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Analyze input and output data and determine what input file contains the data in each output column (one column may pull data from multiple tables) a. Input Files: MCP Scan, BK Rpt, Flex, OIPA b. Output File: Audit File 2. Button(s) to allow user to select the 4 input files 3. Based on analysis in step one, execution button to produce the output file from the 4 input files

INPUT FILES

OUTPUT FILE=

Title 15.86 Bernard Employer Agent Report Date Section 125 Plan Year ABC John Doe 10/22/2021 7:32 01/1/2022 - 12/31/2022 McpNumber Employee SSN Employee ID FirstName LastName Location 111111111 AAAAAAAAA Aaron Arnold OKC School PLANT WORKER 111111111 AAAAAAAAA Aaron Arnold OKC School PLANT WORKER 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob Bernard OKC School ADMIN ASST TO THE SUPT 111111112 BBBBBBBBB Bob OKC School ADMIN ASST TO THE SUPT 111111113 CCCCCCCCC Connor Conrad OKC School ADULT EDUC TEACHER 111111113 CCCCCCCCC Connor Conrad OKC School ADULT EDUC TEACHER 111111113 CCCCCCCCC Connor Conrad OKC School ADULT EDUC TEACHER 111111113 CCCCCCCCC Connor Conrad OKC School ADULT EDUC TEACHER 111111114 DDDDDDDDD Danielle Duvall OKC School PAYROLL SPECIALIST-CONF 111111114 DDDDDDDDD Danielle Duvall OKC School PAYROLL SPECIALIST-CONF 111111114 DDDDDDDDD Danielle Duvall OKC School PAYROLL SPECIALIST-CONF 111111114 DDDDDDDDD Danielle Duvall OKC School PAYROLL SPECIALIST-CONF 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Enid OKC School TEACHER K-3 111111115 EEEEEEEEE Ellen Enid OKC School TEACHER K-3 111111116 FFFFFFFFF Frank Fitzgerald OKC School CAMPUS SECURITY ASST 111111117 GGGGGGGGG Gerald Grand OKC School TEACHER MIDDLE SCHOOL 111111117 GGGGGGGGG Gerald Grand OKC School TEACHER MIDDLE SCHOOL 111111117 GGGGGGGGG Gerald Grand OKC School TEACHER MIDDLE SCHOOL Job Class Company PlanName ProductName TEAMSTERS Dental Co Dental Dental TEAMSTERS Life Co Basic Term Life Basic Term Life CONFIDENTIAL Med Co Medical Medical CONFIDENTIAL Dental Co Dental Dental CONFIDENTIAL Vision Co Vision Vision CONFIDENTIAL Life Co Basic Term Life Basic Term Life CONFIDENTIAL American Fidelity Disability Disability CONFIDENTIAL American Fidelity Accident Accident CONFIDENTIAL American Fidelity Cancer Cancer CONFIDENTIAL American Fidelity Group Critical illness Group Critical illness CONFIDENTIAL Life 2 Co Life2 Life 2 CEA Med Co Medical Medical CEA Dental Co Dental Dental CEA Vision Co Vision Vision CEA Life Co Basic Term Life Basic Term Life CONFIDENTIAL Med Co Medical Medical CONFIDENTIAL Dental Co Dental Dental CONFIDENTIAL Vision Co Vision Vision CONFIDENTIAL Life Co Basic Term Life Basic Term Life CEA Med Co Medical Medical CEA Dental Co Dental Dental CEA Vision Co Vision Vision CEA Basic Term Life Basic Term Life CEA American Fidelity Whole Life Whole Life CEA American Fidelity Whole Life Whole Life CEA Life 2 Co Life 2 Life 2 CEA Life 2 Co Life 2 Life 2 CEA Life 2 Co Life 2 Life 2 CEA Life 2 Co Life 2 Life 2 TEAMSTERS Life Co Basic Term Life Basic Term Life CEA Med Co Medical Medical CEA Dental Co Dental Dental CEA Vision Co Vision Vision DeductionFrequencyID Pre Tax Cost Post Tax Cost EmployerCost EffectiveDate Coverage TerminationDate Action Enrollment Status EventDate EnrollerName 10 55.82 01/01/2022 New Complete 10/15/2021 10:44:12 PM American Fidelity QX Services Account 10 1.08 01/01/2022 Change Complete 10/15/2021 10:44:12 PM American Fidelity QX Services Account 10 417.94 963.4 01/01/2022 Increase Complete 10/11/2021 5:12:12 PM American Fidelity OX Services Account 10 162.37 01/01/2022 Change Complete 10/11/2021 5:12:12 PM American Fidelity QX Services Account 10 01/01/2022 Change Complete 10/11/2021 5:12:12 PM American Fidelity OX Services Account 10 1.08 01/01/2022 Change Complete 10/11/2021 5:12:12 PM American Fidelity QX Services Account 10 86.28 01/01/2022 Increase Complete 10/11/2021 5:12:12 PM American Fidelity ax Services Account 10 40.08 01/01/2020 Complete 10/11/2021 5:12:12 PM American Fidelity ax Services Account 10 61.13 17.64 01/01/2019 Complete 10/11/2021 5:12:12 PM American Fidelity OX Services Account 10 22.49 01/01/2019 Complete 10/11/2021 5:12:12 PM American Fidelity QX Services Account 10 324.22 03/01/2022 New Complete 10/11/2021 5:12:12 PM American Fidelity QX Services Account 10 233.37 631.7 Not Begun 09/29/2021 3:58:56 PM Jane Doe 10 50.09 Not Begun 09/29/2021 3:58:56 PM Jane Doe 10 13.98 Not Begun 09/29/2021 3:58:56 PM Jane Doe 10 0.9 Not Begun 09/29/2021 3:58:56 PM Jane Doe 10 215.52 631.7 01/01/2022 Increase Complete 09/29/2021 9:45:53 PM American Fidelity QX Services Account 10 162.37 01/01/2022 Change Complete 09/29/2021 9:45:53 PM American Fidelity OX Services Account 10 15.86 01/01/2022 Change Complete 09/29/2021 9:45:53 PM American Fidelity QX Services Account 10 1.08 01/01/2022 Change Complete 09/29/2021 9:45:53 PM American Fidelity QX Services Account 10 1005.01 1,240.71 01/01/2022 Increase Complete 09/16/2021 10:17:50 PM American Fidelity QX Services Account 10 162.37 01/01/2022 Change Complete 09/16/2021 10:17:50 PM American Fidelity QX Services Account 10 15.86 01/01/2022 Change Complete 09/16/2021 10:17:50 PM American Fidelity QX Services Account 10 1.08 01/01/2022 Change Complete 09/16/2021 10:17:50 PM American Fidelity Ox Services Account 10 66 01/01/2015 Complete 09/16/2021 10:17:50 PM American Fidelity OX Services Account 10 61.2 01/01/2022 New Complete 09/16/2021 10:17:50 PM American Fidelity QX Services Account 10 23.3 03/01/2020 Complete 09/16/2021 10:17:50 PM American Fidelity QX Services Account 10 23.3 03/01/2020 Complete 09/16/2021 10:17:50 PM American Fidelity QX Services Account 10 66.5 03/01/2021 Complete 09/16/2021 10:17:50 PM American Fidelity ax Services Account 10 66.5 03/01/2021 Complete 09/16/2021 10:17:50 PM American Fidelity QX Services Account 10 0.9 Not Begun 09/08/2021 7:38:17 PM Jane Doe 10 417.94 963.4 01/01/2022 Increase Complete 09/28/2021 11:42:03 PM American Fidelity Ox Services Account 10 162.37 01/01/2022 Change Complete 09/28/2021 11:42:03 PM American Fidelity QX Services Account 10 15.86 01/01/2022 Change Complete 09/28/2021 11:42:03 PM American Fidelity QX Services Account Life Co Ellen Grand 10 15.86 10 1.08 10 100 10 173.09 36 10 10 24.5 111111117 GGGGGGGGG Gerald 111111117 GGGGGGGGG Gerald 111111117 GGGGGGGGG Gerald 111111117 GGGGGGGGG Gerald 111111117 GGGGGGGGG Gerald 111111117 GGGGGGGGG Gerald 111111118 HHHHHHHHH Hank 111111118 HHHHHHHHH Hank 111111118 HHHHHHHHH Hank 111111118 HHHHHHHHH Hank 111111119 ||||||||| Isla 111111119 111111111 Isla 111111119 ||||||| Isla 111111119 ||||||||| Isla Jill 111111120 JJJJJJJJJ Jill 10 OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School Grand Grand Grand Grand Grand Harold Harold Harold Harold Ibiza Ibiza Ibiza 10 10 10 1.08 10 10 OKC School 01/01/2022 01/01/2022 01/01/2022 01/01/2022 09/01/2019 03/01/2021 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 01/01/2022 11/01/2019 01/01/2021 10 Ibiza 10 111111120 Jones 10 149.89 Jones 10 111111120 1.08 963.4 162.37 15.86 1.08 10 Jill Jill TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA INSTRUCTIONAL ASST SP ED CSEA 6 HRS INSTRUCTIONAL ASST SPED CSEA 6 HRS INSTRUCTIONAL ASST SP ED CSEA 6 HRS INSTRUCTIONAL ASST SP ED CSEA 6 HRS TEACHER HIGH SCHOOL CEA TEACHER HIGH SCHOOL CEA TEACHER HIGH SCHOOL CEA TEACHER HIGH SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA COUNSELOR MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA INSTR ASST/BEHAVIOR INTER CSEA 6 HRS INSTR ASST/BEHAVIOR INTER CSEA 6 HRS INSTR ASST/BEHAVIOR INTER CSEA 6 HRS INSTRASST/BEHAVIOR INTER CSEA 6 HRS INSTR ASST/BEHAVIOR INTER CSEA 6 HRS Jones Jones Vision Co Vision Vision Life Co Basic Term Life Basic Term Life AFA Flex Health FSA AFA Health FSA American Fidelity Disability Disability American Fidelity Whole Life Whole Life Life 2 Co Life2 Life 2 Group Waive Medical Waive Medical Group Waive Dental Waive Dental Group Waive Vision Waive Vision Life Co Basic Term Life Basic Term Life Group Waive Medical Waive Medical Group Waive Dental Waive Dental Group Waive Vision Waive Vision Life Co Basic Term Life Basic Term Life Med Co Medical Medical Dental Co Dental Dental Vision Co Vision Vision Life Co Basic Term Life Basic Term Life AFA Flex Health FSA Health FSA American Fidelity Disability Disability American Fidelity Group Critical illness Group Critical illness Life 2 Co Life 2 Life 2 Med Co Medical Health Care HMO Dental Co Dental Delta PPO Vision Co Vision VSP Vision Med Co Basic Term Life Basic Term Life American Fidelity Disability Disability American Fidelity Term Life Term Life American Fidelity Term Life Term Life Group Waive Medical Waive Medical Group Waive Dental Waive Dental Group Waive Vision Waive Vision Med Co Basic Term Life Basic Term Life American Fidelity Disability Disability Change Complete Change Complete New Complete New Complete Complete Complete New Complete New Complete New Complete Change Complete New Complete New Complete New Complete Change Complete Increase Complete Change Complete Change Complete Change Complete New Complete Increase Complete New Complete Complete Not Begun Not Begun Not Begun Not Begun Not Begun Not Begun Not Begun New Complete New Complete New Complete Change Complete Complete 09/28/2021 11:42:03 PM American Fidelity QX Services Account 09/28/2021 11:42:03 PM American Fidelity QX Services Account 09/28/2021 11:42:03 PM American Fidelity QX Services Account 09/28/2021 11:42:03 PM American Fidelity Ox Services Account 09/28/2021 11:42:03 PM American Fidelity QX Services Account 09/28/2021 11:42:03 PM American Fidelity QX Services Account 09/19/2021 5:58:49 PM American Fidelity QX Services Account 09/19/2021 5:58:49 PM American Fidelity QX Services Account 09/19/2021 5:58:49 PM American Fidelity QX Services Account 09/19/2021 5:58:49 PM American Fidelity QX Services Account 10/15/2021 9:23:16 PM American Fidelity ox Services Account 10/15/2021 9:23:16 PM American Fidelity QX Services Account 10/15/2021 9:23:16 PM American Fidelity QX Services Account 10/15/2021 9:23:16 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/15/2021 5:13:09 PM American Fidelity QX Services Account 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/17/2021 11:29:29 PM American Fidelity QX Services Account 09/17/2021 11:29:29 PM American Fidelity ax Services Account 09/17/2021 11:29:29 PM American Fidelity OX Services Account 09/17/2021 11:29:29 PM American Fidelity OX Services Account 09/17/2021 11:29:29 PM American Fidelity QX Services Account 111111120 JJJJJJJJJ 10 10 111111120 JJJJJJJJJ Jill Jones 100 111111120 Jill 10 59.38 Jones Jones 111111120 Jill 10 13.66 111111120 JJJJJJJJ 10 10.2 Jones Kent 111111121 KKKKKKKKK Katherine 10 OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School 233.37 111111121 KKKKKKKKK 111111121 KKKKKKKKK 10 Kent Kent 631.7 145.69 13.98 10 10 111111121 KKKKKKKKK Kent 0.9 Katherine Katherine Katherine Katherine Katherine Katherine Lydia Kent 10 10 Kent 77.62 35.95 51.36 111111121 KKKKKKKKK 111111121 KKKKKKKKK 111111121 KKKKKKKKK 111111122 PPPPPPPPP 111111122 PPPPPPPPP 111111122 PPPPPPPPP 111111122 PPPPPPPPP 10 Kent Link Link 10 01/01/2020 01/01/2021 01/01/2021 01/01/2022 01/01/2022 01/01/2022 01/01/2022 09/01/2019 Lydia 10 Link 10 Lydia Lydia Lydia 10 1.08 Link Link 111111122 PPPPPPPPP 10 68.18 111111121 KKKKKKKKK 10 Kent Kent 111111121 KKKKKKKKK 10 77.62 35.95 51.36 Kent 10 10 Link Katherine Katherine Katherine Lydia Lydia Lydia Lydia Lydia 111111121 KKKKKKKKK 111111122 PPPPPPPPP 111111122 PPPPPPPPP 111111122 PPPPPPPPP 111111122 PPPPPPPPP 111111122 PPPPPPPPP OKC School OKC School OKC School OKC School OKC School OKC School OKC School OKC School TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA TEACHER MIDDLE SCHOOL CEA INSTRASST/BEHAVIOR INTER CSEA 6 HRS INSTR ASST/BEHAVIOR INTER CSEA 6 HRS INSTR ASST/BEHAVIOR INTER CSEA 6 HRS INSTR ASST/BEHAVIOR INTER CSEA 6 HRS INSTR ASST/BEHAVIOR INTER CSEA 6 HRS American Fidelity Disability American Fidelity Term Life American Fidelity Term Life Group Waive Medical Group Waive Dental Group Waive Vision Med Co Basic Term Life American Fidelity Disability Disability Term Life Term Life Waive Medical Waive Dental Waive Vision Basic Term Life Disability 01/01/2020 01/01/2021 01/01/2021 01/01/2022 01/01/2022 01/01/2022 01/01/2022 09/01/2019 Not Begun Not Begun Not Begun New Complete New Complete New Complete Change Complete Complete 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/17/2021 11:29:29 PM American Fidelity QX Services Account 09/17/2021 11:29:29 PM American Fidelity QX Services Account 09/17/2021 11:29:29 PM American Fidelity ax Services Account 09/17/2021 11:29:29 PM American Fidelity OX Services Account 09/17/2021 11:29:29 PM American Fidelity Ox Services Account 10 Link Link Link 10 10 10 1.08 Link 68.18 GroupName SSN NameLast NameFirst PlanCode PlanStartDt PlanEndDt ElectionAmt CarryoverAmt AnnualEmployerAmt ParticipantAmt GroupAmt ABC 111111117 Grand Gerald URM 01/01/2022 12/31/2022 1000 0 0 100 ABC 111111120 Jones Jill URM 01/01/2022 12/31/2022 1000 0 100 O O 0 LDISB Client ID MCP Employer Name Status SSN PlanCode Product Code SubProduct Covered Individuals Premium Mode Annualized Premium Issue Date 8585855 11111 ABC Bernard, Bob AA 111111112 013-385 ACCID AO-03 INDIVIDUAL 31.92 MOT1015 319.2 20200101 8585855 11111 ABC Bernard, Bob AA 111111112 013-391 ACCID BENH INDIVIDUAL 8.16 MOT1015 81.6 20200101 8585855 11111 ABC Bernard, Bob AA 111111112 013-755 CANCR C12D INDIVIDUAL 54.53 MOT1015 545.3 20190101 8585855 11111 ABC Bernard, Bob AA 111111112 013-778 CANCR CIC INDIVIDUAL 17.64 MOT1015 176.4 20210101 8585855 11111 ABC Bernard, Bob AA 111111112 013-769 CANCR ICU INDIVIDUAL 6.6 MOT1015 66 20190101 8585855 11111 ABC Bernard, Bob AA 111111112 017900-2M3 DISAB INDIVIDUAL 78.48 MOT1015 784.8 20190101 8585855 11111 ABC Bernard, Bob PX 111111112 017900-2M3 DISAB LDISB INDIVIDUAL 86.28 MOT1015 862.8 20220101 8585855 11111 ABC Bernard, Bob AA 111111112 018570-BB CRITG CRITG INDIV+CHILDREN 22.49 MOT1015 224.9 20190101 7000000 11111 ABC Grand, Gerald AA 111111117 014406-13 DISAB LDISB INDIVIDUAL 162.29 MOT1015 1622.9 20220101 7000000 11111 ABC Grand, Gerald AA 111111117 014707-R1 DISAB CBFUN INDIVIDUAL 10.8 MOT1015 108 20220101 7000000 11111 ABC Grand, Gerald AA 111111117 013-755 CANCR C12D INDIVIDUAL 71.86 MOT1015 718.6 20200101 7000000 11111 ABC Grand, Gerald AA 111111117 013-769 CANCR ICU INDIVIDUAL 8.52 MOT1015 85.2 20200101 7000000 11111 ABC Grand, Gerald AA 111111117 013-779 CANCR CIC INDIVIDUAL 34.08 MOT1015 340.8 20200101 7000000 11111 ABC Grand, Gerald AA 111111117 013-783 CANCR CIH INDIVIDUAL 22.08 MOT1015 220.8 20200101 2000000 11111 ABC Jones, Jill AA 111111120 014707-R1 DISAB CBFUN INDIVIDUAL 10.8 MOT1015 108 20190901 2000000 11111 ABC Jones, Jill AA 111111120 014707-R1 DISAB CBFUN INDIVIDUAL 10.8 MOT1015 108 20220101 2000000 11111 ABC Jones, Jill AA 111111120 017904-13 DISAB LDISB INDIVIDUAL 48.58 MOT1015 485.8 20220101 2000000 11111 ABC Jones, Jill AA 111111120 017904-13 DISAB LDISB INDIVIDUAL 44.74 MOT1015 447.4 20190101 2000000 11111 ABC Jones, Jill AA 111111120 018570-BB CRITG CRITG INDIV+CHILDREN 13.66 MOT1015 136.6 20220101 1000000 11111 ABC Link, Lydia AA 111111122 017900-2M3 DISAB LDISB INDIVIDUAL 49.23 MOT1015 492.3 20190901 1000000 11111 ABC Link, Lydia AA 111111122 014708-R1 DISAB DIHI INDIVIDUAL 7.2 MOT1015 72 20190901 1000000 11111 ABC Link, Lydia AA 111111122 014709-R1 DISAB CRITI INDIVIDUAL 11.76 MOT1015 117.6 20190901 Indemnity Amount Indemnity Frequency HHMC Customer Number 11111 Group Customer Name ABC ABC Insured NOB (Y/N) Yes Billed Premium 66 Owner Client ID 6666666 7000000 8000000 Total Number Of Segments 1 1 Employee Client ID 6666666 7000000 8000000 9999999 9999999 Yes 11111 11111 Insured Client ID 8888888 9999999 8000000 5555555 9999999 Client Name Ellen Enid Gerald Grand Zeus Zoom Katherine Kent Katherine Kent Policy Number 123456789 12345678 QTT655555 EEE655555 FFF655555 Policy Status Active, Active; Billable, Active Active, Active; Billable, Active . Active, Active; Billable, Active Active, Active; Billable, Active Active, Active; Billable, Active SSN 111111115 111111117 222222222 111111121 111111121 Sub Product WL WL14 WL14 Plan Type Whole Life Whole Life Whole Life Term Life Term Life Product Description WL 2007 CSO 2001 SIMPLIFIED ISSUE NON-SMOKER WL14 NON-TOBACCO WL14 NON-TOBACCO 20YR R&C NON-TOBACCO RCTL14 20YR R&C NON-TOBACCO RCTL14 Face Amount 50000 50000 25000 50000 100000 ABC No 4 36 82.04 35.95 ABC Yes B20YT 3 11111 11111 9999999 9999999 ABC No B20YT 3 51.36 Annualized Premium 660 Bill Mode July, Aug, 10 Deductions July, Aug, 10 Deductions July, Aug, 10 Deductions , July, Aug, 10 Deductions July, Aug, 10 Deductions 360 820.44 359.52 Issue Date 01/01/2015 09/01/2019 09/01/2021 01/01/2021 01/01/2021 Paid To Date 09/01/2021 09/01/2021 09/01/2021 09/01/2021 09/01/2021 Bill Name Change Effective Date Application Date STND STND STND 08/18/2021 STND 10/16/2020 STND 10/16/2020 513.6 Description Account Manager Response SSN 111111112 AFenroll Bkkpr Rpt Amount 40.08 Account Manager Action Needed None None None Complete 111111112 111111112 111111112 111111115 78.77 22.49 86.28 127.2 None None Client Number Multiple Dist ID Multiple MCPS Multiple Pay modes Bill MCP AFenroll Location Client Name Product BK Action AFenrollDed Freq 8585855 11111 OKC School Bernard, Bob ACCID 10 8585855 11111 OKC School Bernard, Bob CANCR 10 8585855 11111 OKC School Bernard, Bob CRITG 10 8585855 11111 OKC School Bernard, Bob DISAB Increase 10 6666666 11111 OKC School Enid, Ellen WHOLE 10 7000000 YES 11111 OKC School Grand, Gerald DISAB New 10 7000000 YES OKC School Grand, Gerald FSA New 10 7000000 YES 11111 OKC School Grand, Gerald WHOLE 10 2000000 YES 11111 OKC School Jones, Jill CRITG New 10 2000000 YES 11111 OKC School Jones, Jill DISAB Increase 10 YES OKC School Jones, Jill FSA New 10 8000000 YES 11111 Zoom, Zeus WHOLE OKC School Kent, Katherine DISAB 10 9999999 11111 OKC School Kent, Katherine TERM 10 1000000 11111 OKC School Enid, Ellen DISAB 10 111111117 111111117 Event Date Enroller Name 10/11/2021 5:12:12 PM American Fidelity QX Service 10/11/2021 5:12:12 PM American Fidelity OX Service 10/11/2021 5:12:12 PM American Fidelity ax Service 10/11/2021 5:12:12 PM American Fidelity QX Service 09/16/2021 10:17:50 PM American Fidelity ax Service 09/28/2021 11:42:03 PM American Fidelity ax Service 09/28/2021 11:42:03 PM American Fidelity QX Service 09/28/2021 11:42:03 PM American Fidelity QX Service 09/15/2021 5:13:09 PM American Fidelity QX Service 09/15/2021 5:13:09 PM American Fidelity QX Service 09/15/2021 5:13:09 PM American Fidelity QX Service Bill Pay Mode Billed Amount BKR (minus) AFA Bill Amount Inconsistency Type 10 40.08 - Match 10 78.771 - Match 10 22.491- Match 10 86.281 - Match 10 66 61.2 Amounts do not match 10 173.09 - Match 10 1001 - Match 101 36 - Match 10 13.66 - Match 10 59.38- Match 10 1001 - Match 10 82.04 -82.04 Not on Bookkeeper Report 77.62 No active coverage 101 87.311 - Match 101 68.19 -0.01 Home Office will resolve 173.09 100 36 13.66 TL bill (minus) AFA Bill Amount Enrollment Status 0 0 Complete 0 Complete 0 Complete o Complete 0 Complete o Complete 0 Complete 0 Complete 0 Complete 0 Complete 0 o Not Begun o Not Begun 0 Complete None None None None 111111117 111111120 111111120 111111120 59.38 100 None 222222222 111111121 111111121 111111122 77.62 87.31 68.18 None Penny Difference None 09/08/2021 7:37:33 PM Jane Doe 09/08/2021 7:37:33 PM Jane Doe 09/17/2021 11:29:29 PM American Fidelity QX Service