1. Sheet1
 ABCDEFGHIJKLMNOPQR
1                 
2 October 31, 2013 November 30, 2013 December 31, 2013
3
4 WEA PLAN 5
5 
6 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM
7 1.00 61 25 28 18 1.00 61 26 28 18 1.00 53 20 26 14
8 .900-.999 5 0 0 1 .900-.999 5 0 0 1 .900-.999 4 0 0 0
9 .825-.899 1 0 0 2 .825-.899 1 0 0 2 .825-.899 0 0 0 1
10 .750-.824 2 0 0 0 .750-.824 2 0 0 0 .750-.824 2 0 0 0
11 .676-.749 0 0 0 0 .676-.749 0 0 1 0 .676-.749 0 0 1 0
12 .583-.675 1 0 0 1 .583-.675 1 0 0 1 .583-.675 1 0 0 1
13 .500-.582 0 1 0 0 .500-.582 0 1 0 0 .500-.582 0 1 0 1
14 .417-.499 0 0 0 0 .417-.499 0 0 0 0 .417-.499 0 0 0 0
15 .330-.416 0 0 0 0 .330-.416 0 0 0 0 .330-.416 0 0 0 0
16 TOTAL 148 TOTAL 148 TOTAL 125
17 
18 WEA PLAN 2 
19 
20 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM 
21 1.00 105 50 53 43 1.00 107 51 53 44 1.00 100 49 53 32 
22 .900-.999 4 7 2 4 .900-.999 4 9 2 3 .900-.999 4 7 3 4 
23 .825-.899 1 0 0 0 .825-.899 1 0 0 0 .825-.899 2 0 0 0 
24 .750-.824 1 1 1 2 .750-.824 1 1 1 2 .750-.824 0 1 0 1 
25 .676-.749 0 0 0 1 .676-.749 0 0 0 0 .676-.749 0 0 0 0 
26 .583-.675 1 0 1 0 .583-.675 1 0 1 0 .583-.675 1 1 1 0 
27 .500-.582 0 2 0 0 .500-.582 0 2 0 0 .500-.582 0 1 0 0 
28 .417-.499 0 0 0 0 .417-.499 0 0 0 0 .417-.499 0 0 0 0 
29 .330-.416 0 0 0 0 .330-.416 0 0 0 0 .330-.416 0 0 0 0 
30 TOTAL 283 TOTAL 283 TOTAL 260
31 
32
33 October 31, 2013 November 30, 2013 December 31, 2013 
34 
35 WEA PLAN 3 
36 
37 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM 
38 1.00 141 83 56 99 1.00 144 86 56 104 1.00 151 81 69 101 
39 .900-.999 9 7 8 4 .900-.999 10 4 9 4 .900-.999 3 5 11 3 
40 .825-.899 4 1 3 1 .825-.899 2 1 3 1 .825-.899 2 1 3 1 
41 .750-.824 5 0 1 3 .750-.824 4 0 1 3 .750-.824 5 0 2 3 
42 .676-.749 0 1 1 0 .676-.749 0 1 1 0 .676-.749 1 1 1 0 
43 .583-.675 3 0 2 0 .583-.675 3 0 2 0 .583-.675 3 0 2 0 
44 .500-.582 0 1 3 3 .500-.582 0 1 3 4 .500-.582 0 2 3 4 
45 .417-.499 0 0 0 1 .417-.499 1 0 0 0 .417-.499 0 0 0 0 
46 .330-.416 0 0 0 1 .330-.416 0 0 0 1 .330-.416 0 0 0 1
47 TOTAL 449 TOTAL 449 TOTAL 459 
48 
49 WEA EASY CHOICE A 
50 
51 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM 
52 1.00 62 9 20 37 1.00 64 10 20 37 1.00 69 20 26 39 
53 .900-.999 2 2 3 3 .900-.999 3 1 4 3 .900-.999 6 1 3 3 
54 .825-.899 0 1 2 2 .825-.899 0 1 1 2 .825-.899 1 0 3 1 
55 .750-.824 1 0 1 0 .750-.824 1 0 1 0 .750-.824 1 0 1 1 
56 .676-.749 0 2 0 0 .676-.749 0 2 0 0 .676-.749 0 2 0 0 
57 .583-.675 1 1 0 1 .583-.675 1 1 0 1 .583-.675 1 1 0 1 
58 .500-.582 1 0 0 0 .500-.582 2 0 0 0 .500-.582 2 0 0 0 
59 .417-.499 0 0 0 1 .417-.499 0 0 0 1 .417-.499 0 0 0 1 
60 .330-.416 0 1 0 0 .330-.416 0 1 0 0 .330-.416 0 1 0 0
61 TOTAL 153 TOTAL 157 TOTAL 184
62 
63 
64 
65 October 31, 2013 November 30, 2013 December 31, 2013 
66 
67 WEA EASY CHOICE B 
68 
69 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM 
70 1.00 11 5 3 7 1.00 11 4 3 9 1.00 12 7 2 17 
71 .900-.999 1 0 0 0 .900-.999 1 0 0 0 .900-.999 1 0 1 0 
72 .825-.899 0 0 0 0 .825-.899 0 0 0 0 .825-.899 0 0 1 0 
73 .750-.824 1 0 0 0 .750-.824 1 0 0 0 .750-.824 1 0 0 0 
74 .676-.749 0 0 0 0 .676-.749 0 0 0 1 .676-.749 0 0 0 1 
75 .583-.675 0 0 1 2 .583-.675 0 0 1 1 .583-.675 0 0 0 1 
76 .500-.582 0 0 0 0 .500-.582 0 0 0 0 .500-.582 0 0 0 0 
77 .417-.499 0 0 0 0 .417-.499 0 0 0 0 .417-.499 0 0 0 0 
78 .330-.416 0 0 0 0 .330-.416 0 0 0 0 .330-.416 0 0 0 0
79 TOTAL 31 TOTAL 32 TOTAL 44 
80
81 WEA EASY CHOICE C 
82 
83 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM 
84 1.00 8 2 2 5 1.00 8 2 2 6 1.00 6 3 2 6 
85 .900-.999 2 0 0 0 .900-.999 1 0 0 0 .900-.999 0 0 0 0 
86 .825-.899 0 0 0 0 .825-.899 0 0 0 0 .825-.899 0 0 0 0 
87 .750-.824 0 0 0 0 .750-.824 0 0 0 0 .750-.824 0 0 0 0 
88 .676-.749 0 0 0 0 .676-.749 0 0 0 0 .676-.749 0 0 0 0 
89 .583-.675 0 0 0 0 .583-.675 0 0 0 0 .583-.675 0 0 0 0 
90 .500-.582 0 0 0 0 .500-.582 0 0 0 0 .500-.582 0 0 0 0 
91 .417-.499 0 0 0 0 .417-.499 0 0 0 0 .417-.499 0 0 0 0 
92 .330-.416 0 0 0 0 .330-.416 0 0 0 0 .330-.416 0 0 0 0 
93 TOTAL 20 TOTAL 19 TOTAL 17
94 
95 
96 
97 
98 
99 
100 October 31, 2013 November 30, 2013 December 31, 2013
101
102 WEA QUALIFIED HIGH DEDUCTIBLE 
103 
104 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM 
105 1.00 4 2 1 1 1.00 4 2 1 2 1.00 7 2 1 4 
106 .900-.999 0 0 0 0 .900-.999 0 0 0 0 .900-.999 0 0 0 0 
107 .825-.899 1 0 0 0 .825-.899 1 0 0 0 .825-.899 1 0 0 0 
108 .750-.824 0 0 0 0 .750-.824 0 0 0 0 .750-.824 0 0 0 0 
109 .676-.749 0 0 0 0 .676-.749 0 0 0 0 .676-.749 0 0 0 0 
110 .583-.675 0 0 0 0 .583-.675 0 0 0 0 .583-.675 0 0 0 0 
111 .500-.582 0 0 0 0 .500-.582 0 0 0 0 .500-.582 0 0 0 0 
112 .417-.499 0 0 0 0 .417-.499 0 0 0 0 .417-.499 0 0 0 0 
113 .330-.416 0 0 0 0 .330-.416 0 0 0 0 .330-.416 0 0 0 0 
114 TOTAL 9 TOTAL 10 TOTAL 15
115
116 GROUP HEALTH COOPERATIVE 
117 
118 BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM BFTE EE ONLY EE + SP/DP EE+CH EE+ FAM 
119 1.00 150 65 75 121 1.00 153 64 78 121 1.00 162 64 76 120 
120 .900-.999 21 9 9 14 .900-.999 21 9 9 14 .900-.999 23 9 7 14 
121 .825-.899 3 0 1 2 .825-.899 4 0 1 2 .825-.899 3 1 0 2 
122 .750-.824 1 0 0 4 .750-.824 0 0 0 4 .750-.824 0 1 0 3 
123 .676-.749 2 1 0 0 .676-.749 2 1 0 0 .676-.749 2 1 0 0 
124 .583-.675 4 1 2 0 .583-.675 4 1 2 0 .583-.675 4 0 2 0 
125 .500-.582 1 3 1 2 .500-.582 1 3 1 2 .500-.582 1 3 1 2 
126 .417-.499 0 0 0 0 .417-.499 0 0 0 0 .417-.499 0 0 0 0 
127 .330-.416 0 0 2 0 .330-.416 0 0 2 0 .330-.416 0 0 2 0 
128 TOTAL 496 TOTAL 499 TOTAL 503 

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