| Name | Relationship | DOB | Plan Name | Enrollee ID | Actions |
|---|---|---|---|---|---|
| Alessandro Kassulke | Primary | June 28, 1979 | Premium Saver | 791095845 | |
| Alva Kassulke | Spouse | August 24, 1981 | Premium Saver | 808643459 | |
| Shaylee Kassulke | Dependent | July 9, 2002 | Premium Saver | 558468452 | |
| Justine Kassulke | Dependent | August 22, 2011 | Premium Saver | 590449352 | |
| Agustin Kassulke | Dependent | January 29, 1999 | Premium Saver | 275167074 | |
| Janelle Kassulke | Dependent | August 23, 1999 | Premium Saver | 740196857 | |
| Kelton Kassulke | Dependent | April 14, 2015 | Premium Saver | 521166154 | |
| Pamela Kassulke | Dependent | December 11, 2016 | Premium Saver | 275226687 | |
| Prince Kassulke | Dependent | November 17, 2013 | Premium Saver | 129130192 | |
| Maxwell Kassulke | Dependent | June 11, 2016 | Premium Saver | 628106816 | |
| Theodora Kassulke | Dependent | June 6, 2021 | Premium Saver | 998133055 |
