1 #SUBSCRIBER-RECORD
2 #SUBSCRIBER-DATA
3 #EMPLOYER-GROUP-ID (A7) 01 - 07
3 #SSN (A9) 08 - 16
3 #LAST-NAME (A25) 17 - 41
3 #SUFFIX (A3) 42 - 44
3 #FIRST-NAME (A18) 45 - 62
3 #MIDDLE-INITIAL (A1) 63 - 63
2 #HLTH-COVERAGE-DATA
3 #HLTH-STATUS (A2) 64 - 65
3 #HLTH-PLAN-CATEGORY (A3) 66 - 68
3 #HLTH-EE-PREMIUM (N4.2) 69 – 74
3 #HLTH-EFF-DATE (A8) 75 - 82
2 #DNTL-COVERAGE-DATA
3 #DNTL-STATUS (A2) 83 - 84
3 #DNTL-PLAN-CATEGORY (A3) 85 - 87
3 #DNTL-EE-PREMIUM (N4.2) 88 – 93
3 #DNTL-EFF-DATE (A8) 94 - 101
2 #DNTP-COVERAGE-DATA
3 #DNTP-STATUS (A2) 102 - 103
3 #DNTP-PLAN-CATEGORY (A3) 104 – 106
3 #DNTP-EE-PREMIUM (N4.2) 107 – 112
3 #DNTP-EFF-DATE (A8) 113 - 120
2 #DL-COVERAGE-DATA
3 #DL-STATUS (A2) 121 - 122
3 #DL-PLAN-CATEGORY (A3) 123 - 125
3 #DL-EE-PREMIUM (N4.2) 126 - 131
3 #DL-EFF-DATE (A8) 132 - 139
2 #SL-COVERAGE-DATA
3 #SL-STATUS (A2) 140 - 141
3 #SL-PLAN-CATEGORY (A3) 142 – 144
3 #SL-EFF-DATE (A8) 145 - 152
2 #LTD-COVERAGE-DATA
3 #LTD-STATUS (A2) 153 - 154
3 #LTD-PLAN-CATEGORY (A3) 155 – 157
3 #LTD-EFF-DATE (A8) 158 - 165
2 #OL-COVERAGE-DATA
3 #OL-STATUS (A2) 166 - 167
3 #OL-PLAN-COVER-LEVEL (A3) 168 – 170
3 #OL-EE-PREMIUM (N4.2) 171 – 176
3 #OL-EFF-DATE (A8) 177 - 184
2 #OLS-COVERAGE-DATA
3 #OLS-STATUS (A2) 185 - 186
3 #OLS-COVER-LEVEL (A3) 187 - 189
3 #OLS-EE-PREMIUM (N4.2) 190 – 195
3 #OLS-EFF-DATE (A8) 196 - 203
2 #VISION-COVERAGE-DATA
3 #VISION-STATUS (A2) 204 – 205
3 #VISION-CATEGORY (A3) 206 - 208
3 #VISION-EE-PREMIUM (N4.2) 209 – 214
3 #VISION-EFF-DATE (A8) 215 - 222
2 #TOBACCO-USER-COVERAGE-DATA
3 #TOB-USER-STATUS (A2) 223 - 224
3 #TOB-USER-EE-PREMIUM (N4.2) 225 – 230
3 #TOB-USER-EFF-DATE (A8) 231 - 238
2 #SLTD-COVERAGE-DATA
3 #SLTD-STATUS (A2) 239 - 240
3 #SLTD-COVER-LEVEL (A3) 241 - 243
3 #SLTD-EE-PREMIUM (N4.2) 244 – 249
3 #SLTD-EFF-DATE (A8) 250 - 257