| Name | Relationship | DOB | Plan Name | Enrollee ID | Actions |
|---|---|---|---|---|---|
| Alessandro Kassulke | Primary | December 24, 1978 | Premium Saver | 791095845 | |
| Alva Kassulke | Spouse | February 22, 1981 | Premium Saver | 808643459 | |
| Shaylee Kassulke | Dependent | January 3, 2002 | Premium Saver | 558468452 | |
| Justine Kassulke | Dependent | February 15, 2011 | Premium Saver | 590449352 | |
| Agustin Kassulke | Dependent | July 27, 1998 | Premium Saver | 275167074 | |
| Janelle Kassulke | Dependent | February 18, 1999 | Premium Saver | 740196857 | |
| Kelton Kassulke | Dependent | October 8, 2014 | Premium Saver | 521166154 | |
| Pamela Kassulke | Dependent | June 6, 2016 | Premium Saver | 275226687 | |
| Prince Kassulke | Dependent | May 13, 2013 | Premium Saver | 129130192 | |
| Maxwell Kassulke | Dependent | December 7, 2015 | Premium Saver | 628106816 | |
| Theodora Kassulke | Dependent | December 1, 2020 | Premium Saver | 998133055 |
