| Name | Relationship | DOB | Plan Name | Enrollee ID | Actions |
|---|---|---|---|---|---|
| Alessandro Kassulke | Primary | March 28, 1979 | Premium Saver | 791095845 | |
| Alva Kassulke | Spouse | May 24, 1981 | Premium Saver | 808643459 | |
| Shaylee Kassulke | Dependent | April 8, 2002 | Premium Saver | 558468452 | |
| Justine Kassulke | Dependent | May 22, 2011 | Premium Saver | 590449352 | |
| Agustin Kassulke | Dependent | October 29, 1998 | Premium Saver | 275167074 | |
| Janelle Kassulke | Dependent | May 23, 1999 | Premium Saver | 740196857 | |
| Kelton Kassulke | Dependent | January 11, 2015 | Premium Saver | 521166154 | |
| Pamela Kassulke | Dependent | September 10, 2016 | Premium Saver | 275226687 | |
| Prince Kassulke | Dependent | August 17, 2013 | Premium Saver | 129130192 | |
| Maxwell Kassulke | Dependent | March 11, 2016 | Premium Saver | 628106816 | |
| Theodora Kassulke | Dependent | March 6, 2021 | Premium Saver | 998133055 |
