contract Record ID: 68315652701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7691 | Status: COMPLETE |
| Request Date: 2019-05-15 | Status Date: 2019-05-15 |
| Member Name: SYLVIA E NEZ | Member ID: 55296996901 |
| Employer ID: NNEBP | Termination Date: 2016-11-21 |
| Contract Record ID: 68315652701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7692 | Status: COMPLETE |
| Request Date: 2019-05-15 | Status Date: 2019-05-15 |
| Member Name: SYLVIA E NEZ | Member ID: 55296996901 |
| Employer ID: NNEBP | Termination Date: 2017-05-20 |
| Contract Record ID: 50458991501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7692 | Status: COMPLETE |
| Request Date: 2019-05-15 | Status Date: 2019-05-15 |
| Member Name: SYLVIA E NEZ | Member ID: 55296996901 |
| Employer ID: NNEBP | Termination Date: 2017-05-20 |
| Contract Record ID: 50458991501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7696 | Status: COMPLETE |
| Request Date: 2019-05-15 | Status Date: 2019-05-15 |
| Member Name: JAMES GRIGAITIS | Member ID: 86412025101 |
| Employer ID: DATAPG | Termination Date: 2017-03-14 |
| Contract Record ID: 24124293101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 7696 | Status: COMPLETE |
| Request Date: 2019-05-15 | Status Date: 2019-05-15 |
| Member Name: JAMES GRIGAITIS | Member ID: 86412025101 |
| Employer ID: DATAPG | Termination Date: 2017-03-14 |
| Contract Record ID: 24124293101 | Term Reason: TERMINATION |
| Comments: Membre needs HSP3 ID cards |
|
| Request ID: 15321 | Status: COMPLETE |
| Request Date: 2019-07-01 | Status Date: 2019-07-01 |
| Member Name: FRANK B HELSLEY | Member ID: 10445932701 |
| Employer ID: FOGLE | Termination Date: 2017-12-13 |
| Contract Record ID: 79745927601 | Term Reason: TERMINATION |
| Comments: last effective date 12/31/17 |
|
| Request ID: 22001 | Status: COMPLETE |
| Request Date: 2019-07-16 | Status Date: 2019-07-16 |
| Member Name: ROBERTO G PEREZ | Member ID: 66374580501 |
| Employer ID: NORTHAM | Termination Date: 2018-09-18 |
| Contract Record ID: 01754546801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 23722 | Status: COMPLETE |
| Request Date: 2019-07-18 | Status Date: 2019-07-18 |
| Member Name: DELANA A STEVENS | Member ID: 66990072501 |
| Employer ID: CNT | Termination Date: 2019-07-31 |
| Contract Record ID: 66990072501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 54201 | Status: COMPLETE |
| Request Date: 2019-11-27 | Status Date: 2019-11-27 |
| Member Name: TAMEKA L RIGGINS | Member ID: 56845024401 |
| Employer ID: BRANDY | Termination Date: 2019-10-01 |
| Contract Record ID: 56845024401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 54989 | Status: COMPLETE |
| Request Date: 2019-12-05 | Status Date: 2019-12-05 |
| Member Name: KERRY L NADEAU | Member ID: 29705901801 |
| Employer ID: BRANDY | Termination Date: 2019-12-01 |
| Contract Record ID: 29705901801 | Term Reason: TERMINATION |
| Comments: Last day worked 11/22/2019 |
|
| Request ID: 55020 | Status: COMPLETE |
| Request Date: 2019-12-06 | Status Date: 2019-12-06 |
| Member Name: KERRY L NADEAU | Member ID: 29705901801 |
| Employer ID: BRANDY | Termination Date: 2020-10-31 |
| Contract Record ID: 29705901801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 58729 | Status: COMPLETE |
| Request Date: 2020-01-17 | Status Date: 2020-01-17 |
| Member Name: MARC J LAPOINTE | Member ID: 31516616501 |
| Employer ID: BRECK | Termination Date: 2020-01-03 |
| Contract Record ID: 31516616501 | Term Reason: TERMINATION |
| Comments: Benefits termination 12/31/2020 |
|
| Request ID: 58730 | Status: COMPLETE |
| Request Date: 2020-01-17 | Status Date: 2020-01-17 |
| Member Name: MELYNDA BARQUIN | Member ID: 96545805701 |
| Employer ID: BRECK | Termination Date: 2020-01-01 |
| Contract Record ID: 96545805701 | Term Reason: VOLUNTARY |
| Comments: Waived Coverage |
|
| Request ID: 58732 | Status: COMPLETE |
| Request Date: 2020-01-17 | Status Date: 2020-01-17 |
| Member Name: MARC J LAPOINTE | Member ID: 31516616501 |
| Employer ID: BRECK | Termination Date: 2020-01-01 |
| Contract Record ID: 31516616501 | Term Reason: VOLUNTARY |
| Comments: Waived Coverage |
|
| Request ID: 60749 | Status: COMPLETE |
| Request Date: 2020-02-04 | Status Date: 2020-02-04 |
| Member Name: JODI WHITE | Member ID: 74843812101 |
| Employer ID: CARBON | Termination Date: 2020-02-01 |
| Contract Record ID: 74843812101 | Term Reason: VOLUNTARY |
| Comments: left for new employment |
|
| Request ID: 63781 | Status: COMPLETE |
| Request Date: 2020-02-13 | Status Date: 2020-02-13 |
| Member Name: JORDAN LOVE | Member ID: 93261687601 |
| Employer ID: VTCORP | Termination Date: 2020-02-14 |
| Contract Record ID: 93261687601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 75223 | Status: COMPLETE |
| Request Date: 2020-04-07 | Status Date: 2020-04-07 |
| Member Name: JERI L TILLMAN | Member ID: 88408431601 |
| Employer ID: CNT | Termination Date: 2020-04-30 |
| Contract Record ID: 88408431601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 75264 | Status: COMPLETE |
| Request Date: 2020-04-09 | Status Date: 2020-04-09 |
| Member Name: JOSEPH OKOLOWITCZ | Member ID: 91237690801 |
| Employer ID: PELTZ | Termination Date: 2020-04-30 |
| Contract Record ID: 91237690801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 77291 | Status: COMPLETE |
| Request Date: 2020-05-12 | Status Date: 2020-05-12 |
| Member Name: JERI L TILLMAN | Member ID: 88408431601 |
| Employer ID: CNT | Termination Date: 2020-04-30 |
| Contract Record ID: 88408431601 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 80678 | Status: COMPLETE |
| Request Date: 2020-06-15 | Status Date: 2020-06-15 |
| Member Name: FELICIA LEE | Member ID: 51254982101 |
| Employer ID: CARBON | Termination Date: 2020-06-15 |
| Contract Record ID: 51254982101 | Term Reason: VOLUNTARY |
| Comments: now on husbands coverage |
|
| Request ID: 81807 | Status: COMPLETE |
| Request Date: 2020-07-02 | Status Date: 2020-07-02 |
| Member Name: CEPHAS MUJURUKI | Member ID: 66456365201 |
| Employer ID: CNT | Termination Date: 2020-06-30 |
| Contract Record ID: 66456365201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 85661 | Status: COMPLETE |
| Request Date: 2020-08-13 | Status Date: 2020-08-13 |
| Member Name: CASSIE STEVENS | Member ID: 09183817601 |
| Employer ID: HPIGRP | Termination Date: 2020-07-31 |
| Contract Record ID: 09183817601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 91382 | Status: COMPLETE |
| Request Date: 2020-09-18 | Status Date: 2020-09-18 |
| Member Name: KASEY ELDER | Member ID: 98370551801 |
| Employer ID: BRECK | Termination Date: 2020-09-30 |
| Contract Record ID: 98370551801 | Term Reason: TERMINATION |
| Comments: Please send COBRA letter. |
|
| Request ID: 91383 | Status: COMPLETE |
| Request Date: 2020-09-18 | Status Date: 2020-09-18 |
| Member Name: KASEY ELDER | Member ID: 98370551801 |
| Employer ID: BRECK | Termination Date: 2020-09-30 |
| Contract Record ID: 98370551801 | Term Reason: TERMINATION |
| Comments: Please send COBRA letter. |
|
| Request ID: 95541 | Status: COMPLETE |
| Request Date: 2020-10-14 | Status Date: 2020-10-14 |
| Member Name: EDUARD A MENDOZA | Member ID: 13156613901 |
| Employer ID: LEHMAN | Termination Date: 2020-07-31 |
| Contract Record ID: 13156613901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 98621 | Status: COMPLETE |
| Request Date: 2020-11-06 | Status Date: 2020-11-06 |
| Member Name: ARIANA HINOJOSA | Member ID: 35334592101 |
| Employer ID: CNT | Termination Date: 2020-11-30 |
| Contract Record ID: 35334592101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 98853 | Status: COMPLETE |
| Request Date: 2020-11-13 | Status Date: 2020-11-13 |
| Member Name: GILFREDO SARDINAS | Member ID: 08414822901 |
| Employer ID: LEHMAN | Termination Date: 2020-11-30 |
| Contract Record ID: 08414822901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 98856 | Status: COMPLETE |
| Request Date: 2020-11-13 | Status Date: 2020-11-13 |
| Member Name: OSCAR M TORRES CASTILLO | Member ID: 44560452901 |
| Employer ID: LEHMAN | Termination Date: 2020-10-31 |
| Contract Record ID: 44560452901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 102421 | Status: COMPLETE |
| Request Date: 2020-12-01 | Status Date: 2020-12-01 |
| Member Name: JEANNIE L LAFOLLETTE | Member ID: 26442082601 |
| Employer ID: LNB | Termination Date: 2020-11-01 |
| Contract Record ID: 26442082601 | Term Reason: VOLUNTARY |
| Comments: This employee wants to terminate health coverage only. All other insurance coverage remains the same. |
|
| Request ID: 102441 | Status: COMPLETE |
| Request Date: 2020-12-01 | Status Date: 2020-12-01 |
| Member Name: LORETTA L ROUTT | Member ID: 51328884001 |
| Employer ID: LNB | Termination Date: 2020-11-01 |
| Contract Record ID: 51328884001 | Term Reason: VOLUNTARY |
| Comments: This employee wants to terminate health coverage only. All other insurance coverage remains the same. |
|
| Request ID: 103021 | Status: COMPLETE |
| Request Date: 2020-12-07 | Status Date: 2020-12-07 |
| Member Name: MEGAN L UNDERWOOD | Member ID: 08255778201 |
| Employer ID: LNB | Termination Date: 2020-11-01 |
| Contract Record ID: 08255778201 | Term Reason: VOLUNTARY |
| Comments: Employee requested to cancel health insurance only. All other policies are still in effect. |
|
| Request ID: 105601 | Status: COMPLETE |
| Request Date: 2020-12-18 | Status Date: 2020-12-18 |
| Member Name: DEBBIE BURLISON | Member ID: 98834913601 |
| Employer ID: CNT | Termination Date: 2020-12-31 |
| Contract Record ID: 98834913601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 108021 | Status: COMPLETE |
| Request Date: 2020-12-30 | Status Date: 2020-12-30 |
| Member Name: TINNA GARCELL | Member ID: 29154780901 |
| Employer ID: LEHMAN | Termination Date: 2020-11-30 |
| Contract Record ID: 29154780901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 109281 | Status: COMPLETE |
| Request Date: 2021-01-05 | Status Date: 2021-01-05 |
| Member Name: VERNON L KESSINGER | Member ID: 71491885801 |
| Employer ID: LNB | Termination Date: 2020-12-31 |
| Contract Record ID: 71491885801 | Term Reason: VOLUNTARY |
| Comments: Employee is only terminating health coverage - will still have dental. Please update Cobra also. |
|
| Request ID: 109301 | Status: COMPLETE |
| Request Date: 2021-01-05 | Status Date: 2021-01-05 |
| Member Name: JOAN KESSINGER | Member ID: 71491885802 |
| Employer ID: LNB | Termination Date: 2020-12-31 |
| Contract Record ID: 71491885801 | Term Reason: VOLUNTARY |
| Comments: Husband is terminating medical coverage only - will still have dental. Please update Cobra. |
|
| Request ID: 109401 | Status: COMPLETE |
| Request Date: 2021-01-05 | Status Date: 2021-01-05 |
| Member Name: RANDALL D MURRAY | Member ID: 78311892801 |
| Employer ID: LNB | Termination Date: 2020-12-31 |
| Contract Record ID: 78311892801 | Term Reason: VOLUNTARY |
| Comments: Employee is canceling health coverage only - still has dental. Please update Cobra. |
|
| Request ID: 109403 | Status: COMPLETE |
| Request Date: 2021-01-05 | Status Date: 2021-01-05 |
| Member Name: STACY S WOLF | Member ID: 05058743801 |
| Employer ID: LNB | Termination Date: 2020-12-31 |
| Contract Record ID: 05058743801 | Term Reason: VOLUNTARY |
| Comments: Employee is terminating health coverage only - still has dental. Please update Cobra. |
|
| Request ID: 109841 | Status: COMPLETE |
| Request Date: 2021-01-06 | Status Date: 2021-01-06 |
| Member Name: MARC PELTZ | Member ID: 14281794401 |
| Employer ID: PELTZ | Termination Date: 2021-01-31 |
| Contract Record ID: 14281794401 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 111171 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: ALI SAIID A AL AMMAL | Member ID: 97381116501 |
| Employer ID: VICTSEN | Termination Date: 2020-12-31 |
| Contract Record ID: 97381116501 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 111172 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: AMELIA BATTEN | Member ID: 88522437001 |
| Employer ID: THERALT | Termination Date: 2020-12-31 |
| Contract Record ID: 88522437001 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 111174 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: HILDA BERNAL | Member ID: 39734280801 |
| Employer ID: VICTSEN | Termination Date: 2020-12-31 |
| Contract Record ID: 39734280801 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 111175 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: TAMIKCO L BETHEA | Member ID: 83196203201 |
| Employer ID: THERALT | Termination Date: 2020-12-31 |
| Contract Record ID: 83196203201 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 111176 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: JOE B BILLINGS JR | Member ID: 63140812901 |
| Employer ID: THERALT | Termination Date: 2020-12-31 |
| Contract Record ID: 63140812901 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 111179 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: MARY BOYD | Member ID: 78911707301 |
| Employer ID: VICTSEN | Termination Date: 2020-12-31 |
| Contract Record ID: 78911707301 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 111180 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: SHAWNDA B MOREE | Member ID: 50896309001 |
| Employer ID: THERALT | Termination Date: 2020-12-31 |
| Contract Record ID: 50896309001 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 111181 | Status: COMPLETE |
| Request Date: 2021-01-12 | Status Date: 2021-01-12 |
| Member Name: RENARTA P BROWN | Member ID: 02809202201 |
| Employer ID: THERALT | Termination Date: 2020-12-31 |
| Contract Record ID: 02809202201 | Term Reason: VOLUNTARY |
| Comments: EMPLOYEE DROPPED AT OE |
|
| Request ID: 112662 | Status: COMPLETE |
| Request Date: 2021-01-21 | Status Date: 2021-01-21 |
| Member Name: CRYSTAL L NELSON | Member ID: 24599147801 |
| Employer ID: LNB | Termination Date: 2021-01-01 |
| Contract Record ID: 24599147801 | Term Reason: VOLUNTARY |
| Comments: Employee never enrolled in medical - signed waiver. Only enrolled in dental. Please update. |
|
| Request ID: 114222 | Status: COMPLETE |
| Request Date: 2021-01-27 | Status Date: 2021-01-27 |
| Member Name: BILLIE PHILLIPS | Member ID: 13275533201 |
| Employer ID: CNT | Termination Date: 2021-01-31 |
| Contract Record ID: 13275533201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 117806 | Status: COMPLETE |
| Request Date: 2021-02-04 | Status Date: 2021-02-04 |
| Member Name: ALICE HOLLOWAY | Member ID: 55666499301 |
| Employer ID: KAUBRY | Termination Date: 2021-01-31 |
| Contract Record ID: 55666499301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 124461 | Status: COMPLETE |
| Request Date: 2021-02-25 | Status Date: 2021-02-25 |
| Member Name: SHERI FIRST | Member ID: 64438481201 |
| Employer ID: PELTZ | Termination Date: 2021-03-01 |
| Contract Record ID: 64438481201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 131361 | Status: COMPLETE |
| Request Date: 2021-03-17 | Status Date: 2021-03-17 |
| Member Name: TARIQ SIDDIQUI | Member ID: 13394135601 |
| Employer ID: LEHMAN | Termination Date: 2021-02-28 |
| Contract Record ID: 13394135601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 137181 | Status: COMPLETE |
| Request Date: 2021-04-02 | Status Date: 2021-04-02 |
| Member Name: LOGAN ROBERTSON | Member ID: 74233370701 |
| Employer ID: DAVIS | Termination Date: 2021-03-31 |
| Contract Record ID: 74233370701 | Term Reason: VOLUNTARY |
| Comments: Found other coverage |
|
| Request ID: 140484 | Status: COMPLETE |
| Request Date: 2021-04-19 | Status Date: 2021-04-19 |
| Member Name: DIONNA THIGPEN | Member ID: 50569306201 |
| Employer ID: PELTZ | Termination Date: 2021-05-01 |
| Contract Record ID: 50569306201 | Term Reason: VOLUNTARY |
| Comments: Gained other coverage through Spouse |
|
| Request ID: 144203 | Status: COMPLETE |
| Request Date: 2021-05-06 | Status Date: 2021-05-06 |
| Member Name: JUDY C WELLS | Member ID: 78791098201 |
| Employer ID: LNB | Termination Date: 2021-04-30 |
| Contract Record ID: 78791098201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 145032 | Status: COMPLETE |
| Request Date: 2021-05-10 | Status Date: 2021-05-10 |
| Member Name: MICHAEL BOANE | Member ID: 57626054301 |
| Employer ID: TPCH | Termination Date: 2021-04-07 |
| Contract Record ID: 57626054301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 145268 | Status: COMPLETE |
| Request Date: 2021-05-17 | Status Date: 2021-05-17 |
| Member Name: CRYSTAL NEWCOMB | Member ID: 53268112801 |
| Employer ID: DAVIS | Termination Date: 2021-05-27 |
| Contract Record ID: 53268112801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 145501 | Status: COMPLETE |
| Request Date: 2021-05-25 | Status Date: 2021-05-25 |
| Member Name: STACY S WOLF | Member ID: 05058743801 |
| Employer ID: LNB | Termination Date: 2021-05-31 |
| Contract Record ID: 05058743801 | Term Reason: VOLUNTARY |
| Comments: Husband has coverage with new job now. |
|
| Request ID: 147901 | Status: COMPLETE |
| Request Date: 2021-06-09 | Status Date: 2021-06-09 |
| Member Name: MICHAEL PATRICK | Member ID: 54247092801 |
| Employer ID: TBX | Termination Date: 2021-06-30 |
| Contract Record ID: 54247092801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 153341 | Status: COMPLETE |
| Request Date: 2021-06-29 | Status Date: 2021-06-29 |
| Member Name: LINDA ALBERT | Member ID: 58385456501 |
| Employer ID: CARBON | Termination Date: 2020-07-01 |
| Contract Record ID: 58385456501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 154142 | Status: COMPLETE |
| Request Date: 2021-07-02 | Status Date: 2021-07-02 |
| Member Name: PAUL HEFFERNAN | Member ID: 48948741001 |
| Employer ID: WCE | Termination Date: 2021-06-24 |
| Contract Record ID: 48948741001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 155222 | Status: COMPLETE |
| Request Date: 2021-07-12 | Status Date: 2021-07-12 |
| Member Name: BOK YEON LEE | Member ID: 58847070501 |
| Employer ID: HANUL | Termination Date: 2021-06-30 |
| Contract Record ID: 58847070501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 155223 | Status: COMPLETE |
| Request Date: 2021-07-12 | Status Date: 2021-07-12 |
| Member Name: BOK YEON LEE | Member ID: 58847070501 |
| Employer ID: HANUL | Termination Date: 2021-06-30 |
| Contract Record ID: 58847070501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 155224 | Status: COMPLETE |
| Request Date: 2021-07-12 | Status Date: 2021-07-12 |
| Member Name: JIN LEE | Member ID: 29981488901 |
| Employer ID: HANUL | Termination Date: 2021-06-30 |
| Contract Record ID: 29981488901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 155225 | Status: COMPLETE |
| Request Date: 2021-07-12 | Status Date: 2021-07-12 |
| Member Name: JONG LEE | Member ID: 29981488902 |
| Employer ID: HANUL | Termination Date: 2021-06-30 |
| Contract Record ID: 29981488901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 155742 | Status: COMPLETE |
| Request Date: 2021-07-19 | Status Date: 2021-07-19 |
| Member Name: MARISSA DANIELLE CAMPOS | Member ID: 25468710001 |
| Employer ID: EASYLVNG | Termination Date: 2021-07-19 |
| Contract Record ID: 25468710001 | Term Reason: VOLUNTARY |
| Comments: Marissa put in her formal resignation effective 7/16/21, but I believe coverage goes through end of month. |
|
| Request ID: 158401 | Status: COMPLETE |
| Request Date: 2021-08-02 | Status Date: 2021-08-02 |
| Member Name: HILLARY A LOGSDON | Member ID: 75600136601 |
| Employer ID: LNB | Termination Date: 2021-07-31 |
| Contract Record ID: 75600136601 | Term Reason: VOLUNTARY |
| Comments: Employee is dropping medical coverage only. |
|
| Request ID: 158981 | Status: COMPLETE |
| Request Date: 2021-08-04 | Status Date: 2021-08-04 |
| Member Name: ERIC HOUGH | Member ID: 53232445001 |
| Employer ID: NEC | Termination Date: 2021-07-22 |
| Contract Record ID: 53232445001 | Term Reason: VOLUNTARY |
| Comments: Please term 7/22/21 prior to coverage starting |
|
| Request ID: 165581 | Status: COMPLETE |
| Request Date: 2021-09-03 | Status Date: 2021-09-03 |
| Member Name: ALEXANDRA LEYDON | Member ID: 03151400201 |
| Employer ID: PELTZ | Termination Date: 2021-08-31 |
| Contract Record ID: 03151400201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 169501 | Status: COMPLETE |
| Request Date: 2021-09-29 | Status Date: 2021-09-29 |
| Member Name: DAVID WYDEMON | Member ID: 81196851701 |
| Employer ID: NEC | Termination Date: 2021-09-24 |
| Contract Record ID: 81196851701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 177421 | Status: COMPLETE |
| Request Date: 2021-10-15 | Status Date: 2021-10-15 |
| Member Name: DAVID GARY JOHNSON | Member ID: 79063121101 |
| Employer ID: BRECK | Termination Date: 2021-10-31 |
| Contract Record ID: 79063121101 | Term Reason: TERMINATION |
| Comments: email COBRA letter |
|
| Request ID: 177602 | Status: COMPLETE |
| Request Date: 2021-10-18 | Status Date: 2021-10-18 |
| Member Name: CHRISTOPHER LAGOS | Member ID: 35787670601 |
| Employer ID: NEC | Termination Date: 2021-10-12 |
| Contract Record ID: 35787670601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 183261 | Status: COMPLETE |
| Request Date: 2021-11-05 | Status Date: 2021-11-05 |
| Member Name: CHANDLER HELMS | Member ID: 53521291501 |
| Employer ID: CNT | Termination Date: 2021-11-30 |
| Contract Record ID: 53521291501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 184041 | Status: COMPLETE |
| Request Date: 2021-11-10 | Status Date: 2021-11-10 |
| Member Name: ASHER JOSEPH | Member ID: 45847593201 |
| Employer ID: CNT | Termination Date: 2021-10-31 |
| Contract Record ID: 45847593201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 185967 | Status: COMPLETE |
| Request Date: 2021-11-15 | Status Date: 2021-11-15 |
| Member Name: MATTHEW TRAPP | Member ID: 28900064701 |
| Employer ID: NEC | Termination Date: 2021-11-12 |
| Contract Record ID: 28900064701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 187701 | Status: COMPLETE |
| Request Date: 2021-11-23 | Status Date: 2021-11-23 |
| Member Name: SAMUEL FERNANDEZ | Member ID: 06545339001 |
| Employer ID: WCE | Termination Date: 2021-10-29 |
| Contract Record ID: 06545339001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 187901 | Status: COMPLETE |
| Request Date: 2021-11-23 | Status Date: 2021-11-23 |
| Member Name: ANDREA BERMAN | Member ID: 79761083801 |
| Employer ID: PELTZ | Termination Date: 2021-12-01 |
| Contract Record ID: 79761083801 | Term Reason: VOLUNTARY |
| Comments: department 990 |
|
| Request ID: 188001 | Status: COMPLETE |
| Request Date: 2021-11-23 | Status Date: 2021-11-23 |
| Member Name: CARLISIA SINGLETON | Member ID: 16620952701 |
| Employer ID: PELTZ | Termination Date: 2021-12-01 |
| Contract Record ID: 16620952701 | Term Reason: VOLUNTARY |
| Comments: department 990 |
|
| Request ID: 189481 | Status: COMPLETE |
| Request Date: 2021-12-01 | Status Date: 2021-12-01 |
| Member Name: LEE KEMP | Member ID: 69212951801 |
| Employer ID: NEC | Termination Date: 2021-11-30 |
| Contract Record ID: 69212951801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 189521 | Status: COMPLETE |
| Request Date: 2021-12-01 | Status Date: 2021-12-01 |
| Member Name: TERRY ARCHIBALD | Member ID: 15004588001 |
| Employer ID: NEC | Termination Date: 2021-11-30 |
| Contract Record ID: 15004588001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 189981 | Status: COMPLETE |
| Request Date: 2021-12-02 | Status Date: 2021-12-02 |
| Member Name: SIDNEY DAVIES | Member ID: 57988492601 |
| Employer ID: MESH | Termination Date: 2021-12-31 |
| Contract Record ID: 57988492601 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 192341 | Status: COMPLETE |
| Request Date: 2021-12-16 | Status Date: 2021-12-16 |
| Member Name: BELINDA G TATE | Member ID: 10226312401 |
| Employer ID: LNB | Termination Date: 2021-12-31 |
| Contract Record ID: 10226312401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 192342 | Status: COMPLETE |
| Request Date: 2021-12-16 | Status Date: 2021-12-16 |
| Member Name: WILLIAM F TATE | Member ID: 10226312402 |
| Employer ID: LNB | Termination Date: 2021-12-31 |
| Contract Record ID: 10226312401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 192421 | Status: COMPLETE |
| Request Date: 2021-12-16 | Status Date: 2021-12-16 |
| Member Name: ANDREA BERMAN | Member ID: 79761083801 |
| Employer ID: PELTZ | Termination Date: 2021-12-01 |
| Contract Record ID: 79761083801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 192461 | Status: COMPLETE |
| Request Date: 2021-12-16 | Status Date: 2021-12-16 |
| Member Name: CARLISIA SINGLETON | Member ID: 16620952701 |
| Employer ID: PELTZ | Termination Date: 2021-12-01 |
| Contract Record ID: 16620952701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 192481 | Status: COMPLETE |
| Request Date: 2021-12-16 | Status Date: 2021-12-16 |
| Member Name: CARLISIA SINGLETON | Member ID: 16620952701 |
| Employer ID: PELTZ | Termination Date: 2021-12-01 |
| Contract Record ID: 16620952701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 193181 | Status: COMPLETE |
| Request Date: 2021-12-21 | Status Date: 2021-12-21 |
| Member Name: JAMES ELY SR | Member ID: 61402517601 |
| Employer ID: MESH | Termination Date: 2021-12-31 |
| Contract Record ID: 61402517601 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 193302 | Status: COMPLETE |
| Request Date: 2021-12-21 | Status Date: 2021-12-21 |
| Member Name: JAMES T LENZ | Member ID: 81268807501 |
| Employer ID: MESH | Termination Date: 2021-12-31 |
| Contract Record ID: 81268807501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 193304 | Status: COMPLETE |
| Request Date: 2021-12-21 | Status Date: 2021-12-21 |
| Member Name: JAMES ELY SR | Member ID: 61402517601 |
| Employer ID: MESH | Termination Date: 2021-12-31 |
| Contract Record ID: 61402517601 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 193641 | Status: COMPLETE |
| Request Date: 2021-12-22 | Status Date: 2021-12-22 |
| Member Name: DAVID WELLS | Member ID: 57272823301 |
| Employer ID: RCI | Termination Date: 2021-09-01 |
| Contract Record ID: 57272823301 | Term Reason: TERMINATION |
| Comments: DOES NOT HAVE VISION |
|
| Request ID: 193661 | Status: COMPLETE |
| Request Date: 2021-12-22 | Status Date: 2021-12-22 |
| Member Name: ZABRINA SMITH-WELLS | Member ID: 57272823302 |
| Employer ID: RCI | Termination Date: 2021-09-01 |
| Contract Record ID: 57272823301 | Term Reason: TERMINATION |
| Comments: DOES NOT HAVE VISION |
|
| Request ID: 193701 | Status: COMPLETE |
| Request Date: 2021-12-22 | Status Date: 2021-12-22 |
| Member Name: DAVID WELLS | Member ID: 57272823301 |
| Employer ID: RCI | Termination Date: 2021-09-01 |
| Contract Record ID: 57272823301 | Term Reason: TERMINATION |
| Comments: DOES NOT HAVE DENTAL |
|
| Request ID: 193721 | Status: COMPLETE |
| Request Date: 2021-12-22 | Status Date: 2021-12-22 |
| Member Name: ZABRINA SMITH-WELLS | Member ID: 57272823302 |
| Employer ID: RCI | Termination Date: 2021-09-01 |
| Contract Record ID: 57272823301 | Term Reason: TERMINATION |
| Comments: DOES NOT HAVE DENTAL |
|
| Request ID: 195341 | Status: COMPLETE |
| Request Date: 2021-12-31 | Status Date: 2021-12-31 |
| Member Name: MIA L YATES | Member ID: 47558740701 |
| Employer ID: LNB | Termination Date: 2022-01-01 |
| Contract Record ID: 47558740701 | Term Reason: VOLUNTARY |
| Comments: Employee was never enrolled - entered into your system incorrectly. |
|
| Request ID: 195461 | Status: COMPLETE |
| Request Date: 2022-01-01 | Status Date: 2022-01-01 |
| Member Name: SHAWN OSBORNE | Member ID: 53161352101 |
| Employer ID: TBX | Termination Date: 2021-12-31 |
| Contract Record ID: 53161352101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 195481 | Status: COMPLETE |
| Request Date: 2022-01-01 | Status Date: 2022-01-01 |
| Member Name: CHARLES A RAY | Member ID: 88833724701 |
| Employer ID: TBX | Termination Date: 2021-12-31 |
| Contract Record ID: 88833724701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 195501 | Status: COMPLETE |
| Request Date: 2022-01-01 | Status Date: 2022-01-01 |
| Member Name: KYLE SHESTACK | Member ID: 14410199401 |
| Employer ID: TBX | Termination Date: 2021-12-31 |
| Contract Record ID: 14410199401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 196002 | Status: COMPLETE |
| Request Date: 2022-01-04 | Status Date: 2022-01-04 |
| Member Name: NEVA THORN | Member ID: 61697971301 |
| Employer ID: CNT | Termination Date: 2021-12-31 |
| Contract Record ID: 61697971301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 197043 | Status: COMPLETE |
| Request Date: 2022-01-10 | Status Date: 2022-01-10 |
| Member Name: ERIC HOUGH | Member ID: 53232445001 |
| Employer ID: NEC | Termination Date: 2021-12-31 |
| Contract Record ID: 53232445001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 197381 | Status: COMPLETE |
| Request Date: 2022-01-10 | Status Date: 2022-01-10 |
| Member Name: MICHAEL SING | Member ID: 85239410301 |
| Employer ID: NEC | Termination Date: 2022-01-03 |
| Contract Record ID: 85239410301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 199685 | Status: COMPLETE |
| Request Date: 2022-01-25 | Status Date: 2022-01-25 |
| Member Name: ULRIC K BRADLEY | Member ID: 09992393601 |
| Employer ID: RCI | Termination Date: 2021-12-23 |
| Contract Record ID: 09992393601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 200182 | Status: COMPLETE |
| Request Date: 2022-01-27 | Status Date: 2022-01-27 |
| Member Name: NATALIE BAILEY | Member ID: 86789665901 |
| Employer ID: NEC | Termination Date: 2022-01-20 |
| Contract Record ID: 86789665901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 200241 | Status: COMPLETE |
| Request Date: 2022-01-27 | Status Date: 2022-01-27 |
| Member Name: ROBERT J MILLER | Member ID: 64985384101 |
| Employer ID: WCE | Termination Date: 2022-01-10 |
| Contract Record ID: 64985384101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 201962 | Status: COMPLETE |
| Request Date: 2022-02-02 | Status Date: 2022-02-02 |
| Member Name: ROBERT J MILLER | Member ID: 64985384101 |
| Employer ID: WCE | Termination Date: 2022-01-10 |
| Contract Record ID: 64985384101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 202921 | Status: COMPLETE |
| Request Date: 2022-02-07 | Status Date: 2022-02-07 |
| Member Name: WILLIAM D COPP | Member ID: 68542907601 |
| Employer ID: MESH | Termination Date: 2022-02-05 |
| Contract Record ID: 68542907601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 203001 | Status: COMPLETE |
| Request Date: 2022-02-07 | Status Date: 2022-02-07 |
| Member Name: MICHAEL SING | Member ID: 85239410301 |
| Employer ID: NEC | Termination Date: 2022-01-31 |
| Contract Record ID: 85239410301 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 203601 | Status: COMPLETE |
| Request Date: 2022-02-09 | Status Date: 2022-02-09 |
| Member Name: MARK ARNOLD | Member ID: 90705643201 |
| Employer ID: NEC | Termination Date: 2022-01-30 |
| Contract Record ID: 90705643201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 203621 | Status: COMPLETE |
| Request Date: 2022-02-09 | Status Date: 2022-02-09 |
| Member Name: BRITTEN SNOW | Member ID: 23796979601 |
| Employer ID: NEC | Termination Date: 2022-01-30 |
| Contract Record ID: 23796979601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 203641 | Status: COMPLETE |
| Request Date: 2022-02-09 | Status Date: 2022-02-09 |
| Member Name: KEVIN R BAILEY | Member ID: 50762884301 |
| Employer ID: NEC | Termination Date: 2022-01-30 |
| Contract Record ID: 50762884301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 203661 | Status: COMPLETE |
| Request Date: 2022-02-09 | Status Date: 2022-02-09 |
| Member Name: AMON L MAHON | Member ID: 91746877601 |
| Employer ID: NEC | Termination Date: 2022-02-01 |
| Contract Record ID: 91746877601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 204201 | Status: COMPLETE |
| Request Date: 2022-02-11 | Status Date: 2022-02-11 |
| Member Name: KIERRE SULLIVAN | Member ID: 96817274001 |
| Employer ID: DNA | Termination Date: 2022-02-28 |
| Contract Record ID: 96817274001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 204281 | Status: COMPLETE |
| Request Date: 2022-02-14 | Status Date: 2022-02-14 |
| Member Name: LEESA B HAILE | Member ID: 23156818801 |
| Employer ID: CNT | Termination Date: 2022-02-28 |
| Contract Record ID: 23156818801 | Term Reason: TERMINATION |
| Comments: Resigned |
|
| Request ID: 204701 | Status: COMPLETE |
| Request Date: 2022-02-15 | Status Date: 2022-02-15 |
| Member Name: TIMOTHY BARWICK | Member ID: 52944434501 |
| Employer ID: NEC | Termination Date: 2022-02-12 |
| Contract Record ID: 52944434501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 204821 | Status: COMPLETE |
| Request Date: 2022-02-16 | Status Date: 2022-02-16 |
| Member Name: MYRON LAMONT LOGAN | Member ID: 70940182101 |
| Employer ID: BRECK | Termination Date: 2022-02-28 |
| Contract Record ID: 70940182101 | Term Reason: INVOLUNTARY |
| Comments: please mail COBRA |
|
| Request ID: 204822 | Status: COMPLETE |
| Request Date: 2022-02-16 | Status Date: 2022-02-16 |
| Member Name: MYRON LAMONT LOGAN | Member ID: 70940182101 |
| Employer ID: BRECK | Termination Date: 2022-02-28 |
| Contract Record ID: 70940182101 | Term Reason: INVOLUNTARY |
| Comments: please mail COBRA |
|
| Request ID: 204921 | Status: COMPLETE |
| Request Date: 2022-02-16 | Status Date: 2022-02-16 |
| Member Name: ALEX HADAWAY | Member ID: 76095497501 |
| Employer ID: AP | Termination Date: 2022-02-03 |
| Contract Record ID: 76095497501 | Term Reason: TERMINATION |
| Comments: Employee resigned effective 02-03-2022. |
|
| Request ID: 205021 | Status: COMPLETE |
| Request Date: 2022-02-16 | Status Date: 2022-02-16 |
| Member Name: PEDRO ARRIAZA | Member ID: 10086998201 |
| Employer ID: YHP00158 | Termination Date: 2022-02-04 |
| Contract Record ID: 10086998201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 205101 | Status: COMPLETE |
| Request Date: 2022-02-17 | Status Date: 2022-02-17 |
| Member Name: JARED RAPIER | Member ID: 55430298301 |
| Employer ID: SFM | Termination Date: 2022-02-28 |
| Contract Record ID: 55430298301 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 205102 | Status: COMPLETE |
| Request Date: 2022-02-17 | Status Date: 2022-02-17 |
| Member Name: JOANNE ELAINE GRAHAM | Member ID: 03950642001 |
| Employer ID: SFM | Termination Date: 2022-02-28 |
| Contract Record ID: 03950642001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 205103 | Status: COMPLETE |
| Request Date: 2022-02-17 | Status Date: 2022-02-17 |
| Member Name: AUBREY KING | Member ID: 52131767201 |
| Employer ID: SFM | Termination Date: 2022-02-28 |
| Contract Record ID: 52131767201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 205381 | Status: COMPLETE |
| Request Date: 2022-02-18 | Status Date: 2022-02-18 |
| Member Name: JOSEPHINE HERNANDEZ | Member ID: 01054187901 |
| Employer ID: BRANDY | Termination Date: 2022-02-04 |
| Contract Record ID: 01054187901 | Term Reason: DECEASED |
| Comments: |
|
| Request ID: 205841 | Status: COMPLETE |
| Request Date: 2022-02-22 | Status Date: 2022-02-22 |
| Member Name: RICKY NOLAN PICKENS | Member ID: 03919206801 |
| Employer ID: BROSOL | Termination Date: 2022-02-28 |
| Contract Record ID: 03919206801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 206161 | Status: COMPLETE |
| Request Date: 2022-02-23 | Status Date: 2022-02-23 |
| Member Name: SHAUN WOODY | Member ID: 69087315601 |
| Employer ID: NEC | Termination Date: 2022-02-16 |
| Contract Record ID: 69087315601 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 206441 | Status: COMPLETE |
| Request Date: 2022-02-24 | Status Date: 2022-02-24 |
| Member Name: ALICIA LINGER | Member ID: 02451455101 |
| Employer ID: TPCH | Termination Date: 2022-02-09 |
| Contract Record ID: 02451455101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 206485 | Status: COMPLETE |
| Request Date: 2022-02-25 | Status Date: 2022-02-25 |
| Member Name: KIMBERLY ALDRIDGE | Member ID: 33045660601 |
| Employer ID: COS | Termination Date: 2022-02-11 |
| Contract Record ID: 33045660601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 206641 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: STERLING NAMAN RAMOS | Member ID: 87944116801 |
| Employer ID: WCE | Termination Date: 2022-02-25 |
| Contract Record ID: 87944116801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 206681 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: TERRY ANDERSON III | Member ID: 18135383801 |
| Employer ID: MESH | Termination Date: 2022-02-14 |
| Contract Record ID: 18135383801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 206761 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: CRYSTAL LOUISE SPANNKNEBEL | Member ID: 92384542901 |
| Employer ID: LNB | Termination Date: 2022-02-28 |
| Contract Record ID: 92384542901 | Term Reason: TERMINATION |
| Comments: Employee ended employment on 2/19/22 |
|
| Request ID: 206801 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: CHARLES B SPANNKNEBEL | Member ID: 92384542902 |
| Employer ID: LNB | Termination Date: 2022-02-28 |
| Contract Record ID: 92384542901 | Term Reason: TERMINATION |
| Comments: Wife terminated employment on 2/19/22. |
|
| Request ID: 207022 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: ROBERT J MILLER | Member ID: 64985384101 |
| Employer ID: WCE | Termination Date: 2022-01-10 |
| Contract Record ID: 64985384101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207023 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: MAURO ARREDONDO JR | Member ID: 74374016301 |
| Employer ID: APRES | Termination Date: 2022-02-28 |
| Contract Record ID: 74374016301 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 207024 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: DANIEL PEREZ | Member ID: 42399027601 |
| Employer ID: APRES | Termination Date: 2022-02-28 |
| Contract Record ID: 42399027601 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 207025 | Status: COMPLETE |
| Request Date: 2022-02-28 | Status Date: 2022-02-28 |
| Member Name: LAURA HEROD | Member ID: 62179721501 |
| Employer ID: APRES | Termination Date: 2022-03-01 |
| Contract Record ID: 62179721501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 207061 | Status: COMPLETE |
| Request Date: 2022-03-01 | Status Date: 2022-03-01 |
| Member Name: NOEL DIGGINS | Member ID: 12324321201 |
| Employer ID: PELTZ | Termination Date: 2021-02-28 |
| Contract Record ID: 12324321201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 207163 | Status: COMPLETE |
| Request Date: 2022-03-01 | Status Date: 2022-03-01 |
| Member Name: JADA PLYLER | Member ID: 74700370801 |
| Employer ID: YHP00015 | Termination Date: 2022-02-28 |
| Contract Record ID: 74700370801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207201 | Status: COMPLETE |
| Request Date: 2022-03-01 | Status Date: 2022-03-01 |
| Member Name: STERLING NAMAN RAMOS | Member ID: 87944116801 |
| Employer ID: WCE | Termination Date: 2022-02-25 |
| Contract Record ID: 87944116801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207223 | Status: COMPLETE |
| Request Date: 2022-03-01 | Status Date: 2022-03-01 |
| Member Name: ROBERT MOORE | Member ID: 97638053201 |
| Employer ID: NEC | Termination Date: 2022-02-28 |
| Contract Record ID: 97638053201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207224 | Status: COMPLETE |
| Request Date: 2022-03-01 | Status Date: 2022-03-01 |
| Member Name: TIMOTHY BARWICK | Member ID: 52944434501 |
| Employer ID: NEC | Termination Date: 2022-02-28 |
| Contract Record ID: 52944434501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 207561 | Status: COMPLETE |
| Request Date: 2022-03-02 | Status Date: 2022-03-02 |
| Member Name: JOHN BARBALAS | Member ID: 22884545001 |
| Employer ID: BROSOL | Termination Date: 2022-03-01 |
| Contract Record ID: 22884545001 | Term Reason: VOLUNTARY |
| Comments: Retired and now enrolled in Medicaid. |
|
| Request ID: 207688 | Status: COMPLETE |
| Request Date: 2022-03-02 | Status Date: 2022-03-02 |
| Member Name: CARMEL WOLFE | Member ID: 34329466301 |
| Employer ID: YHP00158 | Termination Date: 2022-03-01 |
| Contract Record ID: 34329466301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207713 | Status: COMPLETE |
| Request Date: 2022-03-03 | Status Date: 2022-03-03 |
| Member Name: FELECIA MOSQUEDA | Member ID: 69147782401 |
| Employer ID: BRECK | Termination Date: 2022-03-31 |
| Contract Record ID: 69147782401 | Term Reason: TERMINATION |
| Comments: please mail COBRA |
|
| Request ID: 207824 | Status: COMPLETE |
| Request Date: 2022-03-04 | Status Date: 2022-03-04 |
| Member Name: ALISHA M ORNELAS | Member ID: 42954806501 |
| Employer ID: SFM | Termination Date: 2022-02-28 |
| Contract Record ID: 42954806501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207825 | Status: COMPLETE |
| Request Date: 2022-03-04 | Status Date: 2022-03-04 |
| Member Name: DEANNA MEHLHOFF | Member ID: 13608037401 |
| Employer ID: SFM | Termination Date: 2022-02-28 |
| Contract Record ID: 13608037401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207871 | Status: COMPLETE |
| Request Date: 2022-03-07 | Status Date: 2022-03-07 |
| Member Name: LISA SUMMERS | Member ID: 83674350001 |
| Employer ID: YHP00332 | Termination Date: 2022-03-07 |
| Contract Record ID: 83674350001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 207905 | Status: COMPLETE |
| Request Date: 2022-03-08 | Status Date: 2022-03-08 |
| Member Name: HOLLIS WOOD | Member ID: 80850545801 |
| Employer ID: COS | Termination Date: 2022-03-03 |
| Contract Record ID: 80850545801 | Term Reason: TERMINATION |
| Comments: Employee last day of work was on 3/3/2022 |
|
| Request ID: 207906 | Status: COMPLETE |
| Request Date: 2022-03-08 | Status Date: 2022-03-08 |
| Member Name: SCOTT CHRISTOPHER MARTIN | Member ID: 18741773701 |
| Employer ID: COS | Termination Date: 2022-03-04 |
| Contract Record ID: 18741773701 | Term Reason: TERMINATION |
| Comments: Employee last day worked was on 03/04/2022 |
|
| Request ID: 207907 | Status: COMPLETE |
| Request Date: 2022-03-08 | Status Date: 2022-03-08 |
| Member Name: NICOLE FLOYD | Member ID: 46029237401 |
| Employer ID: COS | Termination Date: 2022-03-11 |
| Contract Record ID: 46029237401 | Term Reason: TERMINATION |
| Comments: Employee final day is on 03/11/2022 |
|
| Request ID: 207909 | Status: COMPLETE |
| Request Date: 2022-03-08 | Status Date: 2022-03-08 |
| Member Name: JACHEIN STEWART | Member ID: 06578706001 |
| Employer ID: DAVIS | Termination Date: 2022-03-31 |
| Contract Record ID: 06578706001 | Term Reason: VOLUNTARY |
| Comments: Resigned 3/11 |
|
| Request ID: 207915 | Status: COMPLETE |
| Request Date: 2022-03-08 | Status Date: 2022-03-08 |
| Member Name: KRISTINA MARQUEZ | Member ID: 45091425401 |
| Employer ID: BRECK | Termination Date: 2022-03-31 |
| Contract Record ID: 45091425401 | Term Reason: TERMINATION |
| Comments: please send COBRA |
|
| Request ID: 207945 | Status: COMPLETE |
| Request Date: 2022-03-09 | Status Date: 2022-03-09 |
| Member Name: STEPHANIE CELAYA | Member ID: 93103807301 |
| Employer ID: AZOPT | Termination Date: 2022-02-28 |
| Contract Record ID: 93103807301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 207948 | Status: COMPLETE |
| Request Date: 2022-03-09 | Status Date: 2022-03-09 |
| Member Name: DANIEL MARTIN | Member ID: 28310647301 |
| Employer ID: DNA | Termination Date: 2022-03-31 |
| Contract Record ID: 28310647301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 207995 | Status: COMPLETE |
| Request Date: 2022-03-11 | Status Date: 2022-03-11 |
| Member Name: JAMES E GEE | Member ID: 76826292601 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 76826292601 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 208004 | Status: COMPLETE |
| Request Date: 2022-03-12 | Status Date: 2022-03-12 |
| Member Name: MICHELLE PADDOCK | Member ID: 17384075701 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 17384075701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 208005 | Status: COMPLETE |
| Request Date: 2022-03-12 | Status Date: 2022-03-12 |
| Member Name: IMEE MARIE N SUPERALES | Member ID: 17418053901 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 17418053901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 208039 | Status: COMPLETE |
| Request Date: 2022-03-14 | Status Date: 2022-03-14 |
| Member Name: VERONICA SUSAN SULLIVAN | Member ID: 78051691901 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 78051691901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 208062 | Status: COMPLETE |
| Request Date: 2022-03-15 | Status Date: 2022-03-15 |
| Member Name: KEVIN JOHNSON | Member ID: 28079776701 |
| Employer ID: PELTZ | Termination Date: 2022-03-31 |
| Contract Record ID: 28079776701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 208074 | Status: COMPLETE |
| Request Date: 2022-03-15 | Status Date: 2022-03-15 |
| Member Name: BRIAN CHRISTOPHER MOSS | Member ID: 35482742301 |
| Employer ID: YHP00015 | Termination Date: 2022-02-07 |
| Contract Record ID: 35482742301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 208121 | Status: COMPLETE |
| Request Date: 2022-03-15 | Status Date: 2022-03-15 |
| Member Name: ALEXIS MICHELLE MUSICK | Member ID: 56583019701 |
| Employer ID: YHP00331 | Termination Date: 2022-03-15 |
| Contract Record ID: 56583019701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 208241 | Status: COMPLETE |
| Request Date: 2022-03-15 | Status Date: 2022-03-15 |
| Member Name: LUIS OVALLE | Member ID: 53936469301 |
| Employer ID: APRES | Termination Date: 2022-03-11 |
| Contract Record ID: 53936469301 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 208341 | Status: COMPLETE |
| Request Date: 2022-03-16 | Status Date: 2022-03-16 |
| Member Name: JACOB MCGOUGH | Member ID: 99624537401 |
| Employer ID: NEC | Termination Date: 2022-03-31 |
| Contract Record ID: 99624537401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 208361 | Status: COMPLETE |
| Request Date: 2022-03-16 | Status Date: 2022-03-16 |
| Member Name: TERRY ARCHIBALD | Member ID: 15004588001 |
| Employer ID: NEC | Termination Date: 2022-02-28 |
| Contract Record ID: 15004588001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 208381 | Status: COMPLETE |
| Request Date: 2022-03-16 | Status Date: 2022-03-16 |
| Member Name: BRADLEY MILLER | Member ID: 67048347901 |
| Employer ID: NEC | Termination Date: 2022-03-31 |
| Contract Record ID: 67048347901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 209144 | Status: COMPLETE |
| Request Date: 2022-03-17 | Status Date: 2022-03-17 |
| Member Name: LORI EDWARDS | Member ID: 00895060101 |
| Employer ID: YHP00158 | Termination Date: 2022-03-31 |
| Contract Record ID: 00895060101 | Term Reason: TERMINATION |
| Comments: Employee left the company. |
|
| Request ID: 209182 | Status: COMPLETE |
| Request Date: 2022-03-17 | Status Date: 2022-03-17 |
| Member Name: DANEA THOMAS GORHAM | Member ID: 55657334201 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 55657334201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 209241 | Status: COMPLETE |
| Request Date: 2022-03-18 | Status Date: 2022-03-18 |
| Member Name: DAMIEN COLLINGS | Member ID: 67088454001 |
| Employer ID: BRANDY | Termination Date: 2022-03-31 |
| Contract Record ID: 67088454001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 209501 | Status: COMPLETE |
| Request Date: 2022-03-21 | Status Date: 2022-03-21 |
| Member Name: JESSICA ANDERSON | Member ID: 24466049501 |
| Employer ID: YHP00116 | Termination Date: 2022-02-22 |
| Contract Record ID: 24466049501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 209721 | Status: COMPLETE |
| Request Date: 2022-03-22 | Status Date: 2022-03-22 |
| Member Name: KASSI FUGETT | Member ID: 88549820001 |
| Employer ID: CNT | Termination Date: 2022-03-31 |
| Contract Record ID: 88549820001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 209741 | Status: COMPLETE |
| Request Date: 2022-03-22 | Status Date: 2022-03-22 |
| Member Name: CRYSTAL FASHAUER | Member ID: 65014089301 |
| Employer ID: CARBON | Termination Date: 2022-02-12 |
| Contract Record ID: 65014089301 | Term Reason: VOLUNTARY |
| Comments: employee resigned full time status |
|
| Request ID: 209761 | Status: COMPLETE |
| Request Date: 2022-03-22 | Status Date: 2022-03-22 |
| Member Name: MALLORY J GRIMES | Member ID: 89963583201 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 89963583201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 210143 | Status: COMPLETE |
| Request Date: 2022-03-23 | Status Date: 2022-03-23 |
| Member Name: JOSHUA PENAS | Member ID: 26472846401 |
| Employer ID: DNA | Termination Date: 2022-03-11 |
| Contract Record ID: 26472846401 | Term Reason: VOLUNTARY |
| Comments: Please terminate medical plan effective 3/31/2022.
Thank you. |
|
| Request ID: 210241 | Status: COMPLETE |
| Request Date: 2022-03-23 | Status Date: 2022-03-23 |
| Member Name: TRA W WALTERS | Member ID: 14692182601 |
| Employer ID: BROSOL | Termination Date: 2022-03-31 |
| Contract Record ID: 14692182601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 210261 | Status: COMPLETE |
| Request Date: 2022-03-23 | Status Date: 2022-03-23 |
| Member Name: MARQUIZ D STEVENSON | Member ID: 91823289201 |
| Employer ID: BROSOL | Termination Date: 2022-03-31 |
| Contract Record ID: 91823289201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 210301 | Status: COMPLETE |
| Request Date: 2022-03-23 | Status Date: 2022-03-23 |
| Member Name: AUTEMN PAINTER | Member ID: 25080060001 |
| Employer ID: WCE | Termination Date: 2022-03-22 |
| Contract Record ID: 25080060001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 210521 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: RICKETA BLACKMAN | Member ID: 13463628401 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 13463628401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 210522 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: ROSE J FANNING | Member ID: 27687898601 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 27687898601 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 210523 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: JOHN BUTERA | Member ID: 06944744301 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 06944744301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 210524 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: REBECCA JISUNG YU | Member ID: 43733897401 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 43733897401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 210525 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: VALERIE ROSE MARPLE | Member ID: 45721206001 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 45721206001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 210901 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: FLORITA C CARIASO | Member ID: 85928743301 |
| Employer ID: TPCH | Termination Date: 2022-02-28 |
| Contract Record ID: 85928743301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 210903 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: DRENDA R WILLIAMS | Member ID: 63361688401 |
| Employer ID: TPCH | Termination Date: 2022-03-03 |
| Contract Record ID: 63361688401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 210904 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: KASSI FUGETT | Member ID: 88549820001 |
| Employer ID: CNT | Termination Date: 2022-03-31 |
| Contract Record ID: 88549820001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 210906 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: JASMINE DECOTEAU | Member ID: 07300352901 |
| Employer ID: TPCH | Termination Date: 2022-03-17 |
| Contract Record ID: 07300352901 | Term Reason: VOLUNTARY |
| Comments: TERMINATION |
|
| Request ID: 210907 | Status: COMPLETE |
| Request Date: 2022-03-24 | Status Date: 2022-03-24 |
| Member Name: SIERRA STRANDBERG | Member ID: 74866956101 |
| Employer ID: TPCH | Termination Date: 2022-03-20 |
| Contract Record ID: 74866956101 | Term Reason: VOLUNTARY |
| Comments: TERMINATION |
|
| Request ID: 211061 | Status: COMPLETE |
| Request Date: 2022-03-25 | Status Date: 2022-03-25 |
| Member Name: EDWARD KEE | Member ID: 09704884701 |
| Employer ID: NEC | Termination Date: 2022-03-13 |
| Contract Record ID: 09704884701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211081 | Status: COMPLETE |
| Request Date: 2022-03-25 | Status Date: 2022-03-25 |
| Member Name: JEREMY SIDEBOTOM | Member ID: 07596892801 |
| Employer ID: NEC | Termination Date: 2022-03-04 |
| Contract Record ID: 07596892801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211101 | Status: COMPLETE |
| Request Date: 2022-03-25 | Status Date: 2022-03-25 |
| Member Name: CHRISTOPHER A WORKMAN | Member ID: 41239255201 |
| Employer ID: NEC | Termination Date: 2022-03-07 |
| Contract Record ID: 41239255201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211141 | Status: COMPLETE |
| Request Date: 2022-03-25 | Status Date: 2022-03-25 |
| Member Name: JOSEPH YOUNG | Member ID: 91790943001 |
| Employer ID: NEC | Termination Date: 2022-03-07 |
| Contract Record ID: 91790943001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211381 | Status: COMPLETE |
| Request Date: 2022-03-28 | Status Date: 2022-03-28 |
| Member Name: EDWARD SHAEFFER | Member ID: 42302865101 |
| Employer ID: YHP00126 | Termination Date: 2022-03-27 |
| Contract Record ID: 42302865101 | Term Reason: VOLUNTARY |
| Comments: Quit without notice |
|
| Request ID: 211387 | Status: COMPLETE |
| Request Date: 2022-03-28 | Status Date: 2022-03-28 |
| Member Name: GREGORY WITTHOFT | Member ID: 93030266601 |
| Employer ID: DNA | Termination Date: 2022-03-25 |
| Contract Record ID: 93030266601 | Term Reason: VOLUNTARY |
| Comments: Please terminate coverage eff last day of month - 3/31/2022.
Thank you. |
|
| Request ID: 211390 | Status: COMPLETE |
| Request Date: 2022-03-28 | Status Date: 2022-03-28 |
| Member Name: JENETTE TORRES | Member ID: 50671597201 |
| Employer ID: ADVRX | Termination Date: 2022-03-11 |
| Contract Record ID: 50671597201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 211401 | Status: COMPLETE |
| Request Date: 2022-03-29 | Status Date: 2022-03-29 |
| Member Name: CHEYANNE WOLPERT | Member ID: 65679132601 |
| Employer ID: EASYLVNG | Termination Date: 2022-03-25 |
| Contract Record ID: 65679132601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211414 | Status: COMPLETE |
| Request Date: 2022-03-29 | Status Date: 2022-03-29 |
| Member Name: KOELTON FENTON | Member ID: 67831857201 |
| Employer ID: EASYLVNG | Termination Date: 2022-03-31 |
| Contract Record ID: 67831857201 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 211420 | Status: COMPLETE |
| Request Date: 2022-03-29 | Status Date: 2022-03-29 |
| Member Name: PAUL HEFFERNAN | Member ID: 48948741001 |
| Employer ID: WCE | Termination Date: 2022-03-30 |
| Contract Record ID: 48948741001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 211422 | Status: COMPLETE |
| Request Date: 2022-03-30 | Status Date: 2022-03-30 |
| Member Name: MARY VIOLA HAWKINS | Member ID: 51789175901 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 51789175901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211423 | Status: COMPLETE |
| Request Date: 2022-03-30 | Status Date: 2022-03-30 |
| Member Name: MARY VIOLA HAWKINS | Member ID: 51789175901 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 51789175901 | Term Reason: TERMINATION |
| Comments: Employee retired on 3/15/22 |
|
| Request ID: 211424 | Status: COMPLETE |
| Request Date: 2022-03-30 | Status Date: 2022-03-30 |
| Member Name: DEBRA H MUDD | Member ID: 95765093901 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 95765093901 | Term Reason: TERMINATION |
| Comments: Employee retired 3/25/22 |
|
| Request ID: 211427 | Status: COMPLETE |
| Request Date: 2022-03-30 | Status Date: 2022-03-30 |
| Member Name: JOHN M VELDHUIS | Member ID: 40704690301 |
| Employer ID: BRECKS | Termination Date: 2022-03-31 |
| Contract Record ID: 40704690301 | Term Reason: TERMINATION |
| Comments: Please send COBRA |
|
| Request ID: 211438 | Status: COMPLETE |
| Request Date: 2022-03-30 | Status Date: 2022-03-30 |
| Member Name: CHARLES BELANGER | Member ID: 29451833901 |
| Employer ID: TPCH | Termination Date: 2022-03-31 |
| Contract Record ID: 29451833901 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 211439 | Status: COMPLETE |
| Request Date: 2022-03-30 | Status Date: 2022-03-30 |
| Member Name: CHRISTINE BELANGER | Member ID: 29451833902 |
| Employer ID: TPCH | Termination Date: 2022-03-31 |
| Contract Record ID: 29451833901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211461 | Status: COMPLETE |
| Request Date: 2022-03-31 | Status Date: 2022-03-31 |
| Member Name: PAUL HEFFERNAN | Member ID: 48948741001 |
| Employer ID: WCE | Termination Date: 2022-03-30 |
| Contract Record ID: 48948741001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 211801 | Status: COMPLETE |
| Request Date: 2022-04-01 | Status Date: 2022-04-01 |
| Member Name: MICHELLE PADDOCK | Member ID: 17384075701 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 17384075701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 211821 | Status: COMPLETE |
| Request Date: 2022-04-01 | Status Date: 2022-04-01 |
| Member Name: LEHUA MCMILLAN | Member ID: 45253576401 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 45253576401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 211822 | Status: COMPLETE |
| Request Date: 2022-04-01 | Status Date: 2022-04-01 |
| Member Name: NANCY MARIE PALMER | Member ID: 49634325101 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 49634325101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 211901 | Status: COMPLETE |
| Request Date: 2022-04-02 | Status Date: 2022-04-02 |
| Member Name: TIMOTHY MUDD | Member ID: 95765093902 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 95765093901 | Term Reason: TERMINATION |
| Comments: Debbie Mudd retired and he lost dental coverage as a spouse. Cobra should be notified. |
|
| Request ID: 211921 | Status: COMPLETE |
| Request Date: 2022-04-02 | Status Date: 2022-04-02 |
| Member Name: BARBARA R LYON | Member ID: 41108845301 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 41108845301 | Term Reason: TERMINATION |
| Comments: Retired 3/31/22 |
|
| Request ID: 211941 | Status: COMPLETE |
| Request Date: 2022-04-02 | Status Date: 2022-04-02 |
| Member Name: BARBARA R LYON | Member ID: 41108845301 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 41108845301 | Term Reason: TERMINATION |
| Comments: Retired 3/31/22 |
|
| Request ID: 211961 | Status: COMPLETE |
| Request Date: 2022-04-02 | Status Date: 2022-04-02 |
| Member Name: WILLIAM H LYON | Member ID: 41108845302 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 41108845301 | Term Reason: TERMINATION |
| Comments: Wife Barbara retired 3/31/22 |
|
| Request ID: 211981 | Status: COMPLETE |
| Request Date: 2022-04-02 | Status Date: 2022-04-02 |
| Member Name: CASSIDY L BUTLER | Member ID: 26579758001 |
| Employer ID: LNB | Termination Date: 2022-03-31 |
| Contract Record ID: 26579758001 | Term Reason: TERMINATION |
| Comments: Quit 3/30/22 |
|
| Request ID: 212121 | Status: COMPLETE |
| Request Date: 2022-04-04 | Status Date: 2022-04-04 |
| Member Name: MARCUS REEVES | Member ID: 43697459001 |
| Employer ID: YHP00134 | Termination Date: 2022-03-25 |
| Contract Record ID: 43697459001 | Term Reason: TERMINATION |
| Comments: EMPLOYEE RESIGNED |
|
| Request ID: 212141 | Status: COMPLETE |
| Request Date: 2022-04-04 | Status Date: 2022-04-04 |
| Member Name: ALYSSA MICHELLE PENA | Member ID: 04289466001 |
| Employer ID: YHP00134 | Termination Date: 2022-03-27 |
| Contract Record ID: 04289466001 | Term Reason: TERMINATION |
| Comments: EMPLOYEE QUIT |
|
| Request ID: 212861 | Status: COMPLETE |
| Request Date: 2022-04-05 | Status Date: 2022-04-05 |
| Member Name: DANIEL B FORCE | Member ID: 94688011001 |
| Employer ID: MESH | Termination Date: 2022-03-31 |
| Contract Record ID: 94688011001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 213021 | Status: COMPLETE |
| Request Date: 2022-04-05 | Status Date: 2022-04-05 |
| Member Name: JOSHUA REINA | Member ID: 77269562702 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 77269562701 | Term Reason: VOLUNTARY |
| Comments: Has other coverage |
|
| Request ID: 213161 | Status: COMPLETE |
| Request Date: 2022-04-06 | Status Date: 2022-04-06 |
| Member Name: MICHELLE BARCLAY | Member ID: 22671512701 |
| Employer ID: DNA | Termination Date: 2022-04-01 |
| Contract Record ID: 22671512701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 213181 | Status: COMPLETE |
| Request Date: 2022-04-06 | Status Date: 2022-04-06 |
| Member Name: MICHELLE BARCLAY | Member ID: 22671512701 |
| Employer ID: DNA | Termination Date: 2022-04-01 |
| Contract Record ID: 22671512701 | Term Reason: VOLUNTARY |
| Comments: CLARIFICATION: Employment term date is 4/1/2022; Coverage end date is 4/30/2022; first day of no coverage is 5/1/2022. |
|
| Request ID: 213261 | Status: COMPLETE |
| Request Date: 2022-04-06 | Status Date: 2022-04-06 |
| Member Name: CRYSTAL MCFARLAND | Member ID: 30646401601 |
| Employer ID: YHP00116 | Termination Date: 2022-03-29 |
| Contract Record ID: 30646401601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 213381 | Status: COMPLETE |
| Request Date: 2022-04-07 | Status Date: 2022-04-07 |
| Member Name: CLAYTON DEAN CAMPBELL | Member ID: 28490377201 |
| Employer ID: YHP00134 | Termination Date: 2022-03-31 |
| Contract Record ID: 28490377201 | Term Reason: TERMINATION |
| Comments: EMPLOYMENT TERMINATED |
|
| Request ID: 213561 | Status: COMPLETE |
| Request Date: 2022-04-07 | Status Date: 2022-04-07 |
| Member Name: DANIEL ESCOBAR | Member ID: 95615679501 |
| Employer ID: DNA | Termination Date: 2022-05-01 |
| Contract Record ID: 95615679501 | Term Reason: VOLUNTARY |
| Comments: Employment termination is 4/6/2022. Last day of coverage is 4/30/2022. First Day of no coverage is 5/1/2022. |
|
| Request ID: 213641 | Status: COMPLETE |
| Request Date: 2022-04-07 | Status Date: 2022-04-07 |
| Member Name: GEORGETTE SHAWNA WRIGHT | Member ID: 05003504101 |
| Employer ID: YHP00015 | Termination Date: 2022-03-05 |
| Contract Record ID: 05003504101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 213661 | Status: COMPLETE |
| Request Date: 2022-04-07 | Status Date: 2022-04-07 |
| Member Name: MEDHAT H SANAD | Member ID: 13561816401 |
| Employer ID: TPCH | Termination Date: 2022-04-30 |
| Contract Record ID: 13561816401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 213821 | Status: COMPLETE |
| Request Date: 2022-04-08 | Status Date: 2022-04-08 |
| Member Name: DANIEL S BEROLO | Member ID: 00536420001 |
| Employer ID: WCE | Termination Date: 2022-04-30 |
| Contract Record ID: 00536420001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214001 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: JAMES B HOWE | Member ID: 89947871501 |
| Employer ID: MESH | Termination Date: 2022-04-04 |
| Contract Record ID: 89947871501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 214061 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: NANCY LEES | Member ID: 43092070301 |
| Employer ID: NEC | Termination Date: 2022-03-27 |
| Contract Record ID: 43092070301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214062 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: CHRISTOPHER LAGOS | Member ID: 35787670601 |
| Employer ID: NEC | Termination Date: 2022-03-21 |
| Contract Record ID: 35787670601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214063 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: BRANDON BLAIZE | Member ID: 92555590401 |
| Employer ID: NEC | Termination Date: 2022-03-31 |
| Contract Record ID: 92555590401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214064 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: JOSEPH D PATRICK | Member ID: 54702929301 |
| Employer ID: NEC | Termination Date: 2022-03-25 |
| Contract Record ID: 54702929301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214065 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: VICTOR DURAN | Member ID: 80052430701 |
| Employer ID: NEC | Termination Date: 2022-03-26 |
| Contract Record ID: 80052430701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214066 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: MATTHEW TRAPP | Member ID: 28900064701 |
| Employer ID: NEC | Termination Date: 2022-03-30 |
| Contract Record ID: 28900064701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214067 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: TROY DAFFRON | Member ID: 80691812301 |
| Employer ID: NEC | Termination Date: 2022-03-25 |
| Contract Record ID: 80691812301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214068 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: BRANDON DECOURSEY | Member ID: 01582930201 |
| Employer ID: NEC | Termination Date: 2022-03-19 |
| Contract Record ID: 01582930201 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 214181 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: ANGELA ALEXANDER | Member ID: 46083400501 |
| Employer ID: BRANDY | Termination Date: 2022-03-31 |
| Contract Record ID: 46083400501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 214221 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: LLOYD WIX | Member ID: 78146507201 |
| Employer ID: NEC | Termination Date: 2022-04-04 |
| Contract Record ID: 78146507201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214222 | Status: COMPLETE |
| Request Date: 2022-04-11 | Status Date: 2022-04-11 |
| Member Name: AMON L MAHON | Member ID: 91746877601 |
| Employer ID: NEC | Termination Date: 2022-04-01 |
| Contract Record ID: 91746877601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214421 | Status: COMPLETE |
| Request Date: 2022-04-12 | Status Date: 2022-04-12 |
| Member Name: HADEN BRISTOL | Member ID: 23042703601 |
| Employer ID: NVMECH | Termination Date: 2022-04-01 |
| Contract Record ID: 23042703601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 214461 | Status: COMPLETE |
| Request Date: 2022-04-12 | Status Date: 2022-04-12 |
| Member Name: RANDAL CROWDER | Member ID: 01163478301 |
| Employer ID: NVMECH | Termination Date: 2022-05-01 |
| Contract Record ID: 01163478301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214541 | Status: COMPLETE |
| Request Date: 2022-04-12 | Status Date: 2022-04-12 |
| Member Name: KYLE SHESTACK | Member ID: 14410199401 |
| Employer ID: TBX | Termination Date: 2022-02-28 |
| Contract Record ID: 14410199401 | Term Reason: NON PAYMENT OF PREMIUMS |
| Comments: Employee Termed from COBRA coverage effective 02.28.22 per Ameriflex |
|
| Request ID: 214701 | Status: COMPLETE |
| Request Date: 2022-04-12 | Status Date: 2022-04-12 |
| Member Name: IAN M LARSON | Member ID: 82708286001 |
| Employer ID: AZOPT | Termination Date: 2022-04-30 |
| Contract Record ID: 82708286001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214702 | Status: COMPLETE |
| Request Date: 2022-04-12 | Status Date: 2022-04-12 |
| Member Name: IAN M LARSON | Member ID: 82708286001 |
| Employer ID: AZOPT | Termination Date: 2022-04-30 |
| Contract Record ID: 82708286001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 214961 | Status: COMPLETE |
| Request Date: 2022-04-13 | Status Date: 2022-04-13 |
| Member Name: AIDAN PETERSON | Member ID: 59990384301 |
| Employer ID: NEC | Termination Date: 2022-03-31 |
| Contract Record ID: 59990384301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 215041 | Status: COMPLETE |
| Request Date: 2022-04-13 | Status Date: 2022-04-13 |
| Member Name: LESLIE RONNET GUMBS | Member ID: 48233127101 |
| Employer ID: DNA | Termination Date: 2022-04-13 |
| Contract Record ID: 48233127101 | Term Reason: VOLUNTARY |
| Comments: This employee has voluntarily terminated employment on 4/13/2022 - prior to benefit effective date of 5/1/2022. Please terminate benefits 4/30/2022.
If you have any questions, please contact me.
Thank you.
Kind regards,
Dawn Broderick
Eligibility Specialist - Employee Benefits
Presidio
55 Shuman Blvd. Suite 900
Naperville, IL 60563
D 630.524.6122
F 630.524.6123
E dbroderick@presidiogrp.com
www.Presidiogrp.com |
|
| Request ID: 215521 | Status: COMPLETE |
| Request Date: 2022-04-14 | Status Date: 2022-04-14 |
| Member Name: RICKETA BLACKMAN | Member ID: 13463628401 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 13463628401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 215581 | Status: COMPLETE |
| Request Date: 2022-04-15 | Status Date: 2022-04-15 |
| Member Name: JOEL M BAYLE | Member ID: 03493883501 |
| Employer ID: MESH | Termination Date: 2022-04-15 |
| Contract Record ID: 03493883501 | Term Reason: TERMINATION |
| Comments: employee quit for another job. |
|
| Request ID: 215901 | Status: COMPLETE |
| Request Date: 2022-04-18 | Status Date: 2022-04-18 |
| Member Name: TIAWANNA HARRISON | Member ID: 43111667101 |
| Employer ID: COS | Termination Date: 2022-04-15 |
| Contract Record ID: 43111667101 | Term Reason: VOLUNTARY |
| Comments: Employee resigned as of 4/15/22 |
|
| Request ID: 216280 | Status: COMPLETE |
| Request Date: 2022-04-20 | Status Date: 2022-04-20 |
| Member Name: MAICO SOTTO-CURBELO | Member ID: 76346506201 |
| Employer ID: APRES | Termination Date: 2022-04-29 |
| Contract Record ID: 76346506201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 216281 | Status: COMPLETE |
| Request Date: 2022-04-20 | Status Date: 2022-04-20 |
| Member Name: MELANIE WALTMON | Member ID: 61223160301 |
| Employer ID: APRES | Termination Date: 2022-04-20 |
| Contract Record ID: 61223160301 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 216282 | Status: COMPLETE |
| Request Date: 2022-04-20 | Status Date: 2022-04-20 |
| Member Name: CAROLINA ROCHA | Member ID: 07579901501 |
| Employer ID: APRES | Termination Date: 2022-04-29 |
| Contract Record ID: 07579901501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 216319 | Status: COMPLETE |
| Request Date: 2022-04-21 | Status Date: 2022-04-21 |
| Member Name: JESSICA YADLEY CANTAVE | Member ID: 44029217801 |
| Employer ID: SFM | Termination Date: 2022-04-30 |
| Contract Record ID: 44029217801 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 216320 | Status: COMPLETE |
| Request Date: 2022-04-21 | Status Date: 2022-04-21 |
| Member Name: TANGI VERNETTA HENLEY | Member ID: 22441004501 |
| Employer ID: SFM | Termination Date: 2022-04-30 |
| Contract Record ID: 22441004501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216321 | Status: COMPLETE |
| Request Date: 2022-04-21 | Status Date: 2022-04-21 |
| Member Name: JOYCE MARIE DONOHUE | Member ID: 51551755401 |
| Employer ID: SFM | Termination Date: 2022-04-30 |
| Contract Record ID: 51551755401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216347 | Status: COMPLETE |
| Request Date: 2022-04-22 | Status Date: 2022-04-22 |
| Member Name: JOSEPH BACA | Member ID: 25019702001 |
| Employer ID: NEC | Termination Date: 2022-04-13 |
| Contract Record ID: 25019702001 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 216381 | Status: COMPLETE |
| Request Date: 2022-04-25 | Status Date: 2022-04-25 |
| Member Name: RANDALL E SHAFFER | Member ID: 56671395101 |
| Employer ID: WCE | Termination Date: 2022-05-31 |
| Contract Record ID: 56671395101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 216382 | Status: COMPLETE |
| Request Date: 2022-04-25 | Status Date: 2022-04-25 |
| Member Name: ALICE DANILOVICS | Member ID: 47385897901 |
| Employer ID: PELTZ | Termination Date: 2022-04-30 |
| Contract Record ID: 47385897901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216402 | Status: COMPLETE |
| Request Date: 2022-04-25 | Status Date: 2022-04-25 |
| Member Name: BREANNA MARTINEZ | Member ID: 92081837701 |
| Employer ID: CNT | Termination Date: 2022-01-31 |
| Contract Record ID: 92081837701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216408 | Status: COMPLETE |
| Request Date: 2022-04-25 | Status Date: 2022-04-25 |
| Member Name: CARA N HAMILTON | Member ID: 14068330701 |
| Employer ID: LNB | Termination Date: 2022-04-30 |
| Contract Record ID: 14068330701 | Term Reason: TERMINATION |
| Comments: last day of employment 4/22/22 |
|
| Request ID: 216411 | Status: COMPLETE |
| Request Date: 2022-04-25 | Status Date: 2022-04-25 |
| Member Name: RANDALL E SHAFFER | Member ID: 56671395101 |
| Employer ID: WCE | Termination Date: 2022-05-31 |
| Contract Record ID: 56671395101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 216426 | Status: COMPLETE |
| Request Date: 2022-04-26 | Status Date: 2022-04-26 |
| Member Name: EDWARD EICK | Member ID: 07283743701 |
| Employer ID: DAVIS | Termination Date: 2022-04-30 |
| Contract Record ID: 07283743701 | Term Reason: VOLUNTARY |
| Comments: Resigned |
|
| Request ID: 216456 | Status: COMPLETE |
| Request Date: 2022-04-27 | Status Date: 2022-04-27 |
| Member Name: NATHAN RAMSEY | Member ID: 36201351501 |
| Employer ID: BROSOL | Termination Date: 2022-04-27 |
| Contract Record ID: 36201351501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216464 | Status: COMPLETE |
| Request Date: 2022-04-28 | Status Date: 2022-04-28 |
| Member Name: DARLINGTON NGASSA | Member ID: 97568354901 |
| Employer ID: DNA | Termination Date: 2022-04-30 |
| Contract Record ID: 97568354901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216478 | Status: COMPLETE |
| Request Date: 2022-04-28 | Status Date: 2022-04-28 |
| Member Name: JUAN JACOBO | Member ID: 97543425501 |
| Employer ID: WCE | Termination Date: 2022-04-28 |
| Contract Record ID: 97543425501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216601 | Status: COMPLETE |
| Request Date: 2022-04-29 | Status Date: 2022-04-29 |
| Member Name: CHRISTINA GRANT | Member ID: 02213155501 |
| Employer ID: BRANDY | Termination Date: 2022-03-31 |
| Contract Record ID: 02213155501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216621 | Status: COMPLETE |
| Request Date: 2022-04-29 | Status Date: 2022-04-29 |
| Member Name: ANGELA ROBINSON | Member ID: 01756396101 |
| Employer ID: BRANDY | Termination Date: 2022-03-31 |
| Contract Record ID: 01756396101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216641 | Status: COMPLETE |
| Request Date: 2022-04-29 | Status Date: 2022-04-29 |
| Member Name: JUAN JACOBO | Member ID: 97543425501 |
| Employer ID: WCE | Termination Date: 2022-04-28 |
| Contract Record ID: 97543425501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216661 | Status: COMPLETE |
| Request Date: 2022-04-29 | Status Date: 2022-04-29 |
| Member Name: AMSY GERMOSEN | Member ID: 88796843801 |
| Employer ID: BRANDY | Termination Date: 2022-04-30 |
| Contract Record ID: 88796843801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 216741 | Status: COMPLETE |
| Request Date: 2022-04-29 | Status Date: 2022-04-29 |
| Member Name: SHERRI TAYLOR | Member ID: 51329528701 |
| Employer ID: COS | Termination Date: 2022-04-29 |
| Contract Record ID: 51329528701 | Term Reason: TERMINATION |
| Comments: Last Day Worked 04/29/2022 |
|
| Request ID: 216821 | Status: COMPLETE |
| Request Date: 2022-04-30 | Status Date: 2022-04-30 |
| Member Name: JEREMY A SPENCER | Member ID: 57955510201 |
| Employer ID: MESH | Termination Date: 2022-04-29 |
| Contract Record ID: 57955510201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 216901 | Status: COMPLETE |
| Request Date: 2022-05-02 | Status Date: 2022-05-02 |
| Member Name: DEBRA SMITH | Member ID: 63746033001 |
| Employer ID: YHP00123 | Termination Date: 2022-04-21 |
| Contract Record ID: 63746033001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217002 | Status: COMPLETE |
| Request Date: 2022-05-02 | Status Date: 2022-05-02 |
| Member Name: DAVID BOWDEN | Member ID: 33660987802 |
| Employer ID: APRES | Termination Date: 2022-04-30 |
| Contract Record ID: 33660987801 | Term Reason: VOLUNTARY |
| Comments: Coverage from new job eff 5/1/2022 |
|
| Request ID: 217161 | Status: COMPLETE |
| Request Date: 2022-05-03 | Status Date: 2022-05-03 |
| Member Name: JEREMY BELL | Member ID: 14587246501 |
| Employer ID: CNT | Termination Date: 2022-05-31 |
| Contract Record ID: 14587246501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217221 | Status: COMPLETE |
| Request Date: 2022-05-03 | Status Date: 2022-05-03 |
| Member Name: JAMES MORRIS | Member ID: 24120957601 |
| Employer ID: NEC | Termination Date: 2022-05-01 |
| Contract Record ID: 24120957601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 217222 | Status: COMPLETE |
| Request Date: 2022-05-03 | Status Date: 2022-05-03 |
| Member Name: DAVID MILLER | Member ID: 32374186001 |
| Employer ID: NEC | Termination Date: 2022-04-29 |
| Contract Record ID: 32374186001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 217223 | Status: COMPLETE |
| Request Date: 2022-05-03 | Status Date: 2022-05-03 |
| Member Name: SHANE BACA | Member ID: 35883436001 |
| Employer ID: NEC | Termination Date: 2022-04-28 |
| Contract Record ID: 35883436001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 217343 | Status: COMPLETE |
| Request Date: 2022-05-03 | Status Date: 2022-05-03 |
| Member Name: CHILENA ROSE ALVAREZ | Member ID: 20807388101 |
| Employer ID: CNT | Termination Date: 2022-04-30 |
| Contract Record ID: 20807388101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217524 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: ANN PROKOP | Member ID: 21004024301 |
| Employer ID: PELTZ | Termination Date: 2022-05-31 |
| Contract Record ID: 21004024301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217541 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: PAIGE TOWNSEND | Member ID: 52023945001 |
| Employer ID: PELTZ | Termination Date: 2022-05-31 |
| Contract Record ID: 52023945001 | Term Reason: |
| Comments: |
|
| Request ID: 217601 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: JEREMY BELL | Member ID: 14587246501 |
| Employer ID: CNT | Termination Date: 2022-05-31 |
| Contract Record ID: 14587246501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217602 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: JOSHUA R BLAYLOCK | Member ID: 38123926901 |
| Employer ID: CNT | Termination Date: 2022-04-30 |
| Contract Record ID: 38123926901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217603 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: DEBORAH GREEN | Member ID: 00014426901 |
| Employer ID: CNT | Termination Date: 2022-04-30 |
| Contract Record ID: 00014426901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217604 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: CHILENA ROSE ALVAREZ | Member ID: 20807388101 |
| Employer ID: CNT | Termination Date: 2022-04-30 |
| Contract Record ID: 20807388101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217606 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: MICHAEL DAVID BATES | Member ID: 36611703101 |
| Employer ID: YHP00134 | Termination Date: 2022-04-30 |
| Contract Record ID: 36611703101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 217607 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: TAYLER ERIN LYONS | Member ID: 77657030001 |
| Employer ID: YHP00134 | Termination Date: 2022-04-30 |
| Contract Record ID: 77657030001 | Term Reason: VOLUNTARY |
| Comments: QUIT, NO NOTICE |
|
| Request ID: 217608 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: NATHAN W WICKER | Member ID: 80246341901 |
| Employer ID: TRILAT | Termination Date: 2022-05-03 |
| Contract Record ID: 80246341901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217721 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: MARILYN A BASSETT | Member ID: 68613154901 |
| Employer ID: BRANDY | Termination Date: 2022-03-31 |
| Contract Record ID: 68613154901 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 217741 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: HILDA GAITAN | Member ID: 13537697601 |
| Employer ID: BRANDY | Termination Date: 2022-04-28 |
| Contract Record ID: 13537697601 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 217761 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: NADINE SANKAR | Member ID: 48968995401 |
| Employer ID: BRANDY | Termination Date: 2022-04-06 |
| Contract Record ID: 48968995401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217781 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: MARLON STEWART | Member ID: 08513422201 |
| Employer ID: BRANDY | Termination Date: 2022-03-18 |
| Contract Record ID: 08513422201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217801 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: MARLON STEWART | Member ID: 08513422201 |
| Employer ID: BRANDY | Termination Date: 2022-03-18 |
| Contract Record ID: 08513422201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 217821 | Status: COMPLETE |
| Request Date: 2022-05-04 | Status Date: 2022-05-04 |
| Member Name: LUZ E VALLE | Member ID: 51165674301 |
| Employer ID: BRANDY | Termination Date: 2022-03-24 |
| Contract Record ID: 51165674301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 218081 | Status: COMPLETE |
| Request Date: 2022-05-06 | Status Date: 2022-05-06 |
| Member Name: DAVID J PRZYBYL | Member ID: 02679791201 |
| Employer ID: WCE | Termination Date: 2022-05-03 |
| Contract Record ID: 02679791201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 218181 | Status: COMPLETE |
| Request Date: 2022-05-06 | Status Date: 2022-05-06 |
| Member Name: WHITNEY LIGGETT | Member ID: 13039087301 |
| Employer ID: SFM | Termination Date: 2022-04-30 |
| Contract Record ID: 13039087301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 218203 | Status: COMPLETE |
| Request Date: 2022-05-06 | Status Date: 2022-05-06 |
| Member Name: TERESA MAE SHEPARD | Member ID: 97026184201 |
| Employer ID: SFM | Termination Date: 2022-04-30 |
| Contract Record ID: 97026184201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 218221 | Status: COMPLETE |
| Request Date: 2022-05-06 | Status Date: 2022-05-06 |
| Member Name: GABRIELA MORENO | Member ID: 21290789101 |
| Employer ID: SFM | Termination Date: 2022-04-30 |
| Contract Record ID: 21290789101 | Term Reason: VOLUNTARY |
| Comments: Has other coverage |
|
| Request ID: 218241 | Status: COMPLETE |
| Request Date: 2022-05-06 | Status Date: 2022-05-06 |
| Member Name: BERNICE AMATO | Member ID: 00034296701 |
| Employer ID: SFM | Termination Date: 2022-04-30 |
| Contract Record ID: 00034296701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 218401 | Status: COMPLETE |
| Request Date: 2022-05-08 | Status Date: 2022-05-08 |
| Member Name: ARTURO GARZA | Member ID: 34425629101 |
| Employer ID: APRES | Termination Date: 2022-02-28 |
| Contract Record ID: 34425629101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 218621 | Status: COMPLETE |
| Request Date: 2022-05-09 | Status Date: 2022-05-09 |
| Member Name: SAVANNAH BEST | Member ID: 68682963101 |
| Employer ID: DNA | Termination Date: 2022-06-01 |
| Contract Record ID: 68682963101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 218641 | Status: COMPLETE |
| Request Date: 2022-05-09 | Status Date: 2022-05-09 |
| Member Name: SAVANNAH BEST | Member ID: 68682963101 |
| Employer ID: DNA | Termination Date: 2022-06-01 |
| Contract Record ID: 68682963101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 218721 | Status: COMPLETE |
| Request Date: 2022-05-09 | Status Date: 2022-05-09 |
| Member Name: CODY BURGIN | Member ID: 50084849601 |
| Employer ID: APRES | Termination Date: 2022-05-31 |
| Contract Record ID: 50084849601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 218861 | Status: COMPLETE |
| Request Date: 2022-05-10 | Status Date: 2022-05-10 |
| Member Name: EVAN D GARRENTON | Member ID: 45977155401 |
| Employer ID: BROSOL | Termination Date: 2022-04-28 |
| Contract Record ID: 45977155401 | Term Reason: VOLUNTARY |
| Comments: Evan resigned. |
|
| Request ID: 219081 | Status: COMPLETE |
| Request Date: 2022-05-11 | Status Date: 2022-05-11 |
| Member Name: GLORIA VILLEGAS | Member ID: 55340804101 |
| Employer ID: ADVRX | Termination Date: 2022-05-31 |
| Contract Record ID: 55340804101 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 219301 | Status: COMPLETE |
| Request Date: 2022-05-11 | Status Date: 2022-05-11 |
| Member Name: VANESSA MARSTERS | Member ID: 38222409502 |
| Employer ID: APRES | Termination Date: 2022-05-11 |
| Contract Record ID: 38222409501 | Term Reason: DIVORCE FROM EMPLOYEE |
| Comments: |
|
| Request ID: 219604 | Status: COMPLETE |
| Request Date: 2022-05-12 | Status Date: 2022-05-12 |
| Member Name: MARK KELLOGG | Member ID: 28857923601 |
| Employer ID: YHP00158 | Termination Date: 2022-05-06 |
| Contract Record ID: 28857923601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 219607 | Status: COMPLETE |
| Request Date: 2022-05-12 | Status Date: 2022-05-12 |
| Member Name: CHRISTIAN FURMAN | Member ID: 69214745301 |
| Employer ID: YHP00015 | Termination Date: 2022-04-18 |
| Contract Record ID: 69214745301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 219922 | Status: COMPLETE |
| Request Date: 2022-05-16 | Status Date: 2022-05-16 |
| Member Name: ANTHONY KNIPPEL | Member ID: 34743202801 |
| Employer ID: WCE | Termination Date: 2022-05-20 |
| Contract Record ID: 34743202801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 220081 | Status: COMPLETE |
| Request Date: 2022-05-17 | Status Date: 2022-05-17 |
| Member Name: ANTHONY KNIPPEL | Member ID: 34743202801 |
| Employer ID: WCE | Termination Date: 2022-05-20 |
| Contract Record ID: 34743202801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 220141 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: ANTHONY PORFIDIO | Member ID: 72093386701 |
| Employer ID: ASSI | Termination Date: 2022-05-06 |
| Contract Record ID: 72093386701 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220142 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: ARLENE D ROGERS | Member ID: 55846952501 |
| Employer ID: ASSI | Termination Date: 2022-05-06 |
| Contract Record ID: 55846952501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220143 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: CARLOS A COLON | Member ID: 21865211401 |
| Employer ID: ASSI | Termination Date: 2022-05-04 |
| Contract Record ID: 21865211401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220144 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: DANIEL J MULVEY | Member ID: 44972097801 |
| Employer ID: ASSI | Termination Date: 2022-05-09 |
| Contract Record ID: 44972097801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220145 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: DAWN M POGANIK | Member ID: 82023255801 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 82023255801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220146 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: DENNIS MARTINEZ | Member ID: 41043080401 |
| Employer ID: ASSI | Termination Date: 2022-05-07 |
| Contract Record ID: 41043080401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220147 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: EDWIN RIVAS | Member ID: 50770721301 |
| Employer ID: ASSI | Termination Date: 2022-05-09 |
| Contract Record ID: 50770721301 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220148 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: GARY WHITAKER | Member ID: 15886516501 |
| Employer ID: ASSI | Termination Date: 2022-05-09 |
| Contract Record ID: 15886516501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220149 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: GEORGE P TRIANTIS | Member ID: 60719628701 |
| Employer ID: ASSI | Termination Date: 2022-05-09 |
| Contract Record ID: 60719628701 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220150 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: GREGORY WHITTINGTON | Member ID: 38973097901 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 38973097901 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220151 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: HECTOR L CARABALLO | Member ID: 81517929401 |
| Employer ID: ASSI | Termination Date: 2022-05-05 |
| Contract Record ID: 81517929401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220152 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: HECTOR L CARABALLO | Member ID: 81517929401 |
| Employer ID: ASSI | Termination Date: 2022-05-05 |
| Contract Record ID: 81517929401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220153 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: HERMINIO APONTE | Member ID: 24440486401 |
| Employer ID: ASSI | Termination Date: 2022-05-04 |
| Contract Record ID: 24440486401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220154 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JANET M PELOSI | Member ID: 93106098501 |
| Employer ID: ASSI | Termination Date: 2022-05-07 |
| Contract Record ID: 93106098501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220155 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JOHN J SADLER | Member ID: 43418774401 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 43418774401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220156 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JOHN J SADLER | Member ID: 43418774401 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 43418774401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220157 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JORGE L CHICO | Member ID: 72387498001 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 72387498001 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220158 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JOSEPH SERRANO | Member ID: 23278166501 |
| Employer ID: ASSI | Termination Date: 2022-05-10 |
| Contract Record ID: 23278166501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220159 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JOSEPH SERRANO | Member ID: 23278166501 |
| Employer ID: ASSI | Termination Date: 2022-05-10 |
| Contract Record ID: 23278166501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220160 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JUAN REYES | Member ID: 41957743301 |
| Employer ID: ASSI | Termination Date: 2022-05-08 |
| Contract Record ID: 41957743301 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220161 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: LAWRENCE J ARATO | Member ID: 30276617801 |
| Employer ID: ASSI | Termination Date: 2022-03-25 |
| Contract Record ID: 30276617801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220162 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: MILDRED PALMER | Member ID: 62951057401 |
| Employer ID: ASSI | Termination Date: 2022-05-05 |
| Contract Record ID: 62951057401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220163 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: NANCY Y MALDONADO | Member ID: 59289012801 |
| Employer ID: ASSI | Termination Date: 2022-05-05 |
| Contract Record ID: 59289012801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220165 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: NINO A LAMA | Member ID: 77063426801 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 77063426801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220166 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: NINO A LAMA | Member ID: 77063426801 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 77063426801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220167 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: PHILIP J SIMONIS | Member ID: 66045501301 |
| Employer ID: ASSI | Termination Date: 2022-05-10 |
| Contract Record ID: 66045501301 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220168 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: RICHARD FRESHKO | Member ID: 74096399101 |
| Employer ID: ASSI | Termination Date: 2022-05-10 |
| Contract Record ID: 74096399101 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220169 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: SCOTT W MACKAY | Member ID: 35577235101 |
| Employer ID: ASSI | Termination Date: 2022-05-06 |
| Contract Record ID: 35577235101 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220170 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: THOMAS C MAY | Member ID: 85758825401 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 85758825401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220171 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: TROY OVERTON | Member ID: 54849352401 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 54849352401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220173 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: ADRIAN S REILLY | Member ID: 28574177401 |
| Employer ID: ASSI | Termination Date: 2022-05-12 |
| Contract Record ID: 28574177401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220174 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JOHN V AUGERI | Member ID: 30781602801 |
| Employer ID: ASSI | Termination Date: 2022-05-13 |
| Contract Record ID: 30781602801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220175 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: WILLIAM WILSON | Member ID: 51756760701 |
| Employer ID: ASSI | Termination Date: 2022-05-13 |
| Contract Record ID: 51756760701 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220176 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: ARTHUR R PALMER | Member ID: 82403117701 |
| Employer ID: ASSI | Termination Date: 2022-05-09 |
| Contract Record ID: 82403117701 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220182 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JAMES L SCHERER | Member ID: 15744442801 |
| Employer ID: ASSI | Termination Date: 2022-05-16 |
| Contract Record ID: 15744442801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220183 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: DANIEL K MEJIAS | Member ID: 15467057101 |
| Employer ID: ASSI | Termination Date: 2022-05-16 |
| Contract Record ID: 15467057101 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220184 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: DANIEL K MEJIAS | Member ID: 15467057101 |
| Employer ID: ASSI | Termination Date: 2022-05-16 |
| Contract Record ID: 15467057101 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220185 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: EDWARD A THOMAS | Member ID: 64976126501 |
| Employer ID: ASSI | Termination Date: 2022-05-18 |
| Contract Record ID: 64976126501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220186 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: ORLANDO PEREZ | Member ID: 23928384501 |
| Employer ID: ASSI | Termination Date: 2022-05-18 |
| Contract Record ID: 23928384501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220187 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: ANTHONY J BONANNO | Member ID: 88938808901 |
| Employer ID: ASSI | Termination Date: 2022-05-16 |
| Contract Record ID: 88938808901 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220188 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JERRY R THOMAS | Member ID: 00505315801 |
| Employer ID: ASSI | Termination Date: 2022-05-12 |
| Contract Record ID: 00505315801 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220189 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: JACOB A HERNANDEZ | Member ID: 37880135001 |
| Employer ID: ASSI | Termination Date: 2022-05-16 |
| Contract Record ID: 37880135001 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220190 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: BASIL M KOMONDOREA | Member ID: 59511054001 |
| Employer ID: ASSI | Termination Date: 2022-05-09 |
| Contract Record ID: 59511054001 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220191 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: BASIL M KOMONDOREA | Member ID: 59511054001 |
| Employer ID: ASSI | Termination Date: 2022-05-09 |
| Contract Record ID: 59511054001 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220201 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: MANUEL CRUZ | Member ID: 73554282301 |
| Employer ID: ASSI | Termination Date: 2022-05-14 |
| Contract Record ID: 73554282301 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220221 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: MANUEL CRUZ | Member ID: 73554282301 |
| Employer ID: ASSI | Termination Date: 2022-05-14 |
| Contract Record ID: 73554282301 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 220241 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: TONI R DEMEO | Member ID: 03213988701 |
| Employer ID: ASSI | Termination Date: 2022-05-12 |
| Contract Record ID: 03213988701 | Term Reason: VOLUNTARY |
| Comments: WAIVER |
|
| Request ID: 220321 | Status: COMPLETE |
| Request Date: 2022-05-18 | Status Date: 2022-05-18 |
| Member Name: WHISPER JEAN COULSON | Member ID: 59035252501 |
| Employer ID: YHP00263 | Termination Date: 2022-05-31 |
| Contract Record ID: 59035252501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 220541 | Status: COMPLETE |
| Request Date: 2022-05-19 | Status Date: 2022-05-19 |
| Member Name: LISA MARIE GAIL | Member ID: 66696377501 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 66696377501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 220621 | Status: COMPLETE |
| Request Date: 2022-05-19 | Status Date: 2022-05-19 |
| Member Name: LYNANN CAROL STEPHENS | Member ID: 86953310601 |
| Employer ID: LNB | Termination Date: 2022-05-31 |
| Contract Record ID: 86953310601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 220641 | Status: COMPLETE |
| Request Date: 2022-05-19 | Status Date: 2022-05-19 |
| Member Name: KIMBERLY MEREDITH | Member ID: 39105179602 |
| Employer ID: LNB | Termination Date: 2022-05-31 |
| Contract Record ID: 39105179601 | Term Reason: DIVORCE FROM EMPLOYEE |
| Comments: Please file with Cobra |
|
| Request ID: 220661 | Status: COMPLETE |
| Request Date: 2022-05-19 | Status Date: 2022-05-19 |
| Member Name: AMY J ROTEN | Member ID: 48592062201 |
| Employer ID: LNB | Termination Date: 2022-05-31 |
| Contract Record ID: 48592062201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 220681 | Status: COMPLETE |
| Request Date: 2022-05-19 | Status Date: 2022-05-19 |
| Member Name: MAKAYLA L MCCRADY | Member ID: 94545638101 |
| Employer ID: LNB | Termination Date: 2022-05-31 |
| Contract Record ID: 94545638101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 220941 | Status: COMPLETE |
| Request Date: 2022-05-20 | Status Date: 2022-05-20 |
| Member Name: JASON B DAVIS | Member ID: 16363643701 |
| Employer ID: DAVIS | Termination Date: 2022-05-31 |
| Contract Record ID: 16363643701 | Term Reason: VOLUNTARY |
| Comments: Termed employment |
|
| Request ID: 221201 | Status: COMPLETE |
| Request Date: 2022-05-23 | Status Date: 2022-05-23 |
| Member Name: RUTH THOMAS | Member ID: 45463588701 |
| Employer ID: BRANDY | Termination Date: 2022-03-31 |
| Contract Record ID: 45463588701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 221202 | Status: COMPLETE |
| Request Date: 2022-05-23 | Status Date: 2022-05-23 |
| Member Name: VALGARION L MOSLEY | Member ID: 22384206201 |
| Employer ID: BRANDY | Termination Date: 2022-03-31 |
| Contract Record ID: 22384206201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 221761 | Status: COMPLETE |
| Request Date: 2022-05-24 | Status Date: 2022-05-24 |
| Member Name: OKTAY BAYRAMI | Member ID: 58167868304 |
| Employer ID: TPCH | Termination Date: 2022-04-30 |
| Contract Record ID: 58167868301 | Term Reason: LOSS OF DEPENDANT STATUS |
| Comments: |
|
| Request ID: 221762 | Status: COMPLETE |
| Request Date: 2022-05-24 | Status Date: 2022-05-24 |
| Member Name: MELAKH BAYRAMI | Member ID: 58167868303 |
| Employer ID: TPCH | Termination Date: 2022-04-30 |
| Contract Record ID: 58167868301 | Term Reason: LOSS OF DEPENDANT STATUS |
| Comments: |
|
| Request ID: 221921 | Status: COMPLETE |
| Request Date: 2022-05-25 | Status Date: 2022-05-25 |
| Member Name: EDDIE THOMAS BECK | Member ID: 95220788301 |
| Employer ID: DNA | Termination Date: 2022-05-04 |
| Contract Record ID: 95220788301 | Term Reason: VOLUNTARY |
| Comments: Employment term on 5/4/2022. Coverage ends on 5/31/2022.
First Day of no coverage is 6/1/2022.
Please process this cancellation accordingly.
Thank you.
Dawn Broderick
Eligibility Specialist - Employee Benefits
Presidio
55 Shuman Blvd. Suite 900
Naperville, IL 60563
D 630.524.6122
F 630.524.6123
E dbroderick@presidiogrp.com
www.Presidiogrp.com
Acrisure Agency Partner |
|
| Request ID: 222043 | Status: COMPLETE |
| Request Date: 2022-05-25 | Status Date: 2022-05-25 |
| Member Name: CAROL A MARTIN | Member ID: 87655979901 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 87655979901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 222044 | Status: COMPLETE |
| Request Date: 2022-05-25 | Status Date: 2022-05-25 |
| Member Name: JOSEPH MALLOQUE | Member ID: 34844861401 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 34844861401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 222045 | Status: COMPLETE |
| Request Date: 2022-05-25 | Status Date: 2022-05-25 |
| Member Name: KIANA L JENSEN | Member ID: 95079707601 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 95079707601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 222046 | Status: COMPLETE |
| Request Date: 2022-05-25 | Status Date: 2022-05-25 |
| Member Name: MELAYNA TOWNSEND FALCK | Member ID: 60381427901 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 60381427901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 222102 | Status: COMPLETE |
| Request Date: 2022-05-25 | Status Date: 2022-05-25 |
| Member Name: CAMERON EZEFF | Member ID: 43768889501 |
| Employer ID: COS | Termination Date: 2022-05-04 |
| Contract Record ID: 43768889501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 222141 | Status: COMPLETE |
| Request Date: 2022-05-25 | Status Date: 2022-05-25 |
| Member Name: DENICE BELL | Member ID: 95516091802 |
| Employer ID: COS | Termination Date: 2022-05-01 |
| Contract Record ID: 95516091801 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 222361 | Status: COMPLETE |
| Request Date: 2022-05-26 | Status Date: 2022-05-26 |
| Member Name: WILLIAM HERNANDEZ | Member ID: 50741491801 |
| Employer ID: DNA | Termination Date: 2022-05-31 |
| Contract Record ID: 50741491801 | Term Reason: VOLUNTARY |
| Comments: Employee class changed from Manager to All Others on 5/16/2022, resulting in a significant increase in employee cost for the medical coverage. The EE elected to drop the coverage based on this class change. |
|
| Request ID: 222561 | Status: COMPLETE |
| Request Date: 2022-05-27 | Status Date: 2022-05-27 |
| Member Name: DOROTHY A MELLONE | Member ID: 61746671901 |
| Employer ID: ASSI | Termination Date: 2022-05-19 |
| Contract Record ID: 61746671901 | Term Reason: VOLUNTARY |
| Comments: submit waiver |
|
| Request ID: 222581 | Status: COMPLETE |
| Request Date: 2022-05-27 | Status Date: 2022-05-27 |
| Member Name: JOHNNY L MOTZ | Member ID: 22809654401 |
| Employer ID: ASSI | Termination Date: 2022-05-20 |
| Contract Record ID: 22809654401 | Term Reason: TERMINATION |
| Comments: waiver |
|
| Request ID: 222601 | Status: COMPLETE |
| Request Date: 2022-05-27 | Status Date: 2022-05-27 |
| Member Name: MARK J MAZZELLA | Member ID: 07083177601 |
| Employer ID: ASSI | Termination Date: 2022-05-19 |
| Contract Record ID: 07083177601 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 222721 | Status: COMPLETE |
| Request Date: 2022-05-27 | Status Date: 2022-05-27 |
| Member Name: WILLIAM F KUNTZ | Member ID: 16581703501 |
| Employer ID: ASSI | Termination Date: 2022-02-25 |
| Contract Record ID: 16581703501 | Term Reason: TERMINATION |
| Comments: awol |
|
| Request ID: 222861 | Status: COMPLETE |
| Request Date: 2022-05-27 | Status Date: 2022-05-27 |
| Member Name: ANTHONY ADAMS | Member ID: 98406865201 |
| Employer ID: TPCH | Termination Date: 2022-05-06 |
| Contract Record ID: 98406865201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 222881 | Status: COMPLETE |
| Request Date: 2022-05-27 | Status Date: 2022-05-27 |
| Member Name: MARIE BELLIS | Member ID: 05135902901 |
| Employer ID: TPCH | Termination Date: 2022-05-02 |
| Contract Record ID: 05135902901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 223041 | Status: COMPLETE |
| Request Date: 2022-05-31 | Status Date: 2022-05-31 |
| Member Name: JESSICA SHORT | Member ID: 42844210701 |
| Employer ID: CNT | Termination Date: 2022-05-31 |
| Contract Record ID: 42844210701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 223461 | Status: COMPLETE |
| Request Date: 2022-06-01 | Status Date: 2022-06-01 |
| Member Name: TOMMI SUE JOHNSON | Member ID: 05713976501 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 05713976501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 223481 | Status: COMPLETE |
| Request Date: 2022-06-01 | Status Date: 2022-06-01 |
| Member Name: JESSI TURNER | Member ID: 77502456801 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 77502456801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 223501 | Status: COMPLETE |
| Request Date: 2022-06-01 | Status Date: 2022-06-01 |
| Member Name: KIMBERLY A MITCHELL | Member ID: 54821434901 |
| Employer ID: SFM | Termination Date: 2022-05-31 |
| Contract Record ID: 54821434901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 224322 | Status: COMPLETE |
| Request Date: 2022-06-03 | Status Date: 2022-06-03 |
| Member Name: DESTINEY BEAL | Member ID: 49945138401 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 49945138401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 224642 | Status: COMPLETE |
| Request Date: 2022-06-06 | Status Date: 2022-06-06 |
| Member Name: AURELIO DIAZ RAMOS | Member ID: 17475269301 |
| Employer ID: MESH | Termination Date: 2022-05-28 |
| Contract Record ID: 17475269301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 224643 | Status: COMPLETE |
| Request Date: 2022-06-06 | Status Date: 2022-06-06 |
| Member Name: CALI ADAMSON | Member ID: 67291416601 |
| Employer ID: BRULE | Termination Date: 2022-07-31 |
| Contract Record ID: 67291416601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 224721 | Status: COMPLETE |
| Request Date: 2022-06-07 | Status Date: 2022-06-07 |
| Member Name: ROBERT BONAVITA | Member ID: 70126383801 |
| Employer ID: MESH | Termination Date: 2022-06-03 |
| Contract Record ID: 70126383801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 224801 | Status: COMPLETE |
| Request Date: 2022-06-07 | Status Date: 2022-06-07 |
| Member Name: DAWN M PURSER | Member ID: 36136799501 |
| Employer ID: TPCH | Termination Date: 2022-04-30 |
| Contract Record ID: 36136799501 | Term Reason: TERMINATION |
| Comments: Need credit for May, June |
|
| Request ID: 224861 | Status: COMPLETE |
| Request Date: 2022-06-07 | Status Date: 2022-06-07 |
| Member Name: CECELIA IRIZARRY | Member ID: 50532378001 |
| Employer ID: PELTZ | Termination Date: 2022-05-31 |
| Contract Record ID: 50532378001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 225101 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: DUANE LITZAU | Member ID: 25428519801 |
| Employer ID: YHP00015 | Termination Date: 2022-05-19 |
| Contract Record ID: 25428519801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 225201 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: DOROTHY A MELLONE | Member ID: 61746671901 |
| Employer ID: ASSI | Termination Date: 2022-05-19 |
| Contract Record ID: 61746671901 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 225221 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: MARC J CATHCART | Member ID: 89803026901 |
| Employer ID: ASSI | Termination Date: 2022-05-18 |
| Contract Record ID: 89803026901 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 225241 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: JOHNNY L MOTZ | Member ID: 22809654401 |
| Employer ID: ASSI | Termination Date: 2022-05-20 |
| Contract Record ID: 22809654401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 225261 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: MARK J MAZZELLA | Member ID: 07083177601 |
| Employer ID: ASSI | Termination Date: 2022-05-19 |
| Contract Record ID: 07083177601 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 225281 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: DOROTHY A MELLONE | Member ID: 61746671901 |
| Employer ID: ASSI | Termination Date: 2022-05-19 |
| Contract Record ID: 61746671901 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 225301 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: MATT VOEGTLI | Member ID: 42508605101 |
| Employer ID: WCE | Termination Date: 2022-06-24 |
| Contract Record ID: 42508605101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 225321 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: JAIME GUERRERO | Member ID: 65213895101 |
| Employer ID: WCE | Termination Date: 2022-06-24 |
| Contract Record ID: 65213895101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 225441 | Status: COMPLETE |
| Request Date: 2022-06-08 | Status Date: 2022-06-08 |
| Member Name: JENNIFER L SHELTON | Member ID: 41854646501 |
| Employer ID: TPCH | Termination Date: 2022-05-31 |
| Contract Record ID: 41854646501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 225461 | Status: COMPLETE |
| Request Date: 2022-06-09 | Status Date: 2022-06-09 |
| Member Name: JOSEPH R ALEXANDER | Member ID: 06726411501 |
| Employer ID: BRANDY | Termination Date: 2022-05-31 |
| Contract Record ID: 06726411501 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 225841 | Status: COMPLETE |
| Request Date: 2022-06-10 | Status Date: 2022-06-10 |
| Member Name: SUSAN CRAIG | Member ID: 55960063901 |
| Employer ID: DNA | Termination Date: 2022-07-01 |
| Contract Record ID: 55960063901 | Term Reason: VOLUNTARY |
| Comments: Last day of coverage is 6/30/2022. Please terminate policy accordingly. Thank you. |
|
| Request ID: 225861 | Status: COMPLETE |
| Request Date: 2022-06-10 | Status Date: 2022-06-10 |
| Member Name: THUY-TRANG T HAHN | Member ID: 44113011101 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 44113011101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 225862 | Status: COMPLETE |
| Request Date: 2022-06-10 | Status Date: 2022-06-10 |
| Member Name: RHEA DE RAMA-PARAYNO | Member ID: 00194269101 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 00194269101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 225863 | Status: COMPLETE |
| Request Date: 2022-06-10 | Status Date: 2022-06-10 |
| Member Name: BILLIE JUDD | Member ID: 36721358101 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 36721358101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 225921 | Status: COMPLETE |
| Request Date: 2022-06-13 | Status Date: 2022-06-13 |
| Member Name: MATT VOEGTLI | Member ID: 42508605101 |
| Employer ID: WCE | Termination Date: 2022-06-27 |
| Contract Record ID: 42508605101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 225961 | Status: COMPLETE |
| Request Date: 2022-06-13 | Status Date: 2022-06-13 |
| Member Name: PATRICIA SUROVIC | Member ID: 51778781001 |
| Employer ID: APRES | Termination Date: 2022-06-30 |
| Contract Record ID: 51778781001 | Term Reason: VOLUNTARY |
| Comments: Cancelling COBRA coverage, has other coverage now |
|
| Request ID: 226021 | Status: COMPLETE |
| Request Date: 2022-06-13 | Status Date: 2022-06-13 |
| Member Name: APRIL HOFF | Member ID: 69067198401 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 69067198401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226561 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: JASON B DAVIS | Member ID: 16363643701 |
| Employer ID: DAVIS | Termination Date: 2022-06-01 |
| Contract Record ID: 16363643701 | Term Reason: VOLUNTARY |
| Comments: this is a test |
|
| Request ID: 226601 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: ASHLEY OSINSKI | Member ID: 93930812301 |
| Employer ID: CCRAFT | Termination Date: 2022-02-01 |
| Contract Record ID: 93930812301 | Term Reason: VOLUNTARY |
| Comments: Ashley left the company back in February. |
|
| Request ID: 226621 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: ANTHONY ADAMS | Member ID: 98406865201 |
| Employer ID: TPCH | Termination Date: 2022-05-05 |
| Contract Record ID: 98406865201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226641 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: MALISSA M AITON | Member ID: 71878344301 |
| Employer ID: TPCH | Termination Date: 2022-04-30 |
| Contract Record ID: 71878344301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226661 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: AUDREY ANGELBECK | Member ID: 13648131201 |
| Employer ID: TPCH | Termination Date: 2022-05-27 |
| Contract Record ID: 13648131201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226701 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: JACK FREDERICKS | Member ID: 63772596201 |
| Employer ID: TPCH | Termination Date: 2022-04-30 |
| Contract Record ID: 63772596201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226721 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: LORA A JOHNSON | Member ID: 42406124601 |
| Employer ID: TPCH | Termination Date: 2022-03-27 |
| Contract Record ID: 42406124601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226741 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: ALISSA N LANGWORTHY | Member ID: 33263184301 |
| Employer ID: TPCH | Termination Date: 2022-05-31 |
| Contract Record ID: 33263184301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226761 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: CHARLES LESLIE | Member ID: 36275525501 |
| Employer ID: TPCH | Termination Date: 2022-06-08 |
| Contract Record ID: 36275525501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 226841 | Status: COMPLETE |
| Request Date: 2022-06-15 | Status Date: 2022-06-15 |
| Member Name: LOREN ANNE RAMSEY | Member ID: 99395401301 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 99395401301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 227121 | Status: COMPLETE |
| Request Date: 2022-06-16 | Status Date: 2022-06-16 |
| Member Name: MEDHAT H SANAD | Member ID: 13561816401 |
| Employer ID: TPCH | Termination Date: 2022-04-01 |
| Contract Record ID: 13561816401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 227161 | Status: COMPLETE |
| Request Date: 2022-06-16 | Status Date: 2022-06-16 |
| Member Name: AMY HALL | Member ID: 66996420401 |
| Employer ID: VAUGHAN | Termination Date: 2022-05-12 |
| Contract Record ID: 66996420401 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 227341 | Status: COMPLETE |
| Request Date: 2022-06-17 | Status Date: 2022-06-17 |
| Member Name: JEFFREY LESTER | Member ID: 03737813201 |
| Employer ID: MESH | Termination Date: 2022-06-12 |
| Contract Record ID: 03737813201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 227422 | Status: COMPLETE |
| Request Date: 2022-06-17 | Status Date: 2022-06-17 |
| Member Name: HAILEY DAWN DIESSNER | Member ID: 61865419201 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 61865419201 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 227461 | Status: COMPLETE |
| Request Date: 2022-06-17 | Status Date: 2022-06-17 |
| Member Name: MICHELE REINA | Member ID: 77269562701 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 77269562701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 227481 | Status: COMPLETE |
| Request Date: 2022-06-17 | Status Date: 2022-06-17 |
| Member Name: ADELAIDA SABLAON | Member ID: 79540708701 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 79540708701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 227501 | Status: COMPLETE |
| Request Date: 2022-06-17 | Status Date: 2022-06-17 |
| Member Name: EVAN SPURGEON | Member ID: 57534560901 |
| Employer ID: BROSOL | Termination Date: 2022-05-31 |
| Contract Record ID: 57534560901 | Term Reason: VOLUNTARY |
| Comments: Evan resigned. His last day was 5/26/2022 |
|
| Request ID: 227941 | Status: COMPLETE |
| Request Date: 2022-06-21 | Status Date: 2022-06-21 |
| Member Name: EVAN HAGANMAN | Member ID: 55475437901 |
| Employer ID: PELTZ | Termination Date: 2022-05-13 |
| Contract Record ID: 55475437901 | Term Reason: TERMINATION |
| Comments: Please note this employees coverage never went into effect for 7.1.2022, as they terminated 5.13.2022 |
|
| Request ID: 228381 | Status: COMPLETE |
| Request Date: 2022-06-22 | Status Date: 2022-06-22 |
| Member Name: MCKENZIE MOBERG | Member ID: 38879180901 |
| Employer ID: VAUGHAN | Termination Date: 2022-06-20 |
| Contract Record ID: 38879180901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 228901 | Status: COMPLETE |
| Request Date: 2022-06-24 | Status Date: 2022-06-24 |
| Member Name: STEPHANNEE SCHWINGER | Member ID: 70641715101 |
| Employer ID: YHP00116 | Termination Date: 2022-05-31 |
| Contract Record ID: 70641715101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 228941 | Status: COMPLETE |
| Request Date: 2022-06-24 | Status Date: 2022-06-24 |
| Member Name: TRISTON HUNTER BARRETT | Member ID: 55728432801 |
| Employer ID: YHP00134 | Termination Date: 2022-06-06 |
| Contract Record ID: 55728432801 | Term Reason: VOLUNTARY |
| Comments: PROMOTED TO ASSISTANT RGM. OFFERED/ACCEPTED OTHER COVERAGE |
|
| Request ID: 229161 | Status: COMPLETE |
| Request Date: 2022-06-26 | Status Date: 2022-06-26 |
| Member Name: ROBERT J MILLER | Member ID: 64985384101 |
| Employer ID: WCE | Termination Date: 2022-06-21 |
| Contract Record ID: 64985384101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 229201 | Status: COMPLETE |
| Request Date: 2022-06-26 | Status Date: 2022-06-26 |
| Member Name: MEGAN L UNDERWOOD | Member ID: 08255778201 |
| Employer ID: LNB | Termination Date: 2022-06-30 |
| Contract Record ID: 08255778201 | Term Reason: TERMINATION |
| Comments: Address is actually 9635 New Jackson Hwy, employees last day is 6/29/22 |
|
| Request ID: 229382 | Status: COMPLETE |
| Request Date: 2022-06-27 | Status Date: 2022-06-27 |
| Member Name: COLLTON BECK | Member ID: 73499476801 |
| Employer ID: BRULE | Termination Date: 2022-07-31 |
| Contract Record ID: 73499476801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 229383 | Status: COMPLETE |
| Request Date: 2022-06-27 | Status Date: 2022-06-27 |
| Member Name: TORY ENGEL | Member ID: 65397972401 |
| Employer ID: BRULE | Termination Date: 2022-08-31 |
| Contract Record ID: 65397972401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 229621 | Status: COMPLETE |
| Request Date: 2022-06-28 | Status Date: 2022-06-28 |
| Member Name: ANDY ROMERO | Member ID: 56380140401 |
| Employer ID: BRECK | Termination Date: 2022-05-31 |
| Contract Record ID: 56380140401 | Term Reason: VOLUNTARY |
| Comments: Other employment |
|
| Request ID: 229641 | Status: COMPLETE |
| Request Date: 2022-06-28 | Status Date: 2022-06-28 |
| Member Name: CARTER GRAVES | Member ID: 71573053101 |
| Employer ID: BRECKS | Termination Date: 2022-03-31 |
| Contract Record ID: 71573053101 | Term Reason: TERMINATION |
| Comments: other employment |
|
| Request ID: 229661 | Status: COMPLETE |
| Request Date: 2022-06-28 | Status Date: 2022-06-28 |
| Member Name: MATTHEW HRYNIEWICZ | Member ID: 45440772601 |
| Employer ID: BRECK | Termination Date: 2022-06-30 |
| Contract Record ID: 45440772601 | Term Reason: VOLUNTARY |
| Comments: other employment |
|
| Request ID: 229921 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: KAILYN HAMMERLING | Member ID: 75301484101 |
| Employer ID: YHP00116 | Termination Date: 2022-06-29 |
| Contract Record ID: 75301484101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 230041 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: KIMBERLY ANN THOMPSON | Member ID: 25434900001 |
| Employer ID: FIRSTCUP | Termination Date: 2022-03-19 |
| Contract Record ID: 25434900001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230042 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: JESSIE LE CALL | Member ID: 37373389301 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 37373389301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230043 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: BRIGETTE LANGKILDE | Member ID: 89136382001 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 89136382001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230044 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: CASSIE HANSON | Member ID: 23887390401 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 23887390401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230045 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: SERAH MUTHONI NGANGA | Member ID: 13834141101 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 13834141101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230046 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: KEVIN HAMLET | Member ID: 82722432701 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 82722432701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230047 | Status: COMPLETE |
| Request Date: 2022-06-29 | Status Date: 2022-06-29 |
| Member Name: HUNTER STUTZ | Member ID: 78902732601 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 78902732601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230161 | Status: COMPLETE |
| Request Date: 2022-06-30 | Status Date: 2022-06-30 |
| Member Name: DYLAN M COMPTON | Member ID: 83289943301 |
| Employer ID: BROSOL | Termination Date: 2022-06-30 |
| Contract Record ID: 83289943301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230162 | Status: COMPLETE |
| Request Date: 2022-06-30 | Status Date: 2022-06-30 |
| Member Name: AMANDA MOORE | Member ID: 49137842601 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 49137842601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230163 | Status: COMPLETE |
| Request Date: 2022-06-30 | Status Date: 2022-06-30 |
| Member Name: LINDA COLLINS | Member ID: 60437492101 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 60437492101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230261 | Status: COMPLETE |
| Request Date: 2022-06-30 | Status Date: 2022-06-30 |
| Member Name: MICHAEL CALVENTE | Member ID: 44394046201 |
| Employer ID: ASSI | Termination Date: 2022-06-14 |
| Contract Record ID: 44394046201 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 230281 | Status: COMPLETE |
| Request Date: 2022-06-30 | Status Date: 2022-06-30 |
| Member Name: KIMBERLY ARLLYN CERVANTES | Member ID: 79094657001 |
| Employer ID: FIRSTCUP | Termination Date: 2022-02-28 |
| Contract Record ID: 79094657001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230301 | Status: COMPLETE |
| Request Date: 2022-06-30 | Status Date: 2022-06-30 |
| Member Name: KIMBERLY ANN THOMPSON | Member ID: 25434900001 |
| Employer ID: FIRSTCUP | Termination Date: 2022-03-19 |
| Contract Record ID: 25434900001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230421 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: CODY BURGIN | Member ID: 50084849601 |
| Employer ID: APRES | Termination Date: 2022-06-30 |
| Contract Record ID: 50084849601 | Term Reason: VOLUNTARY |
| Comments: Drop coverage - other coverage |
|
| Request ID: 230441 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: TYLER FIELDS | Member ID: 50084849603 |
| Employer ID: APRES | Termination Date: 2022-06-30 |
| Contract Record ID: 50084849601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 230461 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: CAYLEB BURGIN | Member ID: 50084849604 |
| Employer ID: APRES | Termination Date: 2022-06-30 |
| Contract Record ID: 50084849601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 230481 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: FAYTH BURGIN | Member ID: 50084849602 |
| Employer ID: APRES | Termination Date: 2022-06-30 |
| Contract Record ID: 50084849601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 230621 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: JULIE A LARGE | Member ID: 63968768801 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 63968768801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230701 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: NICOLE HINDS | Member ID: 72883556001 |
| Employer ID: PELTZ | Termination Date: 2022-07-31 |
| Contract Record ID: 72883556001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230722 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: JEFFREY HOLCOMB | Member ID: 03395155501 |
| Employer ID: YHP00049 | Termination Date: 2022-06-23 |
| Contract Record ID: 03395155501 | Term Reason: VOLUNTARY |
| Comments: Resigned for better job |
|
| Request ID: 230723 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: NICOLE HINDS | Member ID: 72883556001 |
| Employer ID: PELTZ | Termination Date: 2022-07-31 |
| Contract Record ID: 72883556001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230724 | Status: COMPLETE |
| Request Date: 2022-07-01 | Status Date: 2022-07-01 |
| Member Name: LISA THOMPSON | Member ID: 45256727201 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 45256727201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 230781 | Status: COMPLETE |
| Request Date: 2022-07-02 | Status Date: 2022-07-02 |
| Member Name: ANGELA REED-BECKER | Member ID: 84600695001 |
| Employer ID: DNA | Termination Date: 2022-07-31 |
| Contract Record ID: 84600695001 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 231063 | Status: COMPLETE |
| Request Date: 2022-07-05 | Status Date: 2022-07-05 |
| Member Name: SHAUN JOHNSON | Member ID: 77646109501 |
| Employer ID: BRECK | Termination Date: 2022-06-30 |
| Contract Record ID: 77646109501 | Term Reason: VOLUNTARY |
| Comments: Please send COBRA lettter |
|
| Request ID: 231202 | Status: COMPLETE |
| Request Date: 2022-07-05 | Status Date: 2022-07-05 |
| Member Name: TORY ENGEL | Member ID: 65397972401 |
| Employer ID: BRULE | Termination Date: 2022-08-31 |
| Contract Record ID: 65397972401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 231504 | Status: COMPLETE |
| Request Date: 2022-07-06 | Status Date: 2022-07-06 |
| Member Name: AARON GUZMAN | Member ID: 28364176101 |
| Employer ID: CLEAR | Termination Date: 2022-06-30 |
| Contract Record ID: 28364176101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 231722 | Status: COMPLETE |
| Request Date: 2022-07-07 | Status Date: 2022-07-07 |
| Member Name: KORI DUNNING | Member ID: 79254071701 |
| Employer ID: CLEAR | Termination Date: 2022-06-01 |
| Contract Record ID: 79254071701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 232021 | Status: COMPLETE |
| Request Date: 2022-07-08 | Status Date: 2022-07-08 |
| Member Name: CHRISTOPHER RITCHIE | Member ID: 89622529001 |
| Employer ID: ACW | Termination Date: 2022-04-30 |
| Contract Record ID: 89622529001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 232022 | Status: COMPLETE |
| Request Date: 2022-07-08 | Status Date: 2022-07-08 |
| Member Name: FRANCELI REBOLLARD | Member ID: 06400119701 |
| Employer ID: ACW | Termination Date: 2022-03-31 |
| Contract Record ID: 06400119701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 232023 | Status: COMPLETE |
| Request Date: 2022-07-08 | Status Date: 2022-07-08 |
| Member Name: CASANDRA GARZA | Member ID: 20149563801 |
| Employer ID: APRES | Termination Date: 2022-07-08 |
| Contract Record ID: 20149563801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 232041 | Status: COMPLETE |
| Request Date: 2022-07-08 | Status Date: 2022-07-08 |
| Member Name: MADELINE MARTINEZ | Member ID: 91723579101 |
| Employer ID: BRECKS | Termination Date: 2022-07-31 |
| Contract Record ID: 91723579101 | Term Reason: VOLUNTARY |
| Comments: Please email COBRA |
|
| Request ID: 232101 | Status: COMPLETE |
| Request Date: 2022-07-10 | Status Date: 2022-07-10 |
| Member Name: CHARLES RAY | Member ID: 88833724703 |
| Employer ID: TBX | Termination Date: 2022-06-30 |
| Contract Record ID: 88833724701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 232121 | Status: COMPLETE |
| Request Date: 2022-07-10 | Status Date: 2022-07-10 |
| Member Name: CHRIS DELLA SALA | Member ID: 26379287501 |
| Employer ID: TBX | Termination Date: 2022-06-30 |
| Contract Record ID: 26379287501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 232161 | Status: COMPLETE |
| Request Date: 2022-07-11 | Status Date: 2022-07-11 |
| Member Name: MORGAN TAYLOR | Member ID: 50051524601 |
| Employer ID: COS | Termination Date: 2022-07-08 |
| Contract Record ID: 50051524601 | Term Reason: TERMINATION |
| Comments: Termination of employment |
|
| Request ID: 232781 | Status: COMPLETE |
| Request Date: 2022-07-12 | Status Date: 2022-07-12 |
| Member Name: CINTHYA MONTEVERDE | Member ID: 96166821201 |
| Employer ID: AZOPT | Termination Date: 2022-07-27 |
| Contract Record ID: 96166821201 | Term Reason: TERMINATION |
| Comments: left before benefits became active |
|
| Request ID: 233121 | Status: COMPLETE |
| Request Date: 2022-07-13 | Status Date: 2022-07-13 |
| Member Name: MACY TURNER | Member ID: 63271110601 |
| Employer ID: YHP00158 | Termination Date: 2022-06-27 |
| Contract Record ID: 63271110601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 233261 | Status: COMPLETE |
| Request Date: 2022-07-14 | Status Date: 2022-07-14 |
| Member Name: THOMAS ONDRIAS | Member ID: 21783199801 |
| Employer ID: APRES | Termination Date: 2022-07-29 |
| Contract Record ID: 21783199801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 234041 | Status: COMPLETE |
| Request Date: 2022-07-18 | Status Date: 2022-07-18 |
| Member Name: HOA NGUYEN | Member ID: 75270400502 |
| Employer ID: APRES | Termination Date: 2022-07-31 |
| Contract Record ID: 75270400501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 234561 | Status: COMPLETE |
| Request Date: 2022-07-19 | Status Date: 2022-07-19 |
| Member Name: JOHN C ROGERS | Member ID: 82192819001 |
| Employer ID: ASSI | Termination Date: 2022-07-19 |
| Contract Record ID: 82192819001 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 235061 | Status: COMPLETE |
| Request Date: 2022-07-21 | Status Date: 2022-07-21 |
| Member Name: JOYCE LYNN DAVID | Member ID: 40268201501 |
| Employer ID: ADVRX | Termination Date: 2022-07-31 |
| Contract Record ID: 40268201501 | Term Reason: TERMINATION |
| Comments: Moved to a 1099 employee |
|
| Request ID: 235081 | Status: COMPLETE |
| Request Date: 2022-07-21 | Status Date: 2022-07-21 |
| Member Name: MICHAELA WARNER | Member ID: 95955835901 |
| Employer ID: ADVRX | Termination Date: 2022-07-31 |
| Contract Record ID: 95955835901 | Term Reason: TERMINATION |
| Comments: Terminated Employment --
COBRA Eligible. |
|
| Request ID: 235261 | Status: COMPLETE |
| Request Date: 2022-07-21 | Status Date: 2022-07-21 |
| Member Name: DAVID MARTINEZ | Member ID: 86254495001 |
| Employer ID: FIRSTCUP | Termination Date: 2022-04-16 |
| Contract Record ID: 86254495001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 235681 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: RICHARD OSBORNE | Member ID: 42096429701 |
| Employer ID: WCE | Termination Date: 2022-06-22 |
| Contract Record ID: 42096429701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 235721 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: PAMELA PETRAK | Member ID: 92950846701 |
| Employer ID: BRULE | Termination Date: 2022-07-22 |
| Contract Record ID: 92950846701 | Term Reason: EMPLOYEES DEATH |
| Comments: this is a test, do not term member |
|
| Request ID: 235761 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: PAMELA PETRAK | Member ID: 92950846701 |
| Employer ID: BRULE | Termination Date: 2022-07-22 |
| Contract Record ID: 92950846701 | Term Reason: |
| Comments: this is a test, do not term member |
|
| Request ID: 235801 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: PAMELA PETRAK | Member ID: 92950846701 |
| Employer ID: BRULE | Termination Date: 2022-07-01 |
| Contract Record ID: 92950846701 | Term Reason: |
| Comments: this is a test, do not term member |
|
| Request ID: 235861 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: SHELBY P SCHROEDER | Member ID: 20690592703 |
| Employer ID: CNT | Termination Date: 2022-07-31 |
| Contract Record ID: 20690592701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 235923 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: KELLY BORG | Member ID: 04617722501 |
| Employer ID: SFM | Termination Date: 2022-07-31 |
| Contract Record ID: 04617722501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 235924 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: HALEY GURR | Member ID: 98509909301 |
| Employer ID: SFM | Termination Date: 2022-07-31 |
| Contract Record ID: 98509909301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 235925 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: ANNA HEBERT | Member ID: 33267284201 |
| Employer ID: SFM | Termination Date: 2022-07-31 |
| Contract Record ID: 33267284201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 235926 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: CHRISTINA ANN KIST | Member ID: 86933732801 |
| Employer ID: SFM | Termination Date: 2022-07-31 |
| Contract Record ID: 86933732801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 235927 | Status: COMPLETE |
| Request Date: 2022-07-22 | Status Date: 2022-07-22 |
| Member Name: PHILLIP R STREETER | Member ID: 00523606101 |
| Employer ID: SFM | Termination Date: 2022-07-31 |
| Contract Record ID: 00523606101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 236323 | Status: COMPLETE |
| Request Date: 2022-07-25 | Status Date: 2022-07-25 |
| Member Name: JOHN C ROGERS | Member ID: 82192819001 |
| Employer ID: ASSI | Termination Date: 2022-07-18 |
| Contract Record ID: 82192819001 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 236324 | Status: COMPLETE |
| Request Date: 2022-07-25 | Status Date: 2022-07-25 |
| Member Name: VINCENT BROOKS | Member ID: 38664013501 |
| Employer ID: ASSI | Termination Date: 2022-06-21 |
| Contract Record ID: 38664013501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 236326 | Status: COMPLETE |
| Request Date: 2022-07-25 | Status Date: 2022-07-25 |
| Member Name: JAMES GROGAN | Member ID: 19534326701 |
| Employer ID: ASSI | Termination Date: 2022-06-07 |
| Contract Record ID: 19534326701 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 236327 | Status: COMPLETE |
| Request Date: 2022-07-25 | Status Date: 2022-07-25 |
| Member Name: GREGORY C BYRNE | Member ID: 42224829701 |
| Employer ID: ASSI | Termination Date: 2022-06-04 |
| Contract Record ID: 42224829701 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 236341 | Status: COMPLETE |
| Request Date: 2022-07-25 | Status Date: 2022-07-25 |
| Member Name: RUTESE DICKERSON | Member ID: 97323951601 |
| Employer ID: DNA | Termination Date: 2022-07-31 |
| Contract Record ID: 97323951601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236901 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: RILEY BELGARDE | Member ID: 32587595201 |
| Employer ID: TPCH | Termination Date: 2022-07-15 |
| Contract Record ID: 32587595201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236902 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: SIERRA K DECOTEAU | Member ID: 29542795501 |
| Employer ID: TPCH | Termination Date: 2022-07-01 |
| Contract Record ID: 29542795501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236903 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: BRAD IVES | Member ID: 79635734101 |
| Employer ID: TPCH | Termination Date: 2022-06-30 |
| Contract Record ID: 79635734101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236904 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: TYLER L IVES | Member ID: 83939548801 |
| Employer ID: TPCH | Termination Date: 2022-06-20 |
| Contract Record ID: 83939548801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236905 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: TANNER E IVES | Member ID: 15447296801 |
| Employer ID: TPCH | Termination Date: 2022-06-20 |
| Contract Record ID: 15447296801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236906 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: TATYANA JACOBS | Member ID: 80911311801 |
| Employer ID: TPCH | Termination Date: 2022-07-18 |
| Contract Record ID: 80911311801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236907 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: KELLI MCDONALD | Member ID: 52768228001 |
| Employer ID: TPCH | Termination Date: 2022-07-04 |
| Contract Record ID: 52768228001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236908 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: HILLARY PURSER | Member ID: 75159406801 |
| Employer ID: TPCH | Termination Date: 2022-07-26 |
| Contract Record ID: 75159406801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236909 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: NOELLE C ROOT | Member ID: 43660467901 |
| Employer ID: TPCH | Termination Date: 2022-07-04 |
| Contract Record ID: 43660467901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236910 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: GREGORY SPENCER | Member ID: 54200447601 |
| Employer ID: TPCH | Termination Date: 2022-07-03 |
| Contract Record ID: 54200447601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 236911 | Status: COMPLETE |
| Request Date: 2022-07-26 | Status Date: 2022-07-26 |
| Member Name: LORI ZINK | Member ID: 24335404801 |
| Employer ID: TPCH | Termination Date: 2022-07-11 |
| Contract Record ID: 24335404801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 237161 | Status: COMPLETE |
| Request Date: 2022-07-27 | Status Date: 2022-07-27 |
| Member Name: CLAUDIA RODRIGUEZ | Member ID: 25430957401 |
| Employer ID: DNA | Termination Date: 2022-07-31 |
| Contract Record ID: 25430957401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 237421 | Status: COMPLETE |
| Request Date: 2022-07-28 | Status Date: 2022-07-28 |
| Member Name: LAFAYETTE LEWIS | Member ID: 89417676801 |
| Employer ID: PELTZ | Termination Date: 2022-07-31 |
| Contract Record ID: 89417676801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 237422 | Status: COMPLETE |
| Request Date: 2022-07-28 | Status Date: 2022-07-28 |
| Member Name: LAFAYETTE LEWIS | Member ID: 89417676801 |
| Employer ID: PELTZ | Termination Date: 2022-07-31 |
| Contract Record ID: 89417676801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 237642 | Status: COMPLETE |
| Request Date: 2022-07-28 | Status Date: 2022-07-28 |
| Member Name: CASSIE HANSON | Member ID: 23887390401 |
| Employer ID: SFM | Termination Date: 2022-06-30 |
| Contract Record ID: 23887390401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 237681 | Status: COMPLETE |
| Request Date: 2022-07-28 | Status Date: 2022-07-28 |
| Member Name: LIEZL HODGES | Member ID: 46942961401 |
| Employer ID: SFM | Termination Date: 2022-03-31 |
| Contract Record ID: 46942961401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 237921 | Status: COMPLETE |
| Request Date: 2022-07-29 | Status Date: 2022-07-29 |
| Member Name: SHEILA C BLOYD | Member ID: 42906283801 |
| Employer ID: LNB | Termination Date: 2022-07-31 |
| Contract Record ID: 42906283801 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: Employee is keeping DENTAL so term only the medical |
|
| Request ID: 238001 | Status: COMPLETE |
| Request Date: 2022-07-29 | Status Date: 2022-07-29 |
| Member Name: TIFFANIE HENSON | Member ID: 22634953201 |
| Employer ID: CNT | Termination Date: 2022-07-31 |
| Contract Record ID: 22634953201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 238002 | Status: COMPLETE |
| Request Date: 2022-07-29 | Status Date: 2022-07-29 |
| Member Name: CHELSEA JANE BAIRD | Member ID: 46273179801 |
| Employer ID: CNT | Termination Date: 2022-07-31 |
| Contract Record ID: 46273179801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 238363 | Status: COMPLETE |
| Request Date: 2022-08-01 | Status Date: 2022-08-01 |
| Member Name: LLOYD GARCIA | Member ID: 19103253801 |
| Employer ID: PELTZ | Termination Date: 2022-07-31 |
| Contract Record ID: 19103253801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 238364 | Status: COMPLETE |
| Request Date: 2022-08-01 | Status Date: 2022-08-01 |
| Member Name: ALEXANDRA LEYDON | Member ID: 03151400201 |
| Employer ID: PELTZ | Termination Date: 2022-07-31 |
| Contract Record ID: 03151400201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 238385 | Status: COMPLETE |
| Request Date: 2022-08-01 | Status Date: 2022-08-01 |
| Member Name: RACHEL ALLEN | Member ID: 63130640301 |
| Employer ID: PELTZ | Termination Date: 2022-07-31 |
| Contract Record ID: 63130640301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 238481 | Status: COMPLETE |
| Request Date: 2022-08-02 | Status Date: 2022-08-02 |
| Member Name: DYLAN MCKEE | Member ID: 20545135601 |
| Employer ID: BROSOL | Termination Date: 2022-07-31 |
| Contract Record ID: 20545135601 | Term Reason: REDUCTION OF HOURS |
| Comments: Employee voluntarily chose to go part-time |
|
| Request ID: 238482 | Status: COMPLETE |
| Request Date: 2022-08-02 | Status Date: 2022-08-02 |
| Member Name: JAMES R MCKEE | Member ID: 37972946601 |
| Employer ID: BROSOL | Termination Date: 2022-07-31 |
| Contract Record ID: 37972946601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 238561 | Status: COMPLETE |
| Request Date: 2022-08-02 | Status Date: 2022-08-02 |
| Member Name: STEPHANIE LYNN JOHNSON | Member ID: 64226073601 |
| Employer ID: DNA | Termination Date: 2022-07-31 |
| Contract Record ID: 64226073601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 238581 | Status: COMPLETE |
| Request Date: 2022-08-02 | Status Date: 2022-08-02 |
| Member Name: STEPHANIE LYNN JOHNSON | Member ID: 64226073601 |
| Employer ID: DNA | Termination Date: 2022-07-31 |
| Contract Record ID: 64226073601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 238645 | Status: COMPLETE |
| Request Date: 2022-08-02 | Status Date: 2022-08-02 |
| Member Name: JENNIFER FAYE COFFMAN | Member ID: 28792159101 |
| Employer ID: SFM | Termination Date: 2022-07-31 |
| Contract Record ID: 28792159101 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 239121 | Status: COMPLETE |
| Request Date: 2022-08-03 | Status Date: 2022-08-03 |
| Member Name: MARGARET BENITEZ | Member ID: 67969235601 |
| Employer ID: YHP00158 | Termination Date: 2022-07-25 |
| Contract Record ID: 67969235601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 239141 | Status: COMPLETE |
| Request Date: 2022-08-03 | Status Date: 2022-08-03 |
| Member Name: LAUREN JOHNSON | Member ID: 97901483601 |
| Employer ID: YHP00158 | Termination Date: 2022-07-22 |
| Contract Record ID: 97901483601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 239481 | Status: COMPLETE |
| Request Date: 2022-08-04 | Status Date: 2022-08-04 |
| Member Name: ALICIA WELTON | Member ID: 85634199301 |
| Employer ID: TPCH | Termination Date: 2022-05-20 |
| Contract Record ID: 85634199301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 239601 | Status: COMPLETE |
| Request Date: 2022-08-05 | Status Date: 2022-08-05 |
| Member Name: ROSCHOD PRINCE | Member ID: 47509156701 |
| Employer ID: CLEAR | Termination Date: 2022-07-31 |
| Contract Record ID: 47509156701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 239662 | Status: COMPLETE |
| Request Date: 2022-08-05 | Status Date: 2022-08-05 |
| Member Name: JOSEPH COLLINS | Member ID: 75145186901 |
| Employer ID: VAUGHAN | Termination Date: 2022-08-01 |
| Contract Record ID: 75145186901 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 239663 | Status: COMPLETE |
| Request Date: 2022-08-05 | Status Date: 2022-08-05 |
| Member Name: BRYAN DIERICK | Member ID: 15470654301 |
| Employer ID: VAUGHAN | Termination Date: 2022-07-29 |
| Contract Record ID: 15470654301 | Term Reason: VOLUNTARY |
| Comments: Retired |
|
| Request ID: 239701 | Status: COMPLETE |
| Request Date: 2022-08-08 | Status Date: 2022-08-08 |
| Member Name: JANAY CONNOR | Member ID: 43528097601 |
| Employer ID: ADVRX | Termination Date: 2022-07-31 |
| Contract Record ID: 43528097601 | Term Reason: TERMINATION |
| Comments: Employment Status Change
(7/20/2022)
Employee went to part time |
|
| Request ID: 240181 | Status: COMPLETE |
| Request Date: 2022-08-09 | Status Date: 2022-08-09 |
| Member Name: SHAWN OSBORNE | Member ID: 53161352101 |
| Employer ID: TBX | Termination Date: 2022-06-30 |
| Contract Record ID: 53161352101 | Term Reason: NON PAYMENT OF PREMIUMS |
| Comments: Cancel EE+FAM HMA 3000 medical coverage COBRA |
|
| Request ID: 240461 | Status: COMPLETE |
| Request Date: 2022-08-10 | Status Date: 2022-08-10 |
| Member Name: STEPHANIE R MOSELEY | Member ID: 48789535401 |
| Employer ID: BRANDY | Termination Date: 2022-06-30 |
| Contract Record ID: 48789535401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 240462 | Status: COMPLETE |
| Request Date: 2022-08-10 | Status Date: 2022-08-10 |
| Member Name: TAMEKA VAUGHAN-TAYLOR | Member ID: 29160857601 |
| Employer ID: BRANDY | Termination Date: 2022-06-30 |
| Contract Record ID: 29160857601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 240463 | Status: COMPLETE |
| Request Date: 2022-08-10 | Status Date: 2022-08-10 |
| Member Name: RHONDA WALTON | Member ID: 66284414901 |
| Employer ID: BRANDY | Termination Date: 2022-06-30 |
| Contract Record ID: 66284414901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 240761 | Status: COMPLETE |
| Request Date: 2022-08-10 | Status Date: 2022-08-10 |
| Member Name: BRADLEY J GUENTHNER | Member ID: 54514578301 |
| Employer ID: TPCH | Termination Date: 2022-05-22 |
| Contract Record ID: 54514578301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 240781 | Status: COMPLETE |
| Request Date: 2022-08-10 | Status Date: 2022-08-10 |
| Member Name: DEAN FULTON | Member ID: 62351309501 |
| Employer ID: TPCH | Termination Date: 2022-06-14 |
| Contract Record ID: 62351309501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 240821 | Status: COMPLETE |
| Request Date: 2022-08-11 | Status Date: 2022-08-11 |
| Member Name: BREANNA MARTINEZ | Member ID: 92081837701 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 92081837701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241141 | Status: COMPLETE |
| Request Date: 2022-08-12 | Status Date: 2022-08-12 |
| Member Name: LISA NIELS | Member ID: 59383859901 |
| Employer ID: VAUGHAN | Termination Date: 2022-08-16 |
| Contract Record ID: 59383859901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 241181 | Status: COMPLETE |
| Request Date: 2022-08-12 | Status Date: 2022-08-12 |
| Member Name: TENLEY NIELS | Member ID: 59383859903 |
| Employer ID: VAUGHAN | Termination Date: 2022-08-31 |
| Contract Record ID: 59383859901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 241401 | Status: COMPLETE |
| Request Date: 2022-08-15 | Status Date: 2022-08-15 |
| Member Name: WILLIAM DOWNS | Member ID: 17042427802 |
| Employer ID: LNB | Termination Date: 2022-07-31 |
| Contract Record ID: 17042427801 | Term Reason: VOLUNTARY |
| Comments: Employees Spouse gained new employment/new eligibility and signed on there. |
|
| Request ID: 241821 | Status: COMPLETE |
| Request Date: 2022-08-17 | Status Date: 2022-08-17 |
| Member Name: DORENA HIRSCHMAN | Member ID: 34062369202 |
| Employer ID: VAUGHAN | Termination Date: 2022-07-31 |
| Contract Record ID: 34062369201 | Term Reason: DIVORCE FROM EMPLOYEE |
| Comments: |
|
| Request ID: 241933 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: STEPHANIE MURGUIA | Member ID: 52362885201 |
| Employer ID: SFM | Termination Date: 2022-08-31 |
| Contract Record ID: 52362885201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241934 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: ROBERTA LYNN COLQUHOUN | Member ID: 70989417401 |
| Employer ID: SFM | Termination Date: 2022-08-31 |
| Contract Record ID: 70989417401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241935 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: KITANNA WILCOX | Member ID: 06888491901 |
| Employer ID: SFM | Termination Date: 2022-08-31 |
| Contract Record ID: 06888491901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241936 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: HOWNAZ FARIS OMAR | Member ID: 17090537901 |
| Employer ID: SFM | Termination Date: 2022-08-31 |
| Contract Record ID: 17090537901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241937 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: CHARLY MARSH | Member ID: 21554125901 |
| Employer ID: SFM | Termination Date: 2022-08-31 |
| Contract Record ID: 21554125901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241942 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: VANESSA EVANGELINE STARESINIC | Member ID: 83111254601 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 83111254601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241953 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: DEVIN DAVIS-LUCAS | Member ID: 81884848501 |
| Employer ID: SFM | Termination Date: 2022-08-31 |
| Contract Record ID: 81884848501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 241954 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: COLETTE BECKMAN | Member ID: 36969182903 |
| Employer ID: SERVHIGH | Termination Date: 2022-06-17 |
| Contract Record ID: 36969182901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241955 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: JOSHUA BECKMAN | Member ID: 36969182901 |
| Employer ID: SERVHIGH | Termination Date: 2022-06-17 |
| Contract Record ID: 36969182901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241957 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: JOHN IV D MACWILLIE | Member ID: 36669033601 |
| Employer ID: SERVHIGH | Termination Date: 2022-07-15 |
| Contract Record ID: 36669033601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241958 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: CARLIE EMMA MACWILLIE | Member ID: 36669033602 |
| Employer ID: SERVHIGH | Termination Date: 2022-07-15 |
| Contract Record ID: 36669033601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241959 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: SAMUEL GOODING | Member ID: 06986635301 |
| Employer ID: SERVHIGH | Termination Date: 2022-07-21 |
| Contract Record ID: 06986635301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241960 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: JOSHUA II CHRISTOPHER BECKMAN | Member ID: 36969182904 |
| Employer ID: SERVHIGH | Termination Date: 2022-06-17 |
| Contract Record ID: 36969182901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241961 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: MARYANN BECKMAN | Member ID: 36969182902 |
| Employer ID: SERVHIGH | Termination Date: 2022-06-17 |
| Contract Record ID: 36969182901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241962 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: JOHN G A MORRIS | Member ID: 80205354101 |
| Employer ID: SERVHIGH | Termination Date: 2022-06-30 |
| Contract Record ID: 80205354101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241963 | Status: COMPLETE |
| Request Date: 2022-08-19 | Status Date: 2022-08-19 |
| Member Name: CASEY MORRIS | Member ID: 80205354102 |
| Employer ID: SERVHIGH | Termination Date: 2022-06-30 |
| Contract Record ID: 80205354101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 241991 | Status: COMPLETE |
| Request Date: 2022-08-22 | Status Date: 2022-08-22 |
| Member Name: JUAN LOPEZ TORRES | Member ID: 72525751401 |
| Employer ID: USEGG | Termination Date: 2022-08-01 |
| Contract Record ID: 72525751401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242009 | Status: COMPLETE |
| Request Date: 2022-08-23 | Status Date: 2022-08-23 |
| Member Name: JONATHAN DURHAM | Member ID: 85081427701 |
| Employer ID: BROSOL | Termination Date: 2022-08-01 |
| Contract Record ID: 85081427701 | Term Reason: VOLUNTARY |
| Comments: Voluntarily quit. |
|
| Request ID: 242010 | Status: COMPLETE |
| Request Date: 2022-08-23 | Status Date: 2022-08-23 |
| Member Name: QUITTEN PEDIGO | Member ID: 18854978801 |
| Employer ID: BROSOL | Termination Date: 2022-09-01 |
| Contract Record ID: 18854978801 | Term Reason: VOLUNTARY |
| Comments: Employee voluntarily quit onn 8/8/2022 |
|
| Request ID: 242012 | Status: COMPLETE |
| Request Date: 2022-08-23 | Status Date: 2022-08-23 |
| Member Name: WILLIAM A MEANS | Member ID: 09417518403 |
| Employer ID: BROSOL | Termination Date: 2022-08-01 |
| Contract Record ID: 09417518401 | Term Reason: VOLUNTARY |
| Comments: William voluntarily terminated on 7/18/2022 |
|
| Request ID: 242020 | Status: COMPLETE |
| Request Date: 2022-08-23 | Status Date: 2022-08-23 |
| Member Name: APRIL MONTGOMERY | Member ID: 31089540901 |
| Employer ID: PELTZ | Termination Date: 2022-08-18 |
| Contract Record ID: 31089540901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242022 | Status: COMPLETE |
| Request Date: 2022-08-23 | Status Date: 2022-08-23 |
| Member Name: JOE ESTRADA | Member ID: 54825526601 |
| Employer ID: BRECKS | Termination Date: 2022-07-31 |
| Contract Record ID: 54825526601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242023 | Status: COMPLETE |
| Request Date: 2022-08-23 | Status Date: 2022-08-23 |
| Member Name: MARTHA JUAREZ | Member ID: 05947083901 |
| Employer ID: BRECKS | Termination Date: 2022-08-31 |
| Contract Record ID: 05947083901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242083 | Status: COMPLETE |
| Request Date: 2022-08-25 | Status Date: 2022-08-25 |
| Member Name: DENNIS JAMES HOHENBRINK | Member ID: 50659967801 |
| Employer ID: EASYLVNG | Termination Date: 2022-08-31 |
| Contract Record ID: 50659967801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242085 | Status: COMPLETE |
| Request Date: 2022-08-25 | Status Date: 2022-08-25 |
| Member Name: JORDAN GRIMALDO | Member ID: 17657205901 |
| Employer ID: YHP00134 | Termination Date: 2022-07-30 |
| Contract Record ID: 17657205901 | Term Reason: VOLUNTARY |
| Comments: VOLUNTARY, OTHER EMPLOYMENT |
|
| Request ID: 242095 | Status: COMPLETE |
| Request Date: 2022-08-25 | Status Date: 2022-08-25 |
| Member Name: ANDREW DICRISI | Member ID: 83483742303 |
| Employer ID: SERVHIGH | Termination Date: 2022-08-05 |
| Contract Record ID: 83483742301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242096 | Status: COMPLETE |
| Request Date: 2022-08-25 | Status Date: 2022-08-25 |
| Member Name: COLLEEN POYAR | Member ID: 76986911901 |
| Employer ID: SERVHIGH | Termination Date: 2022-08-01 |
| Contract Record ID: 76986911901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242097 | Status: COMPLETE |
| Request Date: 2022-08-25 | Status Date: 2022-08-25 |
| Member Name: COLLEEN POYAR | Member ID: 76986911901 |
| Employer ID: SERVHIGH | Termination Date: 2022-08-01 |
| Contract Record ID: 76986911901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242098 | Status: COMPLETE |
| Request Date: 2022-08-25 | Status Date: 2022-08-25 |
| Member Name: IVONNE DUCHARME | Member ID: 96645915601 |
| Employer ID: SERVHIGH | Termination Date: 2022-07-07 |
| Contract Record ID: 96645915601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242127 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: JOSHUA LEE | Member ID: 22217423101 |
| Employer ID: BROSOL | Termination Date: 2022-08-31 |
| Contract Record ID: 22217423101 | Term Reason: TERMINATION |
| Comments: Last day of employment 8/26/2022 |
|
| Request ID: 242128 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: JOSHUA LEE | Member ID: 22217423101 |
| Employer ID: BROSOL | Termination Date: 2022-08-31 |
| Contract Record ID: 22217423101 | Term Reason: TERMINATION |
| Comments: Last day of employment 8/26/2022 |
|
| Request ID: 242130 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: AUSTIN H VALENTINE | Member ID: 57659517401 |
| Employer ID: BROSOL | Termination Date: 2022-08-31 |
| Contract Record ID: 57659517401 | Term Reason: TERMINATION |
| Comments: Last day of employment 8/27/2022 |
|
| Request ID: 242161 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: JESSICA BEDNARZ | Member ID: 92944917901 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 92944917901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242163 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: JESSICA BEDNARZ | Member ID: 92944917901 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 92944917901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242164 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: AUTUMN JOHNSON | Member ID: 12351545301 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 12351545301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242181 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: AUTUMN JOHNSON | Member ID: 12351545301 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 12351545301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242201 | Status: COMPLETE |
| Request Date: 2022-08-26 | Status Date: 2022-08-26 |
| Member Name: DINA HERFORTH | Member ID: 97577795801 |
| Employer ID: SFM | Termination Date: 2022-08-31 |
| Contract Record ID: 97577795801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242342 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: MARIA C MERKEL | Member ID: 07149521801 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 07149521801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242423 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: EVETTE BLEVINS | Member ID: 61728976601 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-16 |
| Contract Record ID: 61728976601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242424 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: TERRY CRAWFORD III | Member ID: 09658775201 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-02 |
| Contract Record ID: 09658775201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242425 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: LARRY EIDE | Member ID: 39543817801 |
| Employer ID: HOSPAUTH | Termination Date: 2022-07-18 |
| Contract Record ID: 39543817801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242426 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: LEAH GIBBONS | Member ID: 23429558801 |
| Employer ID: HOSPAUTH | Termination Date: 2022-06-16 |
| Contract Record ID: 23429558801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 242427 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: YOLONDA HARLEY | Member ID: 92294188801 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-21 |
| Contract Record ID: 92294188801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242428 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: JAMES HOLMES | Member ID: 61560460601 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-18 |
| Contract Record ID: 61560460601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242441 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: AMANDA MORGAN | Member ID: 11184678001 |
| Employer ID: HOSPAUTH | Termination Date: 2021-11-28 |
| Contract Record ID: 11184678001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242461 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: TALISHA C PAIGE | Member ID: 81130214801 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-26 |
| Contract Record ID: 81130214801 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 242462 | Status: COMPLETE |
| Request Date: 2022-08-29 | Status Date: 2022-08-29 |
| Member Name: KYANDRA SMITH | Member ID: 61775987901 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-06 |
| Contract Record ID: 61775987901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 242741 | Status: COMPLETE |
| Request Date: 2022-08-30 | Status Date: 2022-08-30 |
| Member Name: MENNO YODER | Member ID: 04240817001 |
| Employer ID: MESH | Termination Date: 2022-08-24 |
| Contract Record ID: 04240817001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 242781 | Status: COMPLETE |
| Request Date: 2022-08-30 | Status Date: 2022-08-30 |
| Member Name: MOHAMAD ALSADI | Member ID: 29328408401 |
| Employer ID: BRECK | Termination Date: 2022-08-31 |
| Contract Record ID: 29328408401 | Term Reason: VOLUNTARY |
| Comments: please mail the COBRA documents |
|
| Request ID: 243221 | Status: COMPLETE |
| Request Date: 2022-08-31 | Status Date: 2022-08-31 |
| Member Name: SPENCER ORSCHELN | Member ID: 53345840801 |
| Employer ID: TRILAT | Termination Date: 2022-08-31 |
| Contract Record ID: 53345840801 | Term Reason: VOLUNTARY |
| Comments: Gained coverage through his spouse, United Healthcare |
|
| Request ID: 243761 | Status: COMPLETE |
| Request Date: 2022-09-06 | Status Date: 2022-09-06 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 243763 | Status: COMPLETE |
| Request Date: 2022-09-06 | Status Date: 2022-09-06 |
| Member Name: HOLLIE ROSE | Member ID: 24441573101 |
| Employer ID: CNT | Termination Date: 2022-09-30 |
| Contract Record ID: 24441573101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 243881 | Status: COMPLETE |
| Request Date: 2022-09-06 | Status Date: 2022-09-06 |
| Member Name: SHAUN CRUMBLE | Member ID: 02733278201 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 02733278201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244341 | Status: COMPLETE |
| Request Date: 2022-09-07 | Status Date: 2022-09-07 |
| Member Name: SHAUN CRUMBLE | Member ID: 02733278201 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 02733278201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244430 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: MIGUEL ANTONIO ZUNIGA ZAMORA | Member ID: 56593666101 |
| Employer ID: YHP00134 | Termination Date: 2022-08-28 |
| Contract Record ID: 56593666101 | Term Reason: VOLUNTARY |
| Comments: QUIT, OTHER EMPLOYMENT |
|
| Request ID: 244436 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-09-08 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: this is a test, please disregard |
|
| Request ID: 244437 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-09-08 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: this is a test, please disregard |
|
| Request ID: 244438 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-09-08 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: this is a test, please disregard |
|
| Request ID: 244440 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-09-08 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: this is a test please disregard |
|
| Request ID: 244443 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-09-08 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: this is a test, please disregard |
|
| Request ID: 244444 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-09-08 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: this is a test, please disregard |
|
| Request ID: 244445 | Status: COMPLETE |
| Request Date: 2022-09-08 | Status Date: 2022-09-08 |
| Member Name: KAREN ASHLEY DAY | Member ID: 54305682901 |
| Employer ID: CNT | Termination Date: 2022-09-08 |
| Contract Record ID: 54305682901 | Term Reason: TERMINATION |
| Comments: this is a test, please disregard |
|
| Request ID: 244470 | Status: COMPLETE |
| Request Date: 2022-09-09 | Status Date: 2022-09-09 |
| Member Name: AMANDA ZAMBRANO | Member ID: 83918923601 |
| Employer ID: CNT | Termination Date: 2022-09-30 |
| Contract Record ID: 83918923601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244485 | Status: COMPLETE |
| Request Date: 2022-09-12 | Status Date: 2022-09-12 |
| Member Name: DOUGLAS K SICKLER | Member ID: 12818760101 |
| Employer ID: MESH | Termination Date: 2022-08-26 |
| Contract Record ID: 12818760101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244486 | Status: COMPLETE |
| Request Date: 2022-09-12 | Status Date: 2022-09-12 |
| Member Name: TONY CARROLL | Member ID: 37892417201 |
| Employer ID: WCE | Termination Date: 2022-09-23 |
| Contract Record ID: 37892417201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244547 | Status: COMPLETE |
| Request Date: 2022-09-14 | Status Date: 2022-09-14 |
| Member Name: CAMERON HESS | Member ID: 53306012001 |
| Employer ID: YHP00397 | Termination Date: 2022-09-01 |
| Contract Record ID: 53306012001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244550 | Status: COMPLETE |
| Request Date: 2022-09-14 | Status Date: 2022-09-14 |
| Member Name: RENA FRAZIER | Member ID: 85510035301 |
| Employer ID: YHP00397 | Termination Date: 2022-09-13 |
| Contract Record ID: 85510035301 | Term Reason: VOLUNTARY |
| Comments: Employee is eligible for insurance through other employer. |
|
| Request ID: 244581 | Status: COMPLETE |
| Request Date: 2022-09-15 | Status Date: 2022-09-15 |
| Member Name: KENDREA K WARD | Member ID: 19067797101 |
| Employer ID: LNB | Termination Date: 2022-09-30 |
| Contract Record ID: 19067797101 | Term Reason: TERMINATION |
| Comments: last day 9/15/22 - policy thru 9/30/22 |
|
| Request ID: 244626 | Status: COMPLETE |
| Request Date: 2022-09-16 | Status Date: 2022-09-16 |
| Member Name: RONALD A THIBODEAUX | Member ID: 56400707901 |
| Employer ID: BRANDY | Termination Date: 2022-08-31 |
| Contract Record ID: 56400707901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244627 | Status: COMPLETE |
| Request Date: 2022-09-16 | Status Date: 2022-09-16 |
| Member Name: ADAM MATLON | Member ID: 74951796101 |
| Employer ID: TRILAT | Termination Date: 2022-09-15 |
| Contract Record ID: 74951796101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244629 | Status: COMPLETE |
| Request Date: 2022-09-16 | Status Date: 2022-09-16 |
| Member Name: JOSEPH COLLINS | Member ID: 75145186901 |
| Employer ID: VAUGHAN | Termination Date: 2022-08-01 |
| Contract Record ID: 75145186901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244630 | Status: COMPLETE |
| Request Date: 2022-09-16 | Status Date: 2022-09-16 |
| Member Name: MA SOPHIA Y RIVO | Member ID: 71341473201 |
| Employer ID: SFM | Termination Date: 2022-09-30 |
| Contract Record ID: 71341473201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244671 | Status: COMPLETE |
| Request Date: 2022-09-19 | Status Date: 2022-09-19 |
| Member Name: JOSEPH GAGLIARDO | Member ID: 02213123401 |
| Employer ID: ASSI | Termination Date: 2022-09-07 |
| Contract Record ID: 02213123401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 244702 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: COLLIER MCKENZIE | Member ID: 22673916301 |
| Employer ID: APRES | Termination Date: 2022-10-03 |
| Contract Record ID: 22673916301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244703 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: DAVID CHOVANEC | Member ID: 44168881701 |
| Employer ID: WCE | Termination Date: 2022-09-26 |
| Contract Record ID: 44168881701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244704 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: CHARLES W W BEVAN | Member ID: 71616685301 |
| Employer ID: MESH | Termination Date: 2022-09-10 |
| Contract Record ID: 71616685301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244712 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: JAMES CAWEIN | Member ID: 05742825601 |
| Employer ID: ASSI | Termination Date: 2022-09-20 |
| Contract Record ID: 05742825601 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 244713 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: ROSS P FISHETTI | Member ID: 18359142501 |
| Employer ID: ASSI | Termination Date: 2022-09-20 |
| Contract Record ID: 18359142501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 244714 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: JOSEPH GAGLIARDO | Member ID: 02213123401 |
| Employer ID: ASSI | Termination Date: 2022-09-07 |
| Contract Record ID: 02213123401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 244717 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: DENNIS MARTINEZ | Member ID: 41043080401 |
| Employer ID: ASSI | Termination Date: 2022-05-07 |
| Contract Record ID: 41043080401 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 244719 | Status: COMPLETE |
| Request Date: 2022-09-20 | Status Date: 2022-09-20 |
| Member Name: JOHN VENTURA | Member ID: 06775309701 |
| Employer ID: ASSI | Termination Date: 2022-09-20 |
| Contract Record ID: 06775309701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244748 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: STEVEN LIVINGSTON | Member ID: 12580312501 |
| Employer ID: ASSI | Termination Date: 2022-09-21 |
| Contract Record ID: 12580312501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244749 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: SCOTT A BURTON | Member ID: 02478255301 |
| Employer ID: ASSI | Termination Date: 2022-09-21 |
| Contract Record ID: 02478255301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244751 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: STEVEN LIVINGSTON | Member ID: 12580312501 |
| Employer ID: ASSI | Termination Date: 2022-09-21 |
| Contract Record ID: 12580312501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244752 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: JAMES M RICH | Member ID: 86952122001 |
| Employer ID: ASSI | Termination Date: 2022-09-21 |
| Contract Record ID: 86952122001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244764 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: EVETTE BLEVINS | Member ID: 61728976601 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-16 |
| Contract Record ID: 61728976601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244766 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: JUSTIN A ALBERTSON | Member ID: 66912052501 |
| Employer ID: BROSOL | Termination Date: 2022-09-30 |
| Contract Record ID: 66912052501 | Term Reason: VOLUNTARY |
| Comments: Dediced to drop medical coverage during open enrollment. |
|
| Request ID: 244768 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: JAMES HOLMES | Member ID: 61560460601 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-18 |
| Contract Record ID: 61560460601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244770 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: MALENA BRISSETT | Member ID: 54369408901 |
| Employer ID: HOSPAUTH | Termination Date: 2022-05-02 |
| Contract Record ID: 54369408901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244771 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: RODNEY CORWIN | Member ID: 02336613201 |
| Employer ID: HOSPAUTH | Termination Date: 2022-06-30 |
| Contract Record ID: 02336613201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244772 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: TERRY CRAWFORD III | Member ID: 09658775201 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-02 |
| Contract Record ID: 09658775201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244773 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: LASHONDREA CRUZ | Member ID: 58416474401 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-14 |
| Contract Record ID: 58416474401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244774 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: MARKCUS DAY | Member ID: 67915948401 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-24 |
| Contract Record ID: 67915948401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244775 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: LARRY EIDE | Member ID: 39543817801 |
| Employer ID: HOSPAUTH | Termination Date: 2022-07-18 |
| Contract Record ID: 39543817801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244776 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: MARTINIQUE EVANS | Member ID: 11830943501 |
| Employer ID: HOSPAUTH | Termination Date: 2022-06-27 |
| Contract Record ID: 11830943501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244777 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: LEAH GIBBONS | Member ID: 23429558801 |
| Employer ID: HOSPAUTH | Termination Date: 2022-06-16 |
| Contract Record ID: 23429558801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244778 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: SANDRA JESTER | Member ID: 21613327301 |
| Employer ID: HOSPAUTH | Termination Date: 2022-03-22 |
| Contract Record ID: 21613327301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244779 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: RACHEL JETHROE | Member ID: 90103276101 |
| Employer ID: HOSPAUTH | Termination Date: 2022-02-09 |
| Contract Record ID: 90103276101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244780 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: FRANCES KERCE | Member ID: 67021542501 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-01 |
| Contract Record ID: 67021542501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244782 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: GWENDOLYN MCGHEE | Member ID: 91184740201 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-04 |
| Contract Record ID: 91184740201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244783 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: AMANDA MORGAN | Member ID: 11184678001 |
| Employer ID: HOSPAUTH | Termination Date: 2021-11-28 |
| Contract Record ID: 11184678001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244784 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: FRANK ODELL | Member ID: 90856922901 |
| Employer ID: HOSPAUTH | Termination Date: 2022-05-03 |
| Contract Record ID: 90856922901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244785 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: TALISHA C PAIGE | Member ID: 81130214801 |
| Employer ID: HOSPAUTH | Termination Date: 2022-04-26 |
| Contract Record ID: 81130214801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244786 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: BARBARA RATLIFF | Member ID: 90559310501 |
| Employer ID: HOSPAUTH | Termination Date: 2022-03-31 |
| Contract Record ID: 90559310501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244787 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: DOVEY ROBERSON | Member ID: 47547578401 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-22 |
| Contract Record ID: 47547578401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244788 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: LAURENCE WHARTON | Member ID: 12721370203 |
| Employer ID: HOSPAUTH | Termination Date: 2022-05-25 |
| Contract Record ID: 12721370201 | Term Reason: LOSS OF DEPENDANT STATUS |
| Comments: |
|
| Request ID: 244789 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: MARTA CENICEROS | Member ID: 61987399301 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 61987399301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244792 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: DAVID CHOVANEC | Member ID: 44168881701 |
| Employer ID: WCE | Termination Date: 2022-09-26 |
| Contract Record ID: 44168881701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244796 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: SARA LYNNE BONSON | Member ID: 72946785201 |
| Employer ID: SFM | Termination Date: 2022-09-30 |
| Contract Record ID: 72946785201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244797 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: LAURA DAVIS | Member ID: 25388211601 |
| Employer ID: SFM | Termination Date: 2022-09-30 |
| Contract Record ID: 25388211601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244798 | Status: COMPLETE |
| Request Date: 2022-09-21 | Status Date: 2022-09-21 |
| Member Name: CAREY MORRILL | Member ID: 54144615301 |
| Employer ID: SFM | Termination Date: 2022-09-30 |
| Contract Record ID: 54144615301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244804 | Status: COMPLETE |
| Request Date: 2022-09-22 | Status Date: 2022-09-22 |
| Member Name: SCOTT R FAUX | Member ID: 36304647101 |
| Employer ID: MESH | Termination Date: 2022-09-06 |
| Contract Record ID: 36304647101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 244820 | Status: COMPLETE |
| Request Date: 2022-09-22 | Status Date: 2022-09-22 |
| Member Name: ALEXIS ROSE AUSTAD | Member ID: 30422683201 |
| Employer ID: YHP00134 | Termination Date: 2022-08-29 |
| Contract Record ID: 30422683201 | Term Reason: VOLUNTARY |
| Comments: OTHER EMPLOYMENT |
|
| Request ID: 244863 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: JULIA HOLZHAUSEN | Member ID: 23317922801 |
| Employer ID: PELTZ | Termination Date: 2022-10-31 |
| Contract Record ID: 23317922801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244865 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: MARTHA JUAREZ | Member ID: 05947083901 |
| Employer ID: BRECKS | Termination Date: 2022-08-31 |
| Contract Record ID: 05947083901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244879 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: KELLIE CORPUZ | Member ID: 30253007501 |
| Employer ID: SFM | Termination Date: 2022-09-30 |
| Contract Record ID: 30253007501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244883 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: ELAINE FULTON | Member ID: 56023383301 |
| Employer ID: TPCH | Termination Date: 2022-09-02 |
| Contract Record ID: 56023383301 | Term Reason: |
| Comments: |
|
| Request ID: 244885 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: MISTY WHITE | Member ID: 29830095101 |
| Employer ID: TPCH | Termination Date: 2022-08-25 |
| Contract Record ID: 29830095101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244886 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: DAYLON M MARTIN | Member ID: 04131981201 |
| Employer ID: TPCH | Termination Date: 2022-09-18 |
| Contract Record ID: 49161398001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244887 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: JUSTIN SMITH | Member ID: 31912610601 |
| Employer ID: TPCH | Termination Date: 2022-09-18 |
| Contract Record ID: 31912610601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244888 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: JUSTIN L SYMES | Member ID: 79092266501 |
| Employer ID: TPCH | Termination Date: 2022-08-26 |
| Contract Record ID: 79092266501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 244890 | Status: COMPLETE |
| Request Date: 2022-09-26 | Status Date: 2022-09-26 |
| Member Name: GEORGE SPARKS | Member ID: 05209812101 |
| Employer ID: TPCH | Termination Date: 2022-08-26 |
| Contract Record ID: 05209812101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 245362 | Status: COMPLETE |
| Request Date: 2022-09-28 | Status Date: 2022-09-28 |
| Member Name: CAITLIN SPAANSTRA | Member ID: 03515126301 |
| Employer ID: YHP00435 | Termination Date: 2022-10-02 |
| Contract Record ID: 03515126301 | Term Reason: TERMINATION |
| Comments: Caitlin Spaanstra resigned from EAVS effective 10/02/2022. |
|
| Request ID: 245363 | Status: COMPLETE |
| Request Date: 2022-09-28 | Status Date: 2022-09-28 |
| Member Name: CAITLIN SPAANSTRA | Member ID: 03515126301 |
| Employer ID: YHP00435 | Termination Date: 2022-10-02 |
| Contract Record ID: 03515126301 | Term Reason: TERMINATION |
| Comments: Caitlin Spaanstra resigned from EAVS effective 10/02/2022. |
|
| Request ID: 245401 | Status: COMPLETE |
| Request Date: 2022-09-28 | Status Date: 2022-09-28 |
| Member Name: BARU MUELA | Member ID: 66460769001 |
| Employer ID: WCE | Termination Date: 2022-09-28 |
| Contract Record ID: 66460769001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 245521 | Status: COMPLETE |
| Request Date: 2022-09-29 | Status Date: 2022-09-29 |
| Member Name: KELSEY WOODARD | Member ID: 35765619901 |
| Employer ID: YHP00158 | Termination Date: 2022-09-01 |
| Contract Record ID: 35765619901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 245661 | Status: COMPLETE |
| Request Date: 2022-09-29 | Status Date: 2022-09-29 |
| Member Name: KATRINA WATERS | Member ID: 33764536201 |
| Employer ID: HOSPAUTH | Termination Date: 2022-09-19 |
| Contract Record ID: 33764536201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 245861 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: AMBER DAWN BELCHER | Member ID: 68553651701 |
| Employer ID: YHP00227 | Termination Date: 2022-07-30 |
| Contract Record ID: 68553651701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 245881 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: ROBERT J ROBERTSON | Member ID: 65861123101 |
| Employer ID: SERVHIGH | Termination Date: 2022-09-30 |
| Contract Record ID: 65861123101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 245901 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: JACKIE MICHELLE SNIDER | Member ID: 78979253201 |
| Employer ID: YHP00227 | Termination Date: 2022-05-27 |
| Contract Record ID: 78979253201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 245944 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: FELIPE CARBO | Member ID: 03423805201 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 03423805201 | Term Reason: VOLUNTARY |
| Comments: Open Enrollment waive of coverage |
|
| Request ID: 245945 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: ASHANTI CARTER | Member ID: 15759541201 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 15759541201 | Term Reason: VOLUNTARY |
| Comments: Open Enrollment waived coverage |
|
| Request ID: 245950 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: TINA OKOJEVOH | Member ID: 55029867201 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 55029867201 | Term Reason: VOLUNTARY |
| Comments: Open Enrollment waived coverage |
|
| Request ID: 245951 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: TYLER HARTLEY | Member ID: 19297544503 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 19297544501 | Term Reason: VOLUNTARY |
| Comments: Open Enrollment drop child coverage |
|
| Request ID: 245952 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: JULIE SIMMONS | Member ID: 43994300702 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 43994300701 | Term Reason: VOLUNTARY |
| Comments: Open Enrollment drop spouse coverage |
|
| Request ID: 245953 | Status: COMPLETE |
| Request Date: 2022-09-30 | Status Date: 2022-09-30 |
| Member Name: CHERYL SOBIERAJ | Member ID: 80130160501 |
| Employer ID: DNA | Termination Date: 2022-09-30 |
| Contract Record ID: 80130160501 | Term Reason: VOLUNTARY |
| Comments: Open Enrollment waived coverage |
|
| Request ID: 245964 | Status: COMPLETE |
| Request Date: 2022-10-03 | Status Date: 2022-10-03 |
| Member Name: BRITTANY SMITH | Member ID: 63201007301 |
| Employer ID: HOSPAUTH | Termination Date: 2022-08-31 |
| Contract Record ID: 63201007301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 245971 | Status: COMPLETE |
| Request Date: 2022-10-03 | Status Date: 2022-10-03 |
| Member Name: PAULA Z DUNCAN | Member ID: 26691432301 |
| Employer ID: BRANDY | Termination Date: 2022-09-30 |
| Contract Record ID: 26691432301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 245983 | Status: COMPLETE |
| Request Date: 2022-10-03 | Status Date: 2022-10-03 |
| Member Name: JASON MATTISON | Member ID: 06758445903 |
| Employer ID: YHP00123 | Termination Date: 2022-09-30 |
| Contract Record ID: 06758445901 | Term Reason: LOSS OF DEPENDANT STATUS |
| Comments: Please remove the child Jason Mattison DOB 9/15/1996 due to him turning 26 years old |
|
| Request ID: 245994 | Status: COMPLETE |
| Request Date: 2022-10-03 | Status Date: 2022-10-03 |
| Member Name: SUSAN BLAYLCOK | Member ID: 14317759701 |
| Employer ID: YHP00134 | Termination Date: 2022-09-22 |
| Contract Record ID: 14317759701 | Term Reason: VOLUNTARY |
| Comments: QUIT |
|
| Request ID: 246027 | Status: COMPLETE |
| Request Date: 2022-10-04 | Status Date: 2022-10-04 |
| Member Name: DESTINEY BEAL | Member ID: 49945138401 |
| Employer ID: CNT | Termination Date: 2022-06-30 |
| Contract Record ID: 49945138401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246041 | Status: COMPLETE |
| Request Date: 2022-10-05 | Status Date: 2022-10-05 |
| Member Name: DOMYNIQUE ARCHAMBAULT | Member ID: 19748309601 |
| Employer ID: TPCH | Termination Date: 2022-08-16 |
| Contract Record ID: 19748309601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246042 | Status: COMPLETE |
| Request Date: 2022-10-05 | Status Date: 2022-10-05 |
| Member Name: ANTONIO REYES RAMIREZ | Member ID: 17669091201 |
| Employer ID: TPCH | Termination Date: 2022-08-18 |
| Contract Record ID: 17669091201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246043 | Status: COMPLETE |
| Request Date: 2022-10-05 | Status Date: 2022-10-05 |
| Member Name: LACEY M BUGG | Member ID: 57744579301 |
| Employer ID: TPCH | Termination Date: 2022-08-29 |
| Contract Record ID: 57744579301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246044 | Status: COMPLETE |
| Request Date: 2022-10-05 | Status Date: 2022-10-05 |
| Member Name: JENNIFER TUCKER | Member ID: 32982601001 |
| Employer ID: TPCH | Termination Date: 2022-09-14 |
| Contract Record ID: 32982601001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246061 | Status: COMPLETE |
| Request Date: 2022-10-05 | Status Date: 2022-10-05 |
| Member Name: CAITLYN M CUNNINGHAM | Member ID: 62884961201 |
| Employer ID: PELTZ | Termination Date: 2022-10-31 |
| Contract Record ID: 62884961201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246081 | Status: COMPLETE |
| Request Date: 2022-10-05 | Status Date: 2022-10-05 |
| Member Name: JACK MABRY | Member ID: 63354792901 |
| Employer ID: BRANDY | Termination Date: 2022-09-30 |
| Contract Record ID: 63354792901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246461 | Status: COMPLETE |
| Request Date: 2022-10-06 | Status Date: 2022-10-06 |
| Member Name: LESLIE CODY | Member ID: 84111085301 |
| Employer ID: YHP00134 | Termination Date: 2022-09-30 |
| Contract Record ID: 84111085301 | Term Reason: VOLUNTARY |
| Comments: QUIT |
|
| Request ID: 246481 | Status: COMPLETE |
| Request Date: 2022-10-06 | Status Date: 2022-10-06 |
| Member Name: JULIE BEREND | Member ID: 40274105301 |
| Employer ID: CNT | Termination Date: 2022-09-30 |
| Contract Record ID: 40274105301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246501 | Status: COMPLETE |
| Request Date: 2022-10-06 | Status Date: 2022-10-06 |
| Member Name: LESLEY DIAZ | Member ID: 05324515301 |
| Employer ID: CNT | Termination Date: 2022-08-31 |
| Contract Record ID: 05324515301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246661 | Status: COMPLETE |
| Request Date: 2022-10-06 | Status Date: 2022-10-06 |
| Member Name: DANIEL YOFFRIEN | Member ID: 48369615401 |
| Employer ID: DNA | Termination Date: 2022-10-03 |
| Contract Record ID: 48369615401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 246761 | Status: COMPLETE |
| Request Date: 2022-10-07 | Status Date: 2022-10-07 |
| Member Name: ALESIA CAROL LACHER | Member ID: 69303412601 |
| Employer ID: PELTZ | Termination Date: 2022-09-30 |
| Contract Record ID: 69303412601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248061 | Status: COMPLETE |
| Request Date: 2022-10-12 | Status Date: 2022-10-12 |
| Member Name: ANTHONY STAGNER | Member ID: 48072224302 |
| Employer ID: CNT | Termination Date: 2022-09-30 |
| Contract Record ID: 48072224301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248205 | Status: COMPLETE |
| Request Date: 2022-10-13 | Status Date: 2022-10-13 |
| Member Name: EDWARD G YOUNICA | Member ID: 77092655501 |
| Employer ID: MESH | Termination Date: 2022-10-31 |
| Contract Record ID: 77092655501 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 248224 | Status: COMPLETE |
| Request Date: 2022-10-13 | Status Date: 2022-10-13 |
| Member Name: TALITHA LEAH SEELYE | Member ID: 34482236501 |
| Employer ID: YHP00227 | Termination Date: 2022-10-12 |
| Contract Record ID: 34482236501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248226 | Status: COMPLETE |
| Request Date: 2022-10-13 | Status Date: 2022-10-13 |
| Member Name: ROOSEVELT DANIEL | Member ID: 41278922001 |
| Employer ID: HOSPAUTH | Termination Date: 2022-09-30 |
| Contract Record ID: 41278922001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248256 | Status: COMPLETE |
| Request Date: 2022-10-14 | Status Date: 2022-10-14 |
| Member Name: ADDIE JO BUSH | Member ID: 58066360701 |
| Employer ID: SFM | Termination Date: 2022-10-31 |
| Contract Record ID: 58066360701 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 248257 | Status: COMPLETE |
| Request Date: 2022-10-14 | Status Date: 2022-10-14 |
| Member Name: CHERYL A HALL | Member ID: 75537154501 |
| Employer ID: SFM | Termination Date: 2022-10-31 |
| Contract Record ID: 75537154501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248266 | Status: COMPLETE |
| Request Date: 2022-10-17 | Status Date: 2022-10-17 |
| Member Name: COLLIER MCKENZIE | Member ID: 22673916301 |
| Employer ID: APRES | Termination Date: 2022-10-03 |
| Contract Record ID: 22673916301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248267 | Status: COMPLETE |
| Request Date: 2022-10-17 | Status Date: 2022-10-17 |
| Member Name: NIVIDA AGURCIA | Member ID: 63376089301 |
| Employer ID: APRES | Termination Date: 2022-10-21 |
| Contract Record ID: 63376089301 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 248274 | Status: COMPLETE |
| Request Date: 2022-10-17 | Status Date: 2022-10-17 |
| Member Name: NANCY WINDISCH | Member ID: 62025987201 |
| Employer ID: SERVHIGH | Termination Date: 2022-09-30 |
| Contract Record ID: 62025987201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248372 | Status: COMPLETE |
| Request Date: 2022-10-19 | Status Date: 2022-10-19 |
| Member Name: TIMOTHY J MANGRUM | Member ID: 06962021301 |
| Employer ID: YHP00134 | Termination Date: 2022-10-03 |
| Contract Record ID: 06962021301 | Term Reason: TERMINATION |
| Comments: QUIT |
|
| Request ID: 248374 | Status: COMPLETE |
| Request Date: 2022-10-19 | Status Date: 2022-10-19 |
| Member Name: BREANNA FORTNER | Member ID: 39983134201 |
| Employer ID: SFM | Termination Date: 2022-09-30 |
| Contract Record ID: 39983134201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248377 | Status: COMPLETE |
| Request Date: 2022-10-19 | Status Date: 2022-10-19 |
| Member Name: MICHAEL REYES | Member ID: 77767135601 |
| Employer ID: DNA | Termination Date: 2022-10-31 |
| Contract Record ID: 77767135601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248485 | Status: COMPLETE |
| Request Date: 2022-10-24 | Status Date: 2022-10-24 |
| Member Name: KEVIN E PURVIS | Member ID: 57869085701 |
| Employer ID: BROSOL | Termination Date: 2022-10-14 |
| Contract Record ID: 57869085701 | Term Reason: TERMINATION |
| Comments: Coverage termed on 10/31/2022 |
|
| Request ID: 248487 | Status: COMPLETE |
| Request Date: 2022-10-24 | Status Date: 2022-10-24 |
| Member Name: AMY NEWELL | Member ID: 24381686801 |
| Employer ID: YHP00123 | Termination Date: 2022-09-30 |
| Contract Record ID: 24381686801 | Term Reason: TERMINATION |
| Comments: Please terminate all coverage effective 9/30/2022 as she is no longer employed. |
|
| Request ID: 248489 | Status: COMPLETE |
| Request Date: 2022-10-24 | Status Date: 2022-10-24 |
| Member Name: KARINA COLLINS | Member ID: 34337553401 |
| Employer ID: YHP00123 | Termination Date: 2022-08-31 |
| Contract Record ID: 34337553401 | Term Reason: TERMINATION |
| Comments: Please remove all coverage effective 08/31/2022. |
|
| Request ID: 248490 | Status: COMPLETE |
| Request Date: 2022-10-24 | Status Date: 2022-10-24 |
| Member Name: JOSEPH DOHERTY | Member ID: 77997713402 |
| Employer ID: DATAPG | Termination Date: 2021-07-27 |
| Contract Record ID: 77997713401 | Term Reason: DIVORCE FROM EMPLOYEE |
| Comments: Please remove Joseph Doherty as a dependent. This individual would have been removed from the coverage due to a plan change to Member+Children in July 2021. |
|
| Request ID: 248499 | Status: COMPLETE |
| Request Date: 2022-10-24 | Status Date: 2022-10-24 |
| Member Name: MADYLISSA ROSARIO | Member ID: 95304942201 |
| Employer ID: DNA | Termination Date: 2022-11-01 |
| Contract Record ID: 95304942201 | Term Reason: VOLUNTARY |
| Comments: Employee voluntarily terminated employment on 10/21/2022 and is covered through 10/31/2022. First day of no coverage is 11/1/2022. Please terminate coverage on 11/1/2022. Thank you. |
|
| Request ID: 248554 | Status: COMPLETE |
| Request Date: 2022-10-25 | Status Date: 2022-10-25 |
| Member Name: JOSHUA L WHITE | Member ID: 78753005201 |
| Employer ID: BROSOL | Termination Date: 2022-08-15 |
| Contract Record ID: 78753005201 | Term Reason: TERMINATION |
| Comments: Coverage should end 9/1/2022 |
|
| Request ID: 248555 | Status: COMPLETE |
| Request Date: 2022-10-25 | Status Date: 2022-10-25 |
| Member Name: DAMON D MILLER | Member ID: 54842751901 |
| Employer ID: BROSOL | Termination Date: 2022-10-31 |
| Contract Record ID: 54842751901 | Term Reason: VOLUNTARY |
| Comments: Subscriber request to terminate coverage on 11/1/2022 |
|
| Request ID: 248556 | Status: COMPLETE |
| Request Date: 2022-10-25 | Status Date: 2022-10-25 |
| Member Name: KEVIN E PURVIS | Member ID: 57869085701 |
| Employer ID: BROSOL | Termination Date: 2022-10-14 |
| Contract Record ID: 57869085701 | Term Reason: TERMINATION |
| Comments: Coverage should end 11/1/2022 |
|
| Request ID: 248558 | Status: COMPLETE |
| Request Date: 2022-10-25 | Status Date: 2022-10-25 |
| Member Name: KEVIN E PURVIS | Member ID: 57869085701 |
| Employer ID: BROSOL | Termination Date: 2022-10-14 |
| Contract Record ID: 57869085701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248598 | Status: COMPLETE |
| Request Date: 2022-10-26 | Status Date: 2022-10-26 |
| Member Name: PATIENCE MATHIS | Member ID: 19904300603 |
| Employer ID: SFM | Termination Date: 2022-11-01 |
| Contract Record ID: 19904300601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248599 | Status: COMPLETE |
| Request Date: 2022-10-26 | Status Date: 2022-10-26 |
| Member Name: PATIENCE MATHIS | Member ID: 19904300603 |
| Employer ID: SFM | Termination Date: 2022-11-01 |
| Contract Record ID: 19904300601 | Term Reason: VOLUNTARY |
| Comments: Opting out of dependent coverage |
|
| Request ID: 248600 | Status: COMPLETE |
| Request Date: 2022-10-26 | Status Date: 2022-10-26 |
| Member Name: SKYLER MATHIS | Member ID: 19904300604 |
| Employer ID: SFM | Termination Date: 2022-11-01 |
| Contract Record ID: 19904300601 | Term Reason: VOLUNTARY |
| Comments: Opting out of dependent coverage |
|
| Request ID: 248601 | Status: COMPLETE |
| Request Date: 2022-10-26 | Status Date: 2022-10-26 |
| Member Name: MICHAEL ALTLAND | Member ID: 21762202901 |
| Employer ID: YHP00126 | Termination Date: 2022-09-30 |
| Contract Record ID: 21762202901 | Term Reason: TERMINATION |
| Comments: Can we please cancel his insurance for the months of October & November. Please advise |
|
| Request ID: 248625 | Status: COMPLETE |
| Request Date: 2022-10-27 | Status Date: 2022-10-27 |
| Member Name: MARCIA WILSON | Member ID: 56191708501 |
| Employer ID: HOSPAUTH | Termination Date: 2022-10-20 |
| Contract Record ID: 56191708501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248634 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: RAMON ISAIAH BENAVIDEZ | Member ID: 65357513501 |
| Employer ID: FIRSTCUP | Termination Date: 2022-10-24 |
| Contract Record ID: 65357513501 | Term Reason: TERMINATION |
| Comments: vol |
|
| Request ID: 248635 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: TERRANCE DENSMORE | Member ID: 25097611901 |
| Employer ID: FIRSTCUP | Termination Date: 2022-10-24 |
| Contract Record ID: 25097611901 | Term Reason: TERMINATION |
| Comments: Vol |
|
| Request ID: 248636 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: BRANDI NICOLE MACASINAG-PETERSON | Member ID: 26850030801 |
| Employer ID: FIRSTCUP | Termination Date: 2022-10-24 |
| Contract Record ID: 26850030801 | Term Reason: TERMINATION |
| Comments: vol |
|
| Request ID: 248637 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: SUE ANDREA MARQUEZ | Member ID: 74729357401 |
| Employer ID: FIRSTCUP | Termination Date: 2022-10-24 |
| Contract Record ID: 74729357401 | Term Reason: TERMINATION |
| Comments: vol |
|
| Request ID: 248638 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: CECILIA MORENO | Member ID: 23474812201 |
| Employer ID: FIRSTCUP | Termination Date: 2022-10-24 |
| Contract Record ID: 23474812201 | Term Reason: TERMINATION |
| Comments: vol |
|
| Request ID: 248639 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: ERIC SEMUHUNGU | Member ID: 60203835601 |
| Employer ID: FIRSTCUP | Termination Date: 2022-10-24 |
| Contract Record ID: 60203835601 | Term Reason: TERMINATION |
| Comments: voluntary |
|
| Request ID: 248640 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: JADEN MICHAEL WEED | Member ID: 79782231701 |
| Employer ID: FIRSTCUP | Termination Date: 2022-10-24 |
| Contract Record ID: 79782231701 | Term Reason: TERMINATION |
| Comments: vol |
|
| Request ID: 248667 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: TRACY ENGLE | Member ID: 93102188401 |
| Employer ID: BRECK | Termination Date: 2022-10-31 |
| Contract Record ID: 93102188401 | Term Reason: TERMINATION |
| Comments: please send COBRA documents |
|
| Request ID: 248668 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: DAVID ALLAN VROMAN | Member ID: 40763550701 |
| Employer ID: BRECKS | Termination Date: 2022-10-31 |
| Contract Record ID: 40763550701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248669 | Status: COMPLETE |
| Request Date: 2022-10-28 | Status Date: 2022-10-28 |
| Member Name: SARA MICHEL MINOR | Member ID: 17460000401 |
| Employer ID: BRECKS | Termination Date: 2022-10-31 |
| Contract Record ID: 17460000401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248681 | Status: COMPLETE |
| Request Date: 2022-10-29 | Status Date: 2022-10-29 |
| Member Name: ALEXANDER SORIA | Member ID: 22335021601 |
| Employer ID: APRES | Termination Date: 2022-10-29 |
| Contract Record ID: 22335021601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 248942 | Status: COMPLETE |
| Request Date: 2022-11-01 | Status Date: 2022-11-01 |
| Member Name: CHANDRA CRAWFORD | Member ID: 85838736501 |
| Employer ID: HOSPAUTH | Termination Date: 2022-10-22 |
| Contract Record ID: 85838736501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248961 | Status: COMPLETE |
| Request Date: 2022-11-01 | Status Date: 2022-11-01 |
| Member Name: JAHDAREINE WILLIAMS | Member ID: 64236658901 |
| Employer ID: HOSPAUTH | Termination Date: 2022-09-27 |
| Contract Record ID: 64236658901 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248962 | Status: COMPLETE |
| Request Date: 2022-11-01 | Status Date: 2022-11-01 |
| Member Name: LAKESHIA THORNTON | Member ID: 04816704601 |
| Employer ID: HOSPAUTH | Termination Date: 2022-10-04 |
| Contract Record ID: 04816704601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 248981 | Status: COMPLETE |
| Request Date: 2022-11-01 | Status Date: 2022-11-01 |
| Member Name: CARI WILSON | Member ID: 04404698301 |
| Employer ID: SFM | Termination Date: 2022-10-31 |
| Contract Record ID: 04404698301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 249141 | Status: COMPLETE |
| Request Date: 2022-11-02 | Status Date: 2022-11-02 |
| Member Name: JOSE PINEDA | Member ID: 28745336601 |
| Employer ID: MESH | Termination Date: 2022-10-31 |
| Contract Record ID: 28745336601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 249461 | Status: COMPLETE |
| Request Date: 2022-11-03 | Status Date: 2022-11-03 |
| Member Name: SANDRA AKOSA | Member ID: 31142641601 |
| Employer ID: DNA | Termination Date: 2022-11-30 |
| Contract Record ID: 31142641601 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 249802 | Status: COMPLETE |
| Request Date: 2022-11-04 | Status Date: 2022-11-04 |
| Member Name: DEBORAH L LINCOLN | Member ID: 62050274401 |
| Employer ID: TPCH | Termination Date: 2022-10-14 |
| Contract Record ID: 62050274401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 249881 | Status: COMPLETE |
| Request Date: 2022-11-04 | Status Date: 2022-11-04 |
| Member Name: MARIA LOBINO | Member ID: 70587916401 |
| Employer ID: HOSPAUTH | Termination Date: 2022-10-01 |
| Contract Record ID: 70587916401 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: Medicare effective date 10/01/2022 |
|
| Request ID: 249981 | Status: COMPLETE |
| Request Date: 2022-11-04 | Status Date: 2022-11-04 |
| Member Name: ELSIE ALLEN | Member ID: 42498317201 |
| Employer ID: TPCH | Termination Date: 2022-08-21 |
| Contract Record ID: 42498317201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 250021 | Status: COMPLETE |
| Request Date: 2022-11-04 | Status Date: 2022-11-04 |
| Member Name: KRIS LUCHMUN | Member ID: 44541784902 |
| Employer ID: VAUGHAN | Termination Date: 2022-11-30 |
| Contract Record ID: 44541784901 | Term Reason: VOLUNTARY |
| Comments: Eligible for other coverage |
|
| Request ID: 250881 | Status: COMPLETE |
| Request Date: 2022-11-09 | Status Date: 2022-11-09 |
| Member Name: EDMUND GUTKOWSKI | Member ID: 60384635401 |
| Employer ID: MESH | Termination Date: 2022-10-18 |
| Contract Record ID: 60384635401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 250882 | Status: COMPLETE |
| Request Date: 2022-11-09 | Status Date: 2022-11-09 |
| Member Name: LAVERNE SELDON | Member ID: 54561762201 |
| Employer ID: HOSPAUTH | Termination Date: 2022-11-30 |
| Contract Record ID: 54561762201 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 250901 | Status: COMPLETE |
| Request Date: 2022-11-09 | Status Date: 2022-11-09 |
| Member Name: DEANGELA J CRAWFORD | Member ID: 07784357501 |
| Employer ID: YHP00158 | Termination Date: 2022-11-04 |
| Contract Record ID: 07784357501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 251041 | Status: COMPLETE |
| Request Date: 2022-11-10 | Status Date: 2022-11-10 |
| Member Name: STEPHANIE RAE BLAND | Member ID: 23227415901 |
| Employer ID: LNB | Termination Date: 2022-11-30 |
| Contract Record ID: 23227415901 | Term Reason: TERMINATION |
| Comments: Employees last day was 11/4/22 but allowed on our policies thru 11/30/22 |
|
| Request ID: 251149 | Status: COMPLETE |
| Request Date: 2022-11-10 | Status Date: 2022-11-10 |
| Member Name: SARAH WELLMAN | Member ID: 95712157201 |
| Employer ID: TRILAT | Termination Date: 2022-11-04 |
| Contract Record ID: 95712157201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 251184 | Status: COMPLETE |
| Request Date: 2022-11-11 | Status Date: 2022-11-11 |
| Member Name: HARRY R MADER | Member ID: 85103729301 |
| Employer ID: MESH | Termination Date: 2022-11-09 |
| Contract Record ID: 85103729301 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 251219 | Status: COMPLETE |
| Request Date: 2022-11-14 | Status Date: 2022-11-14 |
| Member Name: GREGORY RALLS | Member ID: 44120467801 |
| Employer ID: WCE | Termination Date: 2022-11-11 |
| Contract Record ID: 44120467801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 251227 | Status: COMPLETE |
| Request Date: 2022-11-14 | Status Date: 2022-11-14 |
| Member Name: SARA ATKINSON | Member ID: 97270045501 |
| Employer ID: CNT | Termination Date: 2022-11-30 |
| Contract Record ID: 97270045501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 251242 | Status: COMPLETE |
| Request Date: 2022-11-15 | Status Date: 2022-11-15 |
| Member Name: WALTER MARK | Member ID: 65140857801 |
| Employer ID: DNA | Termination Date: 2022-12-01 |
| Contract Record ID: 65140857801 | Term Reason: VOLUNTARY |
| Comments: Last day of coverage is 11/30/2022. |
|
| Request ID: 251262 | Status: COMPLETE |
| Request Date: 2022-11-15 | Status Date: 2022-11-15 |
| Member Name: BRAD CARSON | Member ID: 20266564001 |
| Employer ID: BRULE | Termination Date: 2022-12-31 |
| Contract Record ID: 20266564001 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 251263 | Status: COMPLETE |
| Request Date: 2022-11-15 | Status Date: 2022-11-15 |
| Member Name: JEAN CARSON | Member ID: 20266564002 |
| Employer ID: BRULE | Termination Date: 2022-12-31 |
| Contract Record ID: 20266564001 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 251461 | Status: COMPLETE |
| Request Date: 2022-11-16 | Status Date: 2022-11-16 |
| Member Name: CATHERINE TRUSSELL | Member ID: 87669953801 |
| Employer ID: TPCH | Termination Date: 2022-11-10 |
| Contract Record ID: 87669953801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 251541 | Status: COMPLETE |
| Request Date: 2022-11-17 | Status Date: 2022-11-17 |
| Member Name: DIAMOND KIANNA BOLDEN | Member ID: 29817444901 |
| Employer ID: ADVRX | Termination Date: 2022-10-31 |
| Contract Record ID: 29817444901 | Term Reason: TERMINATION |
| Comments: Did not elect a coverage
decision |
|
| Request ID: 251641 | Status: COMPLETE |
| Request Date: 2022-11-17 | Status Date: 2022-11-17 |
| Member Name: WANDA HILLARD | Member ID: 39841860201 |
| Employer ID: LNB | Termination Date: 2022-11-30 |
| Contract Record ID: 39841860201 | Term Reason: REDUCTION OF HOURS |
| Comments: Employee voluntarily went to part-time. Still employed. No longer eligible for coverage though. |
|
| Request ID: 251661 | Status: COMPLETE |
| Request Date: 2022-11-17 | Status Date: 2022-11-17 |
| Member Name: MEGAN CLARK | Member ID: 28700347901 |
| Employer ID: LNB | Termination Date: 2022-11-30 |
| Contract Record ID: 28700347901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 252141 | Status: COMPLETE |
| Request Date: 2022-11-18 | Status Date: 2022-11-18 |
| Member Name: ALYSSA J KING | Member ID: 57855577201 |
| Employer ID: BRULE | Termination Date: 2022-12-31 |
| Contract Record ID: 57855577201 | Term Reason: VOLUNTARY |
| Comments: Found insurance elsewher |
|
| Request ID: 253363 | Status: COMPLETE |
| Request Date: 2022-11-21 | Status Date: 2022-11-21 |
| Member Name: KAYLA MARIE CASTRO TOVES | Member ID: 78085241201 |
| Employer ID: SFM | Termination Date: 2022-11-30 |
| Contract Record ID: 78085241201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 253381 | Status: COMPLETE |
| Request Date: 2022-11-21 | Status Date: 2022-11-21 |
| Member Name: CRYSTAL STURTEVANT | Member ID: 33997883201 |
| Employer ID: SFM | Termination Date: 2022-11-30 |
| Contract Record ID: 33997883201 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 254041 | Status: COMPLETE |
| Request Date: 2022-11-22 | Status Date: 2022-11-22 |
| Member Name: MARC J LAPOINTE | Member ID: 31516616501 |
| Employer ID: BRECK | Termination Date: 2022-12-31 |
| Contract Record ID: 31516616501 | Term Reason: VOLUNTARY |
| Comments: Retirement. Please email COBRA as son as possible |
|
| Request ID: 254101 | Status: COMPLETE |
| Request Date: 2022-11-22 | Status Date: 2022-11-22 |
| Member Name: JOANNE ROLLINS | Member ID: 04316924101 |
| Employer ID: YHP00158 | Termination Date: 2022-11-04 |
| Contract Record ID: 04316924101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 255021 | Status: COMPLETE |
| Request Date: 2022-11-23 | Status Date: 2022-11-23 |
| Member Name: BRIAN EATON | Member ID: 85733600101 |
| Employer ID: BROSOL | Termination Date: 2022-09-30 |
| Contract Record ID: 85733600101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 255041 | Status: COMPLETE |
| Request Date: 2022-11-23 | Status Date: 2022-11-23 |
| Member Name: JARED W WESTBROOK | Member ID: 80025483401 |
| Employer ID: BROSOL | Termination Date: 2022-11-30 |
| Contract Record ID: 80025483401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 255201 | Status: COMPLETE |
| Request Date: 2022-11-23 | Status Date: 2022-11-23 |
| Member Name: CRYSTAL STURTEVANT | Member ID: 33997883201 |
| Employer ID: SFM | Termination Date: 2022-11-30 |
| Contract Record ID: 33997883201 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 255221 | Status: COMPLETE |
| Request Date: 2022-11-23 | Status Date: 2022-11-23 |
| Member Name: KAYLA MARIE CASTRO TOVES | Member ID: 78085241201 |
| Employer ID: SFM | Termination Date: 2022-11-30 |
| Contract Record ID: 78085241201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 255661 | Status: COMPLETE |
| Request Date: 2022-11-28 | Status Date: 2022-11-28 |
| Member Name: CACHE JACKSON SIMMS | Member ID: 38188450301 |
| Employer ID: YHP00134 | Termination Date: 2022-11-07 |
| Contract Record ID: 38188450301 | Term Reason: TERMINATION |
| Comments: VOLUNTARY , QUIT |
|
| Request ID: 255721 | Status: COMPLETE |
| Request Date: 2022-11-28 | Status Date: 2022-11-28 |
| Member Name: MORGAN BYNUM | Member ID: 57600276201 |
| Employer ID: CNT | Termination Date: 2022-11-30 |
| Contract Record ID: 57600276201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 255741 | Status: COMPLETE |
| Request Date: 2022-11-28 | Status Date: 2022-11-28 |
| Member Name: RANDI WRIGHT | Member ID: 12999016701 |
| Employer ID: CNT | Termination Date: 2022-11-30 |
| Contract Record ID: 12999016701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 256605 | Status: COMPLETE |
| Request Date: 2022-11-30 | Status Date: 2022-11-30 |
| Member Name: TROY THOMAS | Member ID: 28402726401 |
| Employer ID: SERVHIGH | Termination Date: 2022-11-11 |
| Contract Record ID: 28402726401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 256607 | Status: COMPLETE |
| Request Date: 2022-11-30 | Status Date: 2022-11-30 |
| Member Name: ARIANA HINOJOSA | Member ID: 35334592101 |
| Employer ID: CNT | Termination Date: 2022-11-30 |
| Contract Record ID: 35334592101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 256761 | Status: COMPLETE |
| Request Date: 2022-12-01 | Status Date: 2022-12-01 |
| Member Name: ADALINN M AVELLANEDA | Member ID: 58219701801 |
| Employer ID: YHP00134 | Termination Date: 2022-11-16 |
| Contract Record ID: 58219701801 | Term Reason: TERMINATION |
| Comments: INVOLUNTARY |
|
| Request ID: 256891 | Status: COMPLETE |
| Request Date: 2022-12-02 | Status Date: 2022-12-02 |
| Member Name: JORDAN KASZA | Member ID: 36232092901 |
| Employer ID: CNT | Termination Date: 2022-12-31 |
| Contract Record ID: 36232092901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 256892 | Status: COMPLETE |
| Request Date: 2022-12-02 | Status Date: 2022-12-02 |
| Member Name: ALLISON MATHEWS | Member ID: 50648579501 |
| Employer ID: CNT | Termination Date: 2022-11-30 |
| Contract Record ID: 50648579501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 257021 | Status: COMPLETE |
| Request Date: 2022-12-05 | Status Date: 2022-12-05 |
| Member Name: MARIO MAGANA | Member ID: 94395382601 |
| Employer ID: APRES | Termination Date: 2022-12-30 |
| Contract Record ID: 94395382601 | Term Reason: INVOLUNTARY |
| Comments: |
|
| Request ID: 257181 | Status: COMPLETE |
| Request Date: 2022-12-06 | Status Date: 2022-12-06 |
| Member Name: HARRY R MADER | Member ID: 85103729301 |
| Employer ID: MESH | Termination Date: 2022-11-30 |
| Contract Record ID: 85103729301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 257261 | Status: COMPLETE |
| Request Date: 2022-12-06 | Status Date: 2022-12-06 |
| Member Name: DACIA GARBIG | Member ID: 82014753001 |
| Employer ID: TRILAT | Termination Date: 2022-12-14 |
| Contract Record ID: 82014753001 | Term Reason: TERMINATION |
| Comments: Voluntary termination |
|
| Request ID: 257542 | Status: COMPLETE |
| Request Date: 2022-12-08 | Status Date: 2022-12-08 |
| Member Name: BRIAN WATERS | Member ID: 48886677501 |
| Employer ID: HOSPAUTH | Termination Date: 2022-11-23 |
| Contract Record ID: 48886677501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 257801 | Status: COMPLETE |
| Request Date: 2022-12-09 | Status Date: 2022-12-09 |
| Member Name: FREDDIE ARTUZ | Member ID: 64172799701 |
| Employer ID: DNA | Termination Date: 2022-12-05 |
| Contract Record ID: 64172799701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 257848 | Status: COMPLETE |
| Request Date: 2022-12-09 | Status Date: 2022-12-09 |
| Member Name: PETER HART | Member ID: 31433771701 |
| Employer ID: MESH | Termination Date: 2022-12-31 |
| Contract Record ID: 31433771701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 258161 | Status: COMPLETE |
| Request Date: 2022-12-12 | Status Date: 2022-12-12 |
| Member Name: BRANDON KELLY | Member ID: 96069822403 |
| Employer ID: VAUGHAN | Termination Date: 2022-12-31 |
| Contract Record ID: 96069822401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 258242 | Status: COMPLETE |
| Request Date: 2022-12-12 | Status Date: 2022-12-12 |
| Member Name: SHEILA PELLEGRINO | Member ID: 33726825202 |
| Employer ID: VAUGHAN | Termination Date: 2022-12-31 |
| Contract Record ID: 33726825201 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 258243 | Status: COMPLETE |
| Request Date: 2022-12-12 | Status Date: 2022-12-12 |
| Member Name: COLE SWENSON | Member ID: 59677174003 |
| Employer ID: VAUGHAN | Termination Date: 2022-12-31 |
| Contract Record ID: 59677174001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258244 | Status: COMPLETE |
| Request Date: 2022-12-12 | Status Date: 2022-12-12 |
| Member Name: BLAKE SWENSON | Member ID: 59677174004 |
| Employer ID: VAUGHAN | Termination Date: 2022-12-31 |
| Contract Record ID: 59677174001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 258281 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: SCOTT R FAUX | Member ID: 36304647101 |
| Employer ID: MESH | Termination Date: 2022-11-29 |
| Contract Record ID: 36304647101 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 258301 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: CARMEN PEREZ | Member ID: 64710087101 |
| Employer ID: PELTZ | Termination Date: 2022-12-31 |
| Contract Record ID: 64710087101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258363 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: KADENCE BEAVERS | Member ID: 66520011603 |
| Employer ID: GPR | Termination Date: 2022-12-06 |
| Contract Record ID: 66520011601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258364 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: CAROLINE VASON | Member ID: 34073374501 |
| Employer ID: GPR | Termination Date: 2022-12-11 |
| Contract Record ID: 34073374501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258481 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: ADELA ARELLANO | Member ID: 47288648501 |
| Employer ID: ACW | Termination Date: 2022-07-24 |
| Contract Record ID: 47288648501 | Term Reason: TERMINATION |
| Comments: Sold business |
|
| Request ID: 258482 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: MICHELLE L CAMP | Member ID: 74298180901 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 74298180901 | Term Reason: TERMINATION |
| Comments: Sold Buiness |
|
| Request ID: 258483 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: PAUL CAMPBELL | Member ID: 80265296801 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 80265296801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258484 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: GREGORIO CASIANO | Member ID: 00445775301 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 00445775301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258485 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: ARMANDO CASTRO | Member ID: 30743180101 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 30743180101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258487 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: DACIOUS HUNTER | Member ID: 28215844201 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 28215844201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258488 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: LILIANA LOPEZ | Member ID: 51255988801 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 51255988801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258489 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: HUGO MARTINEZ | Member ID: 43115620901 |
| Employer ID: ACW | Termination Date: 2022-07-24 |
| Contract Record ID: 43115620901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258490 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: JOSE MARIA PICHARDO AVILES | Member ID: 23031691801 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 23031691801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258491 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: WILFRIDO RODRIGUEZ | Member ID: 90584698401 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 90584698401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258492 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: LEON MARCELINO ROMERO FLORES | Member ID: 18201500501 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 18201500501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258493 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: ANTONIO S SALGADO | Member ID: 26041398201 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 26041398201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258494 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: ISMAEL M SALGADO | Member ID: 11324111301 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 11324111301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258495 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: VINCENTE SALINAS | Member ID: 33346426801 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 33346426801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258496 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: JORGE C SANTIAGO | Member ID: 66591786701 |
| Employer ID: ACW | Termination Date: 2022-06-24 |
| Contract Record ID: 66591786701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258497 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: JOSE U SAUCEDO | Member ID: 57892967701 |
| Employer ID: ACW | Termination Date: 2022-07-24 |
| Contract Record ID: 57892967701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258498 | Status: COMPLETE |
| Request Date: 2022-12-13 | Status Date: 2022-12-13 |
| Member Name: DAVID J SCHAETZLE | Member ID: 94371452701 |
| Employer ID: ACW | Termination Date: 2022-07-24 |
| Contract Record ID: 94371452701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 258861 | Status: COMPLETE |
| Request Date: 2022-12-14 | Status Date: 2022-12-14 |
| Member Name: ZACHARY LONG | Member ID: 53423136001 |
| Employer ID: PELTZ | Termination Date: 2022-11-30 |
| Contract Record ID: 53423136001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 259484 | Status: COMPLETE |
| Request Date: 2022-12-15 | Status Date: 2022-12-15 |
| Member Name: BRICHELLE ROSE OLSEN | Member ID: 17796900101 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 17796900101 | Term Reason: REDUCTION OF HOURS |
| Comments: |
|
| Request ID: 259485 | Status: COMPLETE |
| Request Date: 2022-12-15 | Status Date: 2022-12-15 |
| Member Name: KELLY NICHOLE JONES | Member ID: 19615894201 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 19615894201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 259486 | Status: COMPLETE |
| Request Date: 2022-12-15 | Status Date: 2022-12-15 |
| Member Name: KATHRYNE M SCHERER | Member ID: 00904191301 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 00904191301 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 259841 | Status: COMPLETE |
| Request Date: 2022-12-19 | Status Date: 2022-12-19 |
| Member Name: CHRISTOPHER DAVID JONES | Member ID: 62676029201 |
| Employer ID: BRECKS | Termination Date: 2022-12-31 |
| Contract Record ID: 62676029201 | Term Reason: TERMINATION |
| Comments: Please mail and email COBRA documents |
|
| Request ID: 259881 | Status: COMPLETE |
| Request Date: 2022-12-19 | Status Date: 2022-12-19 |
| Member Name: BENJAMIN M DEFENDER | Member ID: 05642410101 |
| Employer ID: BRULE | Termination Date: 2022-11-28 |
| Contract Record ID: 05642410101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 260162 | Status: COMPLETE |
| Request Date: 2022-12-20 | Status Date: 2022-12-20 |
| Member Name: CAWANA BURTON | Member ID: 86569901401 |
| Employer ID: HOSPAUTH | Termination Date: 2022-12-08 |
| Contract Record ID: 86569901401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 260423 | Status: COMPLETE |
| Request Date: 2022-12-22 | Status Date: 2022-12-22 |
| Member Name: SHUMMIEYUM KIMBEL | Member ID: 85466461501 |
| Employer ID: CNT | Termination Date: 2022-12-31 |
| Contract Record ID: 85466461501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 260424 | Status: COMPLETE |
| Request Date: 2022-12-22 | Status Date: 2022-12-22 |
| Member Name: BEVERLY L BYAS | Member ID: 32847072801 |
| Employer ID: CNT | Termination Date: 2022-12-31 |
| Contract Record ID: 32847072801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 260682 | Status: COMPLETE |
| Request Date: 2022-12-23 | Status Date: 2022-12-23 |
| Member Name: JUSTIN DOTSON | Member ID: 94724207801 |
| Employer ID: VAUGHAN | Termination Date: 2022-12-31 |
| Contract Record ID: 94724207801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 260701 | Status: COMPLETE |
| Request Date: 2022-12-27 | Status Date: 2022-12-27 |
| Member Name: JEREMY HANCOCK | Member ID: 77424200501 |
| Employer ID: PELTZ | Termination Date: 2022-12-31 |
| Contract Record ID: 77424200501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 260802 | Status: COMPLETE |
| Request Date: 2022-12-27 | Status Date: 2022-12-27 |
| Member Name: CYNTHIA HOWERY | Member ID: 48095579201 |
| Employer ID: CNT | Termination Date: 2022-12-31 |
| Contract Record ID: 48095579201 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 261162 | Status: COMPLETE |
| Request Date: 2022-12-28 | Status Date: 2022-12-28 |
| Member Name: ASHLEY BALDYGA | Member ID: 47361302401 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 47361302401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 261163 | Status: COMPLETE |
| Request Date: 2022-12-28 | Status Date: 2022-12-28 |
| Member Name: JEREMY WADE VAN GIESON | Member ID: 72611277101 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 72611277101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 261203 | Status: COMPLETE |
| Request Date: 2022-12-29 | Status Date: 2022-12-29 |
| Member Name: JESSE J WEAVER | Member ID: 70575245801 |
| Employer ID: MESH | Termination Date: 2022-12-30 |
| Contract Record ID: 70575245801 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 261782 | Status: COMPLETE |
| Request Date: 2022-12-30 | Status Date: 2022-12-30 |
| Member Name: MYRNA ANDRES | Member ID: 39934594001 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 39934594001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 261881 | Status: COMPLETE |
| Request Date: 2022-12-30 | Status Date: 2022-12-30 |
| Member Name: ZACHARY SZAFRYK | Member ID: 62812718003 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 62812718001 | Term Reason: LOSS OF DEPENDANT STATUS |
| Comments: |
|
| Request ID: 262021 | Status: COMPLETE |
| Request Date: 2023-01-03 | Status Date: 2023-01-03 |
| Member Name: MAKENZIE MOHON | Member ID: 95300455001 |
| Employer ID: BROSOL | Termination Date: 2022-12-31 |
| Contract Record ID: 95300455001 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 262204 | Status: COMPLETE |
| Request Date: 2023-01-03 | Status Date: 2023-01-03 |
| Member Name: KATHERINE GAINES | Member ID: 74247200101 |
| Employer ID: CNT | Termination Date: 2022-12-31 |
| Contract Record ID: 74247200101 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 262601 | Status: COMPLETE |
| Request Date: 2023-01-05 | Status Date: 2023-01-05 |
| Member Name: ZACKARY D MARTINSON | Member ID: 92863291001 |
| Employer ID: SERVHIGH | Termination Date: 2022-12-15 |
| Contract Record ID: 92863291001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 262621 | Status: COMPLETE |
| Request Date: 2023-01-05 | Status Date: 2023-01-05 |
| Member Name: ROXANNE BARRERA | Member ID: 19797229001 |
| Employer ID: SERVHIGH | Termination Date: 2022-12-31 |
| Contract Record ID: 19797229001 | Term Reason: EMPLOYEES MEDICARE ENROLLMENT |
| Comments: |
|
| Request ID: 262961 | Status: COMPLETE |
| Request Date: 2023-01-06 | Status Date: 2023-01-06 |
| Member Name: MARY D GEARON | Member ID: 65248876004 |
| Employer ID: LNB | Termination Date: 2023-01-01 |
| Contract Record ID: 65248876001 | Term Reason: VOLUNTARY |
| Comments: Gained other insurance coverage due to new job. Please leave her on Dental - she is only canceling the health - Please notate..... |
|
| Request ID: 263161 | Status: COMPLETE |
| Request Date: 2023-01-06 | Status Date: 2023-01-06 |
| Member Name: LAUREEN AKPOMUDJE | Member ID: 69813937401 |
| Employer ID: SFM | Termination Date: 2022-12-31 |
| Contract Record ID: 69813937401 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 263381 | Status: COMPLETE |
| Request Date: 2023-01-09 | Status Date: 2023-01-09 |
| Member Name: MICHAEL BONILLA | Member ID: 45323565701 |
| Employer ID: WCE | Termination Date: 2023-01-03 |
| Contract Record ID: 45323565701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 263521 | Status: COMPLETE |
| Request Date: 2023-01-09 | Status Date: 2023-01-09 |
| Member Name: JILLIAN J CHAMBERLAIN | Member ID: 85687479302 |
| Employer ID: APRES | Termination Date: 2022-12-31 |
| Contract Record ID: 85687479301 | Term Reason: VOLUNTARY |
| Comments: Open Enrollment dropping coverage only for spouse, Jillian |
|
| Request ID: 263641 | Status: COMPLETE |
| Request Date: 2023-01-09 | Status Date: 2023-01-09 |
| Member Name: JUSTIN DOTSON | Member ID: 94724207801 |
| Employer ID: VAUGHAN | Termination Date: 2022-12-30 |
| Contract Record ID: 94724207801 | Term Reason: VOLUNTARY |
| Comments: This is the 2nd attempt to term coverage for this member. Original request was made on 12/23/22 with request ID # 260682 |
|
| Request ID: 263661 | Status: COMPLETE |
| Request Date: 2023-01-09 | Status Date: 2023-01-09 |
| Member Name: JASPER G DAVIS | Member ID: 00444484801 |
| Employer ID: TRILAT | Termination Date: 2023-01-06 |
| Contract Record ID: 00444484801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 264321 | Status: COMPLETE |
| Request Date: 2023-01-10 | Status Date: 2023-01-10 |
| Member Name: MATTHEW T BOYD | Member ID: 81884286501 |
| Employer ID: BROSOL | Termination Date: 2022-12-31 |
| Contract Record ID: 81884286501 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 264384 | Status: COMPLETE |
| Request Date: 2023-01-10 | Status Date: 2023-01-10 |
| Member Name: WILLIAM A MEANS | Member ID: 09417518401 |
| Employer ID: BROSOL | Termination Date: 2022-07-18 |
| Contract Record ID: 09417518401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 264501 | Status: COMPLETE |
| Request Date: 2023-01-11 | Status Date: 2023-01-11 |
| Member Name: JESSIE OWENS | Member ID: 18875106401 |
| Employer ID: HOSPAUTH | Termination Date: 2022-12-29 |
| Contract Record ID: 18875106401 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 265181 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: MARIO MAGANA | Member ID: 94395382601 |
| Employer ID: APRES | Termination Date: 2022-12-09 |
| Contract Record ID: 94395382601 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 265361 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: LARIAH MUASAU | Member ID: 40709549501 |
| Employer ID: SFM | Termination Date: 2023-01-31 |
| Contract Record ID: 40709549501 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 265381 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: DESTINY MARINA LUPESINA KEALOHA | Member ID: 44827467901 |
| Employer ID: SFM | Termination Date: 2023-01-31 |
| Contract Record ID: 44827467901 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 265401 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: VIRGINIA MORCOMBE | Member ID: 52262695001 |
| Employer ID: SFM | Termination Date: 2023-01-05 |
| Contract Record ID: 52262695001 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 265441 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: DIANNE FORD | Member ID: 65172949701 |
| Employer ID: HOSPAUTH | Termination Date: 2023-01-12 |
| Contract Record ID: 65172949701 | Term Reason: VOLUNTARY |
| Comments: |
|
| Request ID: 265461 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: GARY WHITAKER | Member ID: 15886516501 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 15886516501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 265481 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: GARY WHITAKER | Member ID: 15886516501 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 15886516501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 265501 | Status: COMPLETE |
| Request Date: 2023-01-13 | Status Date: 2023-01-13 |
| Member Name: GARY WHITAKER | Member ID: 15886516501 |
| Employer ID: ASSI | Termination Date: 2022-05-11 |
| Contract Record ID: 15886516501 | Term Reason: VOLUNTARY |
| Comments: waiver |
|
| Request ID: 265961 | Status: COMPLETE |
| Request Date: 2023-01-16 | Status Date: 2023-01-16 |
| Member Name: CHELSI BEECH | Member ID: 85666624501 |
| Employer ID: CCRAFT | Termination Date: 2023-01-01 |
| Contract Record ID: 85666624501 | Term Reason: VOLUNTARY |
| Comments: Employee voluntary wants to cancel the coverage effective 01/01/2023. |
|
| Request ID: 266041 | Status: COMPLETE |
| Request Date: 2023-01-16 | Status Date: 2023-01-16 |
| Member Name: ROSA GONZALEZ | Member ID: 34253861802 |
| Employer ID: APRES | Termination Date: 2022-12-31 |
| Contract Record ID: 34253861801 | Term Reason: VOLUNTARY |
| Comments: Enrolled in error eff. 1/1/23, please delete |
|
| Request ID: 269461 | Status: COMPLETE |
| Request Date: 2023-01-25 | Status Date: 2023-01-25 |
| Member Name: PETER ZIMMER | Member ID: 28602516701 |
| Employer ID: PELTZ | Termination Date: 2023-01-24 |
| Contract Record ID: 28602516701 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 269667 | Status: COMPLETE |
| Request Date: 2023-01-25 | Status Date: 2023-01-25 |
| Member Name: JENELL OUTERSON | Member ID: 55336731801 |
| Employer ID: SFM | Termination Date: 2023-01-31 |
| Contract Record ID: 55336731801 | Term Reason: TERMINATION |
| Comments: |
|
| Request ID: 270261 | Status: COMPLETE |
| Request Date: 2023-01-26 | Status Date: 2023-01-26 |
| Member Name: BLANCA ZUNIGA | Member ID: 48343505401 |
| Employer ID: SFM | Termination Date: 2023-01-31 |
| Contract Record ID: 48343505401 | Term Reason: VOLUNTARY |
| Comments: Other coverage |
|