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  • Activity Detailed Report - Fri, 21 Jan 2022 04-25-13 GMT

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    Vishnu Dev
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    This document provides employee benefit enrollment details for Antony Moses of ABC Corp. It lists Moses' employee ID, social security number, date of birth, gender, address, hire date, job title, and enrollment in the company's health, dental, and vision insurance plans, with effective dates and carriers. It also includes details on benefit creation and modification dates.

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    Activity Detailed Report_Fri, 21 Jan 2022 04-25-13 GMT

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    This document provides employee benefit enrollment details for Antony Moses of ABC Corp. It lists Moses' employee ID, social security number, date of birth, gender, address, hire date, job title, and enrollment in the company's health, dental, and vision insurance plans, with effective dates and carriers. It also includes details on benefit creation and modification dates.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    2 views10 pages

    Activity Detailed Report - Fri, 21 Jan 2022 04-25-13 GMT

    Uploaded by

    Vishnu Dev
    This document provides employee benefit enrollment details for Antony Moses of ABC Corp. It lists Moses' employee ID, social security number, date of birth, gender, address, hire date, job title, and enrollment in the company's health, dental, and vision insurance plans, with effective dates and carriers. It also includes details on benefit creation and modification dates.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 10

    ABC Corp

    Activity Detailed Report


    # Company Id
    t
    Company Name Company Status
    ABC Corp
    Company Location Eid Employee IdEmployee NMember Id
    483 Antony Moses
    483
    483
    Member TypRelationshi Ssn Last Name First Name Middle NamBirth Date Sex Gender Iden
    7374 Moses Antony 1995-06-15Male Male
    Address1 Address2 City State Zip Country Personal PhWork PhoneMobile Phon
    Email Marital StatHire Date Job Title DepartmentDivision Job Class Scheduled HCompensati
    2020-04-16Program MaEngineeringAdisys 40
    TerminationTerminationTerminationC O B R A DaPayroll Id Change TypChange DateOld Value New Value
    Enrollment Qualifying EQualifying EEffective DaActivity DatPlan Type Carrier Plan Name Election
    New Additi 2020-11-052021-01-18T13:00:00 Health All Savers c 2021 All Savers Vision Plan
    New Additi 2020-11-052021-01-11T13:00:00 Dental zscsc 2021 zscsc STD Plan
    New Additi 2020-11-052021-11-10T02:00:00 Medical 2021 undefined Dental Plan
    Riders Coverage A Primary Care
    Primary CarBenefit CreaBenefit LastBeneficiary Beneficiary Beneficiary
    vers Vision Plan 2021-02-182021-02-18T09:58:28.967 100
    2021-02-182021-02-18T10:00:07.013 100
    ined Dental Plan 2021-06-292021-06-29T05:05:48.067 100
    Last Modifi Last Modified Date
    1 2021-02-18T09:58:28.967
    1 2021-02-18T10:00:07.013
    68 2021-06-29T05:05:48.067

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