| Name | Relationship | DOB | Plan Name | Enrollee ID | Actions |
|---|---|---|---|---|---|
| Alessandro Kassulke | Primary | November 18, 1979 | Premium Saver | 791095845 | |
| Alva Kassulke | Spouse | January 14, 1982 | Premium Saver | 808643459 | |
| Shaylee Kassulke | Dependent | November 28, 2002 | Premium Saver | 558468452 | |
| Justine Kassulke | Dependent | January 11, 2012 | Premium Saver | 590449352 | |
| Agustin Kassulke | Dependent | June 21, 1999 | Premium Saver | 275167074 | |
| Janelle Kassulke | Dependent | January 13, 2000 | Premium Saver | 740196857 | |
| Kelton Kassulke | Dependent | September 2, 2015 | Premium Saver | 521166154 | |
| Pamela Kassulke | Dependent | May 2, 2017 | Premium Saver | 275226687 | |
| Prince Kassulke | Dependent | April 8, 2014 | Premium Saver | 129130192 | |
| Maxwell Kassulke | Dependent | November 1, 2016 | Premium Saver | 628106816 | |
| Theodora Kassulke | Dependent | October 26, 2021 | Premium Saver | 998133055 |
