Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: ALL
Suffix: ALL
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 267 250 43 214 774 0 967 1,741
2011-02 267 248 42 218 775 0 975 1,750
2011-03 269 248 45 219 781 0 982 1,763
2011-04 264 252 45 220 781 0 984 1,765
2011-05 264 250 46 224 784 0 1,000 1,784
2011-06 265 251 45 225 786 0 1,004 1,790
2011-07 263 253 45 225 786 0 1,008 1,794
2011-08 268 253 46 224 791 0 1,009 1,800
2011-09 267 249 47 225 788 0 1,008 1,796
2011-10 265 248 47 225 785 0 1,009 1,794
2011-11 266 250 47 235 798 0 1,046 1,844
2011-12 267 248 47 237 799 0 1,051 1,850
2012-01 270 244 50 244 808 0 1,064 1,872
2012-02 271 243 49 248 811 0 1,073 1,884
2012-03 276 243 49 254 822 0 1,093 1,915
Total 4,009 3,730 693 3,437 11,869 0 15,273 27,142
 
Average number of subscribers: 791.3
Average number of members: 1,809.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: ALL
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 267 250 43 214 774 0 967 1,741
2011-02 267 248 42 218 775 0 975 1,750
2011-03 269 248 45 219 781 0 982 1,763
2011-04 264 252 45 220 781 0 984 1,765
2011-05 264 250 46 224 784 0 1,000 1,784
2011-06 265 251 45 225 786 0 1,004 1,790
2011-07 263 253 45 225 786 0 1,008 1,794
2011-08 268 253 46 224 791 0 1,009 1,800
2011-09 267 249 47 225 788 0 1,008 1,796
2011-10 265 248 47 225 785 0 1,009 1,794
2011-11 266 250 47 235 798 0 1,046 1,844
2011-12 267 248 47 237 799 0 1,051 1,850
2012-01 270 244 50 244 808 0 1,064 1,872
2012-02 271 243 49 248 811 0 1,073 1,884
2012-03 276 243 49 254 822 0 1,093 1,915
Total 4,009 3,730 693 3,437 11,869 0 15,273 27,142
 
Average number of subscribers: 791.3
Average number of members: 1,809.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AF
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 7 3 0 0 10 0 3 13
2011-02 7 3 0 0 10 0 3 13
2011-03 6 3 0 0 9 0 3 12
2011-04 6 3 0 0 9 0 3 12
Total 26 12 0 0 38 0 12 50
 
Average number of subscribers: 9.5
Average number of members: 12.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 4 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AF
Account: 0037
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 7 3 0 0 10 0 3 13
2011-02 7 3 0 0 10 0 3 13
2011-03 6 3 0 0 9 0 3 12
2011-04 6 3 0 0 9 0 3 12
Total 26 12 0 0 38 0 12 50
 
Average number of subscribers: 9.5
Average number of members: 12.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 4 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AG
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 2 2 0 0 4 0 2 6
2011-02 2 2 0 0 4 0 2 6
2011-03 2 2 0 0 4 0 2 6
2011-04 2 2 0 0 4 0 2 6
2011-05 2 2 0 0 4 0 2 6
2011-06 2 2 0 0 4 0 2 6
2011-07 2 2 0 0 4 0 2 6
2011-08 2 2 0 0 4 0 2 6
2011-09 1 2 0 0 3 0 2 5
2011-10 1 2 0 0 3 0 2 5
2011-11 1 2 0 0 3 0 2 5
2011-12 1 2 0 0 3 0 2 5
2012-01 1 1 0 0 2 0 1 3
2012-02 1 1 0 0 2 0 1 3
2012-03 1 1 0 0 2 0 1 3
Total 23 27 0 0 50 0 27 77
 
Average number of subscribers: 3.3
Average number of members: 5.1
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AG
Account: 0101
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 2 2 0 0 4 0 2 6
2011-02 2 2 0 0 4 0 2 6
2011-03 2 2 0 0 4 0 2 6
2011-04 2 2 0 0 4 0 2 6
2011-05 2 2 0 0 4 0 2 6
2011-06 2 2 0 0 4 0 2 6
2011-07 2 2 0 0 4 0 2 6
2011-08 2 2 0 0 4 0 2 6
2011-09 1 2 0 0 3 0 2 5
2011-10 1 2 0 0 3 0 2 5
2011-11 1 2 0 0 3 0 2 5
2011-12 1 2 0 0 3 0 2 5
2012-01 1 1 0 0 2 0 1 3
2012-02 1 1 0 0 2 0 1 3
2012-03 1 1 0 0 2 0 1 3
Total 23 27 0 0 50 0 27 77
 
Average number of subscribers: 3.3
Average number of members: 5.1
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AH
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-05 10 17 0 0 27 0 19 46
2011-06 10 17 0 0 27 0 19 46
2011-07 10 16 0 0 26 0 18 44
2011-08 10 16 0 0 26 0 18 44
2011-09 10 15 0 0 25 0 17 42
2011-10 10 14 0 0 24 0 16 40
2011-11 10 14 0 0 24 0 16 40
2011-12 10 14 0 0 24 0 16 40
2012-01 10 12 0 0 22 0 14 36
2012-02 10 12 0 0 22 0 14 36
2012-03 9 12 0 0 21 0 14 35
Total 109 159 0 0 268 0 181 449
 
Average number of subscribers: 24.4
Average number of members: 40.8
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 11 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AH
Account: 0131
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-05 10 17 0 0 27 0 19 46
2011-06 10 17 0 0 27 0 19 46
2011-07 10 16 0 0 26 0 18 44
2011-08 10 16 0 0 26 0 18 44
2011-09 10 15 0 0 25 0 17 42
2011-10 10 14 0 0 24 0 16 40
2011-11 10 14 0 0 24 0 16 40
2011-12 10 14 0 0 24 0 16 40
2012-01 10 12 0 0 22 0 14 36
2012-02 10 12 0 0 22 0 14 36
2012-03 9 12 0 0 21 0 14 35
Total 109 159 0 0 268 0 181 449
 
Average number of subscribers: 24.4
Average number of members: 40.8
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 11 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AI
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-05 1 0 0 0 1 0 0 1
2011-06 1 0 0 0 1 0 0 1
2011-07 1 0 0 0 1 0 0 1
2011-08 1 0 0 0 1 0 0 1
2011-09 1 0 0 0 1 0 0 1
2011-10 1 0 0 0 1 0 0 1
2011-11 1 0 0 0 1 0 0 1
2011-12 1 0 0 0 1 0 0 1
2012-01 1 0 0 0 1 0 0 1
2012-02 1 0 0 0 1 0 0 1
2012-03 1 0 0 0 1 0 0 1
Total 11 0 0 0 11 0 0 11
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 11 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AI
Account: 0134
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-05 1 0 0 0 1 0 0 1
2011-06 1 0 0 0 1 0 0 1
2011-07 1 0 0 0 1 0 0 1
2011-08 1 0 0 0 1 0 0 1
2011-09 1 0 0 0 1 0 0 1
2011-10 1 0 0 0 1 0 0 1
2011-11 1 0 0 0 1 0 0 1
2011-12 1 0 0 0 1 0 0 1
2012-01 1 0 0 0 1 0 0 1
2012-02 1 0 0 0 1 0 0 1
2012-03 1 0 0 0 1 0 0 1
Total 11 0 0 0 11 0 0 11
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 11 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AJ
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-05 48 53 1 5 107 0 62 169
2011-06 48 53 1 5 107 0 62 169
2011-07 48 53 1 5 107 0 62 169
2011-08 47 53 1 5 106 0 62 168
2011-09 49 53 1 5 108 0 62 170
2011-10 50 53 1 5 109 0 62 171
2011-11 50 53 1 5 109 0 62 171
2011-12 50 53 1 5 109 0 62 171
2012-01 51 53 1 5 110 0 62 172
2012-02 51 53 1 5 110 0 62 172
2012-03 51 53 1 5 110 0 62 172
Total 543 583 11 55 1,192 0 682 1,874
 
Average number of subscribers: 108.4
Average number of members: 170.4
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 11 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AJ
Account: 0134
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-05 42 50 1 5 98 0 59 157
2011-06 42 50 1 5 98 0 59 157
2011-07 42 50 1 5 98 0 59 157
2011-08 42 50 1 5 98 0 59 157
2011-09 43 50 1 5 99 0 59 158
2011-10 44 50 1 5 100 0 59 159
2011-11 44 50 1 5 100 0 59 159
2011-12 44 50 1 5 100 0 59 159
2012-01 44 50 1 5 100 0 59 159
2012-02 44 50 1 5 100 0 59 159
2012-03 44 50 1 5 100 0 59 159
Total 475 550 11 55 1,091 0 649 1,740
 
Average number of subscribers: 99.2
Average number of members: 158.2
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 11 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: AJ
Account: 0135
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-05 6 3 0 0 9 0 3 12
2011-06 6 3 0 0 9 0 3 12
2011-07 6 3 0 0 9 0 3 12
2011-08 5 3 0 0 8 0 3 11
2011-09 6 3 0 0 9 0 3 12
2011-10 6 3 0 0 9 0 3 12
2011-11 6 3 0 0 9 0 3 12
2011-12 6 3 0 0 9 0 3 12
2012-01 7 3 0 0 10 0 3 13
2012-02 7 3 0 0 10 0 3 13
2012-03 7 3 0 0 10 0 3 13
Total 68 33 0 0 101 0 33 134
 
Average number of subscribers: 9.2
Average number of members: 12.2
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 11 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: FA
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 50 68 1 5 124 0 79 203
2011-02 50 68 1 5 124 0 79 203
2011-03 51 68 1 5 125 0 79 204
2011-04 51 68 1 5 125 0 79 204
Total 202 272 4 20 498 0 316 814
 
Average number of subscribers: 124.5
Average number of members: 203.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 4 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: FA
Account: 0077
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 2 2 0 0 4 0 2 6
2011-02 2 2 0 0 4 0 2 6
2011-03 3 2 0 0 5 0 2 7
2011-04 3 2 0 0 5 0 2 7
Total 10 8 0 0 18 0 8 26
 
Average number of subscribers: 4.5
Average number of members: 6.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 4 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: FA
Account: 0085
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 48 66 1 5 120 0 77 197
2011-02 48 66 1 5 120 0 77 197
2011-03 48 66 1 5 120 0 77 197
2011-04 48 66 1 5 120 0 77 197
Total 192 264 4 20 480 0 308 788
 
Average number of subscribers: 120.0
Average number of members: 197.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 4 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: GA
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 1 0 0 0 1 0 0 1
2011-02 1 0 0 0 1 0 0 1
2011-03 1 0 0 0 1 0 0 1
2011-04 1 0 0 0 1 0 0 1
Total 4 0 0 0 4 0 0 4
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 4 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: GA
Account: 0078
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 1 0 0 0 1 0 0 1
2011-02 1 0 0 0 1 0 0 1
2011-03 1 0 0 0 1 0 0 1
2011-04 1 0 0 0 1 0 0 1
Total 4 0 0 0 4 0 0 4
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 4 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: HB
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 40 68 0 4 112 0 77 189
2011-02 40 68 0 4 112 0 77 189
2011-03 40 68 0 4 112 0 77 189
2011-04 40 68 0 4 112 0 77 189
2011-05 41 67 0 4 112 0 76 188
2011-06 41 68 0 3 112 0 75 187
2011-07 39 69 0 3 111 0 76 187
2011-08 38 69 0 3 110 0 76 186
2011-09 38 69 0 3 110 0 76 186
2011-10 38 69 0 3 110 0 76 186
2011-11 38 69 0 3 110 0 76 186
2011-12 38 69 0 3 110 0 76 186
2012-01 39 68 0 3 110 0 75 185
2012-02 39 68 0 3 110 0 75 185
2012-03 39 68 0 3 110 0 75 185
Total 588 1,025 0 50 1,663 0 1,140 2,803
 
Average number of subscribers: 110.9
Average number of members: 186.9
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: HB
Account: 0086
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 40 67 0 4 111 0 76 187
2011-02 40 67 0 4 111 0 76 187
2011-03 40 67 0 4 111 0 76 187
2011-04 40 67 0 4 111 0 76 187
2011-05 41 66 0 4 111 0 75 186
2011-06 41 67 0 3 111 0 74 185
2011-07 39 68 0 3 110 0 75 185
2011-08 38 68 0 3 109 0 75 184
2011-09 38 68 0 3 109 0 75 184
2011-10 38 68 0 3 109 0 75 184
2011-11 38 68 0 3 109 0 75 184
2011-12 38 68 0 3 109 0 75 184
2012-01 39 67 0 3 109 0 74 183
2012-02 39 67 0 3 109 0 74 183
2012-03 39 67 0 3 109 0 74 183
Total 588 1,010 0 50 1,648 0 1,125 2,773
 
Average number of subscribers: 109.9
Average number of members: 184.9
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: HB
Account: 0087
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 0 1 0 0 1 0 1 2
2011-02 0 1 0 0 1 0 1 2
2011-03 0 1 0 0 1 0 1 2
2011-04 0 1 0 0 1 0 1 2
2011-05 0 1 0 0 1 0 1 2
2011-06 0 1 0 0 1 0 1 2
2011-07 0 1 0 0 1 0 1 2
2011-08 0 1 0 0 1 0 1 2
2011-09 0 1 0 0 1 0 1 2
2011-10 0 1 0 0 1 0 1 2
2011-11 0 1 0 0 1 0 1 2
2011-12 0 1 0 0 1 0 1 2
2012-01 0 1 0 0 1 0 1 2
2012-02 0 1 0 0 1 0 1 2
2012-03 0 1 0 0 1 0 1 2
Total 0 15 0 0 15 0 15 30
 
Average number of subscribers: 1.0
Average number of members: 2.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: IA
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 1 0 0 0 1 0 0 1
2011-02 1 0 0 0 1 0 0 1
2011-03 1 0 0 0 1 0 0 1
2011-04 1 0 0 0 1 0 0 1
2011-05 1 0 0 0 1 0 0 1
2011-06 1 0 0 0 1 0 0 1
2011-07 1 0 0 0 1 0 0 1
2011-08 1 0 0 0 1 0 0 1
2011-09 1 0 0 0 1 0 0 1
2011-10 1 0 0 0 1 0 0 1
2011-11 1 0 0 0 1 0 0 1
2011-12 1 0 0 0 1 0 0 1
2012-01 1 0 0 0 1 0 0 1
2012-02 1 0 0 0 1 0 0 1
2012-03 1 0 0 0 1 0 0 1
Total 15 0 0 0 15 0 0 15
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: IA
Account: 0091
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 1 0 0 0 1 0 0 1
2011-02 1 0 0 0 1 0 0 1
2011-03 1 0 0 0 1 0 0 1
2011-04 1 0 0 0 1 0 0 1
2011-05 1 0 0 0 1 0 0 1
2011-06 1 0 0 0 1 0 0 1
2011-07 1 0 0 0 1 0 0 1
2011-08 1 0 0 0 1 0 0 1
2011-09 1 0 0 0 1 0 0 1
2011-10 1 0 0 0 1 0 0 1
2011-11 1 0 0 0 1 0 0 1
2011-12 1 0 0 0 1 0 0 1
2012-01 1 0 0 0 1 0 0 1
2012-02 1 0 0 0 1 0 0 1
2012-03 1 0 0 0 1 0 0 1
Total 15 0 0 0 15 0 0 15
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: KA
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 53 27 18 56 154 0 237 391
2011-02 54 25 18 55 152 0 232 384
2011-03 52 26 19 55 152 0 235 387
2011-04 52 26 19 54 151 0 233 384
2011-05 51 25 19 54 149 0 232 381
2011-06 51 25 19 54 149 0 232 381
2011-07 50 25 19 54 148 0 232 380
2011-08 50 25 19 53 147 0 229 376
2011-09 48 25 19 54 146 0 232 378
2011-10 46 25 20 54 145 0 233 378
2011-11 45 26 20 57 148 0 244 392
2011-12 44 25 20 59 148 0 247 395
2012-01 31 16 14 34 95 0 153 248
2012-02 32 16 14 34 96 0 154 250
2012-03 32 16 13 34 95 0 153 248
Total 691 353 270 761 2,075 0 3,278 5,353
 
Average number of subscribers: 138.3
Average number of members: 356.9
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: KA
Account: 0102
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 41 23 12 43 119 0 173 292
2011-02 41 21 12 42 116 0 168 284
2011-03 40 22 12 43 117 0 172 289
2011-04 40 23 12 42 117 0 171 288
2011-05 40 22 12 42 116 0 170 286
2011-06 41 22 12 42 117 0 170 287
2011-07 41 22 12 42 117 0 170 287
2011-08 41 22 12 41 116 0 167 283
2011-09 40 22 12 42 116 0 170 286
2011-10 38 22 13 42 115 0 171 286
2011-11 38 23 13 45 119 0 182 301
2011-12 37 22 13 47 119 0 185 304
2012-01 23 13 7 22 65 0 90 155
2012-02 23 13 7 22 65 0 90 155
2012-03 23 13 6 22 64 0 89 153
Total 547 305 167 579 1,598 0 2,338 3,936
 
Average number of subscribers: 106.5
Average number of members: 262.4
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: KA
Account: 0103
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 6 1 0 1 8 0 4 12
2011-02 7 1 0 1 9 0 4 13
2011-03 7 1 0 0 8 0 1 9
2011-04 7 0 0 0 7 0 0 7
2011-05 6 0 0 0 6 0 0 6
2011-06 5 0 0 0 5 0 0 5
2011-07 4 0 0 0 4 0 0 4
2011-08 4 0 0 0 4 0 0 4
2011-09 3 0 0 0 3 0 0 3
2011-10 3 0 0 0 3 0 0 3
2011-11 2 0 0 0 2 0 0 2
2011-12 2 0 0 0 2 0 0 2
2012-01 3 0 0 0 3 0 0 3
2012-02 3 0 0 0 3 0 0 3
2012-03 3 0 0 0 3 0 0 3
Total 65 3 0 2 70 0 9 79
 
Average number of subscribers: 4.7
Average number of members: 5.3
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: KA
Account: 0104
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 0 1 1 3 5 0 14 19
2011-02 0 1 1 3 5 0 14 19
2011-03 0 1 1 3 5 0 14 19
2011-04 0 1 1 3 5 0 14 19
2011-05 0 1 1 3 5 0 14 19
2011-06 0 1 1 3 5 0 14 19
2011-07 0 1 1 3 5 0 14 19
2011-08 0 1 1 3 5 0 14 19
2011-09 0 1 1 3 5 0 14 19
2011-10 0 1 1 3 5 0 14 19
2011-11 0 1 1 3 5 0 14 19
2011-12 0 1 1 3 5 0 14 19
2012-01 0 1 1 3 5 0 14 19
2012-02 0 1 1 3 5 0 14 19
2012-03 0 1 1 3 5 0 14 19
Total 0 15 15 45 75 0 210 285
 
Average number of subscribers: 5.0
Average number of members: 19.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: KA
Account: 0105
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2012-02 1 0 0 0 1 0 0 1
2012-03 1 0 0 0 1 0 0 1
Total 2 0 0 0 2 0 0 2
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 2 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: KA
Account: 0106
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 6 2 5 9 22 0 46 68
2011-02 6 2 5 9 22 0 46 68
2011-03 5 2 6 9 22 0 48 70
2011-04 5 2 6 9 22 0 48 70
2011-05 5 2 6 9 22 0 48 70
2011-06 5 2 6 9 22 0 48 70
2011-07 5 2 6 9 22 0 48 70
2011-08 5 2 6 9 22 0 48 70
2011-09 5 2 6 9 22 0 48 70
2011-10 5 2 6 9 22 0 48 70
2011-11 5 2 6 9 22 0 48 70
2011-12 5 2 6 9 22 0 48 70
2012-01 5 2 6 9 22 0 49 71
2012-02 5 2 6 9 22 0 50 72
2012-03 5 2 6 9 22 0 50 72
Total 77 30 88 135 330 0 721 1,051
 
Average number of subscribers: 22.0
Average number of members: 70.1
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: LA
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 39 40 7 30 116 0 151 267
2011-02 38 40 7 32 117 0 157 274
2011-03 42 40 8 33 123 0 161 284
2011-04 40 42 8 32 122 0 155 277
2011-05 39 43 8 34 124 0 163 287
2011-06 40 42 8 35 125 0 164 289
2011-07 42 44 8 34 128 0 164 292
2011-08 46 44 8 34 132 0 164 296
2011-09 45 42 10 35 132 0 165 297
2011-10 45 42 9 35 131 0 167 298
2011-11 44 43 10 39 136 0 185 321
2011-12 44 42 10 39 135 0 184 319
2012-01 49 46 7 49 151 0 205 356
2012-02 49 43 7 53 152 0 212 364
2012-03 49 44 7 55 155 0 218 373
Total 651 637 122 569 1,979 0 2,615 4,594
 
Average number of subscribers: 131.9
Average number of members: 306.3
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: LA
Account: 0108
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 34 38 7 29 108 0 144 252
2011-02 34 38 7 31 110 0 150 260
2011-03 38 38 8 32 116 0 154 270
2011-04 37 40 8 31 116 0 148 264
2011-05 36 41 8 33 118 0 156 274
2011-06 37 40 8 34 119 0 157 276
2011-07 38 42 8 33 121 0 157 278
2011-08 42 42 8 33 125 0 157 282
2011-09 41 40 10 34 125 0 158 283
2011-10 41 40 9 34 124 0 160 284
2011-11 42 41 9 38 130 0 177 307
2011-12 42 40 9 38 129 0 176 305
2012-01 47 44 6 48 145 0 197 342
2012-02 47 41 6 52 146 0 204 350
2012-03 48 42 6 54 150 0 210 360
Total 604 607 117 554 1,882 0 2,505 4,387
 
Average number of subscribers: 125.5
Average number of members: 292.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: LA
Account: 0109
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 4 0 0 0 4 0 0 4
2011-02 3 0 0 0 3 0 0 3
2011-03 3 0 0 0 3 0 0 3
2011-04 2 0 0 0 2 0 0 2
2011-05 2 0 0 0 2 0 0 2
2011-06 2 0 0 0 2 0 0 2
2011-07 3 0 0 0 3 0 0 3
2011-08 3 0 0 0 3 0 0 3
2011-09 3 0 0 0 3 0 0 3
2011-10 3 0 0 0 3 0 0 3
2011-11 2 0 0 0 2 0 0 2
2011-12 2 0 0 0 2 0 0 2
2012-01 2 0 0 0 2 0 0 2
2012-02 2 0 0 0 2 0 0 2
2012-03 1 0 0 0 1 0 0 1
Total 37 0 0 0 37 0 0 37
 
Average number of subscribers: 2.5
Average number of members: 2.5
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: LA
Account: 0110
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 0 1 0 0 1 0 1 2
2011-02 0 1 0 0 1 0 1 2
2011-03 0 1 0 0 1 0 1 2
2011-04 0 1 0 0 1 0 1 2
2011-05 0 1 0 0 1 0 1 2
2011-06 0 1 0 0 1 0 1 2
2011-07 0 1 0 0 1 0 1 2
2011-08 0 1 0 0 1 0 1 2
2011-09 0 1 0 0 1 0 1 2
2011-10 0 1 0 0 1 0 1 2
2011-11 0 1 0 0 1 0 1 2
2011-12 0 1 0 0 1 0 1 2
2012-01 0 1 0 0 1 0 1 2
2012-02 0 1 0 0 1 0 1 2
2012-03 0 1 0 0 1 0 1 2
Total 0 15 0 0 15 0 15 30
 
Average number of subscribers: 1.0
Average number of members: 2.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: LA
Account: 0112
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 1 1 0 1 3 0 6 9
2011-02 1 1 0 1 3 0 6 9
2011-03 1 1 0 1 3 0 6 9
2011-04 1 1 0 1 3 0 6 9
2011-05 1 1 0 1 3 0 6 9
2011-06 1 1 0 1 3 0 6 9
2011-07 1 1 0 1 3 0 6 9
2011-08 1 1 0 1 3 0 6 9
2011-09 1 1 0 1 3 0 6 9
2011-10 1 1 0 1 3 0 6 9
2011-11 0 1 1 1 3 0 7 10
2011-12 0 1 1 1 3 0 7 10
2012-01 0 1 1 1 3 0 7 10
2012-02 0 1 1 1 3 0 7 10
2012-03 0 1 1 1 3 0 7 10
Total 10 15 5 15 45 0 95 140
 
Average number of subscribers: 3.0
Average number of members: 9.3
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: NA
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 69 34 15 106 224 0 368 592
2011-02 69 34 14 108 225 0 373 598
2011-03 69 33 15 108 225 0 373 598
2011-04 66 35 15 111 227 0 383 610
2011-05 66 35 16 113 230 0 394 624
2011-06 66 36 15 114 231 0 398 629
2011-07 66 36 15 115 232 0 402 634
2011-08 69 36 16 115 236 0 406 642
2011-09 70 36 15 114 235 0 403 638
2011-10 69 36 15 114 234 0 402 636
2011-11 72 36 14 116 238 0 406 644
2011-12 74 36 14 116 240 0 408 648
2012-01 86 47 28 151 312 0 544 856
2012-02 86 49 27 151 313 0 545 858
2012-03 92 48 28 155 323 0 560 883
Total 1,089 567 262 1,807 3,725 0 6,365 10,090
 
Average number of subscribers: 248.3
Average number of members: 672.7
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: NA
Account: 0114
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 68 33 15 106 222 0 367 589
2011-02 68 33 14 108 223 0 372 595
2011-03 68 32 15 108 223 0 372 595
2011-04 64 34 15 111 224 0 382 606
2011-05 63 34 16 113 226 0 393 619
2011-06 62 35 15 114 226 0 397 623
2011-07 62 35 15 114 226 0 398 624
2011-08 65 35 15 114 229 0 400 629
2011-09 66 35 14 113 228 0 397 625
2011-10 66 35 14 113 228 0 396 624
2011-11 67 35 14 114 230 0 399 629
2011-12 69 35 14 114 232 0 401 633
2012-01 82 46 28 150 306 0 540 846
2012-02 82 48 27 150 307 0 541 848
2012-03 88 47 28 154 317 0 556 873
Total 1,040 552 259 1,796 3,647 0 6,311 9,958
 
Average number of subscribers: 243.1
Average number of members: 663.9
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: NA
Account: 0116
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 0 1 0 0 1 0 1 2
2011-02 0 1 0 0 1 0 1 2
2011-03 0 1 0 0 1 0 1 2
2011-04 1 1 0 0 2 0 1 3
2011-05 2 1 0 0 3 0 1 4
2011-06 3 1 0 0 4 0 1 5
2011-07 3 1 0 1 5 0 4 9
2011-08 3 1 1 1 6 0 6 12
2011-09 3 1 1 1 6 0 6 12
2011-10 3 1 1 1 6 0 6 12
2011-11 5 1 0 2 8 0 7 15
2011-12 5 1 0 2 8 0 7 15
2012-01 4 1 0 1 6 0 4 10
2012-02 4 1 0 1 6 0 4 10
2012-03 4 1 0 1 6 0 4 10
Total 40 15 3 11 69 0 54 123
 
Average number of subscribers: 4.6
Average number of members: 8.2
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: NA
Account: 0117
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 1 0 0 0 1 0 0 1
2011-02 1 0 0 0 1 0 0 1
2011-03 1 0 0 0 1 0 0 1
2011-04 1 0 0 0 1 0 0 1
2011-05 1 0 0 0 1 0 0 1
2011-06 1 0 0 0 1 0 0 1
2011-07 1 0 0 0 1 0 0 1
2011-08 1 0 0 0 1 0 0 1
2011-09 1 0 0 0 1 0 0 1
Total 9 0 0 0 9 0 0 9
 
Average number of subscribers: 1.0
Average number of members: 1.0
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 9 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: QA
Account: ALL
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 5 8 2 13 28 0 50 78
2011-02 5 8 2 14 29 0 52 81
2011-03 5 8 2 14 29 0 52 81
2011-04 5 8 2 14 29 0 52 81
2011-05 5 8 2 14 29 0 52 81
2011-06 5 8 2 14 29 0 52 81
2011-07 4 8 2 14 28 0 52 80
2011-08 4 8 2 14 28 0 52 80
2011-09 4 7 2 14 27 0 51 78
2011-10 4 7 2 14 27 0 51 78
2011-11 4 7 2 15 28 0 55 83
2011-12 4 7 2 15 28 0 56 84
2012-01 1 1 0 2 4 0 10 14
2012-02 1 1 0 2 4 0 10 14
2012-03 1 1 0 2 4 0 10 14
Total 57 95 24 175 351 0 657 1,008
 
Average number of subscribers: 23.4
Average number of members: 67.2
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: QA
Account: 0124
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 4 8 2 13 27 0 50 77
2011-02 4 8 2 14 28 0 52 80
2011-03 4 8 2 14 28 0 52 80
2011-04 4 8 2 14 28 0 52 80
2011-05 4 8 2 14 28 0 52 80
2011-06 4 8 2 14 28 0 52 80
2011-07 3 8 2 14 27 0 52 79
2011-08 3 8 2 14 27 0 52 79
2011-09 3 7 2 14 26 0 51 77
2011-10 3 7 2 14 26 0 51 77
2011-11 3 6 2 15 26 0 54 80
2011-12 3 6 2 15 26 0 55 81
2012-01 0 1 0 2 3 0 10 13
2012-02 0 1 0 2 3 0 10 13
2012-03 0 1 0 2 3 0 10 13
Total 42 93 24 175 334 0 655 989
 
Average number of subscribers: 22.3
Average number of members: 65.9
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.
Run Date: 4/16/2012 5:39:27 PM
 
Membership By Month
 
Report Filter:
-Policy Number = 000123456
And
Type of Coverage = Medical
And
Funding Arrangement Category = Administrative Services Only
And
Membership Year/Month = 2012-03, 2012-02, 2012-01, 2011-12, 2011-11, 2011-10, 2011-09, 2011-08, 2011-07, 2011-06, 2011-05, 2011-04, 2011-03, 2011-02, 2011-01
 
-Policy Number: 000123456
Suffix: QA
Account: 0125
 
Membership Year/Month Single Subscribers Subscribers plus Spouse Subscribers plus Child/Children Subscribers plus Family Total Subscribers Non-Positively Enrolled Dependents Positively Enrolled Dependents Total Members
2011-01 1 0 0 0 1 0 0 1
2011-02 1 0 0 0 1 0 0 1
2011-03 1 0 0 0 1 0 0 1
2011-04 1 0 0 0 1 0 0 1
2011-05 1 0 0 0 1 0 0 1
2011-06 1 0 0 0 1 0 0 1
2011-07 1 0 0 0 1 0 0 1
2011-08 1 0 0 0 1 0 0 1
2011-09 1 0 0 0 1 0 0 1
2011-10 1 0 0 0 1 0 0 1
2011-11 1 1 0 0 2 0 1 3
2011-12 1 1 0 0 2 0 1 3
2012-01 1 0 0 0 1 0 0 1
2012-02 1 0 0 0 1 0 0 1
2012-03 1 0 0 0 1 0 0 1
Total 15 2 0 0 17 0 2 19
 
Average number of subscribers: 1.1
Average number of members: 1.3
 
Note: This report is based on estimated dependent counts. Average number of subscribers and average number of members were based on 15 months of membership enrollment.