The example XML below was returned from a test case containing only test data. Superfluous data has been removed for brevity. The response contains examples of each of the following elements:
Example XML Response |
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<?xml version="1.0" encoding="utf-8"?> <Transmittal xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" ID="6b3a7cef-9a0e-4cf4-a2b8-b59e7424119c" SenderID="ed608260-45a2-4d25-874f-a24846f19ebd" PortfolioID="87902a63-3ef7-43fa-ada2-d9c9c9b4e0fe"> <Group> <GroupName>Welch Test Case</GroupName> </Group> <Agents> <Agent ID="1503" UniqueID="0aa4b70e-09cf-4451-b8a0-f193c9bd0b2d" Type="Agent"> <Name>Mike Welch</Name> <Address> <Line1>123 Street Road Drive Way Circle</Line1> <Line2 /> <City>Plano</City> <State>TX</State> <Zip>77777</Zip> </Address> <PhoneWork>4694527076</PhoneWork> <Email>mike.welch@selerix.com</Email> <FirstName>Mike</FirstName> <LastName>Welch</LastName> <Split>0</Split> <Organization>Selerix</Organization> <EnrollerType>FaceToFace</EnrollerType> <EffectiveDate>2013-03-25T00:00:00</EffectiveDate> <TerminationDate>2019-12-31T00:00:00</TerminationDate> </Agent> <Agent ID="15" UniqueID="1992721b-97c6-46e9-8814-a58dc393334c" Type="Agent"> <Name>Lyle Griffin</Name> <Address> <Line1 /> <Line2 /> <City /> <State> </State> <Zip> </Zip> </Address> <PhoneWork /> <Email>lyle.griffin@selerix.com</Email> <FirstName>Lyle</FirstName> <LastName>Griffin</LastName> <Split>0</Split> <Organization>Selerix</Organization> <EnrollerType>Unknown</EnrollerType> <EffectiveDate>2000-01-01T00:00:00</EffectiveDate> <TerminationDate>2018-01-31T00:00:00</TerminationDate> </Agent> <Offerings> <Offering ID="9956"> <Name>Colonial Life Accident</Name> <Code>COL_ACC</Code> <OfferingProducts> <OfferingProduct ProductID="12537" /> </OfferingProducts> </Offering> <Offering ID="9962"> <Name>Optional Term Life</Name> <Code>OptionalTermLife</Code> <OfferingProducts> <OfferingProduct ProductID="12519" /> </OfferingProducts> </Offering> <Offering ID="10915"> <Name>Benefit Enhancer Bundle</Name> <Code>BenefitEnhancerBundle</Code> <OfferingProducts> <OfferingProduct ProductID="12933" /> <OfferingProduct ProductID="12936" /> <OfferingProduct ProductID="12932" /> <OfferingProduct ProductID="12935" /> </OfferingProducts> </Offering> <Offering ID="9953"> <Name>Health Savings Account</Name> <Code>PlanSavingsAccount</Code> <OfferingProducts> <OfferingProduct ProductID="12513" /> </OfferingProducts> </Offering> <Offering ID="9959"> <Name>Short Term Disability</Name> <Code>ShortTermDisability</Code> <OfferingProducts> <OfferingProduct ProductID="12516" /> </OfferingProducts> </Offering> <Offering ID="9950"> <Name>Medical</Name> <Code>Medical</Code> <OfferingProducts> <OfferingProduct ProductID="12507" /> <OfferingProduct ProductID="12535" /> <OfferingProduct ProductID="12509" /> <OfferingProduct ProductID="12508" /> </OfferingProducts> </Offering> <Offering ID="9954"> <Name>Health Care FSA</Name> <Code>PlanCareFSA</Code> <OfferingProducts> <OfferingProduct ProductID="12514" /> </OfferingProducts> </Offering> <Offering ID="9951"> <Name>Dental</Name> <Code>Dental</Code> <OfferingProducts> <OfferingProduct ProductID="12510" /> <OfferingProduct ProductID="12511" /> </OfferingProducts> </Offering> <Offering ID="32988"> <Name>Dead Plan No Enrollments</Name> <Code>DEAD_PLAN</Code> <OfferingProducts> <OfferingProduct ProductID="10931" /> </OfferingProducts> </Offering> <Offering ID="9965"> <Name>Baileys Gym</Name> <Code>BaileysGym</Code> <OfferingProducts> <OfferingProduct ProductID="12527" /> <OfferingProduct ProductID="12528" /> <OfferingProduct ProductID="12530" /> <OfferingProduct ProductID="12529" /> <OfferingProduct ProductID="12531" /> </OfferingProducts> </Offering> <Offering ID="9957"> <Name>Colonial Life Cancer</Name> <Code>COL_CAN</Code> <OfferingProducts> <OfferingProduct ProductID="12538" /> </OfferingProducts> </Offering> <Offering ID="9960"> <Name>Long Term Disability</Name> <Code>LongTermDisability</Code> <OfferingProducts> <OfferingProduct ProductID="12536" /> </OfferingProducts> </Offering> <Offering ID="9963"> <Name>Spouse Life</Name> <Code>SpouseLife</Code> <OfferingProducts> <OfferingProduct ProductID="12520" /> </OfferingProducts> </Offering> <Offering ID="9952"> <Name>Vision</Name> <Code>Vision</Code> <OfferingProducts> <OfferingProduct ProductID="12512" /> </OfferingProducts> </Offering> <Offering ID="9958"> <Name>Colonial Life Group Critical Care</Name> <Code>GroupSpecifiedDisease</Code> <OfferingProducts> <OfferingProduct ProductID="10829" /> </OfferingProducts> </Offering> <Offering ID="9964"> <Name>Child Life</Name> <Code>ChildLife</Code> <OfferingProducts> <OfferingProduct ProductID="12521" /> </OfferingProducts> </Offering> <Offering ID="9961"> <Name>Basic Term Life and AD&D</Name> <Code>BasicTermLifeandADD</Code> <OfferingProducts> <OfferingProduct ProductID="12518" /> </OfferingProducts> </Offering> <Offering ID="9955"> <Name>Dependent Care FSA</Name> <Code>DependentCareFSA</Code> <OfferingProducts> <OfferingProduct ProductID="12515" /> </OfferingProducts> </Offering> <Offering ID="10848"> <Name>Benefit Enhancer Bundle Plan</Name> <Code>bebPLANTAG</Code> </Offering> </Offerings> <Applicants> <Applicant ID="b0a947fd-87bb-4996-a702-7c95f8b496b9" UniqueID="b0a947fd-87bb-4996-a702-7c95f8b496b9" EmployeeID="b0a947fd-87bb-4996-a702-7c95f8b496b9"> <AsOfDate>2017-04-21T21:06:18</AsOfDate> <AsOfDateTicks>636284055780000000</AsOfDateTicks> <Address Type="Personal"> <Country>USA</Country> <Line1>123 Circle Drive</Line1> <Line2>#345</Line2> <City>Seattle</City> <State>WA</State> <Zip>98118</Zip> </Address> <SSN>465-46-5465</SSN> <FirstName>Douglas</FirstName> <LastName>Fir</LastName> <Sex>Male</Sex> <Employment Status="Active"> <Employer>TestCo</Employer> <HireDate>2012-01-01T00:00:00</HireDate> <EligibilityDate>2012-01-01T00:00:00</EligibilityDate> <Title>Integration Engineer</Title> <Department>Product Development</Department> <Location>JAX</Location> <JobClass>Salary</JobClass> <PayGroup>Bi-Weekly</PayGroup> <PayrollFrequency>26</PayrollFrequency> <DeductionFrequency>24</DeductionFrequency> <Salary>60000.0000</Salary> <HourlyWage>0.0000</HourlyWage> <FTERate>0.0000</FTERate> <HoursPerWeek>40</HoursPerWeek> <PTOBalance>0.0000</PTOBalance> <PTOCost>0.0000</PTOCost> <FederalTax>0</FederalTax> <FederalUnemploymentTax>0</FederalUnemploymentTax> <StateUnemploymentTax>0</StateUnemploymentTax> <SocialSecurityTax>0</SocialSecurityTax> <MedicareTax>0</MedicareTax> <WorkersComp>0</WorkersComp> <Bonus>0</Bonus> <Commissions>0</Commissions> <Overtime>0</Overtime> <StockOptionGrantValue>0</StockOptionGrantValue> </Employment> <LegalStatus>Employee</LegalStatus> <Relationship>Employee</Relationship> <NeedCalculatePostEnrollmentDeliveries>false</NeedCalculatePostEnrollmentDeliveries> <BirthDate>1980-01-15T00:00:00</BirthDate> <SmokerStatus>Never</SmokerStatus> <MaritalStatus>Married</MaritalStatus> <Student>false</Student> <Disabled>false</Disabled> <EmployeeIdent>Employee_12345</EmployeeIdent> <PIN>546580</PIN> <EnrollmentSession Status="Incomplete"> <Location>JAX</Location> <City>Jacksonville</City> <State>FL</State> <EnrollmentType>Unknown</EnrollmentType> <LastStatusUpdate>2017-03-22T00:54:22</LastStatusUpdate> </EnrollmentSession> <PaymentInfo> <PaymentType>Payroll</PaymentType> <BankDraftDay>0</BankDraftDay> </PaymentInfo> </Applicant> <Applicant ID="14beefbb-d45c-484f-b82f-5ec817f78012" UniqueID="14beefbb-d45c-484f-b82f-5ec817f78012" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012"> <AsOfDate>2017-04-23T20:37:55</AsOfDate> <AsOfDateTicks>636285766750000000</AsOfDateTicks> <Address Type="Personal"> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </Address> <PhoneHome>(777) 444-2222</PhoneHome> <Email>shelby287@ford.com</Email> <SSN>998-75-9263</SSN> <FirstName>Shelby</FirstName> <LastName>Clay</LastName> <Sex>Female</Sex> <PersonalEmail /> <Employment Status="Active"> <Employer>TestCo</Employer> <HireDate>2013-11-01T00:00:00</HireDate> <EligibilityDate>2013-11-01T00:00:00</EligibilityDate> <Title>Director of Marketing</Title> <Department>Marketing</Department> <Location>JAX</Location> <JobClass>Salary</JobClass> <PayGroup>Bi-Weekly</PayGroup> <PayrollFrequency>26</PayrollFrequency> <DeductionFrequency>26</DeductionFrequency> <Salary>93657.0000</Salary> <HourlyWage>0.0000</HourlyWage> <FTERate>0.0000</FTERate> <HoursPerWeek>0</HoursPerWeek> <PTOBalance>0.0000</PTOBalance> <PTOCost>0.0000</PTOCost> <FederalTax>0</FederalTax> <FederalUnemploymentTax>0</FederalUnemploymentTax> <StateUnemploymentTax>0</StateUnemploymentTax> <SocialSecurityTax>0</SocialSecurityTax> <MedicareTax>0</MedicareTax> <WorkersComp>0</WorkersComp> <Bonus>0</Bonus> <Commissions>0</Commissions> <Overtime>0</Overtime> <StockOptionGrantValue>0</StockOptionGrantValue> </Employment> <LegalStatus>Employee</LegalStatus> <Relationship>Employee</Relationship> <NeedCalculatePostEnrollmentDeliveries>false</NeedCalculatePostEnrollmentDeliveries> <BirthDate>1974-03-21T00:00:00</BirthDate> <BirthCountry>US</BirthCountry> <CountryOfCitizenship /> <PriorName /> <SmokerStatus>Never</SmokerStatus> <MaritalStatus>Married</MaritalStatus> <Student>false</Student> <Disabled>false</Disabled> <EmployeeIdent>59264</EmployeeIdent> <PIN>926374</PIN> <EnrollmentSession Status="Complete"> <Location>JAX</Location> <City>Jacksonville</City> <State>FL</State> <EnrollmentType>FaceToFace</EnrollmentType> <LastStatusUpdate>2017-04-23T20:37:55</LastStatusUpdate> </EnrollmentSession> <PaymentInfo> <PaymentType>Payroll</PaymentType> <BankDraftDay>0</BankDraftDay> </PaymentInfo> <CustomFields> <CustomField> <Value>0</Value> <Name>aaaNewCustomField</Name> </CustomField> <CustomField> <Value>Yes</Value> <Name>aaaComplexFieldType</Name> </CustomField> <CustomField> <Value>Value1</Value> <Name>aaaComboBox</Name> </CustomField> </CustomFields> </Applicant> <Applicant ID="b275321d-1709-4d57-8718-ee441660d8f5" UniqueID="b275321d-1709-4d57-8718-ee441660d8f5" DependentNumber="3159264" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012"> <AsOfDate>2014-07-08T00:00:00</AsOfDate> <AsOfDateTicks>635403744000000000</AsOfDateTicks> <Address Type="Personal"> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </Address> <SSN>998-75-9264</SSN> <FirstName>Eric</FirstName> <LastName>Clay</LastName> <Sex>Male</Sex> <LegalStatus>Spouse</LegalStatus> <Relationship>Spouse</Relationship> <BirthDate>1973-04-30T00:00:00</BirthDate> <BirthCountry>US</BirthCountry> <SmokerStatus>Never</SmokerStatus> <Student>false</Student> <Disabled>false</Disabled> </Applicant> <Applicant ID="f95b20f5-b9c6-459a-b96a-dae0a5e68c78" UniqueID="f95b20f5-b9c6-459a-b96a-dae0a5e68c78" DependentNumber="3159265" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012"> <AsOfDate>2014-07-08T00:00:00</AsOfDate> <AsOfDateTicks>635403744000000000</AsOfDateTicks> <Address Type="Personal"> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </Address> <SSN>998-75-9265</SSN> <FirstName>John</FirstName> <LastName>Clay</LastName> <Sex>Male</Sex> <LegalStatus>Child</LegalStatus> <Relationship>Child</Relationship> <BirthDate>2001-05-09T00:00:00</BirthDate> <BirthCountry>US</BirthCountry> <SmokerStatus>Never</SmokerStatus> <Student>false</Student> <Disabled>false</Disabled> </Applicant> <Applicant ID="63734349-264d-4be9-b9e9-12c9bebd60f8" UniqueID="63734349-264d-4be9-b9e9-12c9bebd60f8" DependentNumber="3159266" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012"> <AsOfDate>2014-07-08T00:00:00</AsOfDate> <AsOfDateTicks>635403744000000000</AsOfDateTicks> <Address Type="Personal"> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </Address> <SSN>998-75-9266</SSN> <FirstName>Alton</FirstName> <LastName>Clay</LastName> <Sex>Male</Sex> <LegalStatus>Child</LegalStatus> <Relationship>Child</Relationship> <BirthDate>2004-01-08T00:00:00</BirthDate> <BirthCountry>US</BirthCountry> <SmokerStatus>Never</SmokerStatus> <Student>false</Student> <Disabled>false</Disabled> </Applicant> <Applicant ID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" UniqueID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <Address Type="Personal"> <Country>USA</Country> <Line1>2 NE Athene Hwy</Line1> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </Address> <PhoneHome>(444) 333-2222</PhoneHome> <Email>lucy@someaddr.com</Email> <SSN>998-75-9279</SSN> <FirstName>Lucy</FirstName> <LastName>Boozman</LastName> <Sex>Female</Sex> <PersonalEmail /> <Employment Status="Active"> <Employer>TestCo</Employer> <HireDate>2013-06-17T00:00:00</HireDate> <EligibilityDate>2013-06-17T00:00:00</EligibilityDate> <Title>Associate Warehouse</Title> <Department>Warehouse</Department> <Location>JAX</Location> <JobClass>Hourly</JobClass> <PayGroup>Bi-Weekly</PayGroup> <PayrollFrequency>26</PayrollFrequency> <DeductionFrequency>26</DeductionFrequency> <Salary>24960.0000</Salary> <HourlyWage>0.0000</HourlyWage> <FTERate>0.0000</FTERate> <HoursPerWeek>0</HoursPerWeek> <DaysPerWeek>1</DaysPerWeek> <PTOBalance>0.0000</PTOBalance> <PTOCost>0.0000</PTOCost> <FederalTax>0</FederalTax> <FederalUnemploymentTax>0</FederalUnemploymentTax> <StateUnemploymentTax>0</StateUnemploymentTax> <SocialSecurityTax>0</SocialSecurityTax> <MedicareTax>0</MedicareTax> <WorkersComp>0</WorkersComp> <Bonus>0</Bonus> <Commissions>0</Commissions> <Overtime>0</Overtime> <StockOptionGrantValue>0</StockOptionGrantValue> </Employment> <LegalStatus>Employee</LegalStatus> <Relationship>Employee</Relationship> <NeedCalculatePostEnrollmentDeliveries>false</NeedCalculatePostEnrollmentDeliveries> <BirthDate>1952-06-05T00:00:00</BirthDate> <BirthCountry>US</BirthCountry> <CountryOfCitizenship /> <PriorName /> <SmokerStatus>Never</SmokerStatus> <MaritalStatus>Single</MaritalStatus> <Student>false</Student> <Disabled>false</Disabled> <EmployeeIdent>59280</EmployeeIdent> <UserID /> <PIN>BEZvqp+1bg8e0xI+ZkGuww==</PIN> <EnrollmentSession Status="Complete"> <Location>JAX</Location> <City>Jacksonville</City> <State>FL</State> <EnrollmentType>FaceToFace</EnrollmentType> <LastStatusUpdate>2017-04-23T20:30:53</LastStatusUpdate> </EnrollmentSession> <PaymentInfo> <PaymentType>Payroll</PaymentType> <BankDraftDay>0</BankDraftDay> </PaymentInfo> <CustomFields> <CustomField> <Value>1</Value> <Name>aaaNewCustomField</Name> </CustomField> <CustomField> <Value>Yes</Value> <Name>aaaComplexFieldType</Name> </CustomField> <CustomField> <Value>Value1</Value> <Name>aaaComboBox</Name> </CustomField> </CustomFields> </Applicant> <Applicant ID="d20547a0-dac1-49df-bcd2-310d8bde3fab" UniqueID="d20547a0-dac1-49df-bcd2-310d8bde3fab" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72"> <AsOfDate>2014-08-20T23:43:14</AsOfDate> <AsOfDateTicks>635441749940000000</AsOfDateTicks> <Address Type="Personal"> <Country>USA</Country> <Line1>5300 Spring Pkwy Creek Jack</Line1> <Line2 /> <Line3 /> <City>Foobersville</City> <State>TX</State> <Zip>77777</Zip> </Address> <SSN>334-44-4444</SSN> <FirstName>YMCA</FirstName> <Sex>Male</Sex> <LegalStatus>Charity</LegalStatus> <LegalStatusDescription /> <Relationship>Beneficiary</Relationship> <BirthDate>1950-01-01T00:00:00</BirthDate> <SmokerStatus>Never</SmokerStatus> <Student>false</Student> <Disabled>false</Disabled> </Applicant> </Applicants> <Applications> <Application ID="edba6045-8564-4812-bc53-cf0e9ac585a2" UniqueID="edba6045-8564-4812-bc53-cf0e9ac585a2" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:37:53</AsOfDate> <AsOfDateTicks>636285766730000000</AsOfDateTicks> <OfferingID>9956</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <TerminationDate>2017-06-30T00:00:00</TerminationDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> </Coverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="false" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T00:00:00</ApplicationDate> <PolicyNumber /> </Application> <Application ID="73e0bb23-2027-47fe-a001-bdd17db29126" UniqueID="73e0bb23-2027-47fe-a001-bdd17db29126" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:54</AsOfDate> <AsOfDateTicks>636285766740000000</AsOfDateTicks> <OfferingID>9962</OfferingID> <Coverage ProductID="12519"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>2.4200</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>2.4200</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>30000.0000</BenefitAmount> <BenefitAmountFrequency>1</BenefitAmountFrequency> <OptionCode>1</OptionCode> <Description>$30,000</Description> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <PreviousCoverage ProductID="12519"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>1.6200</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>1.6200</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>20000.0000</BenefitAmount> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>1</OptionCode> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2017-04-30T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2017-05-01T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </PreviousCoverage> <PendingCoverage> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>14.5400</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>180000.0000</BenefitAmount> <OptionCode>1</OptionCode> </PendingCoverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true" /> </Insureds> <Beneficiaries> <Beneficiary UniqueID="00000000-0000-0000-0000-000000000000" ApplicantID="b275321d-1709-4d57-8718-ee441660d8f5"> <Type>Primary</Type> <Name>Eric Clay</Name> <Phone /> <BeneficiaryAddress> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <Line2 /> <Line3 /> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </BeneficiaryAddress> <Percent>100.0000</Percent> <FirstName>Eric</FirstName> <LastName>Clay</LastName> <SSN>998-75-9264</SSN> <RelationshipDescription>Spouse</RelationshipDescription> <Age>44</Age> <BirthDate>1973-04-30T00:00:00</BirthDate> <CountryOfCitizenship /> <Sex>Male</Sex> </Beneficiary> </Beneficiaries> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:54</ApplicationDate> <Events> <Event EventClass="Changed"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:54</EventDate> <ReasonCode>1</ReasonCode> <Reason>[benefit amount changed] [beneficiary changed] </Reason> </Event> </Events> <GroupNumber /> <GroupNumberLabel /> <NetworkID /> <SubgroupNumber /> <PlanSubcode /> <SubnetworkID /> <PlanCode /> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="f90696e1-161f-4605-b600-281a6c991451" UniqueID="f90696e1-161f-4605-b600-281a6c991451" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:52</AsOfDate> <AsOfDateTicks>636285766720000000</AsOfDateTicks> <OfferingID>10915</OfferingID> <Coverage ProductID="12933"> <Tier>Family</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>2.7700</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>2.7700</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <MinimumEssentialCoverage>false</MinimumEssentialCoverage> <MinimumValueCoverage>false</MinimumValueCoverage> <MeetsACAQualification>false</MeetsACAQualification> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode /> <Description>Benefit Enhancer High HSA; FA</Description> <Section125>false</Section125> <InitialEffectiveDate>2017-05-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-01-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> <Insured Age="44" 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<EmployerCost>0.0000</EmployerCost> <OptionCode>HAF</OptionCode> </Rider> <Rider> <Name>Group Medical Bridge</Name> <Code>C3HAF</Code> <Tier>Family</Tier> <EmployeeCost>3.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>3.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <OptionCode>HAF</OptionCode> </Rider> </Riders> <Beneficiaries> <Beneficiary UniqueID="00000000-0000-0000-0000-000000000000" ApplicantID="b275321d-1709-4d57-8718-ee441660d8f5"> <Type>Primary</Type> <Name>Eric Clay</Name> <Phone /> <BeneficiaryAddress> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <Line2 /> <Line3 /> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </BeneficiaryAddress> <Percent>100.0000</Percent> <FirstName>Eric</FirstName> <LastName>Clay</LastName> <SSN>998-75-9264</SSN> <RelationshipDescription>Spouse</RelationshipDescription> <Age>44</Age> <BirthDate>1973-04-30T00:00:00</BirthDate> <CountryOfCitizenship /> <Sex>Male</Sex> </Beneficiary> <Beneficiary UniqueID="00000000-0000-0000-0000-000000000000" ApplicantID="f95b20f5-b9c6-459a-b96a-dae0a5e68c78"> <Type>Contingent</Type> <Name>John Clay</Name> <Phone /> <BeneficiaryAddress> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <Line2 /> <Line3 /> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </BeneficiaryAddress> <Percent>50.0000</Percent> <FirstName>John</FirstName> <LastName>Clay</LastName> <SSN>998-75-9265</SSN> <RelationshipDescription>Child</RelationshipDescription> <Age>15</Age> <BirthDate>2001-05-09T00:00:00</BirthDate> <CountryOfCitizenship /> <Sex>Male</Sex> </Beneficiary> <Beneficiary UniqueID="00000000-0000-0000-0000-000000000000" ApplicantID="63734349-264d-4be9-b9e9-12c9bebd60f8"> <Type>Contingent</Type> <Name>Alton Clay</Name> <Phone /> <BeneficiaryAddress> <Country>USA</Country> <Line1>3 S Lakisha St</Line1> <Line2 /> <Line3 /> <City>Tallahassee</City> <State>FL</State> <Zip>32399</Zip> </BeneficiaryAddress> <Percent>50.0000</Percent> <FirstName>Alton</FirstName> <LastName>Clay</LastName> <SSN>998-75-9266</SSN> <RelationshipDescription>Child</RelationshipDescription> <Age>13</Age> <BirthDate>2004-01-08T00:00:00</BirthDate> <CountryOfCitizenship /> <Sex>Male</Sex> </Beneficiary> </Beneficiaries> <Enrollers> <Enroller AgentID="1503"> <Number /> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:52</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:52</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="d3fed3bd-abb6-45ed-9192-6e14e49c6d8b" UniqueID="d3fed3bd-abb6-45ed-9192-6e14e49c6d8b" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:37:52</AsOfDate> <AsOfDateTicks>636285766720000000</AsOfDateTicks> <OfferingID>9953</OfferingID> <Coverage ProductID="12513"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>150.0000</EmployeeCost> <PreTaxEmployeeCost>150.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>3900.0000</BenefitAmount> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>FA|26</OptionCode> <Description>Waived</Description> <Section125>true</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2017-06-30T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2017-07-01T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="40" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="15"> <Number>Lyle_Main_AgentID</Number> <Split>0.6000</Split> </Enroller> <Enroller AgentID="783"> <Number>test</Number> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T00:00:00</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2014-07-08T00:00:00</EventDate> <ReasonCode>1</ReasonCode> </Event> <Event EventClass="Deleted"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:52</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="3b521f79-211a-4501-b60a-9f70cb67d170" UniqueID="3b521f79-211a-4501-b60a-9f70cb67d170" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:54</AsOfDate> <AsOfDateTicks>636285766740000000</AsOfDateTicks> <OfferingID>9959</OfferingID> <Coverage ProductID="12516"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>18.0000</EmployerCost> <BenefitAmount>1000.0000</BenefitAmount> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>60</OptionCode> <Description>ER Paid STD; $1,000</Description> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <PreviousCoverage ProductID="12516"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>18.0000</EmployerCost> <BenefitAmount>1000.0000</BenefitAmount> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>60</OptionCode> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2017-04-30T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2017-05-01T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </PreviousCoverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:54</ApplicationDate> <Events> <Event EventClass="Changed"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:54</EventDate> <ReasonCode>0</ReasonCode> <Reason>[carry forward] </Reason> </Event> </Events> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="45c53372-4ba8-48e7-a13b-a502e12036dc" UniqueID="45c53372-4ba8-48e7-a13b-a502e12036dc" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:52</AsOfDate> <AsOfDateTicks>636285766720000000</AsOfDateTicks> <OfferingID>9950</OfferingID> <Coverage ProductID="12507"> <Tier>Family</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>358.8900</EmployeeCost> <PreTaxEmployeeCost>358.8900</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>475.7400</EmployerCost> <MinimumEssentialCoverage>false</MinimumEssentialCoverage> <MinimumValueCoverage>false</MinimumValueCoverage> <MeetsACAQualification>false</MeetsACAQualification> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode /> <Description>Blue Care 59 - HMO; FA</Description> <Section125>true</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <PreviousCoverage ProductID="12509"> <Tier>Family</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>218.5500</EmployeeCost> <PreTaxEmployeeCost>218.5500</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>509.9500</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>true</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2017-06-30T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2017-07-01T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </PreviousCoverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true"> <PCPName>Shelby PCP Name</PCPName> <PCPNumber>Shelby PCP Num</PCPNumber> <PCPExistingCustomer>true</PCPExistingCustomer> <OtherInsurance /> </Insured> <Insured Age="44" ApplicantID="b275321d-1709-4d57-8718-ee441660d8f5" IsAllQuestionsAnswered="true"> <PCPName>Eric PCP Name</PCPName> <PCPNumber>Eric PCP Number</PCPNumber> <PCPExistingCustomer>true</PCPExistingCustomer> <OtherInsurance /> </Insured> <Insured Age="16" ApplicantID="f95b20f5-b9c6-459a-b96a-dae0a5e68c78" IsAllQuestionsAnswered="true"> <PCPName>John PCP Name</PCPName> <PCPNumber>John PCP Number</PCPNumber> <PCPExistingCustomer>true</PCPExistingCustomer> <OtherInsurance /> </Insured> <Insured Age="13" ApplicantID="63734349-264d-4be9-b9e9-12c9bebd60f8" IsAllQuestionsAnswered="true"> <PCPName>Alton PCP Name</PCPName> <PCPNumber>Alton PCP Num</PCPNumber> <PCPExistingCustomer>true</PCPExistingCustomer> <OtherInsurance /> </Insured> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>56789</Number> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:52</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:52</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <GroupNumber>Blue 59 HMO-mgn</GroupNumber> <GroupNumberLabel>Blue 59 HMO-mgnl</GroupNumberLabel> <NetworkID>Blue 59 HMO-nwid</NetworkID> <SubgroupNumber>Blue 59 HMO-sgn</SubgroupNumber> <PlanSubcode>Blue 59 HMO-psc</PlanSubcode> <SubnetworkID>Blue 59 HMO-snwid</SubnetworkID> <PlanCode>Blue 59 HMO-pc</PlanCode> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="0777570d-4710-42d4-b6ce-aea254166b02" UniqueID="0777570d-4710-42d4-b6ce-aea254166b02" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:53</AsOfDate> <AsOfDateTicks>636285766730000000</AsOfDateTicks> <OfferingID>9954</OfferingID> <Coverage ProductID="12514"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>96.1500</EmployeeCost> <PreTaxEmployeeCost>96.1500</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>2499.9000</BenefitAmount> <LumpSum>0.0000</LumpSum> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>1|26</OptionCode> <Description>$2,499.90</Description> <Section125>true</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="15"> <Number>Lyle_Main_AgentID</Number> <Split>0.2100</Split> </Enroller> <Enroller AgentID="783"> <Number>test</Number> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:53</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:53</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="4b65352e-5392-4ccc-937b-7bd235178970" UniqueID="4b65352e-5392-4ccc-937b-7bd235178970" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:53</AsOfDate> <AsOfDateTicks>636285766730000000</AsOfDateTicks> <OfferingID>9951</OfferingID> <Coverage ProductID="12510"> <Tier>Family</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>18.4000</EmployeeCost> <PreTaxEmployeeCost>18.4000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>34.1800</EmployerCost> <MinimumEssentialCoverage>false</MinimumEssentialCoverage> <MinimumValueCoverage>false</MinimumValueCoverage> <MeetsACAQualification>false</MeetsACAQualification> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode /> <Description>PPO High; FA</Description> <Section125>true</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <PreviousCoverage ProductID="12510"> <Tier>Family</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>18.4000</EmployeeCost> <PreTaxEmployeeCost>18.4000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>34.1800</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>true</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2017-06-30T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2017-07-01T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </PreviousCoverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> <Insured Age="44" ApplicantID="b275321d-1709-4d57-8718-ee441660d8f5" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> <Insured Age="16" ApplicantID="f95b20f5-b9c6-459a-b96a-dae0a5e68c78" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> <Insured Age="13" ApplicantID="63734349-264d-4be9-b9e9-12c9bebd60f8" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:53</ApplicationDate> <Events> <Event EventClass="Changed"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:53</EventDate> <ReasonCode>1</ReasonCode> <Reason>[carry forward] </Reason> </Event> </Events> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="f1b0ee99-eb0b-4402-9296-3190b29d305a" UniqueID="f1b0ee99-eb0b-4402-9296-3190b29d305a" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:37:52</AsOfDate> <AsOfDateTicks>636285766720000000</AsOfDateTicks> <OfferingID>32988</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> 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IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:53</ApplicationDate> <Events> <Event EventClass="Changed"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:53</EventDate> <ReasonCode>1</ReasonCode> <Reason>[carry forward] </Reason> </Event> </Events> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="4c2a67f7-e12c-46d5-a75e-bfbf0685cf2d" UniqueID="4c2a67f7-e12c-46d5-a75e-bfbf0685cf2d" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:37:54</AsOfDate> <AsOfDateTicks>636285766740000000</AsOfDateTicks> 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EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:54</AsOfDate> <AsOfDateTicks>636285766740000000</AsOfDateTicks> <OfferingID>9964</OfferingID> <Coverage ProductID="12521"> <Tier>Children Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.9600</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.9600</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>10000.0000</BenefitAmount> <BenefitAmountFrequency>1</BenefitAmountFrequency> <OptionCode>1</OptionCode> <Section125>false</Section125> <InitialEffectiveDate>2017-05-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> 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<Application ID="6a0c4d64-5df2-4cf4-a29a-7f8fea8de711" UniqueID="6a0c4d64-5df2-4cf4-a29a-7f8fea8de711" EmployeeID="14beefbb-d45c-484f-b82f-5ec817f78012" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:37:53</AsOfDate> <AsOfDateTicks>636285766730000000</AsOfDateTicks> <OfferingID>9955</OfferingID> <Coverage ProductID="12515"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>192.3000</EmployeeCost> <PreTaxEmployeeCost>192.3000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>4999.8000</BenefitAmount> <LumpSum>0.0000</LumpSum> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>Jointly|26</OptionCode> <Description>$4,999.80</Description> <Section125>true</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="43" ApplicantID="14beefbb-d45c-484f-b82f-5ec817f78012" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="15"> <Number>Lyle_Main_AgentID</Number> <Split>0.2100</Split> </Enroller> <Enroller AgentID="783"> <Number>test</Number> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:37:53</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:37:53</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="6b9f875c-8769-4d78-95d7-a76986190803" UniqueID="6b9f875c-8769-4d78-95d7-a76986190803" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" Waived="true" Status="Complete"> <AsOfDate>2014-08-25T21:42:59</AsOfDate> <AsOfDateTicks>635445997790000000</AsOfDateTicks> <OfferingID>9956</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="false" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2014-08-25T21:42:59</ApplicationDate> <PolicyNumber /> </Application> <Application ID="e47081b3-0d90-4cac-8e94-e8e4db05ef43" UniqueID="e47081b3-0d90-4cac-8e94-e8e4db05ef43" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <OfferingID>9962</OfferingID> <Coverage ProductID="12519"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>28.8200</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>28.8200</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>70000.0000</BenefitAmount> <BenefitAmountFrequency>1</BenefitAmountFrequency> <OptionCode>1</OptionCode> <Description>$70,000</Description> <Section125>false</Section125> <InitialEffectiveDate>2017-05-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Beneficiaries> <Beneficiary UniqueID="00000000-0000-0000-0000-000000000000" ApplicantID="d20547a0-dac1-49df-bcd2-310d8bde3fab"> <Type>Primary</Type> <Name>YMCA </Name> <Phone /> <BeneficiaryAddress> <Country>USA</Country> <Line1>5300 Spring Pkwy Creek Jack</Line1> <Line2 /> <Line3 /> <City>Foobersville</City> <State>TX</State> <Zip>77777</Zip> </BeneficiaryAddress> <Percent>100.0000</Percent> <FirstName>YMCA</FirstName> <LastName /> <SSN>334-44-4444</SSN> <RelationshipDescription>Charity</RelationshipDescription> <Age>64</Age> <BirthDate>1950-01-01T00:00:00</BirthDate> <CountryOfCitizenship /> <Sex>Male</Sex> </Beneficiary> </Beneficiaries> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:53</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:53</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <GroupNumber /> <GroupNumberLabel /> <NetworkID /> <SubgroupNumber /> <PlanSubcode /> <SubnetworkID /> <PlanCode /> <Locked>false</Locked> </Application> <Application ID="10d0f443-911c-4732-b0da-3dcdac97e1df" UniqueID="10d0f443-911c-4732-b0da-3dcdac97e1df" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:51</AsOfDate> <AsOfDateTicks>636285762510000000</AsOfDateTicks> <OfferingID>10915</OfferingID> <Coverage ProductID="12933"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>2.7700</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>2.7700</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <MinimumEssentialCoverage>false</MinimumEssentialCoverage> <MinimumValueCoverage>false</MinimumValueCoverage> <MeetsACAQualification>false</MeetsACAQualification> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode /> <Description>Benefit Enhancer High HSA; EO</Description> <Section125>false</Section125> <InitialEffectiveDate>2017-05-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-01-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> </Insureds> <Riders> <Rider> <Name>Group Accident</Name> <Code>C1HAE</Code> <Tier>Employee Only</Tier> <EmployeeCost>1.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>1.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <OptionCode>HAE</OptionCode> </Rider> <Rider> <Name>Group Critical Care</Name> <Code>C2HAE</Code> <Tier>Employee Only</Tier> <EmployeeCost>2.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>2.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <OptionCode>HAE</OptionCode> </Rider> <Rider> <Name>Group Medical Bridge</Name> <Code>C3HAE</Code> <Tier>Employee Only</Tier> <EmployeeCost>3.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>3.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <OptionCode>HAE</OptionCode> </Rider> </Riders> <Beneficiaries> <Beneficiary UniqueID="00000000-0000-0000-0000-000000000000" ApplicantID="d20547a0-dac1-49df-bcd2-310d8bde3fab"> <Type>Primary</Type> <Name>YMCA </Name> <Phone /> <BeneficiaryAddress> <Country>USA</Country> <Line1>5300 Spring Pkwy Creek Jack</Line1> <Line2 /> <Line3 /> <City>Foobersville</City> <State>TX</State> <Zip>77777</Zip> </BeneficiaryAddress> <Percent>100.0000</Percent> <FirstName>YMCA</FirstName> <LastName /> <SSN>334-44-4444</SSN> <RelationshipDescription>Charity</RelationshipDescription> <Age>64</Age> <BirthDate>1950-01-01T00:00:00</BirthDate> <CountryOfCitizenship /> <Sex>Male</Sex> </Beneficiary> </Beneficiaries> <Enrollers> <Enroller AgentID="1503"> <Number /> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:51</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:51</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="4484e064-b9e4-44f1-b9d7-000260381c22" UniqueID="4484e064-b9e4-44f1-b9d7-000260381c22" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:30:52</AsOfDate> <AsOfDateTicks>636285762520000000</AsOfDateTicks> <OfferingID>9953</OfferingID> <Coverage ProductID="12513"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>20.0000</EmployeeCost> <PreTaxEmployeeCost>20.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>520.0000</BenefitAmount> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>EE|26</OptionCode> <Description>Waived</Description> <Section125>true</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2014-08-31T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2014-09-11T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="62" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="15"> <Number>Lyle_Main_AgentID</Number> <Split>0.2100</Split> </Enroller> <Enroller AgentID="783"> <Number>test</Number> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T00:00:00</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2014-07-08T00:00:00</EventDate> <ReasonCode>1</ReasonCode> </Event> <Event EventClass="Deleted"> <UserID>1503</UserID> <EventDate>2014-08-25T22:25:24</EventDate> <ReasonCode>200</ReasonCode> </Event> </Events> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="60f80795-1af5-46e3-a7e8-c1c6f3272cd9" UniqueID="60f80795-1af5-46e3-a7e8-c1c6f3272cd9" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <OfferingID>9959</OfferingID> <Coverage ProductID="12516"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>5.1800</EmployerCost> <BenefitAmount>288.0000</BenefitAmount> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>60</OptionCode> <Description>ER Paid STD; $288</Description> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <PreviousCoverage ProductID="12516"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>5.1800</EmployerCost> <BenefitAmount>288.0000</BenefitAmount> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>60</OptionCode> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2017-04-30T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2017-05-01T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </PreviousCoverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:53</ApplicationDate> <Events> <Event EventClass="Changed"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:53</EventDate> <ReasonCode>0</ReasonCode> <Reason>[carry forward] </Reason> </Event> </Events> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="77754680-afb4-4029-86ac-86649e4c68bb" UniqueID="77754680-afb4-4029-86ac-86649e4c68bb" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:52</AsOfDate> <AsOfDateTicks>636285762520000000</AsOfDateTicks> <OfferingID>9950</OfferingID> <Coverage ProductID="12535"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>46.1500</EmployeeCost> <PreTaxEmployeeCost>46.1500</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>46.6200</EmployerCost> <MinimumEssentialCoverage>false</MinimumEssentialCoverage> <MinimumValueCoverage>false</MinimumValueCoverage> <MeetsACAQualification>false</MeetsACAQualification> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode /> <Description>Blue Options 03559 - PPO; EO</Description> <Section125>true</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="65" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>mwBCBS_Agent_Num</Number> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:52</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:52</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="947a27f7-d68f-4eb6-8bcd-2f2cf2c4fd28" UniqueID="947a27f7-d68f-4eb6-8bcd-2f2cf2c4fd28" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:52</AsOfDate> <AsOfDateTicks>636285762520000000</AsOfDateTicks> <OfferingID>9954</OfferingID> <Coverage ProductID="12514"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>96.1500</EmployeeCost> <PreTaxEmployeeCost>96.1500</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>2499.9000</BenefitAmount> <LumpSum>0.0000</LumpSum> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>1|26</OptionCode> <Description>$2,499.90</Description> <Section125>true</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="65" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="15"> <Number>Lyle_Main_AgentID</Number> <Split>0.2100</Split> </Enroller> <Enroller AgentID="783"> <Number>test</Number> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:52</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:52</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="ddf549f4-2efe-4c6e-b5ec-fd88e0c87d83" UniqueID="ddf549f4-2efe-4c6e-b5ec-fd88e0c87d83" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Waived="true" Status="Complete"> <AsOfDate>2014-08-25T22:25:24</AsOfDate> <AsOfDateTicks>635446023240000000</AsOfDateTicks> <OfferingID>9951</OfferingID> <Coverage ProductID="12510"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>5.5400</EmployeeCost> <PreTaxEmployeeCost>5.5400</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>10.2900</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Description>Waived</Description> <Section125>true</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-07-01T00:00:00</EffectiveDate> <TerminationDate>2014-08-31T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-07-17T00:00:00</FirstDeductionDate> <LastDeductionDate>2014-09-11T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="62" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2014-08-25T00:00:00</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2014-07-08T00:00:00</EventDate> <ReasonCode>1</ReasonCode> </Event> <Event EventClass="Deleted"> <UserID>1503</UserID> <EventDate>2014-08-25T22:25:24</EventDate> <ReasonCode>200</ReasonCode> </Event> </Events> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="8050df14-0a77-4f40-8a55-05a1f30210f6" UniqueID="8050df14-0a77-4f40-8a55-05a1f30210f6" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:30:51</AsOfDate> <AsOfDateTicks>636285762510000000</AsOfDateTicks> <OfferingID>32988</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <TerminationDate>2017-04-30T00:00:00</TerminationDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="false" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T00:00:00</ApplicationDate> <PolicyNumber /> </Application> <Application ID="3cea723b-b3b9-42ce-acd3-ae9ca44bba7f" UniqueID="3cea723b-b3b9-42ce-acd3-ae9ca44bba7f" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <OfferingID>9965</OfferingID> <Coverage ProductID="12528"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>9.8700</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>9.8700</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <MinimumEssentialCoverage>false</MinimumEssentialCoverage> <MinimumValueCoverage>false</MinimumValueCoverage> <MeetsACAQualification>false</MeetsACAQualification> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode /> <Description>Basic Plus; EO</Description> <Section125>false</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="65" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Baileys_Main_AgentID</Number> <Split>0.7000</Split> </Enroller> <Enroller AgentID="1235"> <Number /> <Split>0.3000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:53</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:53</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="44a38c42-d6d5-4858-a5b5-83c66cdce872" UniqueID="44a38c42-d6d5-4858-a5b5-83c66cdce872" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" Waived="true" Status="Complete"> <AsOfDate>2014-08-25T21:42:59</AsOfDate> <AsOfDateTicks>635445997790000000</AsOfDateTicks> <OfferingID>9957</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="false" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2014-08-25T21:42:59</ApplicationDate> <PolicyNumber /> </Application> <Application ID="c05f4b83-4025-48bf-82c2-f9f8529a5cad" UniqueID="c05f4b83-4025-48bf-82c2-f9f8529a5cad" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <OfferingID>9960</OfferingID> <Coverage ProductID="12536"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>13.1900</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>13.1900</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>700.0000</BenefitAmount> <BenefitAmountFrequency>12</BenefitAmountFrequency> <OptionCode>1</OptionCode> <Description>$700</Description> <Section125>false</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="65" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:53</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:53</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="4dacd476-40e9-4c56-80d4-18e932a61d57" UniqueID="4dacd476-40e9-4c56-80d4-18e932a61d57" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <OfferingID>9963</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <TerminationDate>2017-04-30T00:00:00</TerminationDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="false" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T00:00:00</ApplicationDate> <PolicyNumber /> </Application> <Application ID="afe976ec-b4d6-4b6f-93de-ecf56c266532" UniqueID="afe976ec-b4d6-4b6f-93de-ecf56c266532" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:52</AsOfDate> <AsOfDateTicks>636285762520000000</AsOfDateTicks> <OfferingID>9952</OfferingID> <Coverage ProductID="12512"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>3.4800</EmployeeCost> <PreTaxEmployeeCost>3.4800</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <MinimumEssentialCoverage>false</MinimumEssentialCoverage> <MinimumValueCoverage>false</MinimumValueCoverage> <MeetsACAQualification>false</MeetsACAQualification> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode /> <Description>Vision; EO</Description> <Section125>true</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="65" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true"> <PCPName /> <PCPNumber /> <OtherInsurance /> </Insured> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:52</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:52</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="c909d97d-0ece-47ea-a207-11baa1db1cb6" UniqueID="c909d97d-0ece-47ea-a207-11baa1db1cb6" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" Waived="true" Status="Complete"> <AsOfDate>2014-08-25T21:42:59</AsOfDate> <AsOfDateTicks>635445997790000000</AsOfDateTicks> <OfferingID>9958</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="false" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2014-08-25T21:42:59</ApplicationDate> <PolicyNumber /> </Application> <Application ID="e38ae488-2287-4b2e-9069-ebcf58f8b9d6" UniqueID="e38ae488-2287-4b2e-9069-ebcf58f8b9d6" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" Waived="true" Status="Complete"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <OfferingID>9964</OfferingID> <Coverage> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <TerminationDate>2017-04-30T00:00:00</TerminationDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="false" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T00:00:00</ApplicationDate> <PolicyNumber /> </Application> <Application ID="3eb800d3-04b0-4c22-8d0e-189742fa24c9" UniqueID="3eb800d3-04b0-4c22-8d0e-189742fa24c9" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:53</AsOfDate> <AsOfDateTicks>636285762530000000</AsOfDateTicks> <OfferingID>9961</OfferingID> <Coverage ProductID="12518"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>2.5400</EmployerCost> <BenefitAmount>25000.0000</BenefitAmount> <BenefitAmountFrequency>1</BenefitAmountFrequency> <OptionCode>1</OptionCode> <Description>ER Paid Basic Life; $25,000</Description> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-05-01T00:00:00</EffectiveDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-05-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <PreviousCoverage ProductID="12518"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>0.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>2.5400</EmployerCost> <BenefitAmount>25000.0000</BenefitAmount> <BenefitAmountFrequency>1</BenefitAmountFrequency> <OptionCode>1</OptionCode> <Section125>false</Section125> <InitialEffectiveDate>2014-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2014-09-01T00:00:00</EffectiveDate> <TerminationDate>2017-04-30T00:00:00</TerminationDate> <PlanYearStartDate>2014-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2014-09-11T00:00:00</FirstDeductionDate> <LastDeductionDate>2017-05-01T00:00:00</LastDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </PreviousCoverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Beneficiaries> <Beneficiary UniqueID="00000000-0000-0000-0000-000000000000" ApplicantID="d20547a0-dac1-49df-bcd2-310d8bde3fab"> <Type>Primary</Type> <Name>YMCA </Name> <Phone /> <BeneficiaryAddress> <Country>USA</Country> <Line1>5300 Spring Pkwy Creek Jack</Line1> <Line2 /> <Line3 /> <City>Foobersville</City> <State>TX</State> <Zip>77777</Zip> </BeneficiaryAddress> <Percent>100.0000</Percent> <FirstName>YMCA</FirstName> <LastName /> <SSN>334-44-4444</SSN> <RelationshipDescription>Charity</RelationshipDescription> <Age>64</Age> <BirthDate>1950-01-01T00:00:00</BirthDate> <CountryOfCitizenship /> </Beneficiary> </Beneficiaries> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Assurant_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="1371"> <Number /> <Split>0.0000</Split> </Enroller> <Enroller AgentID="17"> <Number /> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:53</ApplicationDate> <Events> <Event EventClass="Changed"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:53</EventDate> <ReasonCode>0</ReasonCode> <Reason>[carry forward] </Reason> </Event> </Events> <GroupNumber /> <GroupNumberLabel /> <NetworkID /> <SubgroupNumber /> <PlanSubcode /> <SubnetworkID /> <PlanCode /> <Locked>false</Locked> <PolicyNumber /> </Application> <Application ID="f8452629-4619-4b1a-b0db-0a66fb6bbf5a" UniqueID="f8452629-4619-4b1a-b0db-0a66fb6bbf5a" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IncreaseEffectiveImmediate="false" Status="Complete"> <AsOfDate>2017-04-23T20:30:52</AsOfDate> <AsOfDateTicks>636285762520000000</AsOfDateTicks> <OfferingID>9955</OfferingID> <Coverage ProductID="12515"> <Tier>Employee Only</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>128.1900</EmployeeCost> <PreTaxEmployeeCost>128.1900</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <BenefitAmount>3332.9400</BenefitAmount> <LumpSum>0.0000</LumpSum> <BenefitAmountFrequency>0</BenefitAmountFrequency> <OptionCode>Jointly|26</OptionCode> <Description>$3,332.94</Description> <Section125>true</Section125> <InitialEffectiveDate>2017-07-01T00:00:00</InitialEffectiveDate> <EffectiveDate>2017-07-01T00:00:00</EffectiveDate> <PlanYearStartDate>2017-07-01T00:00:00</PlanYearStartDate> <FirstDeductionDate>2017-07-01T00:00:00</FirstDeductionDate> <EmployerFee>0.0000</EmployerFee> <EmployeeFee>0.0000</EmployeeFee> </Coverage> <Insureds> <Insured Age="65" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="true" /> </Insureds> <Enrollers> <Enroller AgentID="1503"> <Number>Mike_Main_AgentID</Number> <Split>0.4000</Split> </Enroller> <Enroller AgentID="15"> <Number>Lyle_Main_AgentID</Number> <Split>0.2100</Split> </Enroller> <Enroller AgentID="783"> <Number>test</Number> <Split>0.0000</Split> </Enroller> </Enrollers> <ApplicationDate>2017-04-23T15:30:52</ApplicationDate> <Events> <Event EventClass="Added"> <UserID>1503</UserID> <EventDate>2017-04-23T20:30:52</EventDate> <ReasonCode>1</ReasonCode> </Event> </Events> <Locked>false</Locked> </Application> <Application ID="8b826d70-d970-4dce-83db-e3ca8f79f3e3" UniqueID="8b826d70-d970-4dce-83db-e3ca8f79f3e3" EmployeeID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" Waived="true" Status="Complete"> <AsOfDate>2014-08-26T17:08:18</AsOfDate> <AsOfDateTicks>635446696980000000</AsOfDateTicks> <OfferingID>10848</OfferingID> <Coverage ProductID="12891"> <Tier>No Coverage</Tier> <DeductionFrequency>26</DeductionFrequency> <EmployeeCost>30.0000</EmployeeCost> <PreTaxEmployeeCost>0.0000</PreTaxEmployeeCost> <PostTaxEmployeeCost>30.0000</PostTaxEmployeeCost> <EmployerCost>0.0000</EmployerCost> <RateCardCost>30.0000</RateCardCost> <BenefitAmountFrequency>0</BenefitAmountFrequency> <Section125>false</Section125> <AllowSection125Change>false</AllowSection125Change> </Coverage> <Insureds> <Insured Age="64" ApplicantID="48f2f0cd-3da3-4b99-be69-4b823ca12f72" IsAllQuestionsAnswered="false" /> </Insureds> <Riders> <Rider> <Name>Col1</Name> <Code>40.10</Code> <Tier>Family</Tier> <EmployeeCost>0.00</EmployeeCost> <PreTaxEmployeeCost>0.00</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.00</PostTaxEmployeeCost> <EmployerCost>0.00</EmployerCost> <Units>10.00</Units> <OptionCode>nonya</OptionCode> </Rider> <Rider> <Name>Col2</Name> <Code>40.11</Code> <Tier>Family</Tier> <EmployeeCost>0.00</EmployeeCost> <PreTaxEmployeeCost>0.00</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.00</PostTaxEmployeeCost> <EmployerCost>0.00</EmployerCost> <Units>20.00</Units> <OptionCode>nonya</OptionCode> </Rider> <Rider> <Name>Col3</Name> <Code>40.12</Code> <Tier>Family</Tier> <EmployeeCost>0.00</EmployeeCost> <PreTaxEmployeeCost>0.00</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.00</PostTaxEmployeeCost> <EmployerCost>0.00</EmployerCost> <Units>30.00</Units> <OptionCode>nonya</OptionCode> </Rider> <Rider> <Name>Col1 Breakdown</Name> <Code>Col1</Code> <Tier>Family</Tier> <EmployeeCost>33.33</EmployeeCost> <PreTaxEmployeeCost>22.22</PreTaxEmployeeCost> <PostTaxEmployeeCost>11.11</PostTaxEmployeeCost> <EmployerCost>33.33</EmployerCost> <BenefitAmount>55.55</BenefitAmount> <Units>44.44</Units> <OptionCode>optCode</OptionCode> </Rider> <Rider> <Name>Col3</Name> <Code>0</Code> <Tier>Family</Tier> <EmployeeCost>0.00</EmployeeCost> <PreTaxEmployeeCost>0.00</PreTaxEmployeeCost> <PostTaxEmployeeCost>0.00</PostTaxEmployeeCost> <EmployerCost>0.00</EmployerCost> <Units>30.00</Units> <OptionCode>nonya</OptionCode> </Rider> </Riders> <Enrollers> <Enroller AgentID="1503"> <Split>100</Split> </Enroller> </Enrollers> <ApplicationDate>2014-08-26T17:08:18</ApplicationDate> <PolicyNumber /> </Application> </Applications> <TransmittalResult Status="OK" /> <Products> <Product ID="12537"> <Name>Colonial Accident</Name> <Code>COL_ACC</Code> </Product> <Product ID="12519"> <Name>EE Vol Life and AD&D</Name> <Code>OptionalTermLifeProduct</Code> </Product> <Product ID="12933"> <Name>Benefit Enhancer High HSA</Name> <Code>beHighWithHSA</Code> </Product> <Product ID="12936"> <Name>Benefit Enhancer High No HSA</Name> <Code>beHighNoHSA</Code> </Product> <Product ID="12932"> <Name>Benefit Enhancer Low 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