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
-Policy Number	Suffix	Account	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
000123456	AF	0037	2011-01	267	250	43	214	774	0	967	1,741
000123456	AF	0037	2011-02	267	248	42	218	775	0	975	1,750
000123456	AF	0037	2011-03	269	248	45	219	781	0	982	1,763
000123456	AF	0037	2011-04	264	252	45	220	781	0	984	1,765
000123456	AG	0101	2011-05	264	250	46	224	784	0	1,000	1,784
000123456	AG	0101	2011-06	265	251	45	225	786	0	1,004	1,790
000123456	AG	0101	2011-07	263	253	45	225	786	0	1,008	1,794
000123456	AG	0101	2011-08	268	253	46	224	791	0	1,009	1,800
000123456	AG	0101	2011-09	267	249	47	225	788	0	1,008	1,796
000123456	AG	0101	2011-10	265	248	47	225	785	0	1,009	1,794
000123456	AG	0101	2011-11	266	250	47	235	798	0	1,046	1,844
000123456	AG	0101	2011-12	267	248	47	237	799	0	1,051	1,850
000123456	AG	0101	2012-01	270	244	50	244	808	0	1,064	1,872
000123456	AG	0101	2012-02	271	243	49	248	811	0	1,073	1,884
000123456	AG	0101	2012-03	276	243	49	254	822	0	1,093	1,915
000123456	AF	0037	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
-Policy Number	Suffix	Account	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
000123456	AF	0037	2011-01	267	250	43	214	774	0	967	1,741
000123456	AF	0037	2011-02	267	248	42	218	775	0	975	1,750
000123456	AF	0037	2011-03	269	248	45	219	781	0	982	1,763
000123456	AF	0037	2011-04	264	252	45	220	781	0	984	1,765
000123456	AG	0101	2011-05	264	250	46	224	784	0	1,000	1,784
000123456	AG	0101	2011-06	265	251	45	225	786	0	1,004	1,790
000123456	AG	0101	2011-07	263	253	45	225	786	0	1,008	1,794
000123456	AG	0101	2011-08	268	253	46	224	791	0	1,009	1,800
000123456	AG	0101	2011-09	267	249	47	225	788	0	1,008	1,796
000123456	AG	0101	2011-10	265	248	47	225	785	0	1,009	1,794
000123456	AG	0101	2011-11	266	250	47	235	798	0	1,046	1,844
000123456	AG	0101	2011-12	267	248	47	237	799	0	1,051	1,850
000123456	AG	0101	2012-01	270	244	50	244	808	0	1,064	1,872
000123456	AG	0101	2012-02	271	243	49	248	811	0	1,073	1,884
000123456	AG	0101	2012-03	276	243	49	254	822	0	1,093	1,915
000123456	AF	0037	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
-Policy Number	Suffix	Account	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
000123456	AF	0037	2011-01	7	3	0	0	10	0	3	13
000123456	AF	0037	2011-02	7	3	0	0	10	0	3	13
000123456	AF	0037	2011-03	6	3	0	0	9	0	3	12
000123456	AF	0037	2011-04	6	3	0	0	9	0	3	12
000123456	AF	0037	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
-Policy Number	Suffix	Account	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
000123456	AF	0037	2011-01	7	3	0	0	10	0	3	13
000123456	AF	0037	2011-02	7	3	0	0	10	0	3	13
000123456	AF	0037	2011-03	6	3	0	0	9	0	3	12
000123456	AF	0037	2011-04	6	3	0	0	9	0	3	12
000123456	AF	0037	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
-Policy Number	Suffix	Account	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
000123456	AG	0101	2011-01	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-02	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-03	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-04	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-05	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-06	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-07	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-08	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-09	1	2	0	0	3	0	2	5
000123456	AG	0101	2011-10	1	2	0	0	3	0	2	5
000123456	AG	0101	2011-11	1	2	0	0	3	0	2	5
000123456	AG	0101	2011-12	1	2	0	0	3	0	2	5
000123456	AG	0101	2012-01	1	1	0	0	2	0	1	3
000123456	AG	0101	2012-02	1	1	0	0	2	0	1	3
000123456	AG	0101	2012-03	1	1	0	0	2	0	1	3
000123456	AG	0101	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
-Policy Number	Suffix	Account	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
000123456	AG	0101	2011-01	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-02	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-03	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-04	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-05	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-06	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-07	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-08	2	2	0	0	4	0	2	6
000123456	AG	0101	2011-09	1	2	0	0	3	0	2	5
000123456	AG	0101	2011-10	1	2	0	0	3	0	2	5
000123456	AG	0101	2011-11	1	2	0	0	3	0	2	5
000123456	AG	0101	2011-12	1	2	0	0	3	0	2	5
000123456	AG	0101	2012-01	1	1	0	0	2	0	1	3
000123456	AG	0101	2012-02	1	1	0	0	2	0	1	3
000123456	AG	0101	2012-03	1	1	0	0	2	0	1	3
000123456	AG	0101	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
-Policy Number	Suffix	Account	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
000123456	AH	0131	2011-05	10	17	0	0	27	0	19	46
000123456	AH	0131	2011-06	10	17	0	0	27	0	19	46
000123456	AH	0131	2011-07	10	16	0	0	26	0	18	44
000123456	AH	0131	2011-08	10	16	0	0	26	0	18	44
000123456	AH	0131	2011-09	10	15	0	0	25	0	17	42
000123456	AH	0131	2011-10	10	14	0	0	24	0	16	40
000123456	AH	0131	2011-11	10	14	0	0	24	0	16	40
000123456	AH	0131	2011-12	10	14	0	0	24	0	16	40
000123456	AH	0131	2012-01	10	12	0	0	22	0	14	36
000123456	AH	0131	2012-02	10	12	0	0	22	0	14	36
000123456	AH	0131	2012-03	9	12	0	0	21	0	14	35
000123456	AH	0131	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
-Policy Number	Suffix	Account	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
000123456	AH	0131	2011-05	10	17	0	0	27	0	19	46
000123456	AH	0131	2011-06	10	17	0	0	27	0	19	46
000123456	AH	0131	2011-07	10	16	0	0	26	0	18	44
000123456	AH	0131	2011-08	10	16	0	0	26	0	18	44
000123456	AH	0131	2011-09	10	15	0	0	25	0	17	42
000123456	AH	0131	2011-10	10	14	0	0	24	0	16	40
000123456	AH	0131	2011-11	10	14	0	0	24	0	16	40
000123456	AH	0131	2011-12	10	14	0	0	24	0	16	40
000123456	AH	0131	2012-01	10	12	0	0	22	0	14	36
000123456	AH	0131	2012-02	10	12	0	0	22	0	14	36
000123456	AH	0131	2012-03	9	12	0	0	21	0	14	35
000123456	AH	0131	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
-Policy Number	Suffix	Account	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
000123456	AI	0134	2011-05	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-06	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-07	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-08	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-09	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-10	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-11	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-12	1	0	0	0	1	0	0	1
000123456	AI	0134	2012-01	1	0	0	0	1	0	0	1
000123456	AI	0134	2012-02	1	0	0	0	1	0	0	1
000123456	AI	0134	2012-03	1	0	0	0	1	0	0	1
000123456	AI	0134	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
-Policy Number	Suffix	Account	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
000123456	AI	0134	2011-05	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-06	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-07	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-08	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-09	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-10	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-11	1	0	0	0	1	0	0	1
000123456	AI	0134	2011-12	1	0	0	0	1	0	0	1
000123456	AI	0134	2012-01	1	0	0	0	1	0	0	1
000123456	AI	0134	2012-02	1	0	0	0	1	0	0	1
000123456	AI	0134	2012-03	1	0	0	0	1	0	0	1
000123456	AI	0134	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
-Policy Number	Suffix	Account	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
000123456	AJ	0134	2011-05	48	53	1	5	107	0	62	169
000123456	AJ	0134	2011-06	48	53	1	5	107	0	62	169
000123456	AJ	0134	2011-07	48	53	1	5	107	0	62	169
000123456	AJ	0134	2011-08	47	53	1	5	106	0	62	168
000123456	AJ	0134	2011-09	49	53	1	5	108	0	62	170
000123456	AJ	0134	2011-10	50	53	1	5	109	0	62	171
000123456	AJ	0134	2011-11	50	53	1	5	109	0	62	171
000123456	AJ	0134	2011-12	50	53	1	5	109	0	62	171
000123456	AJ	0134	2012-01	51	53	1	5	110	0	62	172
000123456	AJ	0134	2012-02	51	53	1	5	110	0	62	172
000123456	AJ	0134	2012-03	51	53	1	5	110	0	62	172
000123456	AJ	0134	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
-Policy Number	Suffix	Account	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
000123456	AJ	0134	2011-05	42	50	1	5	98	0	59	157
000123456	AJ	0134	2011-06	42	50	1	5	98	0	59	157
000123456	AJ	0134	2011-07	42	50	1	5	98	0	59	157
000123456	AJ	0134	2011-08	42	50	1	5	98	0	59	157
000123456	AJ	0134	2011-09	43	50	1	5	99	0	59	158
000123456	AJ	0134	2011-10	44	50	1	5	100	0	59	159
000123456	AJ	0134	2011-11	44	50	1	5	100	0	59	159
000123456	AJ	0134	2011-12	44	50	1	5	100	0	59	159
000123456	AJ	0134	2012-01	44	50	1	5	100	0	59	159
000123456	AJ	0134	2012-02	44	50	1	5	100	0	59	159
000123456	AJ	0134	2012-03	44	50	1	5	100	0	59	159
000123456	AJ	0134	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
-Policy Number	Suffix	Account	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
000123456	AJ	0135	2011-05	6	3	0	0	9	0	3	12
000123456	AJ	0135	2011-06	6	3	0	0	9	0	3	12
000123456	AJ	0135	2011-07	6	3	0	0	9	0	3	12
000123456	AJ	0135	2011-08	5	3	0	0	8	0	3	11
000123456	AJ	0135	2011-09	6	3	0	0	9	0	3	12
000123456	AJ	0135	2011-10	6	3	0	0	9	0	3	12
000123456	AJ	0135	2011-11	6	3	0	0	9	0	3	12
000123456	AJ	0135	2011-12	6	3	0	0	9	0	3	12
000123456	AJ	0135	2012-01	7	3	0	0	10	0	3	13
000123456	AJ	0135	2012-02	7	3	0	0	10	0	3	13
000123456	AJ	0135	2012-03	7	3	0	0	10	0	3	13
000123456	AJ	0135	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
-Policy Number	Suffix	Account	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
000123456	FA	0077	2011-01	50	68	1	5	124	0	79	203
000123456	FA	0077	2011-02	50	68	1	5	124	0	79	203
000123456	FA	0077	2011-03	51	68	1	5	125	0	79	204
000123456	FA	0077	2011-04	51	68	1	5	125	0	79	204
000123456	FA	0077	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
-Policy Number	Suffix	Account	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
000123456	FA	0077	2011-01	2	2	0	0	4	0	2	6
000123456	FA	0077	2011-02	2	2	0	0	4	0	2	6
000123456	FA	0077	2011-03	3	2	0	0	5	0	2	7
000123456	FA	0077	2011-04	3	2	0	0	5	0	2	7
000123456	FA	0077	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
-Policy Number	Suffix	Account	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
000123456	FA	0085	2011-01	48	66	1	5	120	0	77	197
000123456	FA	0085	2011-02	48	66	1	5	120	0	77	197
000123456	FA	0085	2011-03	48	66	1	5	120	0	77	197
000123456	FA	0085	2011-04	48	66	1	5	120	0	77	197
000123456	FA	0085	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
-Policy Number	Suffix	Account	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
000123456	GA	0078	2011-01	1	0	0	0	1	0	0	1
000123456	GA	0078	2011-02	1	0	0	0	1	0	0	1
000123456	GA	0078	2011-03	1	0	0	0	1	0	0	1
000123456	GA	0078	2011-04	1	0	0	0	1	0	0	1
000123456	GA	0078	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
-Policy Number	Suffix	Account	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
000123456	GA	0078	2011-01	1	0	0	0	1	0	0	1
000123456	GA	0078	2011-02	1	0	0	0	1	0	0	1
000123456	GA	0078	2011-03	1	0	0	0	1	0	0	1
000123456	GA	0078	2011-04	1	0	0	0	1	0	0	1
000123456	GA	0078	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
-Policy Number	Suffix	Account	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
000123456	HB	0086	2011-01	40	68	0	4	112	0	77	189
000123456	HB	0086	2011-02	40	68	0	4	112	0	77	189
000123456	HB	0086	2011-03	40	68	0	4	112	0	77	189
000123456	HB	0086	2011-04	40	68	0	4	112	0	77	189
000123456	HB	0086	2011-05	41	67	0	4	112	0	76	188
000123456	HB	0086	2011-06	41	68	0	3	112	0	75	187
000123456	HB	0086	2011-07	39	69	0	3	111	0	76	187
000123456	HB	0086	2011-08	38	69	0	3	110	0	76	186
000123456	HB	0086	2011-09	38	69	0	3	110	0	76	186
000123456	HB	0086	2011-10	38	69	0	3	110	0	76	186
000123456	HB	0086	2011-11	38	69	0	3	110	0	76	186
000123456	HB	0086	2011-12	38	69	0	3	110	0	76	186
000123456	HB	0086	2012-01	39	68	0	3	110	0	75	185
000123456	HB	0086	2012-02	39	68	0	3	110	0	75	185
000123456	HB	0086	2012-03	39	68	0	3	110	0	75	185
000123456	HB	0086	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
-Policy Number	Suffix	Account	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
000123456	HB	0086	2011-01	40	67	0	4	111	0	76	187
000123456	HB	0086	2011-02	40	67	0	4	111	0	76	187
000123456	HB	0086	2011-03	40	67	0	4	111	0	76	187
000123456	HB	0086	2011-04	40	67	0	4	111	0	76	187
000123456	HB	0086	2011-05	41	66	0	4	111	0	75	186
000123456	HB	0086	2011-06	41	67	0	3	111	0	74	185
000123456	HB	0086	2011-07	39	68	0	3	110	0	75	185
000123456	HB	0086	2011-08	38	68	0	3	109	0	75	184
000123456	HB	0086	2011-09	38	68	0	3	109	0	75	184
000123456	HB	0086	2011-10	38	68	0	3	109	0	75	184
000123456	HB	0086	2011-11	38	68	0	3	109	0	75	184
000123456	HB	0086	2011-12	38	68	0	3	109	0	75	184
000123456	HB	0086	2012-01	39	67	0	3	109	0	74	183
000123456	HB	0086	2012-02	39	67	0	3	109	0	74	183
000123456	HB	0086	2012-03	39	67	0	3	109	0	74	183
000123456	HB	0086	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
-Policy Number	Suffix	Account	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
000123456	HB	0087	2011-01	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-02	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-03	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-04	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-05	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-06	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-07	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-08	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-09	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-10	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-11	0	1	0	0	1	0	1	2
000123456	HB	0087	2011-12	0	1	0	0	1	0	1	2
000123456	HB	0087	2012-01	0	1	0	0	1	0	1	2
000123456	HB	0087	2012-02	0	1	0	0	1	0	1	2
000123456	HB	0087	2012-03	0	1	0	0	1	0	1	2
000123456	HB	0087	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
-Policy Number	Suffix	Account	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
000123456	IA	0091	2011-01	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-02	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-03	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-04	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-05	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-06	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-07	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-08	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-09	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-10	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-11	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-12	1	0	0	0	1	0	0	1
000123456	IA	0091	2012-01	1	0	0	0	1	0	0	1
000123456	IA	0091	2012-02	1	0	0	0	1	0	0	1
000123456	IA	0091	2012-03	1	0	0	0	1	0	0	1
000123456	IA	0091	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
-Policy Number	Suffix	Account	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
000123456	IA	0091	2011-01	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-02	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-03	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-04	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-05	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-06	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-07	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-08	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-09	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-10	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-11	1	0	0	0	1	0	0	1
000123456	IA	0091	2011-12	1	0	0	0	1	0	0	1
000123456	IA	0091	2012-01	1	0	0	0	1	0	0	1
000123456	IA	0091	2012-02	1	0	0	0	1	0	0	1
000123456	IA	0091	2012-03	1	0	0	0	1	0	0	1
000123456	IA	0091	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
-Policy Number	Suffix	Account	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
000123456	KA	0102	2011-01	53	27	18	56	154	0	237	391
000123456	KA	0102	2011-02	54	25	18	55	152	0	232	384
000123456	KA	0102	2011-03	52	26	19	55	152	0	235	387
000123456	KA	0102	2011-04	52	26	19	54	151	0	233	384
000123456	KA	0102	2011-05	51	25	19	54	149	0	232	381
000123456	KA	0102	2011-06	51	25	19	54	149	0	232	381
000123456	KA	0102	2011-07	50	25	19	54	148	0	232	380
000123456	KA	0102	2011-08	50	25	19	53	147	0	229	376
000123456	KA	0102	2011-09	48	25	19	54	146	0	232	378
000123456	KA	0102	2011-10	46	25	20	54	145	0	233	378
000123456	KA	0102	2011-11	45	26	20	57	148	0	244	392
000123456	KA	0102	2011-12	44	25	20	59	148	0	247	395
000123456	KA	0102	2012-01	31	16	14	34	95	0	153	248
000123456	KA	0102	2012-02	32	16	14	34	96	0	154	250
000123456	KA	0102	2012-03	32	16	13	34	95	0	153	248
000123456	KA	0102	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
-Policy Number	Suffix	Account	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
000123456	KA	0102	2011-01	41	23	12	43	119	0	173	292
000123456	KA	0102	2011-02	41	21	12	42	116	0	168	284
000123456	KA	0102	2011-03	40	22	12	43	117	0	172	289
000123456	KA	0102	2011-04	40	23	12	42	117	0	171	288
000123456	KA	0102	2011-05	40	22	12	42	116	0	170	286
000123456	KA	0102	2011-06	41	22	12	42	117	0	170	287
000123456	KA	0102	2011-07	41	22	12	42	117	0	170	287
000123456	KA	0102	2011-08	41	22	12	41	116	0	167	283
000123456	KA	0102	2011-09	40	22	12	42	116	0	170	286
000123456	KA	0102	2011-10	38	22	13	42	115	0	171	286
000123456	KA	0102	2011-11	38	23	13	45	119	0	182	301
000123456	KA	0102	2011-12	37	22	13	47	119	0	185	304
000123456	KA	0102	2012-01	23	13	7	22	65	0	90	155
000123456	KA	0102	2012-02	23	13	7	22	65	0	90	155
000123456	KA	0102	2012-03	23	13	6	22	64	0	89	153
000123456	KA	0102	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
-Policy Number	Suffix	Account	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
000123456	KA	0103	2011-01	6	1	0	1	8	0	4	12
000123456	KA	0103	2011-02	7	1	0	1	9	0	4	13
000123456	KA	0103	2011-03	7	1	0	0	8	0	1	9
000123456	KA	0103	2011-04	7	0	0	0	7	0	0	7
000123456	KA	0103	2011-05	6	0	0	0	6	0	0	6
000123456	KA	0103	2011-06	5	0	0	0	5	0	0	5
000123456	KA	0103	2011-07	4	0	0	0	4	0	0	4
000123456	KA	0103	2011-08	4	0	0	0	4	0	0	4
000123456	KA	0103	2011-09	3	0	0	0	3	0	0	3
000123456	KA	0103	2011-10	3	0	0	0	3	0	0	3
000123456	KA	0103	2011-11	2	0	0	0	2	0	0	2
000123456	KA	0103	2011-12	2	0	0	0	2	0	0	2
000123456	KA	0103	2012-01	3	0	0	0	3	0	0	3
000123456	KA	0103	2012-02	3	0	0	0	3	0	0	3
000123456	KA	0103	2012-03	3	0	0	0	3	0	0	3
000123456	KA	0103	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
-Policy Number	Suffix	Account	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
000123456	KA	0104	2011-01	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-02	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-03	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-04	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-05	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-06	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-07	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-08	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-09	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-10	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-11	0	1	1	3	5	0	14	19
000123456	KA	0104	2011-12	0	1	1	3	5	0	14	19
000123456	KA	0104	2012-01	0	1	1	3	5	0	14	19
000123456	KA	0104	2012-02	0	1	1	3	5	0	14	19
000123456	KA	0104	2012-03	0	1	1	3	5	0	14	19
000123456	KA	0104	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
-Policy Number	Suffix	Account	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
000123456	KA	0105	2012-02	1	0	0	0	1	0	0	1
000123456	KA	0105	2012-03	1	0	0	0	1	0	0	1
000123456	KA	0105	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
-Policy Number	Suffix	Account	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
000123456	KA	0106	2011-01	6	2	5	9	22	0	46	68
000123456	KA	0106	2011-02	6	2	5	9	22	0	46	68
000123456	KA	0106	2011-03	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-04	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-05	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-06	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-07	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-08	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-09	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-10	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-11	5	2	6	9	22	0	48	70
000123456	KA	0106	2011-12	5	2	6	9	22	0	48	70
000123456	KA	0106	2012-01	5	2	6	9	22	0	49	71
000123456	KA	0106	2012-02	5	2	6	9	22	0	50	72
000123456	KA	0106	2012-03	5	2	6	9	22	0	50	72
000123456	KA	0106	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
-Policy Number	Suffix	Account	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
000123456	LA	0108	2011-01	39	40	7	30	116	0	151	267
000123456	LA	0108	2011-02	38	40	7	32	117	0	157	274
000123456	LA	0108	2011-03	42	40	8	33	123	0	161	284
000123456	LA	0108	2011-04	40	42	8	32	122	0	155	277
000123456	LA	0108	2011-05	39	43	8	34	124	0	163	287
000123456	LA	0108	2011-06	40	42	8	35	125	0	164	289
000123456	LA	0108	2011-07	42	44	8	34	128	0	164	292
000123456	LA	0108	2011-08	46	44	8	34	132	0	164	296
000123456	LA	0108	2011-09	45	42	10	35	132	0	165	297
000123456	LA	0108	2011-10	45	42	9	35	131	0	167	298
000123456	LA	0108	2011-11	44	43	10	39	136	0	185	321
000123456	LA	0108	2011-12	44	42	10	39	135	0	184	319
000123456	LA	0108	2012-01	49	46	7	49	151	0	205	356
000123456	LA	0108	2012-02	49	43	7	53	152	0	212	364
000123456	LA	0108	2012-03	49	44	7	55	155	0	218	373
000123456	LA	0108	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
-Policy Number	Suffix	Account	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
000123456	LA	0108	2011-01	34	38	7	29	108	0	144	252
000123456	LA	0108	2011-02	34	38	7	31	110	0	150	260
000123456	LA	0108	2011-03	38	38	8	32	116	0	154	270
000123456	LA	0108	2011-04	37	40	8	31	116	0	148	264
000123456	LA	0108	2011-05	36	41	8	33	118	0	156	274
000123456	LA	0108	2011-06	37	40	8	34	119	0	157	276
000123456	LA	0108	2011-07	38	42	8	33	121	0	157	278
000123456	LA	0108	2011-08	42	42	8	33	125	0	157	282
000123456	LA	0108	2011-09	41	40	10	34	125	0	158	283
000123456	LA	0108	2011-10	41	40	9	34	124	0	160	284
000123456	LA	0108	2011-11	42	41	9	38	130	0	177	307
000123456	LA	0108	2011-12	42	40	9	38	129	0	176	305
000123456	LA	0108	2012-01	47	44	6	48	145	0	197	342
000123456	LA	0108	2012-02	47	41	6	52	146	0	204	350
000123456	LA	0108	2012-03	48	42	6	54	150	0	210	360
000123456	LA	0108	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
-Policy Number	Suffix	Account	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
000123456	LA	0109	2011-01	4	0	0	0	4	0	0	4
000123456	LA	0109	2011-02	3	0	0	0	3	0	0	3
000123456	LA	0109	2011-03	3	0	0	0	3	0	0	3
000123456	LA	0109	2011-04	2	0	0	0	2	0	0	2
000123456	LA	0109	2011-05	2	0	0	0	2	0	0	2
000123456	LA	0109	2011-06	2	0	0	0	2	0	0	2
000123456	LA	0109	2011-07	3	0	0	0	3	0	0	3
000123456	LA	0109	2011-08	3	0	0	0	3	0	0	3
000123456	LA	0109	2011-09	3	0	0	0	3	0	0	3
000123456	LA	0109	2011-10	3	0	0	0	3	0	0	3
000123456	LA	0109	2011-11	2	0	0	0	2	0	0	2
000123456	LA	0109	2011-12	2	0	0	0	2	0	0	2
000123456	LA	0109	2012-01	2	0	0	0	2	0	0	2
000123456	LA	0109	2012-02	2	0	0	0	2	0	0	2
000123456	LA	0109	2012-03	1	0	0	0	1	0	0	1
000123456	LA	0109	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
-Policy Number	Suffix	Account	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
000123456	LA	0110	2011-01	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-02	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-03	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-04	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-05	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-06	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-07	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-08	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-09	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-10	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-11	0	1	0	0	1	0	1	2
000123456	LA	0110	2011-12	0	1	0	0	1	0	1	2
000123456	LA	0110	2012-01	0	1	0	0	1	0	1	2
000123456	LA	0110	2012-02	0	1	0	0	1	0	1	2
000123456	LA	0110	2012-03	0	1	0	0	1	0	1	2
000123456	LA	0110	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
-Policy Number	Suffix	Account	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
000123456	LA	0112	2011-01	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-02	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-03	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-04	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-05	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-06	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-07	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-08	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-09	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-10	1	1	0	1	3	0	6	9
000123456	LA	0112	2011-11	0	1	1	1	3	0	7	10
000123456	LA	0112	2011-12	0	1	1	1	3	0	7	10
000123456	LA	0112	2012-01	0	1	1	1	3	0	7	10
000123456	LA	0112	2012-02	0	1	1	1	3	0	7	10
000123456	LA	0112	2012-03	0	1	1	1	3	0	7	10
000123456	LA	0112	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
-Policy Number	Suffix	Account	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
000123456	NA	0114	2011-01	69	34	15	106	224	0	368	592
000123456	NA	0114	2011-02	69	34	14	108	225	0	373	598
000123456	NA	0114	2011-03	69	33	15	108	225	0	373	598
000123456	NA	0114	2011-04	66	35	15	111	227	0	383	610
000123456	NA	0114	2011-05	66	35	16	113	230	0	394	624
000123456	NA	0114	2011-06	66	36	15	114	231	0	398	629
000123456	NA	0114	2011-07	66	36	15	115	232	0	402	634
000123456	NA	0114	2011-08	69	36	16	115	236	0	406	642
000123456	NA	0114	2011-09	70	36	15	114	235	0	403	638
000123456	NA	0114	2011-10	69	36	15	114	234	0	402	636
000123456	NA	0114	2011-11	72	36	14	116	238	0	406	644
000123456	NA	0114	2011-12	74	36	14	116	240	0	408	648
000123456	NA	0114	2012-01	86	47	28	151	312	0	544	856
000123456	NA	0114	2012-02	86	49	27	151	313	0	545	858
000123456	NA	0114	2012-03	92	48	28	155	323	0	560	883
000123456	NA	0114	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
-Policy Number	Suffix	Account	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
000123456	NA	0114	2011-01	68	33	15	106	222	0	367	589
000123456	NA	0114	2011-02	68	33	14	108	223	0	372	595
000123456	NA	0114	2011-03	68	32	15	108	223	0	372	595
000123456	NA	0114	2011-04	64	34	15	111	224	0	382	606
000123456	NA	0114	2011-05	63	34	16	113	226	0	393	619
000123456	NA	0114	2011-06	62	35	15	114	226	0	397	623
000123456	NA	0114	2011-07	62	35	15	114	226	0	398	624
000123456	NA	0114	2011-08	65	35	15	114	229	0	400	629
000123456	NA	0114	2011-09	66	35	14	113	228	0	397	625
000123456	NA	0114	2011-10	66	35	14	113	228	0	396	624
000123456	NA	0114	2011-11	67	35	14	114	230	0	399	629
000123456	NA	0114	2011-12	69	35	14	114	232	0	401	633
000123456	NA	0114	2012-01	82	46	28	150	306	0	540	846
000123456	NA	0114	2012-02	82	48	27	150	307	0	541	848
000123456	NA	0114	2012-03	88	47	28	154	317	0	556	873
000123456	NA	0114	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
-Policy Number	Suffix	Account	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
000123456	NA	0116	2011-01	0	1	0	0	1	0	1	2
000123456	NA	0116	2011-02	0	1	0	0	1	0	1	2
000123456	NA	0116	2011-03	0	1	0	0	1	0	1	2
000123456	NA	0116	2011-04	1	1	0	0	2	0	1	3
000123456	NA	0116	2011-05	2	1	0	0	3	0	1	4
000123456	NA	0116	2011-06	3	1	0	0	4	0	1	5
000123456	NA	0116	2011-07	3	1	0	1	5	0	4	9
000123456	NA	0116	2011-08	3	1	1	1	6	0	6	12
000123456	NA	0116	2011-09	3	1	1	1	6	0	6	12
000123456	NA	0116	2011-10	3	1	1	1	6	0	6	12
000123456	NA	0116	2011-11	5	1	0	2	8	0	7	15
000123456	NA	0116	2011-12	5	1	0	2	8	0	7	15
000123456	NA	0116	2012-01	4	1	0	1	6	0	4	10
000123456	NA	0116	2012-02	4	1	0	1	6	0	4	10
000123456	NA	0116	2012-03	4	1	0	1	6	0	4	10
000123456	NA	0116	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
-Policy Number	Suffix	Account	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
000123456	NA	0117	2011-01	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-02	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-03	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-04	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-05	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-06	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-07	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-08	1	0	0	0	1	0	0	1
000123456	NA	0117	2011-09	1	0	0	0	1	0	0	1
000123456	NA	0117	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
-Policy Number	Suffix	Account	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
000123456	QA	0124	2011-01	5	8	2	13	28	0	50	78
000123456	QA	0124	2011-02	5	8	2	14	29	0	52	81
000123456	QA	0124	2011-03	5	8	2	14	29	0	52	81
000123456	QA	0124	2011-04	5	8	2	14	29	0	52	81
000123456	QA	0124	2011-05	5	8	2	14	29	0	52	81
000123456	QA	0124	2011-06	5	8	2	14	29	0	52	81
000123456	QA	0124	2011-07	4	8	2	14	28	0	52	80
000123456	QA	0124	2011-08	4	8	2	14	28	0	52	80
000123456	QA	0124	2011-09	4	7	2	14	27	0	51	78
000123456	QA	0124	2011-10	4	7	2	14	27	0	51	78
000123456	QA	0124	2011-11	4	7	2	15	28	0	55	83
000123456	QA	0124	2011-12	4	7	2	15	28	0	56	84
000123456	QA	0124	2012-01	1	1	0	2	4	0	10	14
000123456	QA	0124	2012-02	1	1	0	2	4	0	10	14
000123456	QA	0124	2012-03	1	1	0	2	4	0	10	14
000123456	QA	0124	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
-Policy Number	Suffix	Account	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
000123456	QA	0124	2011-01	4	8	2	13	27	0	50	77
000123456	QA	0124	2011-02	4	8	2	14	28	0	52	80
000123456	QA	0124	2011-03	4	8	2	14	28	0	52	80
000123456	QA	0124	2011-04	4	8	2	14	28	0	52	80
000123456	QA	0124	2011-05	4	8	2	14	28	0	52	80
000123456	QA	0124	2011-06	4	8	2	14	28	0	52	80
000123456	QA	0124	2011-07	3	8	2	14	27	0	52	79
000123456	QA	0124	2011-08	3	8	2	14	27	0	52	79
000123456	QA	0124	2011-09	3	7	2	14	26	0	51	77
000123456	QA	0124	2011-10	3	7	2	14	26	0	51	77
000123456	QA	0124	2011-11	3	6	2	15	26	0	54	80
000123456	QA	0124	2011-12	3	6	2	15	26	0	55	81
000123456	QA	0124	2012-01	0	1	0	2	3	0	10	13
000123456	QA	0124	2012-02	0	1	0	2	3	0	10	13
000123456	QA	0124	2012-03	0	1	0	2	3	0	10	13
000123456	QA	0124	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
-Policy Number	Suffix	Account	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
000123456	QA	0125	2011-01	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-02	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-03	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-04	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-05	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-06	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-07	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-08	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-09	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-10	1	0	0	0	1	0	0	1
000123456	QA	0125	2011-11	1	1	0	0	2	0	1	3
000123456	QA	0125	2011-12	1	1	0	0	2	0	1	3
000123456	QA	0125	2012-01	1	0	0	0	1	0	0	1
000123456	QA	0125	2012-02	1	0	0	0	1	0	0	1
000123456	QA	0125	2012-03	1	0	0	0	1	0	0	1
000123456	QA	0125	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.