pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_d_opt_identifier	pbp_d_opt_description	pbp_d_amt_opt_premium	pbp_d_opt_maxplan_ben_cov_yn	pbp_d_opt_maxplan_ben_cov_amt	pbp_d_opt_maxplan_per	pbp_d_opt_apply_moop_yn	pbp_d_opt_deduct_yn	pbp_d_opt_deduct_amt	pbp_d_opt_deduct_cats	pbp_d_opt_secb_cats	pbp_d_opt_other_benefits
H0028	004	0	1	01	01	H0028_004_0	5	001	MyOption Enhanced Dental HMO	34.40	1	2000.00	3	2	2				16a;16b;
H0028	004	0	1	01	01	H0028_004_0	5	002	MyOption Total Dental HMO	39.90	1	2000.00	3	2	2				16a;16b;
H0028	011	0	1	01	01	H0028_011_0	5	001	MyOption Enhanced Dental HMO	25.90	1	2000.00	3	2	2				16a;16b;
H0028	013	0	1	01	01	H0028_013_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H0028	013	0	1	01	01	H0028_013_0	3	002	MyOption Platinum Dental	23.70	1	2000.00	3	2	2			16a;16b;	
H0028	016	0	1	01	01	H0028_016_0	4	001	MyOption Enhanced Dental HMO	22.80	1	2000.00	3	2	2				16a;16b;
H0028	016	0	1	01	01	H0028_016_0	4	002	MyOption Total Dental HMO	27.20	1	2000.00	3	2	2				16a;16b;
H0028	017	0	1	01	01	H0028_017_0	4	001	MyOption Total Dental HMO	27.20	1	2000.00	3	2	2				16a;16b;
H0028	019	0	1	01	01	H0028_019_0	5	001	MyOption Dental High PPO	19.20	1	2000.00	3	2	2			16a;16b;	
H0028	020	0	1	01	01	H0028_020_0	5	001	MyOption Dental High PPO	26.60	1	2000.00	3	2	2			16a;16b;	
H0028	021	0	1	01	01	H0028_021_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H0028	021	0	1	01	01	H0028_021_0	4	002	MyOption Enhanced Dental Plus HMO	35.50	1	2000.00	3	2	2				16a;16b;
H0028	022	0	1	01	01	H0028_022_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H0028	022	0	1	01	01	H0028_022_0	4	002	MyOption Enhanced Dental HMO	28.30	1	2000.00	3	2	2				16a;16b;
H0028	023	0	1	01	01	H0028_023_0	4	001	MyOption Dental High PPO	26.60	1	2000.00	3	2	2			16a;16b;	
H0028	023	0	1	01	01	H0028_023_0	4	002	MyOption Vision	15.30	2			2	2				17a;17b;
H0028	023	0	1	01	01	H0028_023_0	4	003	MyOption Plus	22.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H0028	024	0	1	01	01	H0028_024_0	5	001	MyOption Enhanced Dental HMO	28.30	1	2000.00	3	2	2				16a;16b;
H0028	025	1	1	01	01	H0028_025_1	4	001	MyOption Dental High PPO	25.10	1	2000.00	3	2	2			16a;16b;	
H0028	025	2	1	01	01	H0028_025_2	4	001	MyOption Dental High PPO	25.10	1	2000.00	3	2	2			16a;16b;	
H0028	026	1	1	01	01	H0028_026_1	5	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H0028	026	2	1	01	01	H0028_026_2	5	001	MyOption Total Dental HMO	34.20	1	2000.00	3	2	2				16a;16b;
H0028	027	0	1	01	01	H0028_027_0	4	001	MyOption Platinum Dental	31.70	1	2000.00	3	2	2			16a;16b;	
H0028	028	0	1	01	01	H0028_028_0	5	001	MyOption Dental Enriched HMO	28.30	1	2000.00	3	2	2				16a;16b;
H0028	035	0	1	01	01	H0028_035_0	5	001	MyOption Enhanced Dental Plus HMO	24.10	1	2000.00	3	2	2				16a;16b;
H0028	038	0	1	01	01	H0028_038_0	5	001	MyOption Dental High PPO	16.60	1	2000.00	3	2	2			16a;16b;	
H0028	041	0	1	01	01	H0028_041_0	5	001	MyOption Dental High PPO	16.60	1	2000.00	3	2	2			16a;16b;	
H0028	041	0	1	01	01	H0028_041_0	5	002	MyOption Fitness	15.00	2			2	2			14c;	
H0028	043	2	1	01	01	H0028_043_2	4	001	MyOption Dental High PPO	16.60	1	2000.00	3	2	2			16a;16b;	
H0292	001	0	1	01	01	H0292_001_0	3	001	MyOption Enhanced Dental Plus HMO	25.40	1	2000.00	3	2	2				16a;16b;
H0292	001	0	1	01	01	H0292_001_0	3	002	MyOption Total Dental Plus HMO	29.20	1	2000.00	3	2	2				16a;16b;
H0292	002	0	1	01	01	H0292_002_0	4	001	MyOption Enhanced Dental HMO	19.50	1	2000.00	3	2	2				16a;16b;
H0292	002	0	1	01	01	H0292_002_0	4	002	MyOption Total Dental HMO	23.30	1	2000.00	3	2	2				16a;16b;
H0294	002	0	1	04	01	H0294_002_0	3	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H0294	004	0	1	04	01	H0294_004_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0294	010	0	1	04	01	H0294_010_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H0294	011	0	1	04	01	H0294_011_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0294	012	0	1	04	01	H0294_012_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H0351	030	0	1	01	01	H0351_030_0	2	001	Gold Package # 1	49.00	2			2	2			7b;13a;16a;16b;17a;17b;	
H0351	030	0	1	01	01	H0351_030_0	2	002	Gold Package # 2	24.00	2			2	1	50.00	16a;16b;		16a;16b;17a;17b;
H0351	038	0	1	01	01	H0351_038_0	6	001	Gold Package # 1	49.00	2			2	2			7b;13a;16a;16b;17a;17b;	
H0351	038	0	1	01	01	H0351_038_0	6	002	Gold Package # 2	24.00	2			2	1	50.00	16a;16b;		16a;16b;17a;17b;
H0351	044	1	1	01	01	H0351_044_1	3	001	Gold Package # 1	49.00	2			2	2			7b;13a;16a;16b;17a;17b;	
H0351	044	1	1	01	01	H0351_044_1	3	002	Gold Package # 2	24.00	2			2	1	50.00	16a;16b;		16a;16b;17a;17b;
H0351	044	2	1	01	01	H0351_044_2	3	001	Gold Package # 1	49.00	2			2	2			7b;13a;16a;16b;17a;17b;	
H0351	044	2	1	01	01	H0351_044_2	3	002	Gold Package # 2	24.00	2			2	1	50.00	16a;16b;		16a;16b;17a;17b;
H0351	044	3	1	01	01	H0351_044_3	3	001	Gold Package # 1	49.00	2			2	2			7b;13a;16a;16b;17a;17b;	
H0351	044	3	1	01	01	H0351_044_3	3	002	Gold Package # 2	24.00	2			2	1	50.00	16a;16b;		16a;16b;17a;17b;
H0351	050	0	1	01	01	H0351_050_0	3	001	Gold Package # 1	49.00	2			2	2			7b;13a;16a;16b;17a;17b;	
H0351	050	0	1	01	01	H0351_050_0	3	002	Gold Package # 2	24.00	2			2	1	50.00	16a;16b;		16a;16b;17a;17b;
H0351	051	0	1	01	01	H0351_051_0	3	001	Gold Package #3	45.00	2			2	2			7b;13a;16a;16b;	
H0351	051	0	1	01	01	H0351_051_0	3	002	Gold Package #4	21.00	2			2	1	50.00	16a;16b;		16a;16b;
H0354	001	0	1	01	01	H0354_001_0	6	001	Cigna Dental Care Plan	20.00	2			2	2			16a;16b;	
H0354	024	0	1	01	01	H0354_024_0	6	001	Cigna Dental Care Plan	20.00	2			2	2			16a;16b;	
H0354	027	0	1	01	01	H0354_027_0	6	001	Cigna Dental Care Plan	20.00	2			2	2			16a;16b;	
H0354	028	0	1	01	01	H0354_028_0	6	001	Cigna Dental Care Plan	20.00	2			2	2			16a;16b;	
H0432	001	0	1	01	01	H0432_001_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0432	003	0	1	01	01	H0432_003_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0432	005	0	1	01	01	H0432_005_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0432	007	0	1	01	01	H0432_007_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0439	003	1	1	01	01	H0439_003_1	6	001	Enhanced Dental - Comprehensive	27.80	1	1500.00	3	2	2			16b;	
H0439	003	2	1	01	01	H0439_003_2	6	001	Enhanced Dental - Comprehensive	27.80	1	1500.00	3	2	2			16b;	
H0504	015	0	1	01	01	H0504_015_0	4	001	Dental HMO	12.40	2			2	2			;	16a;16b;
H0504	015	0	1	01	01	H0504_015_0	4	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	017	0	1	01	01	H0504_017_0	2	001	Dental HMO	12.40	2			2	2			16a;16b;	
H0504	017	0	1	01	01	H0504_017_0	2	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	021	0	1	01	01	H0504_021_0	2	001	Dental HMO	12.40	2			2	2				16a;16b;
H0504	021	0	1	01	01	H0504_021_0	2	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	026	0	1	01	01	H0504_026_0	2	001	Dental HMO	12.40	2			2	2			16a;16b;	
H0504	026	0	1	01	01	H0504_026_0	2	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	028	0	1	01	01	H0504_028_0	4	001	Dental HMO	12.40	2			2	2			;	16a;16b;
H0504	028	0	1	01	01	H0504_028_0	4	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	029	0	1	01	01	H0504_029_0	4	001	Dental HMO	12.40	2			2	2			16a;16b;	
H0504	029	0	1	01	01	H0504_029_0	4	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	031	0	1	01	01	H0504_031_0	4	001	Dental HMO	12.40	2			2	2			16a;16b;	
H0504	031	0	1	01	01	H0504_031_0	4	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	037	0	1	01	01	H0504_037_0	2	001	Dental HMO	12.40	2			2	2			16a;16b;	
H0504	037	0	1	01	01	H0504_037_0	2	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	038	0	1	01	01	H0504_038_0	3	001	Dental HMO	12.40	2			2	2			16a;16b;	
H0504	038	0	1	01	01	H0504_038_0	3	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0504	039	0	1	01	01	H0504_039_0	3	001	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;	16a;16b;	
H0504	040	0	1	01	01	H0504_040_0	4	001	Dental HMO	12.40	2			2	2				16a;16b;
H0504	040	0	1	01	01	H0504_040_0	4	002	Dental PPO	34.90	1	1500.00	6	2	1	50.00	16b;		16a;16b;
H0524	002	0	2	01	01	H0524_002_0	7	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	003	0	1	01	01	H0524_003_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	008	0	1	01	01	H0524_008_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	010	0	2	01	01	H0524_010_0	8	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	013	0	1	01	01	H0524_013_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	015	0	1	01	01	H0524_015_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	031	0	1	01	01	H0524_031_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	032	0	1	01	01	H0524_032_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	033	0	1	01	01	H0524_033_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	034	0	1	01	01	H0524_034_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	035	0	1	01	01	H0524_035_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	036	0	1	01	01	H0524_036_0	7	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	037	0	1	01	01	H0524_037_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	038	0	1	01	01	H0524_038_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	039	0	1	01	01	H0524_039_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	040	0	1	01	01	H0524_040_0	7	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	041	0	1	01	01	H0524_041_0	7	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	042	0	1	01	01	H0524_042_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	043	0	1	01	01	H0524_043_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	046	0	1	01	01	H0524_046_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	051	0	1	01	01	H0524_051_0	6	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0524	054	0	1	01	01	H0524_054_0	7	001	Advantage Plus	20.00	2			2	2			14c;16a;16b;18a;18b;	17b;
H0543	001	0	1	01	01	H0543_001_0	2	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	001	0	1	01	01	H0543_001_0	2	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	013	0	1	01	01	H0543_013_0	2	001	High Option Dental Rider	10.00	2			2	2				16a;16b;
H0543	013	0	1	01	01	H0543_013_0	2	002	Fitness Rider	18.00	2			2	2			14c;	
H0543	022	0	1	01	01	H0543_022_0	2	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	022	0	1	01	01	H0543_022_0	2	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	028	0	1	01	01	H0543_028_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	029	0	1	01	01	H0543_029_0	2	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	029	0	1	01	01	H0543_029_0	2	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	032	0	1	01	01	H0543_032_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	035	0	1	01	01	H0543_035_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	036	0	1	01	01	H0543_036_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	060	0	1	01	01	H0543_060_0	2	001	High Option Dental Rider	10.00	2			2	2				16a;16b;
H0543	070	0	1	01	01	H0543_070_0	2	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	070	0	1	01	01	H0543_070_0	2	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	089	0	1	01	01	H0543_089_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	138	0	1	01	01	H0543_138_0	3	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	138	0	1	01	01	H0543_138_0	3	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	140	0	1	01	01	H0543_140_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	140	0	1	01	01	H0543_140_0	4	002	Fitness Rider	18.00	2			2	2			14c;	
H0543	144	0	1	01	01	H0543_144_0	3	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	144	0	1	01	01	H0543_144_0	3	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	145	0	1	01	01	H0543_145_0	3	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	145	0	1	01	01	H0543_145_0	3	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	146	0	1	01	01	H0543_146_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	147	0	1	01	01	H0543_147_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	148	0	1	01	01	H0543_148_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	151	0	1	01	01	H0543_151_0	3	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	151	0	1	01	01	H0543_151_0	3	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	152	0	1	01	01	H0543_152_0	3	001	High Option Dental Rider	12.50	2			2	2				16a;16b;
H0543	152	0	1	01	01	H0543_152_0	3	002	Optional Dental Rider	2.50	2			2	2				16a;16b;
H0543	152	0	1	01	01	H0543_152_0	3	003	Fitness Rider	18.00	2			2	2			14c;	
H0543	158	0	1	01	01	H0543_158_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	163	0	1	01	01	H0543_163_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	167	0	1	01	01	H0543_167_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	175	0	1	01	01	H0543_175_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	176	0	1	01	01	H0543_176_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	177	0	1	01	01	H0543_177_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	178	0	1	01	01	H0543_178_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0543	179	0	1	01	01	H0543_179_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0544	002	0	1	01	01	H0544_002_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	002	0	1	01	01	H0544_002_0	8	002	Optional Dental 2	9.00	2			2	2				16a;16b;
H0544	004	0	1	01	01	H0544_004_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	004	0	1	01	01	H0544_004_0	7	002	Optional Dental 2	9.00	2			2	2				16a;16b;
H0544	005	0	1	01	01	H0544_005_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	005	0	1	01	01	H0544_005_0	7	002	Optional Dental 2	9.00	2			2	2				16a;16b;
H0544	007	0	1	01	01	H0544_007_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	007	0	1	01	01	H0544_007_0	7	002	Optional Dental 2	9.00	2			2	2				16a;16b;
H0544	008	0	1	01	01	H0544_008_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	008	0	1	01	01	H0544_008_0	7	002	Optional Dental 2	9.00	2			2	2				16a;16b;
H0544	010	0	1	01	01	H0544_010_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	010	0	1	01	01	H0544_010_0	8	002	Optional Dental 2	9.00	2			2	2			16a;16b;	
H0544	012	0	1	01	01	H0544_012_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	012	0	1	01	01	H0544_012_0	8	002	Optional Dental 2	9.00	2			2	2			16a;16b;	
H0544	013	0	1	01	01	H0544_013_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	013	0	1	01	01	H0544_013_0	8	002	Optional Dental 2	9.00	2			2	2				16a;16b;
H0544	014	0	1	01	01	H0544_014_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	014	0	1	01	01	H0544_014_0	8	002	Optional Dental 2	9.00	2			2	2				16a;16b;
H0544	015	0	1	01	01	H0544_015_0	9	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	019	0	1	01	01	H0544_019_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	019	0	1	01	01	H0544_019_0	8	002	Optional Dental 2	9.00	2			2	2			16a;16b;	
H0544	020	0	1	01	01	H0544_020_0	9	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	021	0	1	01	01	H0544_021_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	021	0	1	01	01	H0544_021_0	8	002	Optional Dental 2	9.00	2			2	2			16a;16b;	
H0544	024	0	1	01	01	H0544_024_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	024	0	1	01	01	H0544_024_0	8	002	Optional Dental 2	9.00	2			2	2			;	
H0544	025	0	1	01	01	H0544_025_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	025	0	1	01	01	H0544_025_0	8	002	Optional Dental 2	9.00	2			2	2			;	
H0544	027	0	1	01	01	H0544_027_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	027	0	1	01	01	H0544_027_0	8	002	Optional Dental 2	9.00	2			2	2			16a;16b;	
H0544	031	0	1	01	01	H0544_031_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	031	0	1	01	01	H0544_031_0	8	002	Optional Dental 2	9.00	2			2	2			;	
H0544	032	0	1	01	01	H0544_032_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	032	0	1	01	01	H0544_032_0	8	002	Optional Dental 2	9.00	2			2	2			;	
H0544	036	0	1	01	01	H0544_036_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	036	0	1	01	01	H0544_036_0	8	002	Optional Dental 2	9.00	2			2	2			;	
H0544	037	0	1	01	01	H0544_037_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	037	0	1	01	01	H0544_037_0	8	002	Optional Dental 2	9.00	2			2	2			;	
H0544	038	0	1	01	01	H0544_038_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	038	0	1	01	01	H0544_038_0	8	002	Optional Dental 2	9.00	2			2	2			16a;16b;	
H0544	049	0	1	01	01	H0544_049_0	9	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	050	0	1	01	01	H0544_050_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H0544	050	0	1	01	01	H0544_050_0	7	002	Optional Dental 2	9.00	2			2	2			;	
H0544	056	0	1	01	01	H0544_056_0	10	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	056	0	1	01	01	H0544_056_0	10	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	056	0	1	01	01	H0544_056_0	10	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	057	0	1	01	01	H0544_057_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	057	0	1	01	01	H0544_057_0	11	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	057	0	1	01	01	H0544_057_0	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	058	0	1	01	01	H0544_058_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	058	0	1	01	01	H0544_058_0	11	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	058	0	1	01	01	H0544_058_0	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	059	0	1	01	01	H0544_059_0	10	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	059	0	1	01	01	H0544_059_0	10	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	059	0	1	01	01	H0544_059_0	10	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	060	3	1	01	01	H0544_060_3	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	060	3	1	01	01	H0544_060_3	11	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	060	3	1	01	01	H0544_060_3	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	060	4	1	01	01	H0544_060_4	10	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	060	4	1	01	01	H0544_060_4	10	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	060	4	1	01	01	H0544_060_4	10	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	061	0	1	01	01	H0544_061_0	9	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	061	0	1	01	01	H0544_061_0	9	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	061	0	1	01	01	H0544_061_0	9	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	062	0	1	01	01	H0544_062_0	10	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	062	0	1	01	01	H0544_062_0	10	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	062	0	1	01	01	H0544_062_0	10	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	063	0	1	01	01	H0544_063_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	063	0	1	01	01	H0544_063_0	11	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	063	0	1	01	01	H0544_063_0	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	064	0	1	01	01	H0544_064_0	10	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	064	0	1	01	01	H0544_064_0	10	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	064	0	1	01	01	H0544_064_0	10	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	065	0	1	01	01	H0544_065_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	065	0	1	01	01	H0544_065_0	11	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	065	0	1	01	01	H0544_065_0	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	066	0	1	01	01	H0544_066_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	066	0	1	01	01	H0544_066_0	11	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	066	0	1	01	01	H0544_066_0	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	067	0	1	01	01	H0544_067_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	067	0	1	01	01	H0544_067_0	11	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	067	0	1	01	01	H0544_067_0	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	069	0	1	01	01	H0544_069_0	10	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	069	0	1	01	01	H0544_069_0	10	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	069	0	1	01	01	H0544_069_0	10	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0544	074	0	1	01	01	H0544_074_0	10	001	Preventive Dental Package	12.00	2			2	2				16a;
H0544	074	0	1	01	01	H0544_074_0	10	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H0544	074	0	1	01	01	H0544_074_0	10	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H0545	001	0	1	01	01	H0545_001_0	5	001	Enhanced Dental	11.50	1	2000.00	3	2	2				16a;16b;
H0562	009	0	1	01	01	H0562_009_0	3	001	Buy-Up #6: Comp DPPO+Eyewear+Chiro/Acu+Fitness	25.00	2			2	2			7b;13a;14c;16b;17b;	
H0562	012	0	1	01	01	H0562_012_0	3	001	Buy-Up #5: DHMO+Chiro/Acupuncture	11.00	2			2	2			7b;13a;16a;16b;	
H0562	012	0	1	01	01	H0562_012_0	3	002	Buy-Up #11: DPPO+Chiro/Acupuncture	21.00	2			2	2			7b;13a;	16a;16b;
H0562	039	0	1	01	01	H0562_039_0	3	001	Buy-Up #7: Eyewear+Chiro/Acupuncture	9.00	2			2	2			7b;13a;17b;	
H0562	045	0	1	01	01	H0562_045_0	2	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	20.00	2			2	2			7b;13a;14c;16a;16b;17b;	
H0562	045	0	1	01	01	H0562_045_0	2	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	30.00	2			2	2			7b;13a;14c;17b;	16a;16b;
H0562	068	0	1	01	01	H0562_068_0	3	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	20.00	2			2	2			7b;13a;14c;16a;16b;17b;	
H0562	068	0	1	01	01	H0562_068_0	3	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	30.00	2			2	2			7b;13a;14c;17b;	16a;16b;
H0562	079	0	1	01	01	H0562_079_0	3	001	Buy-Up #3: DHMO+Chiro/Acupuncture+Fitness	14.00	2			2	2			7b;13a;14c;16a;16b;	
H0562	079	0	1	01	01	H0562_079_0	3	002	Buy-Up #4: DPPO+Chiro/Acupuncture+Fitness	25.00	2			2	2			7b;13a;14c;	16a;16b;
H0562	084	0	1	01	01	H0562_084_0	3	001	Buy Up #9: Eyewear+Chiro/Acupuncture+fitness	12.00	2			2	2			7b;13a;14c;17b;	
H0562	090	0	1	01	01	H0562_090_0	4	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	20.00	2			2	2			7b;13a;14c;16a;16b;17b;	
H0562	090	0	1	01	01	H0562_090_0	4	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	30.00	2			2	2			7b;13a;14c;17b;	16a;16b;
H0562	097	0	1	01	01	H0562_097_0	3	001	Buy-Up #5: DHMO+Chiro/Acupuncture	11.00	2			2	2			7b;13a;16a;16b;	
H0562	097	0	1	01	01	H0562_097_0	3	002	Buy-Up #11: DPPO+Chiro/Acupuncture	21.00	2			2	2			7b;13a;	16a;16b;
H0562	100	1	1	01	01	H0562_100_1	3	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	20.00	2			2	2			7b;13a;14c;16a;16b;17b;	
H0562	100	1	1	01	01	H0562_100_1	3	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	30.00	2			2	2			7b;13a;14c;17b;	16a;16b;
H0562	100	2	1	01	01	H0562_100_2	3	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	20.00	2			2	2			7b;13a;14c;16a;16b;17b;	
H0562	100	2	1	01	01	H0562_100_2	3	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	30.00	2			2	2			7b;13a;14c;17b;	16a;16b;
H0562	103	0	1	01	01	H0562_103_0	3	001	Buy-Up #3: DHMO+Chiro/Acupuncture+Fitness	14.00	2			2	2			7b;13a;14c;16a;16b;	
H0562	103	0	1	01	01	H0562_103_0	3	002	Buy-Up #4: DPPO+Chiro/Acupuncture+Fitness	25.00	2			2	2			7b;13a;14c;	16a;16b;
H0562	113	0	1	01	01	H0562_113_0	3	001	Buy-Up #3: DHMO+Chiro/Acupuncture+Fitness	14.00	2			2	2			7b;13a;14c;16a;16b;	
H0562	113	0	1	01	01	H0562_113_0	3	002	Buy-Up #4: DPPO+Chiro/Acupuncture+Fitness	25.00	2			2	2			7b;13a;14c;	16a;16b;
H0562	114	0	1	01	01	H0562_114_0	3	001	Buy-Up #5: DHMO+Chiro/Acupuncture	11.00	2			2	2			7b;13a;16a;16b;	
H0562	114	0	1	01	01	H0562_114_0	3	002	Buy-Up #11: DPPO+Chiro/Acupuncture	21.00	2			2	2			7b;13a;	16a;16b;
H0562	116	0	1	01	01	H0562_116_0	3	001	Buy-Up #5: DHMO+Chiro/Acupuncture	11.00	2			2	2			7b;13a;16a;16b;	
H0562	116	0	1	01	01	H0562_116_0	3	002	Buy-Up #11: DPPO+Chiro/Acupuncture	21.00	2			2	2			7b;13a;	16a;16b;
H0571	001	0	1	01	01	H0571_001_0	4	001	Dental Plan	18.00	2			2	2			16a;16b;	
H0602	001	0	1	18	06	H0602_001_0	2	001	Dental Services	45.00	2			2	1	100.00	16b;		16a;16b;
H0602	001	0	1	18	06	H0602_001_0	2	002	Vision Services	12.00	2			2	2				17a;17b;
H0602	003	0	1	18	06	H0602_003_0	2	001	Dental Services	45.00	2			2	1	100.00	16b;		16a;16b;
H0602	003	0	1	18	06	H0602_003_0	2	002	Vision Services	12.00	2			2	2				17a;17b;
H0602	027	0	1	18	06	H0602_027_0	2	001	Dental Services	45.00	2			2	1	100.00	16b;		16a;16b;
H0602	027	0	1	18	06	H0602_027_0	2	002	Vision Services	12.00	2			2	2				17a;17b;
H0602	042	0	1	18	06	H0602_042_0	2	001	Dental Services	45.00	2			2	1	100.00	16b;		16a;16b;
H0602	042	0	1	18	06	H0602_042_0	2	002	Vision Services	12.00	2			2	2				17a;17b;
H0609	002	0	1	01	01	H0609_002_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	007	0	1	01	01	H0609_007_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	012	0	1	01	01	H0609_012_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	015	0	1	01	01	H0609_015_0	2	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	018	0	1	01	01	H0609_018_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	020	0	1	01	01	H0609_020_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	025	0	1	01	01	H0609_025_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0609	026	0	1	01	01	H0609_026_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	027	0	1	01	01	H0609_027_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0609	028	0	1	01	01	H0609_028_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0609	031	0	1	01	01	H0609_031_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0609	032	0	1	01	01	H0609_032_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0609	033	0	1	01	01	H0609_033_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0630	013	0	1	01	01	H0630_013_0	16	001	Advantage Plus - Option 1	35.00	2			2	2			16a;16b;17b;18b;	
H0630	013	0	1	01	01	H0630_013_0	16	002	Advantage Plus - Option 2	14.00	2			2	2			10b;13a;18b;	
H0630	015	0	1	01	01	H0630_015_0	9	001	Advantage Plus - Option 1	35.00	2			2	2			16b;18b;	16a;17b;
H0630	015	0	1	01	01	H0630_015_0	9	002	Advantage Plus - Option 2	14.00	2			2	2			10b;13a;18b;	
H0630	016	0	1	01	01	H0630_016_0	9	001	Advantage Plus - Option 1	35.00	2			2	2			16b;18b;	16a;17b;
H0630	016	0	1	01	01	H0630_016_0	9	002	Advantage Plus - Option 2	14.00	2			2	2			13a;18b;	10b;
H0630	017	0	1	01	01	H0630_017_0	8	001	Advantage Plus - Option 1	35.00	2			2	2			16a;16b;17b;18b;	
H0630	017	0	1	01	01	H0630_017_0	8	002	Advantage Plus - Option 2	14.00	2			2	2			10b;13a;18b;	
H0630	018	0	1	01	01	H0630_018_0	9	001	Advantage Plus - Option 1	35.00	2			2	2			16b;18b;	16a;17b;
H0630	018	0	1	01	01	H0630_018_0	9	002	Advantage Plus - Option 2	14.00	2			2	2			13a;18b;	10b;
H0630	020	0	1	01	01	H0630_020_0	9	001	Advantage Plus - Option 1	35.00	2			2	2			16a;16b;17b;18b;	
H0630	020	0	1	01	01	H0630_020_0	9	002	Advantage Plus - Option 2	14.00	2			2	2			10b;13a;18b;	
H0630	021	0	1	01	01	H0630_021_0	9	001	Advantage Plus - Option 1	35.00	2			2	2			16b;18b;	16a;17b;
H0630	021	0	1	01	01	H0630_021_0	9	002	Advantage Plus - Option 2	14.00	2			2	2			10b;13a;18b;	
H0755	032	0	1	01	01	H0755_032_0	2	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0755	033	0	1	01	01	H0755_033_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H0755	034	0	1	01	01	H0755_034_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0755	035	0	1	01	01	H0755_035_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0755	036	0	1	01	01	H0755_036_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0755	037	0	1	01	01	H0755_037_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H0755	038	0	1	01	01	H0755_038_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1035	002	0	1	02	01	H1035_002_0	8	001	Optional Point of Service Benefit	70.00	2			2	2			POS;	
H1036	137	0	1	01	01	H1036_137_0	5	001	MyOption Enhanced Dental HMO	26.30	1	2000.00	3	2	2				16a;16b;
H1036	137	0	1	01	01	H1036_137_0	5	002	MyOption Total Dental HMO	30.90	1	2000.00	3	2	2				16a;16b;
H1036	151	0	1	01	01	H1036_151_0	5	001	MyOption Total Dental HMO	22.10	1	2000.00	3	2	2				16a;16b;
H1036	153	0	1	01	01	H1036_153_0	4	001	MyOption Enhanced Dental HMO	28.40	1	2000.00	3	2	2				16a;16b;
H1036	171	0	1	01	01	H1036_171_0	5	001	MyOption Total Dental HMO	22.10	1	2000.00	3	2	2				16a;16b;
H1036	219	0	1	01	01	H1036_219_0	4	001	MyOption Dental High PPO	22.50	1	2000.00	3	2	2			16a;16b;	
H1036	223	0	1	01	01	H1036_223_0	5	001	MyOption Total Dental HMO	22.10	1	2000.00	3	2	2				16a;16b;
H1036	233	0	1	01	01	H1036_233_0	5	001	MyOption Enhanced Dental HMO	26.30	1	2000.00	3	2	2				16a;16b;
H1036	233	0	1	01	01	H1036_233_0	5	002	MyOption Total Dental HMO	30.90	1	2000.00	3	2	2				16a;16b;
H1036	234	0	1	01	01	H1036_234_0	3	001	MyOption Enhanced Dental Plus HMO	25.40	1	2000.00	3	2	2				16a;16b;
H1036	234	0	1	01	01	H1036_234_0	3	002	MyOption Total Dental Plus HMO	29.20	1	2000.00	3	2	2				16a;16b;
H1036	236	0	1	01	01	H1036_236_0	4	001	MyOption Enhanced Dental HMO	19.50	1	2000.00	3	2	2				16a;16b;
H1036	236	0	1	01	01	H1036_236_0	4	002	MyOption Total Dental HMO	23.30	1	2000.00	3	2	2				16a;16b;
H1036	263	0	1	01	01	H1036_263_0	5	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H1036	263	0	1	01	01	H1036_263_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H1036	263	0	1	01	01	H1036_263_0	5	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H1036	275	1	1	01	01	H1036_275_1	5	001	MyOption Enhanced Dental HMO	26.30	1	2000.00	3	2	2				16a;16b;
H1036	275	1	1	01	01	H1036_275_1	5	002	MyOption Total Dental HMO	30.90	1	2000.00	3	2	2				16a;16b;
H1036	275	2	1	01	01	H1036_275_2	5	001	MyOption Enhanced Dental HMO	26.30	1	2000.00	3	2	2				16a;16b;
H1036	275	2	1	01	01	H1036_275_2	5	002	MyOption Total Dental HMO	30.90	1	2000.00	3	2	2				16a;16b;
H1111	006	0	1	01	01	H1111_006_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1142	001	0	1	01	01	H1142_001_0	9	001	OH HMO Comprehensive Dental	15.00	1	1000.00	3	2	2			16b;	
H1142	002	0	1	01	01	H1142_002_0	9	001	OH HMO Comprehensive Dental	15.00	1	1000.00	3	2	2			16b;	
H1170	002	0	1	01	01	H1170_002_0	7	001	Advantage Plus	15.00	2			2	2			16a;16b;17b;18a;18b;	
H1170	008	0	1	01	01	H1170_008_0	8	001	Advantage Plus	15.00	2			2	2			16a;16b;18a;18b;	17b;
H1170	009	0	1	01	01	H1170_009_0	8	001	Advantage Plus	15.00	2			2	2			16a;16b;17b;18a;18b;	
H1181	001	0		07	02	H1181_001_0	4	001	Dental	35.00	1	1000.00	3		1	100.00	16b;		16a;16b;
H1225	001	0	1	01	01	H1225_001_0	10	001	Dental and Fitness	32.00	1	1200.00	3	2	2			14c;	16b;
H1225	002	0	1	01	01	H1225_002_0	10	001	Dental and Fitness	32.00	1	1200.00	3	2	2			14c;	16b;
H1230	001	0	1	01	01	H1230_001_0	12	001	Advantage Plus	19.00	2			2	2			16a;16b;17b;18a;18b;	
H1230	001	0	1	01	01	H1230_001_0	12	002	Advantage Plus Complete	43.00	2			2	2			17b;18a;18b;	16a;16b;
H1230	003	0	1	01	01	H1230_003_0	12	001	Advantage Plus	19.00	2			2	2			16a;16b;17b;18a;18b;	
H1230	003	0	1	01	01	H1230_003_0	12	002	Advantage Plus Complete	43.00	2			2	2			17b;18a;18b;	16a;16b;
H1230	013	0	1	01	01	H1230_013_0	14	001	Advantage Plus	19.00	2			2	2			16a;16b;17b;18a;18b;	
H1230	013	0	1	01	01	H1230_013_0	14	002	Advantage Plus Complete	43.00	2			2	2			17b;18a;18b;	16a;16b;
H1230	014	0	1	01	01	H1230_014_0	12	001	Advantage Plus	19.00	2			2	2			16a;16b;17b;18a;18b;	
H1230	014	0	1	01	01	H1230_014_0	12	002	Advantage Plus Complete	43.00	2			2	2			17b;18a;18b;	16a;16b;
H1278	001	0	1	04	01	H1278_001_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H1278	002	0	1	04	01	H1278_002_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H1278	003	0	1	04	01	H1278_003_0	6	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H1278	004	0	1	04	01	H1278_004_0	6	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H1278	005	0	1	04	01	H1278_005_0	6	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H1286	002	0	1	01	01	H1286_002_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1286	009	0	1	01	01	H1286_009_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1302	004	0	1	04	01	H1302_004_0	4	001	Healthy Smiles Basic	9.20	1	750.00	3	2	1	50.00	16b;		16b;
H1304	001	0	1	04	01	H1304_001_0	6	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H1304	002	0	1	04	01	H1304_002_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H1304	008	0	1	04	01	H1304_008_0	7	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H1304	009	0	1	04	01	H1304_009_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H1350	006	0	1	01	01	H1350_006_0	3	001	Healthy Smiles Basic	9.20	1	750.00	3	2	1	50.00	16b;		16b;
H1350	015	1	1	01	01	H1350_015_1	4	001	Healthy Smiles Plus Dental	23.60	1	1000.00	3	2	2				16a;16b;
H1350	015	2	1	01	01	H1350_015_2	4	001	Healthy Smiles Plus Dental	23.60	1	1000.00	3	2	2				16a;16b;
H1350	016	1	1	01	01	H1350_016_1	4	001	Healthy Smiles Plus Dental	23.60	1	1000.00	3	2	2				16a;16b;
H1350	016	2	1	01	01	H1350_016_2	4	001	Healthy Smiles Plus Dental	23.60	1	1000.00	3	2	2				16a;16b;
H1350	019	1	1	01	01	H1350_019_1	4	001	Healthy Smiles Basic	9.20	1	750.00	3	2	1	50.00	16b;		16b;
H1350	019	2	1	01	01	H1350_019_2	4	001	Healthy Smiles Basic	9.20	1	750.00	3	2	1	50.00	16b;		16b;
H1350	021	0	1	01	01	H1350_021_0	5	001	Healthy Smiles Basic	9.20	1	750.00	3	2	1	50.00	16b;		16b;
H1350	022	1	1	01	01	H1350_022_1	5	001	Healthy Smiles Basic	9.20	1	750.00	3	2	1	50.00	16b;		16b;
H1350	022	2	1	01	01	H1350_022_2	5	001	Healthy Smiles Basic	9.20	1	750.00	3	2	1	50.00	16b;		16b;
H1393	001	0	1	04	01	H1393_001_0	11	001	TN PPO Vision Materials	4.00	2			2	2			17b;	
H1393	001	0	1	04	01	H1393_001_0	11	002	TN PPO Comprehensive Dental	20.00	1	1000.00	3	2	2			16b;	
H1415	021	0	1	02	01	H1415_021_0	4	001	Enhanced Vision and Enhanced Dental	20.90	1	1000.00	3	2	2			16a;16b;17a;17b;	
H1607	012	0	1	04	01	H1607_012_0	7	001	Preventive Dental Package	20.00	2			2	2				16a;
H1607	012	0	1	04	01	H1607_012_0	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H1607	012	0	1	04	01	H1607_012_0	7	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H1607	014	0	1	04	01	H1607_014_0	7	001	Preventive Dental Package	20.00	2			2	2				16a;
H1607	014	0	1	04	01	H1607_014_0	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H1607	014	0	1	04	01	H1607_014_0	7	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H1608	016	0	1	04	01	H1608_016_0	3	001	Advantage Optional Supplemental Package	23.00	1	1000.00	3	2	2			16b;	
H1608	035	0	1	04	01	H1608_035_0	3	001	Advantage Optional Supplemental Package	22.00	1	1000.00	3	2	2			16b;	
H1608	051	0	1	04	01	H1608_051_0	3	001	Advantage Optional Supplemental Package	22.00	1	1000.00	3	2	2			16b;	
H1651	008	0	1	18	06	H1651_008_0	1	001	Out of Network Benefit	25.00	2			2	2				13d;
H1651	009	0	1	18	06	H1651_009_0	1	001	Out of Network Benefit	25.00	2			2	2				13d;
H1664	001	0	1	01	01	H1664_001_0	5	001	Comprehensive Dental Buy-up Package	24.00	1	1000.00	3	2	2			16b;	
H1664	002	0	1	01	01	H1664_002_0	5	001	Comprehensive Dental Buy-up Package	26.00	1	1000.00	3	2	2			16b;	
H1664	004	0	1	01	01	H1664_004_0	5	001	Comprehensive Dental Buy-up Package	24.00	1	1000.00	3	2	2			16b;	
H1846	004	0	1	04	01	H1846_004_0	5	001	Dental	24.00	1	1000.00	3	2	2			16a;16b;	
H1894	001	0	1	01	01	H1894_001_0	8	001	Preventive Dental Package	12.00	2			2	2				16a;
H1894	001	0	1	01	01	H1894_001_0	8	002	Dental and Vision Package	32.00	2			2	2				16a;16b;17b;
H1894	001	0	1	01	01	H1894_001_0	8	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H1944	001	0	1	01	01	H1944_001_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	004	0	1	01	01	H1944_004_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	005	0	1	01	01	H1944_005_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	006	0	1	01	01	H1944_006_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	009	0	1	01	01	H1944_009_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	010	0	1	01	01	H1944_010_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1944	015	0	1	01	01	H1944_015_0	2	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1944	016	0	1	01	01	H1944_016_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1944	017	0	1	01	01	H1944_017_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	018	0	1	01	01	H1944_018_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	019	0	1	01	01	H1944_019_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1944	021	0	1	01	01	H1944_021_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1944	022	0	1	01	01	H1944_022_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1944	024	0	1	01	01	H1944_024_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H1944	028	0	1	01	01	H1944_028_0	5	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H1951	013	0	1	01	01	H1951_013_0	3	001	MyOption Enhanced Dental HMO	27.30	1	2000.00	3	2	2				16a;16b;
H1951	028	0	1	01	01	H1951_028_0	3	001	MyOption Enhanced Dental Plus HMO	35.20	1	2000.00	3	2	2				16a;16b;
H1951	030	0	1	01	01	H1951_030_0	2	001	MyOption Dental High PPO	25.80	1	2000.00	3	2	2			16a;16b;	
H1951	047	1	1	01	01	H1951_047_1	3	001	MyOption Dental Enriched HMO	27.30	1	2000.00	3	2	2				16a;16b;
H1951	047	2	1	01	01	H1951_047_2	3	001	MyOption Dental Enriched HMO	27.30	1	2000.00	3	2	2				16a;16b;
H1951	048	1	1	01	01	H1951_048_1	3	001	MyOption Dental Enriched HMO	27.30	1	2000.00	3	2	2				16a;16b;
H1951	048	2	1	01	01	H1951_048_2	3	001	MyOption Dental Enriched HMO	27.30	1	2000.00	3	2	2				16a;16b;
H1969	002	0	1	01	01	H1969_002_0	8	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H1969	004	0	1	01	01	H1969_004_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H1994	001	0	1	01	01	H1994_001_0	6	001	SelectHealth Dental Comprehensive Benefit	35.00	1	1000.00	3	2	2			16a;16b;	
H1994	001	0	1	01	01	H1994_001_0	6	002	SelectHealth Dental Comprehensive Plus Eyewear	40.00	1	1200.00	3	2	2			16a;16b;17b;	
H1994	002	0	1	01	01	H1994_002_0	5	001	SelectHealth Dental Comprehensive Benefit	35.00	1	1000.00	3	2	2			16a;16b;	
H1994	002	0	1	01	01	H1994_002_0	5	002	SelectHealth Dental Comprehensive Plus Eyewear	40.00	1	1200.00	3	2	2			16a;16b;17b;	
H1994	003	0	1	01	01	H1994_003_0	9	001	Idaho Delta Dental Advantage	38.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H1994	003	0	1	01	01	H1994_003_0	9	002	Idaho Delta Dental Advantage Plus Eyewear	43.00	1	1200.00	3	2	1	50.00	16b;	16a;16b;17b;	
H1994	004	0	1	01	01	H1994_004_0	8	001	Idaho Delta Dental Advantage	38.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H1994	004	0	1	01	01	H1994_004_0	8	002	Idaho Delta Dental Advantage Plus Eyewear	43.00	1	1200.00	3	2	1	50.00	16b;	16a;16b;17b;	
H1994	005	0	1	01	01	H1994_005_0	5	001	SelectHealth Dental Comprehensive Benefit	35.00	1	1000.00	3	2	2			16a;16b;	
H1994	005	0	1	01	01	H1994_005_0	5	002	SelectHealth Dental Comprehensive Plus Eyewear	40.00	1	1200.00	3	2	2			16a;16b;17b;	
H1994	007	0	1	01	01	H1994_007_0	5	001	SelectHealth Dental Comprehensive Benefit	28.00	1	1000.00	3	2	2			16b;	
H1994	007	0	1	01	01	H1994_007_0	5	002	SelectHealth Dental Comprehensive Plus Eyewear	33.00	1	1200.00	3	2	2			16b;17b;	
H1994	008	0	1	01	01	H1994_008_0	8	001	Idaho Delta Dental Advantage	31.00	1	1000.00	3	2	1	50.00	16b;	16b;	
H1994	008	0	1	01	01	H1994_008_0	8	002	Idaho Delta Dental Advantage Plus Eyewear	36.00	1	1200.00	3	2	1	50.00	16b;	16b;17b;	
H1994	009	0	1	01	01	H1994_009_0	7	001	Delta Dental Comprehensive Benefit	22.00	1	1000.00	3	2	1	100.00	16b;	16b;	
H1994	010	0	1	01	01	H1994_010_0	6	001	Delta Dental Comprehensive Benefit	25.00	1	1000.00	3	2	1	100.00	16b;	16b;	
H1994	011	0	1	01	01	H1994_011_0	7	001	Delta Dental Comprehensive Benefit	25.00	1	1000.00	3	2	1	100.00	16b;	16b;	
H1997	002	0	1	01	01	H1997_002_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H1997	007	1	1	01	01	H1997_007_1	8	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H1997	007	2	1	01	01	H1997_007_2	8	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H2001	001	0	1	04	01	H2001_001_0	3	001	Fitness Rider	18.00	2			2	2			14c;	
H2001	001	0	1	04	01	H2001_001_0	3	002	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2001	010	0	1	04	01	H2001_010_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2011	001	0	1	01	01	H2011_001_0	11	001	TN HMO Comprehensive Dental	18.00	1	1000.00	3	2	2			16b;	
H2032	001	0	1	04	01	H2032_001_0	5	001	Dental Services	20.00	1	2000.00	3	2	2				16a;16b;
H2032	002	0	1	04	01	H2032_002_0	5	001	Dental Services	20.00	1	2000.00	3	2	2				16a;16b;
H2108	001	0	1	01	01	H2108_001_0	4	001	Enhanced Dental - Preventive	7.30	2			2	2			16a;	
H2108	029	0	1	01	01	H2108_029_0	4	001	Enhanced Dental - Comprehensive	37.00	1	1000.00	3	2	2			16b;	
H2108	032	0	1	01	01	H2108_032_0	4	001	Enhanced Dental - Comprehensive	37.30	1	1000.00	3	2	2			16b;	
H2150	002	0	1	18	06	H2150_002_0	9	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2150	009	0	1	18	06	H2150_009_0	9	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2150	021	0	1	18	06	H2150_021_0	6	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2150	022	0	1	18	06	H2150_022_0	6	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2150	029	0	2	18	06	H2150_029_0	9	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2171	001	0	1	01	01	H2171_001_0	5	001	Dental Rider	18.00	2			2	2			16b;	
H2172	001	0	1	01	01	H2172_001_0	7	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2172	002	0	1	01	01	H2172_002_0	7	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2172	003	0	1	01	01	H2172_003_0	7	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2172	004	0	1	01	01	H2172_004_0	7	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2172	005	0	1	01	01	H2172_005_0	8	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2172	006	0	1	01	01	H2172_006_0	9	001	Advantage Plus	23.00	2			2	2			18a;18b;	16a;16b;17b;
H2228	019	0	1	04	01	H2228_019_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	020	0	1	04	01	H2228_020_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	021	0	1	04	01	H2228_021_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	024	0	1	04	01	H2228_024_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	025	0	1	04	01	H2228_025_0	2	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	029	0	1	04	01	H2228_029_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	031	0	1	04	01	H2228_031_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	032	0	1	04	01	H2228_032_0	3	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	035	0	1	04	01	H2228_035_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	037	0	1	04	01	H2228_037_0	3	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	047	0	1	04	01	H2228_047_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	049	0	1	04	01	H2228_049_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	064	0	1	04	01	H2228_064_0	5	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	065	0	1	04	01	H2228_065_0	5	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	066	0	1	04	01	H2228_066_0	5	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2228	067	0	1	04	01	H2228_067_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	068	0	1	04	01	H2228_068_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2228	071	0	1	04	01	H2228_071_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H2256	001	1	1	01	01	H2256_001_1	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	001	2	1	01	01	H2256_001_2	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	001	6	1	01	01	H2256_001_6	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	015	1	1	01	01	H2256_015_1	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	015	2	1	01	01	H2256_015_2	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	015	6	1	01	01	H2256_015_6	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	016	1	1	01	01	H2256_016_1	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	016	2	1	01	01	H2256_016_2	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	018	1	1	01	01	H2256_018_1	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	018	7	1	01	01	H2256_018_7	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	018	8	1	01	01	H2256_018_8	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	019	1	1	01	01	H2256_019_1	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	019	7	1	01	01	H2256_019_7	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	026	1	1	01	01	H2256_026_1	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	026	2	1	01	01	H2256_026_2	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	026	3	1	01	01	H2256_026_3	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	028	0	1	01	01	H2256_028_0	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	033	0	1	01	01	H2256_033_0	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	034	0	1	01	01	H2256_034_0	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	036	0	1	01	01	H2256_036_0	7	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	039	0	1	01	01	H2256_039_0	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	040	0	1	01	01	H2256_040_0	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	041	0	1	01	01	H2256_041_0	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2256	042	0	1	01	01	H2256_042_0	6	001	Delta Dental Option	54.00	2			2	2				16a;16b;
H2288	001	0	1	01	01	H2288_001_0	9	001	NY HMO Comprehensive Dental	13.00	1	1000.00	3	2	2			16b;	
H2320	007	0	1	02	01	H2320_007_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	008	0	1	02	01	H2320_008_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	011	0	1	02	01	H2320_011_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	012	0	1	02	01	H2320_012_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	013	0	1	02	01	H2320_013_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	015	0	1	02	01	H2320_015_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	016	0	1	02	01	H2320_016_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	018	0	1	02	01	H2320_018_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	019	0	1	02	01	H2320_019_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	021	0	1	02	01	H2320_021_0	14	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	022	1	1	02	01	H2320_022_1	14	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	022	2	1	02	01	H2320_022_2	14	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	022	3	1	02	01	H2320_022_3	14	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	022	4	1	02	01	H2320_022_4	14	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2320	022	5	1	02	01	H2320_022_5	14	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H2322	004	0	1	04	01	H2322_004_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2			;	16a;16b;
H2322	004	0	1	04	01	H2322_004_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2			;	16a;16b;
H2322	008	0	1	04	01	H2322_008_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2			;	16a;16b;
H2322	008	0	1	04	01	H2322_008_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2			;	16a;16b;
H2322	011	0	1	04	01	H2322_011_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2			;	16a;16b;
H2322	011	0	1	04	01	H2322_011_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2			;	16a;16b;
H2322	012	0	1	04	01	H2322_012_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2			;	16a;16b;
H2322	012	0	1	04	01	H2322_012_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2			;	16a;16b;
H2354	015	0	1	01	01	H2354_015_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2				16a;16b;
H2354	015	0	1	01	01	H2354_015_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2				16a;16b;
H2354	018	0	1	01	01	H2354_018_0	7	001	Delta Dental Option 1	22.60	1	800.00	3	2	2				16a;16b;
H2354	018	0	1	01	01	H2354_018_0	7	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2				16a;16b;
H2354	019	0	1	01	01	H2354_019_0	5	001	Delta Dental Option 1	22.60	1	800.00	3	2	2				16a;16b;
H2354	019	0	1	01	01	H2354_019_0	5	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2				16a;16b;
H2354	020	0	1	02	01	H2354_020_0	5	001	Delta Dental Option 1	22.60	1	800.00	3	2	2				16a;16b;
H2354	020	0	1	02	01	H2354_020_0	5	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2				16a;16b;
H2354	021	0	1	02	01	H2354_021_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2				16a;16b;
H2354	021	0	1	02	01	H2354_021_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2				16a;16b;
H2354	022	0	1	02	01	H2354_022_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2				16a;16b;
H2354	022	0	1	02	01	H2354_022_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2				16a;16b;
H2354	024	0	1	01	01	H2354_024_0	6	001	Delta Dental Option 1	22.60	1	800.00	3	2	2				16a;16b;
H2354	024	0	1	01	01	H2354_024_0	6	002	Delta Dental Option 2	43.30	1	1500.00	3	2	2				16a;16b;
H2450	040	0	1	18	06	H2450_040_0	3	002	Wisconsin Rider	46.00	1	30000.00	3	2	2				2;6;12;
H2450	041	0	1	18	06	H2450_041_0	5	002	Wisconsin Rider	46.00	1	30000.00	3	2	2				2;6;12;
H2459	001	0	1	02	01	H2459_001_0	4	001	Choice Dental	21.00	1	1000.00	3	2	1	75.00	16b;		16a;16b;
H2459	021	1	1	02	01	H2459_021_1	6	001	Classic Choice Dental	21.00	1	1200.00	3	2	1	50.00	16b;		16b;
H2459	021	2	1	02	01	H2459_021_2	4	001	Classic Choice Dental	21.00	1	1200.00	3	2	1	50.00	16b;		16b;
H2459	021	3	1	02	01	H2459_021_3	4	001	Classic Choice Dental	21.00	1	1200.00	3	2	1	50.00	16b;		16b;
H2459	023	1	1	02	01	H2459_023_1	6	001	Choice Dental	21.00	1	1000.00	3	2	1	75.00	16b;		16a;16b;
H2459	023	2	1	02	01	H2459_023_2	6	001	Choice Dental	21.00	1	1000.00	3	2	1	75.00	16b;		16a;16b;
H2459	024	0	1	02	01	H2459_024_0	7	001	Choice Dental	21.00	1	1000.00	3	2	1	75.00	16b;		16a;16b;
H2462	010	0	1	18	06	H2462_010_0	6	001	Freedom Comprehensive Dental Benefit	41.50	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H2462	016	0	1	18	06	H2462_016_0	5	001	Wisconsin Rider	42.00	2			2	2			2;	6;7b;
H2462	016	0	1	18	06	H2462_016_0	5	002	Freedom Comprehensive Dental Benefit	43.10	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H2462	017	0	1	18	06	H2462_017_0	8	001	Freedom Comprehensive Dental Benefit	43.10	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H2462	018	0	1	18	06	H2462_018_0	5	001	Freedom Comprehensive Dental Benefit	43.10	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H2462	019	0	1	18	06	H2462_019_0	8	001	Freedom Comprehensive Dental Benefit	43.10	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H2463	001	0	1	01	01	H2463_001_0	4	001	MyOption Enhanced Dental HMO	28.30	1	2000.00	3	2	2				16a;16b;
H2463	002	0	1	01	01	H2463_002_0	4	001	MyOption Enhanced Dental HMO	28.30	1	2000.00	3	2	2				16a;16b;
H2486	003	0	1	01	01	H2486_003_0	4	001	MyOption Platinum Dental	28.20	1	2000.00	3	2	2			16a;16b;	
H2563	003	0	1	01	01	H2563_003_0	8	001	Preventive Plus Plan	13.50	1	750.00	3	2	2			16b;	
H2563	003	0	1	01	01	H2563_003_0	8	002	Comprehensive Plan	16.00	1	1000.00	3	2	2			16b;	
H2563	005	1	1	01	01	H2563_005_1	8	001	Preventive Plus Plan	13.50	1	750.00	3	2	2			16b;	
H2563	005	1	1	01	01	H2563_005_1	8	002	Comprehensive Plan	16.00	1	1000.00	3	2	2			16b;	
H2563	005	2	1	01	01	H2563_005_2	8	001	Preventive Plus Plan	13.50	1	750.00	3	2	2			16b;	
H2563	005	2	1	01	01	H2563_005_2	8	002	Comprehensive Plan	16.00	1	1000.00	3	2	2			16b;	
H2593	001	0	1	01	01	H2593_001_0	9	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	003	0	1	01	01	H2593_003_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	005	0	1	01	01	H2593_005_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	006	0	1	01	01	H2593_006_0	9	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	013	0	1	01	01	H2593_013_0	9	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	018	0	1	01	01	H2593_018_0	10	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	019	0	1	01	01	H2593_019_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	020	0	1	01	01	H2593_020_0	11	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H2593	022	0	1	01	01	H2593_022_0	9	001	Preventive Dental Package	16.00	2			2	2				16a;
H2593	022	0	1	01	01	H2593_022_0	9	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H2593	022	0	1	01	01	H2593_022_0	9	003	Enhanced Dental and Vision Package	43.00	2			2	2				16a;16b;17b;
H2593	023	0	1	01	01	H2593_023_0	9	001	Preventive Dental Package	16.00	2			2	2				16a;
H2593	023	0	1	01	01	H2593_023_0	9	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H2593	023	0	1	01	01	H2593_023_0	9	003	Enhanced Dental and Vision Package	43.00	2			2	2				16a;16b;17b;
H2593	024	0	1	01	01	H2593_024_0	9	001	Preventive Dental Package	16.00	2			2	2				16a;
H2593	024	0	1	01	01	H2593_024_0	9	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H2593	024	0	1	01	01	H2593_024_0	9	003	Enhanced Dental and Vision Package	43.00	2			2	2				16a;16b;17b;
H2593	025	0	1	01	01	H2593_025_0	9	001	Preventive Dental Package	16.00	2			2	2				16a;
H2593	025	0	1	01	01	H2593_025_0	9	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H2593	025	0	1	01	01	H2593_025_0	9	003	Enhanced Dental and Vision Package	43.00	2			2	2				16a;16b;17b;
H2663	017	0	1	01	01	H2663_017_0	2	001	Advantage Optional Supplemental Package	22.00	1	1000.00	3	2	2			16b;	
H2663	022	0	1	01	01	H2663_022_0	3	001	Advantage Optional Supplemental Package	23.00	1	1000.00	3	2	2			16b;	
H2663	025	0	1	01	01	H2663_025_0	2	001	Advantage Optional Supplemental Package	23.00	1	1000.00	3	2	2			16b;	
H2663	026	0	1	01	01	H2663_026_0	3	001	Advantage Optional Supplemental Package	23.00	1	1000.00	3	2	2			16b;	
H2663	027	0	1	01	01	H2663_027_0	3	001	Advantage Optional Supplemental Package	23.00	1	1000.00	3	2	2			16b;	
H2663	032	0	1	01	01	H2663_032_0	2	001	Advantage Optional Supplemental Package	22.00	1	1000.00	3	2	2			16b;	
H2802	007	0	1	01	01	H2802_007_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	008	0	1	01	01	H2802_008_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2802	010	0	1	01	01	H2802_010_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2802	012	0	1	01	01	H2802_012_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	013	0	1	01	01	H2802_013_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	014	0	1	01	01	H2802_014_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	016	0	1	01	01	H2802_016_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	017	0	1	01	01	H2802_017_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	018	0	1	01	01	H2802_018_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	019	0	1	01	01	H2802_019_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	020	0	1	01	01	H2802_020_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	021	0	1	01	01	H2802_021_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	024	0	1	01	01	H2802_024_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2802	025	0	1	01	01	H2802_025_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	029	0	1	01	01	H2802_029_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	034	0	1	01	01	H2802_034_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	045	0	1	01	01	H2802_045_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H2802	048	0	1	01	01	H2802_048_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H2829	001	0	1	01	01	H2829_001_0	4	001	Innovation Health Medicare Dental/Hearing	17.00	1	1500.00	3	2	1	50.00	16b;	16a;16b;18b;	
H2944	013	0	1	09	04	H2944_013_0	6	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H2944	013	0	1	09	04	H2944_013_0	6	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H2944	013	0	1	09	04	H2944_013_0	6	003	MyOption Plus	21.80	2			2	1	50.00	16b;		17a;17b;16a;16b;
H2944	013	0	1	09	04	H2944_013_0	6	004	MyOption Fitness	15.00	2			2	2			14c;	
H2944	114	0	1	09	04	H2944_114_0	3	001	MyOption Dental High PPO	16.90	1	2000.00	3	2	2			16a;16b;	
H2944	114	0	1	09	04	H2944_114_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H2944	114	0	1	09	04	H2944_114_0	3	003	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H2944	124	0	1	09	04	H2944_124_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H2944	124	0	1	09	04	H2944_124_0	3	002	MyOption Platinum Dental	25.00	1	2000.00	3	2	2			16a;16b;	
H2944	127	0	1	09	04	H2944_127_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H2944	127	0	1	09	04	H2944_127_0	4	002	MyOption Platinum Dental	21.60	1	2000.00	3	2	2			16a;16b;	
H2944	197	0	1	09	04	H2944_197_0	2	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H2944	197	0	1	09	04	H2944_197_0	2	002	MyOption Fitness	15.00	2			2	2			14c;	
H2960	019	0	1	01	01	H2960_019_0	5	001	Comprehensive Dental	30.00	1	1000.00	3	2	1	100.00	16b;	16b;	
H2986	001	0	1	01	01	H2986_001_0	9	001	Dental and Vision	20.00	2			2	2			16a;16b;17a;17b;	
H2986	002	0	1	01	01	H2986_002_0	9	001	Dental and Vision	20.00	2			2	2			16a;16b;17a;17b;	
H2986	004	0	1	01	01	H2986_004_0	9	001	Dental and Vision	20.00	2			2	2			16a;16b;17a;17b;	
H2986	005	0	1	01	01	H2986_005_0	9	001	Dental and Vision	20.00	2			2	2			16a;16b;17a;17b;	
H2986	006	0	1	01	01	H2986_006_0	8	001	Dental and Vision	20.00	2			2	2			16a;16b;17a;17b;	
H2986	007	0	1	01	01	H2986_007_0	9	001	Dental and Vision	20.00	2			2	2			16a;16b;17a;17b;	
H3152	022	0	1	01	01	H3152_022_0	4	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3152	045	0	1	01	01	H3152_045_0	2	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3152	045	0	1	01	01	H3152_045_0	2	002	DMO Dental Plus EyeWear and Hearing Aids	19.00	2			2	2			16a;16b;17b;18b;	
H3152	080	0	1	01	01	H3152_080_0	3	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3152	080	0	1	01	01	H3152_080_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	19.00	2			2	2			16a;16b;17b;18b;	
H3152	085	0	1	01	01	H3152_085_0	3	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3152	085	0	1	01	01	H3152_085_0	3	002	DMO Dental Plus EyeWear	16.00	2			2	2			16a;16b;17b;	
H3251	002	0	1	01	01	H3251_002_0	9	001	Optional Supplemental	32.00	1	2150.00	6	2	2			16a;16b;17b;18a;18b;	
H3307	025	0	1	01	01	H3307_025_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3312	002	0	1	01	01	H3312_002_0	4	001	DMO Dental	12.00	2			2	2			16a;16b;	
H3312	002	0	1	01	01	H3312_002_0	4	002	DMO Dental Plus EyeWear and Hearing Aids	21.00	2			2	2			16a;16b;17b;18b;	
H3312	018	0	1	01	01	H3312_018_0	3	001	DMO Dental	12.00	2			2	2			16a;16b;	
H3312	018	0	1	01	01	H3312_018_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	21.00	2			2	2			16a;16b;17b;18b;	
H3312	063	0	1	01	01	H3312_063_0	3	001	DMO Dental	12.00	2			2	2			16a;16b;	
H3312	063	0	1	01	01	H3312_063_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	21.00	2			2	2			16a;16b;17b;18b;	
H3312	064	0	1	01	01	H3312_064_0	3	001	DMO Dental	12.00	2			2	2			16a;16b;	
H3312	064	0	1	01	01	H3312_064_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	21.00	2			2	2			16a;16b;17b;18b;	
H3312	065	0	1	01	01	H3312_065_0	3	001	Aetna Medicare EPO Dental	18.00	1	1000.00	3	1	1	50.00	16b;	16a;16b;	
H3312	065	0	1	01	01	H3312_065_0	3	002	Aetna Medicare EPO Dental/Vision/Hearing	27.00	1	1425.00	3	2	1	50.00	16b;	16a;16b;17b;18b;	
H3330	036	0	1	01	01	H3330_036_0	9	001	Comprehensive Dental	11.50	2			2	2				16b;
H3330	036	0	1	01	01	H3330_036_0	9	002	Fitness Benefit	15.00	2			2	2				14c;
H3330	040	0	1	01	01	H3330_040_0	10	001	Comprehensive Dental	11.50	2			2	2				16b;
H3330	040	0	1	01	01	H3330_040_0	10	002	Fitness Benefit	15.00	2			2	2				14c;
H3342	019	0	1	04	01	H3342_019_0	6	001	Preventive Dental Package	19.00	2			2	2				16a;
H3342	019	0	1	04	01	H3342_019_0	6	002	Dental and Vision Package	30.00	2			2	2				16a;16b;17b;
H3342	019	0	1	04	01	H3342_019_0	6	003	Enhanced Dental and Vision Package	49.00	2			2	2				16a;16b;17b;
H3379	039	0	1	01	01	H3379_039_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3379	040	0	1	01	01	H3379_040_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3379	041	0	1	01	01	H3379_041_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3384	013	0	1	01	01	H3384_013_0	6	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2	2				16a;16b;
H3384	013	0	1	01	01	H3384_013_0	6	002	Optional Supplemental Dental Enhanced	38.00	1	1000.00	3	2	2				16a;16b;
H3384	019	0	1	01	01	H3384_019_0	6	001	Optional Supplemental Dental Basic	9.00	1	500.00	3	2	2				16b;
H3384	019	0	1	01	01	H3384_019_0	6	002	Optional Supplemental Dental Enhanced	24.00	1	1000.00	3	2	2				16b;
H3384	022	0	1	01	01	H3384_022_0	5	001	Optional Supplemental Dental Basic	9.00	1	500.00	3	2	2				16b;
H3384	022	0	1	01	01	H3384_022_0	5	002	Optional Supplemental Dental Enhanced	24.00	1	1000.00	3	2	2				16b;
H3384	058	0	1	01	01	H3384_058_0	5	001	Optional Supplemental Dental Basic	9.00	1	500.00	3	2	2				16b;
H3384	058	0	1	01	01	H3384_058_0	5	002	Optional Supplemental Dental Enhanced	24.00	1	1000.00	3	2	2				16b;
H3384	059	0	1	02	01	H3384_059_0	6	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2	2				16a;16b;
H3384	059	0	1	02	01	H3384_059_0	6	002	Optional Supplemental Dental Enhanced	38.00	1	1000.00	3	2	2				16a;16b;
H3384	062	0	1	01	01	H3384_062_0	6	001	Optional Supplemental Dental Basic	9.00	1	500.00	3	2	2				16b;
H3384	062	0	1	01	01	H3384_062_0	6	002	Optional Supplemental Dental Enhanced	24.00	1	1000.00	3	2	2				16b;
H3384	063	0	1	02	01	H3384_063_0	5	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2	2				16a;16b;
H3384	063	0	1	02	01	H3384_063_0	5	002	Optional Supplemental Dental Enhanced	38.00	1	1000.00	3	2	2				16a;16b;
H3384	064	0	1	02	01	H3384_064_0	5	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2	2				16a;16b;
H3384	064	0	1	02	01	H3384_064_0	5	002	Optional Supplemental Dental Enhanced	38.00	1	1000.00	3	2	2				16a;16b;
H3447	001	0	1	01	01	H3447_001_0	4	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H3447	003	0	1	01	01	H3447_003_0	4	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H3447	004	0	1	01	01	H3447_004_0	4	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H3447	005	0	1	01	01	H3447_005_0	4	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H3447	010	0	1	01	01	H3447_010_0	5	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H3447	013	0	1	01	01	H3447_013_0	7	001	Preventive Dental Package	17.00	2			2	2				16a;
H3447	013	0	1	01	01	H3447_013_0	7	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H3447	013	0	1	01	01	H3447_013_0	7	003	Enhanced Dental and Vision Package	39.00	2			2	2				16a;16b;17b;
H3447	014	0	1	01	01	H3447_014_0	6	001	Preventive Dental Package	17.00	2			2	2				16a;
H3447	014	0	1	01	01	H3447_014_0	6	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H3447	014	0	1	01	01	H3447_014_0	6	003	Enhanced Dental and Vision Package	39.00	2			2	2				16a;16b;17b;
H3447	019	0	1	01	01	H3447_019_0	11	001	Preventive Dental Package	17.00	2			2	2				16a;
H3447	019	0	1	01	01	H3447_019_0	11	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H3447	019	0	1	01	01	H3447_019_0	11	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H3447	021	0	1	01	01	H3447_021_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H3447	021	0	1	01	01	H3447_021_0	11	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3447	021	0	1	01	01	H3447_021_0	11	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H3447	022	0	1	01	01	H3447_022_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H3447	022	0	1	01	01	H3447_022_0	11	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3447	022	0	1	01	01	H3447_022_0	11	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H3447	023	0	1	01	01	H3447_023_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H3447	023	0	1	01	01	H3447_023_0	11	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3447	023	0	1	01	01	H3447_023_0	11	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H3447	024	0	1	01	01	H3447_024_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H3447	024	0	1	01	01	H3447_024_0	11	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3447	024	0	1	01	01	H3447_024_0	11	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H3464	001	0	1	01	01	H3464_001_0	5	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3464	003	0	1	01	01	H3464_003_0	6	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3464	005	0	1	01	01	H3464_005_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3528	003	0	1	01	01	H3528_003_0	9	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16b;	
H3528	006	0	1	02	01	H3528_006_0	10	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16a;16b;	
H3528	011	1	1	02	01	H3528_011_1	11	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16a;16b;	
H3528	011	2	1	02	01	H3528_011_2	11	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16a;16b;	
H3528	012	1	1	02	01	H3528_012_1	10	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16a;16b;	
H3528	012	2	1	02	01	H3528_012_2	11	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16a;16b;	
H3528	013	1	1	01	01	H3528_013_1	11	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16a;16b;	
H3528	013	2	1	01	01	H3528_013_2	11	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16a;16b;	
H3528	014	0	1	01	01	H3528_014_0	11	001	Dental	34.00	1	1000.00	3	2	1	100.00	16b;	16b;	
H3533	001	0	1	01	01	H3533_001_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H3533	001	0	1	01	01	H3533_001_0	4	002	MyOption Enhanced Dental HMO	28.00	1	2000.00	3	2	2				16a;16b;
H3533	001	0	1	01	01	H3533_001_0	4	003	MyOption Fitness	15.00	2			2	2			14c;	
H3533	001	0	1	01	01	H3533_001_0	4	004	MyOption Total Dental HMO	33.00	1	2000.00	3	2	2				16a;16b;
H3533	006	0	1	01	01	H3533_006_0	4	001	MyOption Total Dental HMO	33.00	1	2000.00	3	2	2				16a;16b;
H3533	010	0	1	01	01	H3533_010_0	4	001	MyOption Enhanced Dental HMO	28.00	1	2000.00	3	2	2				16a;16b;
H3533	010	0	1	01	01	H3533_010_0	4	002	MyOption Total Dental HMO	33.00	1	2000.00	3	2	2				16a;16b;
H3533	020	0	1	01	01	H3533_020_0	3	001	MyOption Platinum Dental	30.40	1	2000.00	3	2	2			16a;16b;	
H3533	027	0	1	01	01	H3533_027_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H3533	027	0	1	01	01	H3533_027_0	3	002	MyOption Platinum Dental	30.40	1	2000.00	3	2	2			16a;16b;	
H3536	002	0	1	01	01	H3536_002_0	6	001	Preventive Dental Package	16.00	2			2	2				16a;
H3536	002	0	1	01	01	H3536_002_0	6	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H3536	002	0	1	01	01	H3536_002_0	6	003	Enhanced Dental and Vision Package	46.00	2			2	2				16a;16b;17b;
H3536	005	0	1	01	01	H3536_005_0	6	001	Preventive Dental Package	16.00	2			2	2				16a;
H3536	005	0	1	01	01	H3536_005_0	6	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H3536	005	0	1	01	01	H3536_005_0	6	003	Enhanced Dental and Vision Package	46.00	2			2	2				16a;16b;17b;
H3653	004	0	1	01	01	H3653_004_0	6	001	OPTIONAL DENTAL PREVENTIVE BENEFIT PACKAGE	18.10	1	500.00	3	2	2			16a;	
H3653	004	0	1	01	01	H3653_004_0	6	002	OPTIONAL DENTAL PREVENTIVE-COMPREHENSIVE PACKAGE	30.00	1	1000.00	3	2	1	25.00	16b;	16a;16b;	
H3653	015	0	1	01	01	H3653_015_0	6	001	OPTIONAL DENTAL PREVENTIVE BENEFIT PACKAGE	18.10	1	500.00	3	2	2			16a;	
H3653	015	0	1	01	01	H3653_015_0	6	002	OPTIONAL DENTAL PREVENTIVE-COMPREHENSIVE PACKAGE	30.00	1	1000.00	3	2	1	25.00	16b;	16a;16b;	
H3653	018	0	1	01	01	H3653_018_0	6	001	OPTIONAL DENTAL PREVENTIVE BENEFIT PACKAGE	18.10	1	500.00	3	2	2			16a;	
H3653	018	0	1	01	01	H3653_018_0	6	002	OPTIONAL DENTAL PREVENTIVE-COMPREHENSIVE PACKAGE	30.00	1	1000.00	3	2	1	25.00	16b;	16a;16b;	
H3653	022	0	1	01	01	H3653_022_0	6	001	OPTIONAL DENTAL PREVENTIVE BENEFIT PACKAGE	18.10	1	500.00	3	2	2			16a;	
H3653	022	0	1	01	01	H3653_022_0	6	002	OPTIONAL DENTAL PREVENTIVE-COMPREHENSIVE PACKAGE	30.00	1	1000.00	3	2	1	25.00	16b;	16a;16b;	
H3655	032	0	1	01	01	H3655_032_0	7	001	Preventive Dental Package	14.00	2			2	2				16a;
H3655	032	0	1	01	01	H3655_032_0	7	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3655	032	0	1	01	01	H3655_032_0	7	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H3655	034	0	1	01	01	H3655_034_0	7	001	Preventive Dental Package	14.00	2			2	2				16a;
H3655	034	0	1	01	01	H3655_034_0	7	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3655	034	0	1	01	01	H3655_034_0	7	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H3655	038	0	1	01	01	H3655_038_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H3655	038	0	1	01	01	H3655_038_0	11	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3655	038	0	1	01	01	H3655_038_0	11	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H3655	040	0	1	01	01	H3655_040_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H3655	040	0	1	01	01	H3655_040_0	11	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3655	040	0	1	01	01	H3655_040_0	11	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H3655	041	0	1	01	01	H3655_041_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H3655	041	0	1	01	01	H3655_041_0	11	002	Dental and Vision Package	26.00	2			2	2				16a;16b;17b;
H3655	041	0	1	01	01	H3655_041_0	11	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H3660	028	0	1	02	01	H3660_028_0	10	001	Optional Supplemental Dental	25.00	1	1000.00	3	2	2				16a;16b;
H3660	029	0	1	02	01	H3660_029_0	10	001	Optional Supplemental Dental	25.00	1	1000.00	3	2	2				16a;16b;
H3660	044	0	1	01	01	H3660_044_0	10	001	Optional Supplemental Dental	25.00	1	1000.00	3	2	2				16a;16b;
H3660	047	0	1	01	01	H3660_047_0	9	001	Optional Supplemental Dental	25.00	1	1000.00	3	2	2				16a;16b;
H3660	048	0	1	02	01	H3660_048_0	8	001	Optional Supplemental Dental	25.00	1	1000.00	3	2	2				16a;16b;
H3660	050	0	1	01	01	H3660_050_0	12	001	Optional Supplemental Dental	25.00	1	1000.00	3	2	2				16a;16b;
H3668	013	0	1	01	01	H3668_013_0	4	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	014	0	1	01	01	H3668_014_0	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	015	0	1	01	01	H3668_015_0	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	016	0	1	01	01	H3668_016_0	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	017	0	1	01	01	H3668_017_0	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	018	1	1	01	01	H3668_018_1	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	018	2	1	01	01	H3668_018_2	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	018	3	1	01	01	H3668_018_3	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	019	1	1	01	01	H3668_019_1	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	019	2	1	01	01	H3668_019_2	5	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3668	019	3	1	01	01	H3668_019_3	6	001	Dental	16.00	1	1000.00	3	2	2			16b;	
H3749	020	0	1	01	01	H3749_020_0	6	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3805	001	0	1	01	01	H3805_001_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3805	007	0	1	01	01	H3805_007_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3805	012	0	1	01	01	H3805_012_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3805	013	0	1	01	01	H3805_013_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3805	014	0	1	01	01	H3805_014_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3805	015	0	1	01	01	H3805_015_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H3805	016	0	1	01	01	H3805_016_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3805	017	0	1	01	01	H3805_017_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3805	018	0	1	01	01	H3805_018_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3805	019	0	1	01	01	H3805_019_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3805	020	0	1	01	01	H3805_020_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3805	021	0	1	01	01	H3805_021_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H3810	001	0	1	01	01	H3810_001_0	7	001	Dental Benefit	19.00	2			2	2			16a;16b;	
H3810	003	0	1	01	01	H3810_003_0	11	001	Dental Benefit	19.00	2			2	2			16a;16b;	
H3810	020	0	1	01	01	H3810_020_0	11	001	Dental	19.00	2			2	2			16a;16b;	
H3813	001	0	1	04	01	H3813_001_0	6	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H3813	006	0	1	04	01	H3813_006_0	10	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H3813	007	0	1	04	01	H3813_007_0	10	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H3813	008	0	1	04	01	H3813_008_0	10	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H3813	009	0	1	04	01	H3813_009_0	10	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H3817	008	1	1	04	01	H3817_008_1	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H3817	008	2	1	04	01	H3817_008_2	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H3817	010	0	1	04	01	H3817_010_0	6	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H3817	011	1	1	04	01	H3817_011_1	8	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H3817	011	2	1	04	01	H3817_011_2	9	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H3822	007	0	1	02	01	H3822_007_0	9	001	Optional Supplemental	32.00	1	2150.00	6	2	2			16a;16b;17b;18a;18b;	
H3864	002	0	1	01	01	H3864_002_0	2	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	006	0	1	01	01	H3864_006_0	7	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	014	0	1	02	01	H3864_014_0	4	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	021	0	1	01	01	H3864_021_0	4	001	Preventive Dental	21.00	2			2	2			16a;	
H3864	024	0	1	02	01	H3864_024_0	4	001	Preventive Dental	21.00	2			2	2			16a;	
H3864	026	1	1	01	01	H3864_026_1	5	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	026	2	1	01	01	H3864_026_2	4	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	027	0	1	01	01	H3864_027_0	8	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	029	0	1	01	01	H3864_029_0	5	001	Preventive Dental	21.00	2			2	2			16a;	
H3864	030	0	1	01	01	H3864_030_0	2	001	Preventive Dental	21.00	2			2	2			16a;	
H3864	032	0	1	01	01	H3864_032_0	5	001	Preventive Dental	21.00	2			2	2			16a;	
H3864	033	0	1	01	01	H3864_033_0	4	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	034	0	1	01	01	H3864_034_0	4	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	035	0	1	01	01	H3864_035_0	2	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	036	0	1	01	01	H3864_036_0	4	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	037	0	1	01	01	H3864_037_0	6	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	038	0	1	01	01	H3864_038_0	4	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	039	0	1	01	01	H3864_039_0	4	001	Preventive Dental	28.00	2			2	2			16a;	
H3864	040	0	1	01	01	H3864_040_0	6	001	Preventive Dental	28.00	2			2	2			16a;	
H3890	001	0	1	04	01	H3890_001_0	10	001	Dental and Fitness	32.00	1	1200.00	3	2	2			14c;	16b;
H3890	002	0	1	04	01	H3890_002_0	9	001	Dental	28.00	1	1200.00	3	2	2				16b;
H3909	001	0	1	04	01	H3909_001_0	17	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3909	007	0	1	04	01	H3909_007_0	4	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3909	009	0	1	04	01	H3909_009_0	8	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3924	059	10	1	04	01	H3924_059_10	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	11	1	04	01	H3924_059_11	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	12	1	04	01	H3924_059_12	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	13	1	04	01	H3924_059_13	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	14	1	04	01	H3924_059_14	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	15	1	04	01	H3924_059_15	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	16	1	04	01	H3924_059_16	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	17	1	04	01	H3924_059_17	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	18	1	04	01	H3924_059_18	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	10	1	04	01	H3924_060_10	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	11	1	04	01	H3924_060_11	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	12	1	04	01	H3924_060_12	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	13	1	04	01	H3924_060_13	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	14	1	04	01	H3924_060_14	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	15	1	04	01	H3924_060_15	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	16	1	04	01	H3924_060_16	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	17	1	04	01	H3924_060_17	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	18	1	04	01	H3924_060_18	4	001	Geisinger Gold Health+	38.00	2			2	2			14c;16a;16b;17a;17b;18a;18b;	
H3931	064	0	1	01	01	H3931_064_0	3	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3931	064	0	1	01	01	H3931_064_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	20.00	2			2	2			16a;16b;17b;18b;	
H3931	095	0	1	01	01	H3931_095_0	3	001	DMO Dental	9.00	2			2	2			16a;16b;	
H3931	095	0	1	01	01	H3931_095_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	18.00	2			2	2			16a;16b;17b;18b;	
H3931	106	0	1	01	01	H3931_106_0	3	001	DMO Dental	11.00	2			2	2			16a;16b;	
H3931	106	0	1	01	01	H3931_106_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	20.00	2			2	2			16a;16b;17b;18b;	
H3931	107	0	1	01	01	H3931_107_0	3	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3931	107	0	1	01	01	H3931_107_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	19.00	2			2	2			16a;16b;17b;18b;	
H3931	110	0	1	01	01	H3931_110_0	3	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3931	110	0	1	01	01	H3931_110_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	19.00	2			2	2			16a;16b;17b;18b;	
H3931	118	0	1	01	01	H3931_118_0	3	001	DMO Dental	8.00	2			2	2			16a;16b;	
H3931	118	0	1	01	01	H3931_118_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	17.00	2			2	2			16a;16b;17b;18b;	
H3931	132	0	1	01	01	H3931_132_0	3	001	DMO Dental	10.00	2			2	2			16a;16b;	
H3931	132	0	1	01	01	H3931_132_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	19.00	2			2	2			16a;16b;17b;18b;	
H3931	133	0	1	01	01	H3931_133_0	3	001	DMO Dental	8.00	2			2	2			16a;16b;	
H3931	133	0	1	01	01	H3931_133_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	17.00	2			2	2			16a;16b;17b;18b;	
H3931	134	0	1	01	01	H3931_134_0	3	001	DMO Dental	8.00	2			2	2			16a;16b;	
H3931	134	0	1	01	01	H3931_134_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	17.00	2			2	2			16a;16b;17b;18b;	
H3952	048	0	1	01	01	H3952_048_0	2	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	048	0	1	01	01	H3952_048_0	2	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3952	049	0	1	01	01	H3952_049_0	3	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	049	0	1	01	01	H3952_049_0	3	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3952	050	0	1	01	01	H3952_050_0	2	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	050	0	1	01	01	H3952_050_0	2	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3952	051	0	1	01	01	H3952_051_0	8	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	051	0	1	01	01	H3952_051_0	8	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3952	053	0	1	02	01	H3952_053_0	3	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	053	0	1	02	01	H3952_053_0	3	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3952	054	0	1	02	01	H3952_054_0	3	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	054	0	1	02	01	H3952_054_0	3	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3952	055	0	1	01	01	H3952_055_0	3	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	055	0	1	01	01	H3952_055_0	3	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3952	056	0	1	01	01	H3952_056_0	3	001	Choice Plus Program	20.00	2			2	2			16a;16b;17a;17b;18a;18b;	
H3952	056	0	1	01	01	H3952_056_0	3	002	Choice Program	7.00	2			2	2				16a;17a;17b;18a;18b;
H3979	001	0	1	01	01	H3979_001_0	8	001	Optional Supplemental	32.00	1	2150.00	6	2	2			16a;16b;17b;18a;18b;	
H4036	008	0	1	04	01	H4036_008_0	7	001	Preventive Dental Package	15.00	2			2	2				16a;
H4036	008	0	1	04	01	H4036_008_0	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4036	008	0	1	04	01	H4036_008_0	7	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H4036	009	0	1	04	01	H4036_009_0	7	001	Preventive Dental Package	15.00	2			2	2				16a;
H4036	009	0	1	04	01	H4036_009_0	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4036	009	0	1	04	01	H4036_009_0	7	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H4036	010	1	1	04	01	H4036_010_1	7	001	Preventive Dental Package	20.00	2			2	2				16a;
H4036	010	1	1	04	01	H4036_010_1	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4036	010	1	1	04	01	H4036_010_1	7	003	Enhanced Dental and Vision Package	42.00	2			2	2				16a;16b;17b;
H4036	010	2	1	04	01	H4036_010_2	7	001	Preventive Dental Package	20.00	2			2	2				16a;
H4036	010	2	1	04	01	H4036_010_2	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4036	010	2	1	04	01	H4036_010_2	7	003	Enhanced Dental and Vision Package	42.00	2			2	2				16a;16b;17b;
H4036	016	0	1	04	01	H4036_016_0	6	001	Preventive Dental Package	15.00	2			2	2				16a;
H4036	016	0	1	04	01	H4036_016_0	6	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4036	016	0	1	04	01	H4036_016_0	6	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H4036	017	0	1	04	01	H4036_017_0	7	001	Preventive Dental Package	20.00	2			2	2				16a;
H4036	017	0	1	04	01	H4036_017_0	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4036	017	0	1	04	01	H4036_017_0	7	003	Enhanced Dental and Vision Package	42.00	2			2	2				16a;16b;17b;
H4089	001	0	1	01	01	H4089_001_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H4141	015	0	1	01	01	H4141_015_0	4	001	MyOption Enhanced Dental HMO	19.60	1	2000.00	3	2	2				16a;16b;
H4141	017	3	1	01	01	H4141_017_3	3	001	MyOption Enhanced Dental HMO	19.60	1	2000.00	3	2	2				16a;16b;
H4141	017	4	1	01	01	H4141_017_4	3	001	MyOption Enhanced Dental HMO	19.60	1	2000.00	3	2	2				16a;16b;
H4141	019	1	1	01	01	H4141_019_1	3	001	MyOption Enhanced Dental HMO	19.60	1	2000.00	3	2	2				16a;16b;
H4141	019	2	1	01	01	H4141_019_2	3	001	MyOption Enhanced Dental HMO	19.60	1	2000.00	3	2	2				16a;16b;
H4152	004	0	1	01	01	H4152_004_0	9	001	Dental Rider	21.60	1	1000.00	3	2	2			16a;16b;	
H4152	017	0	1	01	01	H4152_017_0	11	001	Dental Rider	21.60	1	1000.00	3	2	2			16a;16b;	
H4346	001	0	1	01	01	H4346_001_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H4346	005	0	1	01	01	H4346_005_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H4346	006	0	1	01	01	H4346_006_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H4346	008	0	1	01	01	H4346_008_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H4346	009	0	1	01	01	H4346_009_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H4346	010	0	1	01	01	H4346_010_0	7	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H4346	011	0	1	01	01	H4346_011_0	8	001	Optional Dental 1	35.00	1	1500.00	3	2	2				16a;16b;
H4346	012	0	1	01	01	H4346_012_0	10	001	Preventive Dental Package	6.00	2			2	2				16a;
H4346	012	0	1	01	01	H4346_012_0	10	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H4346	012	0	1	01	01	H4346_012_0	10	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H4346	013	0	1	01	01	H4346_013_0	11	001	Preventive Dental Package	6.00	2			2	2				16a;
H4346	013	0	1	01	01	H4346_013_0	11	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H4346	013	0	1	01	01	H4346_013_0	11	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H4346	017	0	1	01	01	H4346_017_0	11	001	Preventive Dental Package	13.00	2			2	2				16a;
H4346	017	0	1	01	01	H4346_017_0	11	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H4346	017	0	1	01	01	H4346_017_0	11	003	Enhanced Dental and Vision Package	40.00	2			2	2				16a;16b;17b;
H4407	011	0	1	01	01	H4407_011_0	3	001	Enhanced Dental - Comprehensive	34.70	1	1500.00	3	2	2			16b;	
H4407	026	0	1	01	01	H4407_026_0	4	001	Enhanced Dental - Comprehensive	34.70	1	1500.00	3	2	2			16b;	
H4461	030	1	1	01	01	H4461_030_1	4	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H4461	031	1	1	01	01	H4461_031_1	3	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H4461	031	2	1	01	01	H4461_031_2	4	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H4461	031	3	1	01	01	H4461_031_3	3	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H4461	034	0	1	01	01	H4461_034_0	3	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H4461	035	0	1	01	01	H4461_035_0	3	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H4461	036	0	1	01	01	H4461_036_0	3	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H4497	001	1	1	04	01	H4497_001_1	26	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H4497	001	2	1	04	01	H4497_001_2	8	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H4497	002	1	1	04	01	H4497_002_1	8	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H4497	002	2	1	04	01	H4497_002_2	8	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H4513	045	0	1	01	01	H4513_045_0	3	001	Enhanced Dental - Comprehensive	35.00	1	1500.00	3	2	2			16b;	
H4513	046	1	1	01	01	H4513_046_1	4	001	Enhanced Dental - Comprehensive	35.00	1	1500.00	3	2	2			16b;	
H4513	046	2	1	01	01	H4513_046_2	4	001	Enhanced Dental - Comprehensive	35.00	1	1500.00	3	2	2			16b;	
H4514	007	0	1	01	01	H4514_007_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4527	002	0	1	01	01	H4527_002_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4527	024	0	1	01	01	H4527_024_0	2	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H4527	037	0	1	01	01	H4527_037_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H4527	038	0	1	01	01	H4527_038_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4590	012	0	1	01	01	H4590_012_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4590	025	0	1	01	01	H4590_025_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H4590	027	0	1	01	01	H4590_027_0	2	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4590	042	0	1	01	01	H4590_042_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4604	003	0	1	01	01	H4604_003_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H4604	011	0	1	01	01	H4604_011_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4604	012	0	1	01	01	H4604_012_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H4605	001	0	1	04	01	H4605_001_0	6	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H4605	002	0	1	04	01	H4605_002_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H4605	007	0	1	04	01	H4605_007_0	8	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H4754	004	0	1	04	01	H4754_004_0	5	001	Preventive Dental	28.00	2			2	2			16a;	
H4754	006	0	1	04	01	H4754_006_0	2	001	Preventive Dental	21.00	2			2	2			16a;	
H4754	007	0	1	04	01	H4754_007_0	6	001	Preventive Dental	28.00	2			2	2			16a;	
H4754	008	0	1	04	01	H4754_008_0	2	001	Preventive Dental	28.00	2			2	2			16a;	
H4754	009	0	1	04	01	H4754_009_0	5	001	Preventive Dental	21.00	2			2	2			16a;	
H4754	011	0	1	04	01	H4754_011_0	6	001	Preventive Dental	21.00	2			2	2			16a;	
H4754	012	0	1	04	01	H4754_012_0	2	001	Preventive Dental	21.00	2			2	2			16a;	
H4853	001	0	1	01	01	H4853_001_0	9	001	AZ HMO Comprehensive Dental	17.00	2			2	2			16b;	
H4853	001	0	1	01	01	H4853_001_0	9	002	AZ HMO Vision Materials	4.00	2			2	2			17b;	
H4853	003	0	1	02	01	H4853_003_0	9	001	AZ HMO Comprehensive Dental	17.00	2			2	2			16b;	
H4853	003	0	1	02	01	H4853_003_0	9	002	AZ HMO Vision Materials	4.00	2			2	2			17b;	
H4875	016	1	1	04	01	H4875_016_1	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	016	2	1	04	01	H4875_016_2	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	016	3	1	04	01	H4875_016_3	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	016	4	1	04	01	H4875_016_4	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	016	5	1	04	01	H4875_016_5	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	017	1	1	04	01	H4875_017_1	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	017	2	1	04	01	H4875_017_2	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	017	3	1	04	01	H4875_017_3	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	017	4	1	04	01	H4875_017_4	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	017	5	1	04	01	H4875_017_5	13	001	Enhanced Vision, Dental and Hearing	27.20	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	018	1	1	04	01	H4875_018_1	13	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	018	2	1	04	01	H4875_018_2	13	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	018	3	1	04	01	H4875_018_3	13	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	018	4	1	04	01	H4875_018_4	13	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4875	018	5	1	04	01	H4875_018_5	13	001	Enhanced Vision, Dental and Hearing	32.00	1	2100.00	6	2	2			16b;17a;17b;18a;18b;	16a;
H4882	001	0	1	04	01	H4882_001_0	6	001	Journey Comprehensive Dental Benefit	43.10	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H4882	002	0	1	04	01	H4882_002_0	6	001	Journey Comprehensive Dental Benefit	43.10	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H4882	003	0	1	04	01	H4882_003_0	6	001	Journey Comprehensive Dental Benefit	34.50	1	1100.00	3	2	1	50.00	16b;		16a;16b;
H4909	014	0	1	04	01	H4909_014_0	6	001	Preventive Dental Package	22.00	2			2	2				16a;
H4909	014	0	1	04	01	H4909_014_0	6	002	Dental and Vision Package	31.00	2			2	2				16a;16b;17b;
H4909	014	0	1	04	01	H4909_014_0	6	003	Enhanced Dental and Vision Package	49.00	2			2	2				16a;16b;17b;
H4909	015	0	1	04	01	H4909_015_0	8	001	Preventive Dental Package	19.00	2			2	2				16a;
H4909	015	0	1	04	01	H4909_015_0	8	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4909	015	0	1	04	01	H4909_015_0	8	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H4909	016	0	1	04	01	H4909_016_0	7	001	Preventive Dental Package	19.00	2			2	2				16a;
H4909	016	0	1	04	01	H4909_016_0	7	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
H4909	016	0	1	04	01	H4909_016_0	7	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H4922	008	0	1	01	01	H4922_008_0	9	001	Preventive and Comprehensive Dental	16.00	2			1	2			16a;16b;	
H4922	011	0	1	01	01	H4922_011_0	9	001	Preventive and Comprehensive Dental	16.00	2			1	2			16a;16b;	
H4922	011	0	1	01	01	H4922_011_0	9	002	Routine Eye Exams and Eye Wear	9.00	2			2	2			17a;17b;	
H5009	001	0	1	04	01	H5009_001_0	6	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H5009	002	0	1	04	01	H5009_002_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H5009	008	0	1	04	01	H5009_008_0	9	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H5010	001	0	1	04	01	H5010_001_0	6	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H5010	002	0	1	04	01	H5010_002_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H5050	001	0	1	01	01	H5050_001_0	4	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5050	004	0	1	01	01	H5050_004_0	6	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5050	009	0	1	01	01	H5050_009_0	6	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5050	013	0	1	01	01	H5050_013_0	6	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5050	017	0	1	01	01	H5050_017_0	5	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5050	019	0	1	01	01	H5050_019_0	6	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5050	021	0	1	01	01	H5050_021_0	5	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5050	022	0	1	01	01	H5050_022_0	5	001	Dental HMO	54.00	1	1500.00	3	2	2			16a;16b;	
H5215	001	0	1	04	01	H5215_001_0	8	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5215	002	0	1	04	01	H5215_002_0	10	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5215	005	0	1	04	01	H5215_005_0	9	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5215	006	0	1	04	01	H5215_006_0	7	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5215	008	0	1	04	01	H5215_008_0	9	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5215	009	0	1	04	01	H5215_009_0	9	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5215	010	0	1	04	01	H5215_010_0	9	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5215	011	0	1	04	01	H5215_011_0	9	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5216	001	0	1	04	01	H5216_001_0	5	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	001	0	1	04	01	H5216_001_0	5	002	MyOption Enhanced Dental PPO	29.40	1	2000.00	3	2	2				16a;16b;
H5216	006	0	1	04	01	H5216_006_0	5	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	006	0	1	04	01	H5216_006_0	5	002	MyOption Dental Enriched PPO	29.40	1	2000.00	3	2	2				16a;16b;
H5216	009	0	1	04	01	H5216_009_0	4	001	MyOption Enhanced Dental PPO	23.30	1	2000.00	3	2	2				16a;16b;
H5216	009	0	1	04	01	H5216_009_0	4	002	MyOption Total Dental PPO	28.30	1	2000.00	3	2	2				16a;16b;
H5216	011	0	1	04	01	H5216_011_0	4	001	MyOption Enhanced Dental PPO	23.30	1	2000.00	3	2	2				16a;16b;
H5216	011	0	1	04	01	H5216_011_0	4	002	MyOption Total Dental PPO	28.30	1	2000.00	3	2	2				16a;16b;
H5216	013	0	1	04	01	H5216_013_0	5	001	MyOption Enhanced Dental PPO	19.60	1	2000.00	3	2	2				16a;16b;
H5216	014	0	1	04	01	H5216_014_0	5	001	MyOption Dental High PPO	17.30	1	2000.00	3	2	2			16a;16b;	
H5216	014	0	1	04	01	H5216_014_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	014	0	1	04	01	H5216_014_0	5	003	MyOption Plus	20.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	015	1	1	04	01	H5216_015_1	4	001	MyOption Enhanced Dental PPO	21.70	1	2000.00	3	2	2				16a;16b;
H5216	015	1	1	04	01	H5216_015_1	4	002	MyOption Total Dental PPO	25.70	1	2000.00	3	2	2				16a;16b;
H5216	015	2	1	04	01	H5216_015_2	4	001	MyOption Enhanced Dental PPO	21.70	1	2000.00	3	2	2				16a;16b;
H5216	015	2	1	04	01	H5216_015_2	4	002	MyOption Total Dental PPO	25.70	1	2000.00	3	2	2				16a;16b;
H5216	017	0	1	04	01	H5216_017_0	4	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H5216	017	0	1	04	01	H5216_017_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	017	0	1	04	01	H5216_017_0	4	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	018	0	1	04	01	H5216_018_0	3	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5216	018	0	1	04	01	H5216_018_0	3	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5216	019	0	1	04	01	H5216_019_0	3	001	MyOption Enhanced Dental PPO	18.00	1	2000.00	3	2	2				16a;16b;
H5216	019	0	1	04	01	H5216_019_0	3	002	MyOption Total Dental PPO	21.60	1	2000.00	3	2	2				16a;16b;
H5216	020	0	1	04	01	H5216_020_0	3	001	MyOption Enhanced Dental PPO	18.00	1	2000.00	3	2	2				16a;16b;
H5216	020	0	1	04	01	H5216_020_0	3	002	MyOption Total Dental PPO	21.60	1	2000.00	3	2	2				16a;16b;
H5216	021	0	1	04	01	H5216_021_0	3	001	MyOption Enhanced Dental PPO	20.70	1	2000.00	3	2	2				16a;16b;
H5216	021	0	1	04	01	H5216_021_0	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	022	0	1	04	01	H5216_022_0	3	001	MyOption Enhanced Dental PPO	20.70	1	2000.00	3	2	2				16a;16b;
H5216	022	0	1	04	01	H5216_022_0	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	023	0	1	04	01	H5216_023_0	3	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5216	023	0	1	04	01	H5216_023_0	3	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5216	024	0	1	04	01	H5216_024_0	4	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H5216	024	0	1	04	01	H5216_024_0	4	002	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H5216	025	0	1	04	01	H5216_025_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	025	0	1	04	01	H5216_025_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	025	0	1	04	01	H5216_025_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H5216	026	0	1	04	01	H5216_026_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	026	0	1	04	01	H5216_026_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	026	0	1	04	01	H5216_026_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H5216	027	0	1	04	01	H5216_027_0	4	001	MyOption Platinum Dental	25.30	1	2000.00	3	2	2			16a;16b;	
H5216	028	0	1	04	01	H5216_028_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	028	0	1	04	01	H5216_028_0	4	002	MyOption Plus	28.20	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	028	0	1	04	01	H5216_028_0	4	003	MyOption Platinum Dental	33.80	1	2000.00	3	2	2				16a;16b;
H5216	029	0	1	04	01	H5216_029_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	029	0	1	04	01	H5216_029_0	4	002	MyOption Enhanced Dental PPO	24.70	1	2000.00	3	2	2				16a;16b;
H5216	029	0	1	04	01	H5216_029_0	4	003	MyOption Total Dental PPO	29.80	1	2000.00	3	2	2				16a;16b;
H5216	034	0	1	04	01	H5216_034_0	5	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	034	0	1	04	01	H5216_034_0	5	002	MyOption Enhanced Dental PPO	26.60	1	2000.00	3	2	2				16a;16b;
H5216	035	0	1	04	01	H5216_035_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	035	0	1	04	01	H5216_035_0	4	002	MyOption Dental Enriched PPO	26.60	1	2000.00	3	2	2				16a;16b;
H5216	036	0	1	04	01	H5216_036_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	036	0	1	04	01	H5216_036_0	4	002	MyOption Dental Enriched PPO	30.20	1	2000.00	3	2	2				16a;16b;
H5216	036	0	1	04	01	H5216_036_0	4	003	MyOption Total Dental PPO	35.70	1	2000.00	3	2	2				16a;16b;
H5216	037	0	1	04	01	H5216_037_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	037	0	1	04	01	H5216_037_0	4	002	MyOption Plus	24.60	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	037	0	1	04	01	H5216_037_0	4	003	MyOption Platinum Dental	35.70	1	2000.00	3	2	2				16a;16b;
H5216	039	0	1	04	01	H5216_039_0	4	001	MyOption Dental High PPO	30.20	1	2000.00	3	2	2			16a;16b;	
H5216	039	0	1	04	01	H5216_039_0	4	002	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	039	0	1	04	01	H5216_039_0	4	003	MyOption Plus	24.60	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	041	0	1	04	01	H5216_041_0	3	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	041	0	1	04	01	H5216_041_0	3	002	MyOption Enhanced Dental PPO	30.50	1	2000.00	3	2	2				16a;16b;
H5216	041	0	1	04	01	H5216_041_0	3	003	MyOption Total Dental PPO	35.60	1	2000.00	3	2	2				16a;16b;
H5216	044	0	1	04	01	H5216_044_0	5	001	MyOption Platinum Dental	28.60	1	2000.00	3	2	2			16a;16b;	
H5216	045	0	1	04	01	H5216_045_0	3	001	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
H5216	045	0	1	04	01	H5216_045_0	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	047	0	1	04	01	H5216_047_0	4	001	MyOption Dental High PPO	36.20	1	2000.00	3	2	2			16a;16b;	
H5216	048	0	1	04	01	H5216_048_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	048	0	1	04	01	H5216_048_0	4	002	MyOption Total Dental Plus PPO	54.00	1	2000.00	3	2	2				16a;16b;
H5216	050	0	1	04	01	H5216_050_0	3	001	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
H5216	050	0	1	04	01	H5216_050_0	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	051	0	1	04	01	H5216_051_0	3	001	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
H5216	051	0	1	04	01	H5216_051_0	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	052	1	1	04	01	H5216_052_1	3	001	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
H5216	052	1	1	04	01	H5216_052_1	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	052	2	1	04	01	H5216_052_2	3	001	MyOption Enhanced Dental PPO	20.70	1	2000.00	3	2	2				16a;16b;
H5216	052	2	1	04	01	H5216_052_2	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	053	0	1	04	01	H5216_053_0	3	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5216	053	0	1	04	01	H5216_053_0	3	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5216	054	0	1	04	01	H5216_054_0	3	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5216	054	0	1	04	01	H5216_054_0	3	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5216	055	0	1	04	01	H5216_055_0	3	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5216	055	0	1	04	01	H5216_055_0	3	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5216	057	0	1	04	01	H5216_057_0	5	001	MyOption Enhanced Dental PPO	29.10	1	2000.00	3	2	2				16a;16b;
H5216	057	0	1	04	01	H5216_057_0	5	002	MyOption Total Dental PPO	34.30	1	2000.00	3	2	2				16a;16b;
H5216	058	0	1	04	01	H5216_058_0	5	001	MyOption Platinum Dental	34.30	1	2000.00	3	2	2			16a;16b;	
H5216	059	0	1	04	01	H5216_059_0	2	001	MyOption Platinum Dental	34.30	1	2000.00	3	2	2			16a;16b;	
H5216	066	0	1	04	01	H5216_066_0	3	001	MyOption Total Dental PPO	19.20	1	2000.00	3	2	2				16a;16b;
H5216	067	0	1	04	01	H5216_067_0	3	001	MyOption Total Dental PPO	19.20	1	2000.00	3	2	2				16a;16b;
H5216	071	0	1	04	01	H5216_071_0	3	001	MyOption Dental Enriched PPO	16.90	1	2000.00	3	2	2				16a;16b;
H5216	073	0	1	04	01	H5216_073_0	3	001	MyOption Dental High PPO	16.90	1	2000.00	3	2	2			16a;16b;	
H5216	073	0	1	04	01	H5216_073_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	073	0	1	04	01	H5216_073_0	3	003	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	075	0	1	04	01	H5216_075_0	4	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H5216	075	0	1	04	01	H5216_075_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	075	0	1	04	01	H5216_075_0	4	003	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	076	0	1	04	01	H5216_076_0	3	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H5216	076	0	1	04	01	H5216_076_0	3	002	MyOption Platinum Dental	22.00	1	2000.00	3	2	2				16a;16b;
H5216	077	0	1	04	01	H5216_077_0	5	001	MyOption Enhanced Dental PPO	25.10	1	2000.00	3	2	2				16a;16b;
H5216	078	1	1	04	01	H5216_078_1	5	001	MyOption Dental High PPO	25.10	1	2000.00	3	2	2			16a;16b;	
H5216	078	2	1	04	01	H5216_078_2	4	001	MyOption Dental High PPO	25.10	1	2000.00	3	2	2			16a;16b;	
H5216	081	0	1	04	01	H5216_081_0	4	001	MyOption Dental Enriched PPO	19.70	1	2000.00	3	2	2				16a;16b;
H5216	083	0	1	04	01	H5216_083_0	3	001	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
H5216	083	0	1	04	01	H5216_083_0	3	002	MyOption Total Dental PPO	23.70	1	2000.00	3	2	2				16a;16b;
H5216	085	0	1	04	01	H5216_085_0	5	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5216	085	0	1	04	01	H5216_085_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	085	0	1	04	01	H5216_085_0	5	003	MyOption Plus	21.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	086	0	1	04	01	H5216_086_0	4	001	MyOption Enhanced Dental Plus PPO	40.90	1	2000.00	3	2	2				16a;16b;
H5216	088	0	1	04	01	H5216_088_0	5	001	MyOption Dental Enriched PPO	25.20	1	2000.00	3	2	2				16a;16b;
H5216	089	0	1	04	01	H5216_089_0	5	001	MyOption Dental High PPO	21.00	1	2000.00	3	2	2			16a;16b;	
H5216	089	0	1	04	01	H5216_089_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	089	0	1	04	01	H5216_089_0	5	003	MyOption Plus	22.90	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	091	0	1	04	01	H5216_091_0	5	001	MyOption Dental High PPO	17.30	1	2000.00	3	2	2			16a;16b;	
H5216	091	0	1	04	01	H5216_091_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	091	0	1	04	01	H5216_091_0	5	003	MyOption Plus	20.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	092	0	1	04	01	H5216_092_0	5	001	MyOption Dental High PPO	30.50	1	2000.00	3	2	2			16a;16b;	
H5216	092	0	1	04	01	H5216_092_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	092	0	1	04	01	H5216_092_0	5	003	MyOption Plus	26.00	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	093	0	1	04	01	H5216_093_0	4	001	MyOption Dental High PPO	19.30	1	2000.00	3	2	2			16a;16b;	
H5216	094	0	1	04	01	H5216_094_0	3	001	MyOption Dental High PPO	15.20	1	2000.00	3	2	2			16a;16b;	
H5216	096	0	1	04	01	H5216_096_0	3	001	MyOption Dental High PPO	15.20	1	2000.00	3	2	2			16a;16b;	
H5216	097	0	1	04	01	H5216_097_0	3	001	MyOption Dental High PPO	19.30	1	2000.00	3	2	2			16a;16b;	
H5216	098	0	1	04	01	H5216_098_0	4	001	MyOption Dental High PPO	19.30	1	2000.00	3	2	2			16a;16b;	
H5216	100	0	1	04	01	H5216_100_0	3	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5216	104	0	1	04	01	H5216_104_0	5	001	MyOption Enhanced Dental PPO	17.30	1	2000.00	3	2	2				16a;16b;
H5216	105	0	1	04	01	H5216_105_0	2	001	MyOption Enhanced Dental PPO	18.00	1	2000.00	3	2	2				16a;16b;
H5216	105	0	1	04	01	H5216_105_0	2	002	MyOption Total Dental PPO	21.60	1	2000.00	3	2	2				16a;16b;
H5216	106	0	1	04	01	H5216_106_0	3	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H5216	106	0	1	04	01	H5216_106_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	106	0	1	04	01	H5216_106_0	3	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H5216	107	0	1	04	01	H5216_107_0	4	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5216	107	0	1	04	01	H5216_107_0	4	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5216	108	0	1	04	01	H5216_108_0	3	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H5216	108	0	1	04	01	H5216_108_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	108	0	1	04	01	H5216_108_0	3	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H5216	109	0	1	04	01	H5216_109_0	3	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H5216	109	0	1	04	01	H5216_109_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	109	0	1	04	01	H5216_109_0	3	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H5216	110	0	1	04	01	H5216_110_0	3	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H5216	110	0	1	04	01	H5216_110_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	110	0	1	04	01	H5216_110_0	3	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H5216	111	0	1	04	01	H5216_111_0	3	001	MyOption Dental High PPO	21.10	1	2000.00	3	2	2			16a;16b;	
H5216	111	0	1	04	01	H5216_111_0	3	002	MyOption Platinum Dental	25.00	1	2000.00	3	2	2				16a;16b;
H5216	112	0	1	04	01	H5216_112_0	3	001	MyOption Dental High PPO	21.10	1	2000.00	3	2	2			16a;16b;	
H5216	112	0	1	04	01	H5216_112_0	3	002	MyOption Platinum Dental	25.00	1	2000.00	3	2	2				16a;16b;
H5216	113	0	1	04	01	H5216_113_0	3	001	MyOption Dental High PPO	21.10	1	2000.00	3	2	2			16a;16b;	
H5216	113	0	1	04	01	H5216_113_0	3	002	MyOption Platinum Dental	25.00	1	2000.00	3	2	2				16a;16b;
H5216	114	0	1	04	01	H5216_114_0	3	001	MyOption Dental High PPO	21.10	1	2000.00	3	2	2			16a;16b;	
H5216	114	0	1	04	01	H5216_114_0	3	002	MyOption Platinum Dental	25.00	1	2000.00	3	2	2				16a;16b;
H5216	116	0	1	04	01	H5216_116_0	2	001	MyOption Enhanced Dental PPO	18.90	1	2000.00	3	2	2				16a;16b;
H5216	116	0	1	04	01	H5216_116_0	2	002	MyOption Total Dental PPO	23.00	1	2000.00	3	2	2				16a;16b;
H5216	119	0	1	04	01	H5216_119_0	5	001	MyOption Enhanced Dental Plus PPO	25.20	1	2000.00	3	2	2				16a;16b;
H5216	119	0	1	04	01	H5216_119_0	5	002	MyOption Total Dental Plus PPO	29.30	1	2000.00	3	2	2				16a;16b;
H5216	120	0	1	04	01	H5216_120_0	5	001	MyOption Enhanced Dental Plus PPO	25.20	1	2000.00	3	2	2				16a;16b;
H5216	120	0	1	04	01	H5216_120_0	5	002	MyOption Total Dental Plus PPO	29.30	1	2000.00	3	2	2				16a;16b;
H5216	121	0	1	04	01	H5216_121_0	5	001	MyOption Enhanced Dental Plus PPO	25.20	1	2000.00	3	2	2				16a;16b;
H5216	121	0	1	04	01	H5216_121_0	5	002	MyOption Total Dental Plus PPO	29.30	1	2000.00	3	2	2				16a;16b;
H5216	122	0	1	04	01	H5216_122_0	4	001	MyOption Enhanced Dental PPO	18.90	1	2000.00	3	2	2				16a;16b;
H5216	122	0	1	04	01	H5216_122_0	4	002	MyOption Total Dental PPO	23.00	1	2000.00	3	2	2				16a;16b;
H5216	123	0	1	04	01	H5216_123_0	2	001	MyOption Enhanced Dental PPO	20.70	1	2000.00	3	2	2				16a;16b;
H5216	123	0	1	04	01	H5216_123_0	2	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	124	0	1	04	01	H5216_124_0	5	001	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5216	127	0	1	04	01	H5216_127_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	127	0	1	04	01	H5216_127_0	3	002	MyOption Plus	28.20	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	127	0	1	04	01	H5216_127_0	3	003	MyOption Platinum Dental	33.80	1	2000.00	3	2	2				16a;16b;
H5216	128	0	1	04	01	H5216_128_0	2	001	MyOption Dental High PPO	16.60	1	2000.00	3	2	2			16a;16b;	
H5216	129	0	1	04	01	H5216_129_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	129	0	1	04	01	H5216_129_0	3	002	MyOption Enhanced Dental PPO	24.70	1	2000.00	3	2	2				16a;16b;
H5216	129	0	1	04	01	H5216_129_0	3	003	MyOption Total Dental PPO	29.80	1	2000.00	3	2	2				16a;16b;
H5216	131	0	1	04	01	H5216_131_0	4	001	MyOption Enhanced Dental PPO	24.00	1	2000.00	3	2	2				16a;16b;
H5216	132	0	1	04	01	H5216_132_0	4	001	MyOption Dental High PPO	24.60	1	2000.00	3	2	2			16a;16b;	
H5216	133	0	1	04	01	H5216_133_0	4	001	MyOption Enhanced Dental PPO	23.30	1	2000.00	3	2	2				16a;16b;
H5216	133	0	1	04	01	H5216_133_0	4	002	MyOption Total Dental PPO	28.30	1	2000.00	3	2	2				16a;16b;
H5216	136	0	1	04	01	H5216_136_0	3	001	MyOption Total Dental PPO	19.20	1	2000.00	3	2	2				16a;16b;
H5216	137	0	1	04	01	H5216_137_0	4	001	MyOption Dental High PPO	19.20	1	2000.00	3	2	2			16a;16b;	
H5216	138	0	1	04	01	H5216_138_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	138	0	1	04	01	H5216_138_0	3	002	MyOption Fitness	15.00	2			2	2			14c;	
H5216	138	0	1	04	01	H5216_138_0	3	003	MyOption Platinum Dental	34.30	1	2000.00	3	2	2			16a;16b;	
H5216	139	0	1	04	01	H5216_139_0	3	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	139	0	1	04	01	H5216_139_0	3	002	MyOption Dental Enriched PPO	19.70	1	2000.00	3	2	2				16a;16b;
H5216	140	0	1	04	01	H5216_140_0	2	001	MyOption Dental Enriched PPO	19.90	1	2000.00	3	2	2				16a;16b;
H5216	141	0	1	04	01	H5216_141_0	4	001	MyOption Dental Enriched PPO	30.20	1	2000.00	3	2	2				16a;16b;
H5216	142	1	1	04	01	H5216_142_1	3	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H5216	142	1	1	04	01	H5216_142_1	3	002	MyOption Platinum Dental	22.00	1	2000.00	3	2	2				16a;16b;
H5216	142	2	1	04	01	H5216_142_2	3	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H5216	142	2	1	04	01	H5216_142_2	3	002	MyOption Platinum Dental	22.00	1	2000.00	3	2	2				16a;16b;
H5216	143	0	1	04	01	H5216_143_0	4	001	MyOption Enhanced Dental PPO	16.90	1	2000.00	3	2	2				16a;16b;
H5216	144	0	1	04	01	H5216_144_0	4	001	MyOption Platinum Dental	25.30	1	2000.00	3	2	2			16a;16b;	
H5216	146	0	1	04	01	H5216_146_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	146	0	1	04	01	H5216_146_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	146	0	1	04	01	H5216_146_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H5216	147	0	1	04	01	H5216_147_0	3	001	MyOption Enhanced Dental PPO	16.90	1	2000.00	3	2	2				16a;16b;
H5216	148	0	1	04	01	H5216_148_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	148	0	1	04	01	H5216_148_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	148	0	1	04	01	H5216_148_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H5216	150	0	1	04	01	H5216_150_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	150	0	1	04	01	H5216_150_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	150	0	1	04	01	H5216_150_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H5216	151	0	1	04	01	H5216_151_0	4	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5216	151	0	1	04	01	H5216_151_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	151	0	1	04	01	H5216_151_0	4	003	MyOption Plus	21.40	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	152	0	1	04	01	H5216_152_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	152	0	1	04	01	H5216_152_0	3	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5216	152	0	1	04	01	H5216_152_0	3	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H5216	154	0	1	04	01	H5216_154_0	3	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H5216	154	0	1	04	01	H5216_154_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	154	0	1	04	01	H5216_154_0	3	003	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	156	0	1	04	01	H5216_156_0	3	001	MyOption Enhanced Dental PPO	17.80	1	2000.00	3	2	2				16a;16b;
H5216	158	0	1	04	01	H5216_158_0	4	001	MyOption Total Dental PPO	19.20	1	2000.00	3	2	2				16a;16b;
H5216	159	0	1	04	01	H5216_159_0	3	001	MyOption Total Dental PPO	19.20	1	2000.00	3	2	2				16a;16b;
H5216	163	0	1	04	01	H5216_163_0	3	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H5216	163	0	1	04	01	H5216_163_0	3	002	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	163	0	1	04	01	H5216_163_0	3	003	MyOption Plus	21.80	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5216	169	0	1	04	01	H5216_169_0	4	001	MyOption Enhanced Dental PPO	27.60	1	2000.00	3	2	2				16a;16b;
H5216	169	0	1	04	01	H5216_169_0	4	002	MyOption Total Dental PPO	32.50	1	2000.00	3	2	2				16a;16b;
H5216	170	0	1	04	01	H5216_170_0	4	001	MyOption Enhanced Dental PPO	27.60	1	2000.00	3	2	2				16a;16b;
H5216	170	0	1	04	01	H5216_170_0	4	002	MyOption Total Dental PPO	32.50	1	2000.00	3	2	2				16a;16b;
H5216	172	0	1	04	01	H5216_172_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	172	0	1	04	01	H5216_172_0	4	002	MyOption Fitness	15.00	2			2	2			14c;	
H5216	172	0	1	04	01	H5216_172_0	4	003	MyOption Platinum Dental	32.50	1	2000.00	3	2	2			16a;16b;	
H5216	174	0	1	04	01	H5216_174_0	3	001	MyOption Total Dental PPO	32.50	1	2000.00	3	2	2				16a;16b;
H5216	175	0	1	04	01	H5216_175_0	5	001	MyOption Platinum Dental	29.60	1	2000.00	3	2	2			16a;16b;	
H5216	177	0	1	04	01	H5216_177_0	5	001	MyOption Enhanced Dental PPO	25.20	1	2000.00	3	2	2				16a;16b;
H5216	177	0	1	04	01	H5216_177_0	5	002	MyOption Total Dental PPO	29.60	1	2000.00	3	2	2				16a;16b;
H5216	178	1	1	04	01	H5216_178_1	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	178	1	1	04	01	H5216_178_1	4	002	MyOption Enhanced Dental Plus PPO	38.70	1	2000.00	3	2	2				16a;16b;
H5216	182	0	1	04	01	H5216_182_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	182	0	1	04	01	H5216_182_0	3	002	MyOption Platinum Dental	24.20	1	2000.00	3	2	2			16a;16b;	
H5216	183	0	1	04	01	H5216_183_0	3	001	MyOption Enhanced Dental PPO	27.60	1	2000.00	3	2	2				16a;16b;
H5216	183	0	1	04	01	H5216_183_0	3	002	MyOption Total Dental PPO	32.50	1	2000.00	3	2	2				16a;16b;
H5216	184	0	1	04	01	H5216_184_0	3	001	MyOption Enhanced Dental PPO	27.60	1	2000.00	3	2	2				16a;16b;
H5216	184	0	1	04	01	H5216_184_0	3	002	MyOption Total Dental PPO	32.50	1	2000.00	3	2	2				16a;16b;
H5216	185	0	1	04	01	H5216_185_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	185	0	1	04	01	H5216_185_0	3	002	MyOption Platinum Dental	32.50	1	2000.00	3	2	2			16a;16b;	
H5216	187	0	1	04	01	H5216_187_0	5	001	MyOption Enhanced Dental PPO	18.00	1	2000.00	3	2	2				16a;16b;
H5216	187	0	1	04	01	H5216_187_0	5	002	MyOption Total Dental PPO	21.60	1	2000.00	3	2	2				16a;16b;
H5216	188	0	1	04	01	H5216_188_0	3	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5216	188	0	1	04	01	H5216_188_0	3	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5216	189	0	1	04	01	H5216_189_0	4	001	MyOption Platinum Dental	28.20	1	2000.00	3	2	2			16a;16b;	
H5216	190	0	1	04	01	H5216_190_0	5	001	MyOption Enhanced Dental PPO	23.30	1	2000.00	3	2	2				16a;16b;
H5216	190	0	1	04	01	H5216_190_0	5	002	MyOption Total Dental PPO	28.30	1	2000.00	3	2	2				16a;16b;
H5216	192	0	1	04	01	H5216_192_0	4	001	MyOption Dental High PPO	21.10	1	2000.00	3	2	2			16a;16b;	
H5216	192	0	1	04	01	H5216_192_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5216	192	0	1	04	01	H5216_192_0	4	003	MyOption Platinum Dental	25.00	1	2000.00	3	2	2				16a;16b;
H5216	194	0	1	04	01	H5216_194_0	4	001	MyOption Enhanced Dental PPO	30.20	1	2000.00	3	2	2				16a;16b;
H5216	194	0	1	04	01	H5216_194_0	4	002	MyOption Total Dental PPO	35.70	1	2000.00	3	2	2				16a;16b;
H5216	196	1	1	04	01	H5216_196_1	4	001	MyOption Dental High PPO	19.20	1	2000.00	3	2	2			16a;16b;	
H5216	196	2	1	04	01	H5216_196_2	4	001	MyOption Dental High PPO	19.20	1	2000.00	3	2	2			16a;16b;	
H5216	198	0	1	04	01	H5216_198_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5216	198	0	1	04	01	H5216_198_0	4	002	MyOption Enhanced Dental PPO	26.60	1	2000.00	3	2	2				16a;16b;
H5253	004	0	1	01	01	H5253_004_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	011	0	1	01	01	H5253_011_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	030	0	1	01	01	H5253_030_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	033	0	1	01	01	H5253_033_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	034	0	1	01	01	H5253_034_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	035	0	1	02	01	H5253_035_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	036	0	1	01	01	H5253_036_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	037	0	1	01	01	H5253_037_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	038	0	1	01	01	H5253_038_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	039	0	1	01	01	H5253_039_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	044	0	1	01	01	H5253_044_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	045	0	1	01	01	H5253_045_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	046	0	1	01	01	H5253_046_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	049	0	1	01	01	H5253_049_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	052	0	1	01	01	H5253_052_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	057	0	1	01	01	H5253_057_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	062	0	1	01	01	H5253_062_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	067	0	1	01	01	H5253_067_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	072	0	1	01	01	H5253_072_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	073	0	1	01	01	H5253_073_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	074	0	1	01	01	H5253_074_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	075	0	1	01	01	H5253_075_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	076	0	1	01	01	H5253_076_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	077	0	1	01	01	H5253_077_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	079	0	1	01	01	H5253_079_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	080	0	1	01	01	H5253_080_0	5	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	081	0	1	01	01	H5253_081_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	082	0	1	01	01	H5253_082_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	083	0	1	01	01	H5253_083_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	084	0	1	01	01	H5253_084_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	091	0	1	01	01	H5253_091_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	097	0	1	01	01	H5253_097_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	099	0	1	01	01	H5253_099_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	100	0	1	01	01	H5253_100_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	102	0	1	01	01	H5253_102_0	7	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	103	0	1	01	01	H5253_103_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5253	104	0	1	01	01	H5253_104_0	6	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H5253	105	0	1	01	01	H5253_105_0	6	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H5256	004	0	1	18	06	H5256_004_0	1	001	Out of Network Benefit	25.00	2			2	2				13d;
H5377	001	0	1	01	01	H5377_001_0	4	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5386	003	0	1	01	01	H5386_003_0	3	001	Delta Dental Advantage for Sharp Health Plan	11.00	2			2	2			16a;16b;	
H5410	004	0	1	01	01	H5410_004_0	4	001	Enhanced Dental - Comprehensive	29.60	1	1500.00	3	2	2			16b;	
H5410	018	0	1	01	01	H5410_018_0	6	001	Enhanced Dental - Comprehensive	29.60	1	1500.00	3	2	2			16b;	
H5422	008	0	1	01	01	H5422_008_0	8	001	Preventive Dental Package	14.00	2			2	2				16a;
H5422	008	0	1	01	01	H5422_008_0	8	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H5422	008	0	1	01	01	H5422_008_0	8	003	Enhanced Dental and Vision Package	43.00	2			2	2				16a;16b;17b;
H5422	011	0	1	01	01	H5422_011_0	11	001	Preventive Dental Package	14.00	2			2	2				16a;
H5422	011	0	1	01	01	H5422_011_0	11	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H5422	011	0	1	01	01	H5422_011_0	11	003	Enhanced Dental and Vision Package	43.00	2			2	2				16a;16b;17b;
H5425	001	0	1	01	01	H5425_001_0	4	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	001	0	1	01	01	H5425_001_0	4	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	004	0	1	01	01	H5425_004_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	004	0	1	01	01	H5425_004_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	005	0	1	01	01	H5425_005_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	005	0	1	01	01	H5425_005_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	006	0	1	01	01	H5425_006_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	006	0	1	01	01	H5425_006_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	007	0	1	01	01	H5425_007_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	007	0	1	01	01	H5425_007_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	008	0	1	01	01	H5425_008_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	008	0	1	01	01	H5425_008_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	009	0	1	01	01	H5425_009_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	009	0	1	01	01	H5425_009_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	019	0	1	01	01	H5425_019_0	4	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	019	0	1	01	01	H5425_019_0	4	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	020	0	1	01	01	H5425_020_0	4	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	020	0	1	01	01	H5425_020_0	4	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	028	0	1	01	01	H5425_028_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	028	0	1	01	01	H5425_028_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	033	0	1	01	01	H5425_033_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	033	0	1	01	01	H5425_033_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	034	0	1	01	01	H5425_034_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	034	0	1	01	01	H5425_034_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	052	0	1	01	01	H5425_052_0	4	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	052	0	1	01	01	H5425_052_0	4	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	053	0	1	01	01	H5425_053_0	4	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	053	0	1	01	01	H5425_053_0	4	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	054	0	1	01	01	H5425_054_0	4	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	054	0	1	01	01	H5425_054_0	4	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	055	0	1	01	01	H5425_055_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	055	0	1	01	01	H5425_055_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	061	0	1	01	01	H5425_061_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	061	0	1	01	01	H5425_061_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5425	064	0	1	01	01	H5425_064_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H5425	064	0	1	01	01	H5425_064_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H5439	010	0	1	04	01	H5439_010_0	4	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	010	0	1	04	01	H5439_010_0	4	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	011	0	1	04	01	H5439_011_0	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	011	0	1	04	01	H5439_011_0	5	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	012	0	1	04	01	H5439_012_0	4	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	012	0	1	04	01	H5439_012_0	4	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	013	0	1	04	01	H5439_013_0	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	013	0	1	04	01	H5439_013_0	5	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	014	1	1	04	01	H5439_014_1	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	014	1	1	04	01	H5439_014_1	5	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	014	1	1	04	01	H5439_014_1	5	003	Routine Vision	4.00	1	250.00	2	2	2			17a;17b;	
H5439	014	2	1	04	01	H5439_014_2	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	014	2	1	04	01	H5439_014_2	5	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	014	2	1	04	01	H5439_014_2	5	003	Routine Vision	4.00	1	250.00	2	2	2			17a;17b;	
H5439	014	3	1	04	01	H5439_014_3	6	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	014	3	1	04	01	H5439_014_3	6	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	014	4	1	04	01	H5439_014_4	6	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	014	4	1	04	01	H5439_014_4	6	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	014	4	1	04	01	H5439_014_4	6	003	Routine Vision	4.00	1	250.00	2	2	2			17a;17b;	
H5439	015	0	1	04	01	H5439_015_0	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	015	0	1	04	01	H5439_015_0	5	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	016	1	1	04	01	H5439_016_1	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	016	1	1	04	01	H5439_016_1	5	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5439	016	2	1	04	01	H5439_016_2	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H5439	016	2	1	04	01	H5439_016_2	5	002	Preventive & Diagnostic Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H5521	053	0	1	04	01	H5521_053_0	3	001	Aetna Medicare Advantage PPO Dental Plan	23.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	053	0	1	04	01	H5521_053_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	26.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5521	056	0	1	04	01	H5521_056_0	3	001	Aetna Medicare Advantage PPO Dental Plan	23.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	056	0	1	04	01	H5521_056_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	26.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5521	085	0	1	04	01	H5521_085_0	3	001	Aetna Medicare Advantage PPO Dental Plan	11.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	085	0	1	04	01	H5521_085_0	3	002	Aetna Medicare PPO Dental/Vision/Hearing Plan	20.00	1	1425.00	3	2	1	50.00	16b;	16a;16b;17b;18b;	
H5521	087	0	1	04	01	H5521_087_0	3	001	Aetna Medicare Advantage PPO Dental Plan	13.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	087	0	1	04	01	H5521_087_0	3	002	Aetna Medicare PPO Dental/Vision/Hearing Plan	22.00	1	1425.00	3	2	1	50.00	16b;	16a;16b;17b;18b;	
H5521	089	0	1	04	01	H5521_089_0	3	001	Aetna Medicare Advantage PPO Dental Plan	13.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	089	0	1	04	01	H5521_089_0	3	002	Aetna Medicare PPO Dental/Vision/Hearing Plan	22.00	1	1425.00	3	2	1	50.00	16b;	16a;16b;17b;18b;	
H5521	118	0	1	04	01	H5521_118_0	3	001	Aetna Medicare Advantage PPO Dental Plan	21.00	1	750.00	3	2	1	50.00	16b;	16a;16b;	
H5521	120	0	1	04	01	H5521_120_0	3	001	Aetna Medicare Advantage PPO Dental Plan	21.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	125	0	1	04	01	H5521_125_0	3	001	Aetna Medicare Advantage PPO Dental Plan	23.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	125	0	1	04	01	H5521_125_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	26.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5521	126	0	1	04	01	H5521_126_0	3	001	Aetna Medicare Advantage PPO Dental Plan	23.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	126	0	1	04	01	H5521_126_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	26.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5521	127	0	1	04	01	H5521_127_0	3	001	Aetna Medicare Advantage PPO Dental Plan	20.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	127	0	1	04	01	H5521_127_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	23.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5521	205	0	1	04	01	H5521_205_0	3	001	Aetna Medicare Advantage PPO Dental Plan	23.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	205	0	1	04	01	H5521_205_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	26.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5521	206	0	1	04	01	H5521_206_0	3	001	Aetna Medicare Advantage PPO Dental Plan	23.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	206	0	1	04	01	H5521_206_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	26.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5521	237	0	1	04	01	H5521_237_0	3	001	Aetna Medicare Advantage PPO Dental Plan	20.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H5521	237	0	1	04	01	H5521_237_0	3	002	Aetna Medicare Advantage PPO Dental/Hearing Plan	23.00	1	1300.00	3	2	1	50.00	16b;	16a;16b;18b;	
H5525	004	0	1	04	01	H5525_004_0	5	001	MyOption Vision	15.30	2			2	2				17a;17b;
H5525	004	0	1	04	01	H5525_004_0	5	002	MyOption Dental Enriched PPO	19.60	1	2000.00	3	2	2				16a;16b;
H5525	005	0	1	04	01	H5525_005_0	5	001	MyOption Enhanced Dental PPO	18.90	1	2000.00	3	2	2				16a;16b;
H5525	005	0	1	04	01	H5525_005_0	5	002	MyOption Total Dental PPO	23.00	1	2000.00	3	2	2				16a;16b;
H5525	006	0	1	04	01	H5525_006_0	4	001	MyOption Enhanced Dental PPO	18.90	1	2000.00	3	2	2				16a;16b;
H5525	006	0	1	04	01	H5525_006_0	4	002	MyOption Total Dental PPO	23.00	1	2000.00	3	2	2				16a;16b;
H5525	007	0	1	04	01	H5525_007_0	5	001	MyOption Enhanced Dental PPO	18.90	1	2000.00	3	2	2				16a;16b;
H5525	007	0	1	04	01	H5525_007_0	5	002	MyOption Total Dental PPO	23.00	1	2000.00	3	2	2				16a;16b;
H5525	008	0	1	04	01	H5525_008_0	3	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
H5525	008	0	1	04	01	H5525_008_0	3	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
H5525	017	0	1	04	01	H5525_017_0	5	001	MyOption Enhanced Dental PPO	18.90	1	2000.00	3	2	2				16a;16b;
H5525	017	0	1	04	01	H5525_017_0	5	002	MyOption Total Dental PPO	23.00	1	2000.00	3	2	2				16a;16b;
H5525	020	0	1	04	01	H5525_020_0	3	001	MyOption Dental High PPO	15.20	1	2000.00	3	2	2			16a;16b;	
H5525	022	0	1	04	01	H5525_022_0	3	001	MyOption Platinum Dental	21.60	1	2000.00	3	2	2			16a;16b;	
H5525	023	0	1	04	01	H5525_023_0	3	001	MyOption Enhanced Dental PPO	20.70	1	2000.00	3	2	2				16a;16b;
H5525	023	0	1	04	01	H5525_023_0	3	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5525	024	0	1	04	01	H5525_024_0	3	001	MyOption Dental High PPO	16.90	1	2000.00	3	2	2			16a;16b;	
H5525	024	0	1	04	01	H5525_024_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5525	024	0	1	04	01	H5525_024_0	3	003	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5525	025	0	1	04	01	H5525_025_0	3	001	MyOption Platinum Dental	22.00	1	2000.00	3	2	2			16a;16b;	
H5525	026	0	1	04	01	H5525_026_0	4	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H5525	026	0	1	04	01	H5525_026_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5525	026	0	1	04	01	H5525_026_0	4	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5525	027	0	1	04	01	H5525_027_0	5	001	MyOption Dental High PPO	21.00	1	2000.00	3	2	2			16a;16b;	
H5525	027	0	1	04	01	H5525_027_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5525	027	0	1	04	01	H5525_027_0	5	003	MyOption Plus	22.90	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5525	030	0	1	04	01	H5525_030_0	4	001	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
H5525	030	0	1	04	01	H5525_030_0	4	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H5525	031	0	1	04	01	H5525_031_0	4	001	MyOption Enhanced Dental Plus PPO	31.70	1	2000.00	3	2	2				16a;16b;
H5525	032	0	1	04	01	H5525_032_0	4	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H5525	032	0	1	04	01	H5525_032_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5525	032	0	1	04	01	H5525_032_0	4	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5525	033	0	1	04	01	H5525_033_0	4	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H5525	033	0	1	04	01	H5525_033_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5525	033	0	1	04	01	H5525_033_0	4	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5525	035	0	1	04	01	H5525_035_0	4	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H5525	035	0	1	04	01	H5525_035_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5525	035	0	1	04	01	H5525_035_0	4	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5525	038	0	1	04	01	H5525_038_0	3	001	MyOption Enhanced Dental PPO	18.90	1	2000.00	3	2	2				16a;16b;
H5525	038	0	1	04	01	H5525_038_0	3	002	MyOption Total Dental PPO	23.00	1	2000.00	3	2	2				16a;16b;
H5525	042	0	1	04	01	H5525_042_0	4	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H5525	042	0	1	04	01	H5525_042_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5525	042	0	1	04	01	H5525_042_0	4	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H5526	004	0	1	04	01	H5526_004_0	6	001	Optional Supplemental Dental Basic	9.00	1	500.00	3	2	2				16b;
H5526	004	0	1	04	01	H5526_004_0	6	002	Optional Supplemental Dental Enhanced	24.00	1	1000.00	3	2	2				16b;
H5526	016	0	1	04	01	H5526_016_0	6	001	Optional Supplemental Dental Basic	9.00	1	500.00	3	2	2				16b;
H5526	016	0	1	04	01	H5526_016_0	6	002	Optional Supplemental Dental Enhanced	24.00	1	1000.00	3	2	2				16b;
H5526	018	0	1	04	01	H5526_018_0	7	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2	2				16a;16b;
H5526	018	0	1	04	01	H5526_018_0	7	002	Optional Supplemental Dental Enhanced	38.00	1	1000.00	3	2	2				16a;16b;
H5613	002	0		07	02	H5613_002_0	3	001	Optional Supplemental Rider	22.00	2				2				14c;16a;17a;17b;18a;18b;
H5613	801	0		07	02	H5613_801_0	1	001	Optional Supplemental Rider		2				2				14c;16a;17a;17b;18a;18b;
H5613	802	0		07	02	H5613_802_0	1	001	Optional Supplemental Rider		2				2				14c;16a;17a;17b;18a;18b;
H5619	001	0	1	01	01	H5619_001_0	4	001	MyOption Enhanced Dental HMO	27.80	1	2000.00	3	2	2				16a;16b;
H5619	012	0	1	01	01	H5619_012_0	4	001	MyOption Dental High PPO	27.30	1	2000.00	3	2	2			16a;16b;	
H5619	012	0	1	01	01	H5619_012_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	012	0	1	01	01	H5619_012_0	4	003	MyOption Plus	23.40	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5619	013	0	1	01	01	H5619_013_0	4	001	MyOption Dental High PPO	27.30	1	2000.00	3	2	2			16a;16b;	
H5619	013	0	1	01	01	H5619_013_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	013	0	1	01	01	H5619_013_0	4	003	MyOption Plus	23.40	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5619	015	0	1	01	01	H5619_015_0	4	001	MyOption Dental High PPO	27.30	1	2000.00	3	2	2			16a;16b;	
H5619	015	0	1	01	01	H5619_015_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	015	0	1	01	01	H5619_015_0	4	003	MyOption Plus	23.40	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5619	023	0	1	01	01	H5619_023_0	4	001	MyOption Dental Enriched HMO	31.80	1	2000.00	3	2	2				16a;16b;
H5619	026	0	1	01	01	H5619_026_0	5	001	MyOption Dental High PPO	27.30	1	2000.00	3	2	2			16a;16b;	
H5619	039	1	1	01	01	H5619_039_1	5	001	MyOption Dental High PPO	27.30	1	2000.00	3	2	2			16a;16b;	
H5619	039	2	1	01	01	H5619_039_2	5	001	MyOption Enhanced Dental HMO	31.80	1	2000.00	3	2	2				16a;16b;
H5619	040	1	1	01	01	H5619_040_1	5	001	MyOption Platinum Dental	34.30	1	2000.00	3	2	2			16a;16b;	
H5619	040	2	1	01	01	H5619_040_2	4	001	MyOption Platinum Dental	34.30	1	2000.00	3	2	2			16a;16b;	
H5619	040	3	1	01	01	H5619_040_3	4	001	MyOption Platinum Dental	29.60	1	2000.00	3	2	2			16a;16b;	
H5619	041	0	1	01	01	H5619_041_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	041	0	1	01	01	H5619_041_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H5619	041	0	1	01	01	H5619_041_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H5619	042	1	1	01	01	H5619_042_1	4	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5619	042	2	1	01	01	H5619_042_2	4	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5619	044	0	1	01	01	H5619_044_0	5	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5619	044	0	1	01	01	H5619_044_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	044	0	1	01	01	H5619_044_0	5	003	MyOption Plus	21.40	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5619	045	0	1	01	01	H5619_045_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	045	0	1	01	01	H5619_045_0	4	002	MyOption Enhanced Dental HMO	24.70	1	2000.00	3	2	2				16a;16b;
H5619	046	0	1	01	01	H5619_046_0	5	001	MyOption Enhanced Dental HMO	24.70	1	2000.00	3	2	2				16a;16b;
H5619	046	0	1	01	01	H5619_046_0	5	002	MyOption Total Dental HMO	28.90	1	2000.00	3	2	2				16a;16b;
H5619	047	0	1	01	01	H5619_047_0	5	001	MyOption Enhanced Dental HMO	24.70	1	2000.00	3	2	2				16a;16b;
H5619	047	0	1	01	01	H5619_047_0	5	002	MyOption Total Dental HMO	28.90	1	2000.00	3	2	2				16a;16b;
H5619	049	0	1	01	01	H5619_049_0	4	001	MyOption Dental Enriched HMO	25.10	1	2000.00	3	2	2				16a;16b;
H5619	049	0	1	01	01	H5619_049_0	4	002	MyOption Total Dental HMO	29.50	1	2000.00	3	2	2				16a;16b;
H5619	050	0	1	01	01	H5619_050_0	4	001	MyOption Dental Enriched HMO	25.10	1	2000.00	3	2	2				16a;16b;
H5619	050	0	1	01	01	H5619_050_0	4	002	MyOption Total Dental HMO	29.50	1	2000.00	3	2	2				16a;16b;
H5619	051	0	1	01	01	H5619_051_0	4	001	MyOption Dental Enriched HMO	25.10	1	2000.00	3	2	2				16a;16b;
H5619	051	0	1	01	01	H5619_051_0	4	002	MyOption Total Dental HMO	29.50	1	2000.00	3	2	2				16a;16b;
H5619	052	0	1	01	01	H5619_052_0	4	001	MyOption Dental Enriched HMO	25.10	1	2000.00	3	2	2				16a;16b;
H5619	052	0	1	01	01	H5619_052_0	4	002	MyOption Total Dental HMO	29.50	1	2000.00	3	2	2				16a;16b;
H5619	053	0	1	01	01	H5619_053_0	4	001	MyOption Dental Enriched HMO	25.10	1	2000.00	3	2	2				16a;16b;
H5619	053	0	1	01	01	H5619_053_0	4	002	MyOption Total Dental HMO	29.50	1	2000.00	3	2	2				16a;16b;
H5619	055	0	1	01	01	H5619_055_0	5	001	MyOption Enhanced Dental Plus HMO	31.80	1	2000.00	3	2	2				16a;16b;
H5619	055	0	1	01	01	H5619_055_0	5	002	MyOption Total Dental Plus HMO	36.20	1	2000.00	3	2	2				16a;16b;
H5619	056	0	1	01	01	H5619_056_0	3	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	057	0	1	01	01	H5619_057_0	3	001	MyOption Dental High PPO	36.20	1	2000.00	3	2	2			16a;16b;	
H5619	059	0	1	01	01	H5619_059_0	3	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	060	0	1	01	01	H5619_060_0	3	001	MyOption Dental High PPO	36.20	1	2000.00	3	2	2			16a;16b;	
H5619	061	0	1	01	01	H5619_061_0	5	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	062	0	1	01	01	H5619_062_0	3	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	063	0	1	01	01	H5619_063_0	3	001	MyOption Platinum Dental	41.50	1	2000.00	3	2	2			16a;16b;	
H5619	064	0	1	01	01	H5619_064_0	4	001	MyOption Platinum Dental	41.50	1	2000.00	3	2	2			16a;16b;	
H5619	066	0	1	01	01	H5619_066_0	3	001	MyOption Fitness	15.00	2			2	2			14c;	
H5619	066	0	1	01	01	H5619_066_0	3	002	MyOption Platinum Dental	29.60	1	2000.00	3	2	2			16a;16b;	
H5619	069	0	1	01	01	H5619_069_0	3	001	MyOption Enhanced Dental HMO	19.90	1	2000.00	3	2	2				16a;16b;
H5619	070	1	1	01	01	H5619_070_1	4	001	MyOption Total Dental HMO	23.20	1	2000.00	3	2	2				16a;16b;
H5619	071	0	1	01	01	H5619_071_0	4	001	MyOption Enhanced Dental HMO	19.50	1	2000.00	3	2	2				16a;16b;
H5619	071	0	1	01	01	H5619_071_0	4	002	MyOption Total Dental HMO	23.30	1	2000.00	3	2	2				16a;16b;
H5619	073	0	1	01	01	H5619_073_0	5	001	MyOption Enhanced Dental HMO	19.50	1	2000.00	3	2	2				16a;16b;
H5619	073	0	1	01	01	H5619_073_0	5	002	MyOption Total Dental HMO	23.30	1	2000.00	3	2	2				16a;16b;
H5619	077	0	1	01	01	H5619_077_0	4	001	MyOption Enhanced Dental HMO	26.90	1	2000.00	3	2	2				16a;16b;
H5619	078	0	1	01	01	H5619_078_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	078	0	1	01	01	H5619_078_0	4	002	MyOption Platinum Dental	28.60	1	2000.00	3	2	2			16a;16b;	
H5619	079	0	1	01	01	H5619_079_0	4	001	MyOption Platinum Dental	28.60	1	2000.00	3	2	2			16a;16b;	
H5619	081	0	1	01	01	H5619_081_0	3	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H5619	081	0	1	01	01	H5619_081_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H5619	081	0	1	01	01	H5619_081_0	3	003	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H5619	083	0	1	01	01	H5619_083_0	6	001	MyOption Enhanced Dental HMO	20.60	1	2000.00	3	2	2				16a;16b;
H5619	084	0	1	01	01	H5619_084_0	4	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H5619	086	0	1	01	01	H5619_086_0	4	001	MyOption Enhanced Dental HMO	20.60	1	2000.00	3	2	2				16a;16b;
H5619	087	0	1	01	01	H5619_087_0	4	001	MyOption Enhanced Dental HMO	20.60	1	2000.00	3	2	2				16a;16b;
H5619	095	0	1	01	01	H5619_095_0	3	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H5619	097	0	1	01	01	H5619_097_0	4	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	099	0	1	01	01	H5619_099_0	4	001	MyOption Platinum Dental	41.50	1	2000.00	3	2	2			16a;16b;	
H5619	100	0	1	01	01	H5619_100_0	4	001	MyOption Platinum Dental	41.50	1	2000.00	3	2	2			16a;16b;	
H5619	101	0	1	01	01	H5619_101_0	4	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	102	0	1	01	01	H5619_102_0	4	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	104	0	1	01	01	H5619_104_0	4	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	110	0	1	01	01	H5619_110_0	4	001	MyOption Enhanced Dental HMO	20.60	1	2000.00	3	2	2				16a;16b;
H5619	113	0	1	01	01	H5619_113_0	5	001	MyOption Enhanced Dental HMO	22.40	1	2000.00	3	2	2				16a;16b;
H5619	113	0	1	01	01	H5619_113_0	5	002	MyOption Total Dental HMO	26.00	1	2000.00	3	2	2				16a;16b;
H5619	114	0	1	01	01	H5619_114_0	3	001	MyOption Dental High PPO	36.20	1	2000.00	3	2	2			16a;16b;	
H5619	115	0	1	01	01	H5619_115_0	3	001	MyOption Enhanced Dental HMO	40.80	1	2000.00	3	2	2				16a;16b;
H5619	116	0	1	01	01	H5619_116_0	6	001	MyOption Enhanced Dental HMO	31.80	1	2000.00	3	2	2				16a;16b;
H5619	116	0	1	01	01	H5619_116_0	6	002	MyOption Total Dental HMO	39.30	1	2000.00	3	2	2				16a;16b;
H5644	002	0	1	01	01	H5644_002_0	6	001	Dental	35.00	1	1000.00	3	2	1	100.00	16b;		16a;16b;
H5854	007	0	1	01	01	H5854_007_0	5	001	Preventive Dental Package	16.00	2			2	2				16a;
H5854	007	0	1	01	01	H5854_007_0	5	002	Dental and Vision Package	30.00	2			2	2				16a;16b;17b;
H5854	007	0	1	01	01	H5854_007_0	5	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H5854	009	0	1	01	01	H5854_009_0	5	001	Preventive Dental Package	16.00	2			2	2				16a;
H5854	009	0	1	01	01	H5854_009_0	5	002	Dental and Vision Package	30.00	2			2	2				16a;16b;17b;
H5854	009	0	1	01	01	H5854_009_0	5	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H5883	001	1	1	02	01	H5883_001_1	6	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	001	1	1	02	01	H5883_001_1	6	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	001	2	1	02	01	H5883_001_2	5	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	001	2	1	02	01	H5883_001_2	5	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	001	3	1	02	01	H5883_001_3	5	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	001	3	1	02	01	H5883_001_3	5	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	001	4	1	02	01	H5883_001_4	5	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	001	4	1	02	01	H5883_001_4	5	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	001	5	1	02	01	H5883_001_5	6	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	001	5	1	02	01	H5883_001_5	6	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	002	1	1	02	01	H5883_002_1	7	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	002	1	1	02	01	H5883_002_1	7	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	002	2	1	02	01	H5883_002_2	6	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	002	2	1	02	01	H5883_002_2	6	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	002	3	1	02	01	H5883_002_3	6	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	002	3	1	02	01	H5883_002_3	6	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	002	4	1	02	01	H5883_002_4	6	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	002	4	1	02	01	H5883_002_4	6	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	002	7	1	02	01	H5883_002_7	7	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	002	7	1	02	01	H5883_002_7	7	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	003	1	1	02	01	H5883_003_1	8	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	003	1	1	02	01	H5883_003_1	8	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	003	2	1	02	01	H5883_003_2	7	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	003	2	1	02	01	H5883_003_2	7	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	003	3	1	02	01	H5883_003_3	7	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	003	3	1	02	01	H5883_003_3	7	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	003	4	1	02	01	H5883_003_4	7	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	003	4	1	02	01	H5883_003_4	7	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	003	5	1	02	01	H5883_003_5	8	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;18a;18b;	17b;
H5883	003	5	1	02	01	H5883_003_5	8	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	004	1	1	02	01	H5883_004_1	7	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	004	1	1	02	01	H5883_004_1	7	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	004	2	1	02	01	H5883_004_2	5	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	004	2	1	02	01	H5883_004_2	5	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	004	3	1	02	01	H5883_004_3	6	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	004	3	1	02	01	H5883_004_3	6	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	004	4	1	02	01	H5883_004_4	6	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	004	4	1	02	01	H5883_004_4	6	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	004	5	1	02	01	H5883_004_5	7	001	Supplemental Dental, Vision, Hearing Package 1	21.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	004	5	1	02	01	H5883_004_5	7	002	Supplemental Dental, Vision, Hearing Package 2	32.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	007	0	1	01	01	H5883_007_0	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	007	0	1	01	01	H5883_007_0	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	008	1	1	01	01	H5883_008_1	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	008	1	1	01	01	H5883_008_1	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	008	2	1	01	01	H5883_008_2	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	008	2	1	01	01	H5883_008_2	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	009	1	1	01	01	H5883_009_1	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	009	1	1	01	01	H5883_009_1	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	009	2	1	01	01	H5883_009_2	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	009	2	1	01	01	H5883_009_2	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	009	3	1	01	01	H5883_009_3	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	009	3	1	01	01	H5883_009_3	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	011	1	1	01	01	H5883_011_1	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	011	1	1	01	01	H5883_011_1	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	011	2	1	01	01	H5883_011_2	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	011	2	1	01	01	H5883_011_2	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5883	011	3	1	01	01	H5883_011_3	6	001	Supplemental Dental, Vision, Hearing Package 1	13.50	1	3000.00	6	2	2			16a;16b;17b;18a;18b;	
H5883	011	3	1	01	01	H5883_011_3	6	002	Supplemental Dental, Vision, Hearing Package 2	25.50	1	5400.00	6	2	2				16a;16b;17b;18a;18b;
H5945	001	0	1	01	01	H5945_001_0	9	001	Comprehensive Dental	29.00	1	1500.00	3	2	2			16a;16b;	
H5945	002	0	1	01	01	H5945_002_0	9	001	Comprehensive Dental	29.00	1	1500.00	3	2	2			16a;16b;	
H5970	001	0	1	04	01	H5970_001_0	5	001	MyOption Enhanced Dental PPO	25.60	1	2000.00	3	2	2				16a;16b;
H5970	001	0	1	04	01	H5970_001_0	5	002	MyOption Total Dental PPO	30.40	1	2000.00	3	2	2				16a;16b;
H5970	015	0	1	04	01	H5970_015_0	5	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5970	015	0	1	04	01	H5970_015_0	5	002	MyOption Platinum Dental	30.40	1	2000.00	3	2	2			16a;16b;	
H5970	016	0	1	04	01	H5970_016_0	2	001	MyOption Total Dental PPO	30.40	1	2000.00	3	2	2				16a;16b;
H5970	018	0	1	04	01	H5970_018_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5970	018	0	1	04	01	H5970_018_0	3	002	MyOption Platinum Dental	30.40	1	2000.00	3	2	2			16a;16b;	
H5970	019	0	1	04	01	H5970_019_0	5	001	MyOption Enhanced Dental PPO	25.60	1	2000.00	3	2	2				16a;16b;
H5970	019	0	1	04	01	H5970_019_0	5	002	MyOption Total Dental PPO	30.40	1	2000.00	3	2	2				16a;16b;
H5970	021	0	1	04	01	H5970_021_0	5	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H5970	021	0	1	04	01	H5970_021_0	5	002	MyOption Platinum Dental	30.40	1	2000.00	3	2	2			16a;16b;	
H5970	022	0	1	04	01	H5970_022_0	5	001	MyOption Total Dental PPO	30.40	1	2000.00	3	2	2				16a;16b;
H6237	004	0	1	01	01	H6237_004_0	8	001	Dental, Vision and Hearing Option	20.00	1	100.00	3	2	2			16a;17a;17b;18a;18b;	
H6237	005	0	1	01	01	H6237_005_0	8	001	Dental and Hearing Option	28.00	2			2	2			16b;18a;18b;	
H6328	001	0	1	04	01	H6328_001_0	5	001	Dental Rider	18.00	2			2	2			16b;	
H6328	002	0	1	04	01	H6328_002_0	5	001	Dental Rider	18.00	2			2	2			16b;	
H6328	003	0	1	04	01	H6328_003_0	5	001	Dental Rider	18.00	2			2	2			16b;	
H6328	005	0	1	04	01	H6328_005_0	4	001	Dental Rider	18.00	2			2	2			16b;	
H6351	002	0	1	01	01	H6351_002_0	4	001	Personal Care	11.00	2			2	2			13d;	
H6526	002	0	1	01	01	H6526_002_0	5	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H6528	006	0	1	04	01	H6528_006_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H6550	001	0	1	01	01	H6550_001_0	4	001	Comprehensive Dental Buy-up Package	26.00	1	1000.00	3	2	2			16b;	
H6550	003	0	1	01	01	H6550_003_0	4	001	Comprehensive Dental Buy-up Package	25.00	1	1000.00	3	2	2			16b;	
H6622	001	0	1	01	01	H6622_001_0	5	001	MyOption Enhanced Dental Plus HMO	43.60	1	2000.00	3	2	2				16a;16b;
H6622	002	0	1	01	01	H6622_002_0	5	001	MyOption Dental Enriched HMO	33.90	1	2000.00	3	2	2				16a;16b;
H6622	004	0	1	01	01	H6622_004_0	5	001	MyOption Enhanced Dental HMO	24.70	1	2000.00	3	2	2				16a;16b;
H6622	004	0	1	01	01	H6622_004_0	5	002	MyOption Total Dental HMO	28.90	1	2000.00	3	2	2				16a;16b;
H6622	005	0	1	01	01	H6622_005_0	5	001	MyOption Enhanced Dental HMO	24.70	1	2000.00	3	2	2				16a;16b;
H6622	005	0	1	01	01	H6622_005_0	5	002	MyOption Total Dental HMO	28.90	1	2000.00	3	2	2				16a;16b;
H6622	007	0	1	01	01	H6622_007_0	5	001	MyOption Dental Enriched HMO	29.80	1	2000.00	3	2	2				16a;16b;
H6622	010	0	1	01	01	H6622_010_0	5	001	MyOption Enhanced Dental HMO	31.10	1	2000.00	3	2	2				16a;16b;
H6622	010	0	1	01	01	H6622_010_0	5	002	MyOption Total Dental HMO	35.60	1	2000.00	3	2	2				16a;16b;
H6622	011	0	1	01	01	H6622_011_0	3	001	MyOption Enhanced Dental Plus HMO	28.50	1	2000.00	3	2	2				16a;16b;
H6622	011	0	1	01	01	H6622_011_0	3	002	MyOption Total Dental Plus HMO	33.10	1	2000.00	3	2	2				16a;16b;
H6622	012	0	1	01	01	H6622_012_0	3	001	MyOption Enhanced Dental Plus HMO	28.50	1	2000.00	3	2	2				16a;16b;
H6622	012	0	1	01	01	H6622_012_0	3	002	MyOption Total Dental Plus HMO	33.10	1	2000.00	3	2	2				16a;16b;
H6622	013	0	1	01	01	H6622_013_0	3	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
H6622	013	0	1	01	01	H6622_013_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H6622	013	0	1	01	01	H6622_013_0	3	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H6622	014	0	1	01	01	H6622_014_0	4	001	MyOption Enhanced Dental HMO	22.20	1	2000.00	3	2	2				16a;16b;
H6622	014	0	1	01	01	H6622_014_0	4	002	MyOption Total Dental HMO	26.80	1	2000.00	3	2	2				16a;16b;
H6622	016	0	1	01	01	H6622_016_0	3	001	MyOption Enhanced Dental Plus HMO	28.50	1	2000.00	3	2	2				16a;16b;
H6622	016	0	1	01	01	H6622_016_0	3	002	MyOption Total Dental Plus HMO	33.10	1	2000.00	3	2	2				16a;16b;
H6622	017	0	1	01	01	H6622_017_0	3	001	MyOption Enhanced Dental Plus HMO	28.50	1	2000.00	3	2	2				16a;16b;
H6622	017	0	1	01	01	H6622_017_0	3	002	MyOption Total Dental Plus HMO	33.10	1	2000.00	3	2	2				16a;16b;
H6622	019	0	1	01	01	H6622_019_0	6	001	MyOption Dental Enriched HMO	22.20	1	2000.00	3	2	2				16a;16b;
H6622	019	0	1	01	01	H6622_019_0	6	002	MyOption Total Dental HMO	26.80	1	2000.00	3	2	2				16a;16b;
H6622	021	1	1	01	01	H6622_021_1	3	001	MyOption Dental High PPO	18.00	1	2000.00	3	2	2			16a;16b;	
H6622	021	1	1	01	01	H6622_021_1	3	002	MyOption Platinum Dental	21.60	1	2000.00	3	2	2				16a;16b;
H6622	021	2	1	01	01	H6622_021_2	3	001	MyOption Enhanced Dental Plus HMO	28.50	1	2000.00	3	2	2				16a;16b;
H6622	021	2	1	01	01	H6622_021_2	3	002	MyOption Total Dental Plus HMO	33.10	1	2000.00	3	2	2				16a;16b;
H6622	022	0	1	01	01	H6622_022_0	3	001	MyOption Enhanced Dental Plus HMO	28.50	1	2000.00	3	2	2				16a;16b;
H6622	022	0	1	01	01	H6622_022_0	3	002	MyOption Total Dental Plus HMO	33.10	1	2000.00	3	2	2				16a;16b;
H6622	023	0	1	01	01	H6622_023_0	5	001	MyOption Enhanced Dental Plus HMO	28.50	1	2000.00	3	2	2				16a;16b;
H6622	023	0	1	01	01	H6622_023_0	5	002	MyOption Total Dental Plus HMO	33.10	1	2000.00	3	2	2				16a;16b;
H6622	025	0	1	01	01	H6622_025_0	4	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H6622	026	0	1	01	01	H6622_026_0	5	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H6622	028	0	1	01	01	H6622_028_0	4	001	MyOption Enhanced Dental HMO	31.00	1	2000.00	3	2	2				16a;16b;
H6622	029	0	1	01	01	H6622_029_0	6	001	MyOption Enhanced Dental HMO	31.00	1	2000.00	3	2	2				16a;16b;
H6622	030	0	1	01	01	H6622_030_0	4	001	MyOption Enhanced Dental HMO	31.00	1	2000.00	3	2	2				16a;16b;
H6622	031	0	1	01	01	H6622_031_0	6	001	MyOption Enhanced Dental Plus HMO	38.50	1	2000.00	3	2	2				16a;16b;
H6622	031	0	1	01	01	H6622_031_0	6	002	MyOption Total Dental Plus HMO	44.10	1	2000.00	3	2	2				16a;16b;
H6622	032	0	1	01	01	H6622_032_0	3	001	MyOption Enhanced Dental Plus HMO	29.40	1	2000.00	3	2	2				16a;16b;
H6622	033	0	1	01	01	H6622_033_0	3	001	MyOption Enhanced Dental Plus HMO	29.40	1	2000.00	3	2	2				16a;16b;
H6622	034	0	1	01	01	H6622_034_0	5	001	MyOption Dental Enriched HMO	33.90	1	2000.00	3	2	2				16a;16b;
H6622	035	0	1	01	01	H6622_035_0	4	001	MyOption Enhanced Dental HMO	21.20	1	2000.00	3	2	2				16a;16b;
H6622	035	0	1	01	01	H6622_035_0	4	002	MyOption Total Dental HMO	25.50	1	2000.00	3	2	2				16a;16b;
H6622	036	0	1	01	01	H6622_036_0	4	001	MyOption Enhanced Dental HMO	21.20	1	2000.00	3	2	2				16a;16b;
H6622	036	0	1	01	01	H6622_036_0	4	002	MyOption Total Dental HMO	25.50	1	2000.00	3	2	2				16a;16b;
H6622	037	0	1	01	01	H6622_037_0	4	001	MyOption Enhanced Dental HMO	21.20	1	2000.00	3	2	2				16a;16b;
H6622	037	0	1	01	01	H6622_037_0	4	002	MyOption Total Dental HMO	25.50	1	2000.00	3	2	2				16a;16b;
H6622	039	0	1	01	01	H6622_039_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H6622	039	0	1	01	01	H6622_039_0	3	002	MyOption Platinum Dental	23.00	1	2000.00	3	2	2			16a;16b;	
H6622	040	0	1	01	01	H6622_040_0	5	001	MyOption Dental High PPO	29.40	1	2000.00	3	2	2			16a;16b;	
H6622	040	0	1	01	01	H6622_040_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H6622	040	0	1	01	01	H6622_040_0	5	003	MyOption Plus	24.80	2			2	1	50.00	16b;		17a;17b;16a;16b;
H6622	043	0	1	01	01	H6622_043_0	3	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H6622	043	0	1	01	01	H6622_043_0	3	002	MyOption Platinum Dental	23.00	1	2000.00	3	2	2			16a;16b;	
H6622	047	0	1	01	01	H6622_047_0	4	001	MyOption Dental Enriched HMO	18.70	1	2000.00	3	2	2				16a;16b;
H6622	052	0	1	01	01	H6622_052_0	4	001	MyOption Enhanced Dental HMO	21.20	1	2000.00	3	2	2				16a;16b;
H6622	052	0	1	01	01	H6622_052_0	4	002	MyOption Total Dental HMO	25.50	1	2000.00	3	2	2				16a;16b;
H6622	053	0	1	01	01	H6622_053_0	4	001	MyOption Enhanced Dental HMO	21.20	1	2000.00	3	2	2				16a;16b;
H6622	053	0	1	01	01	H6622_053_0	4	002	MyOption Total Dental HMO	25.50	1	2000.00	3	2	2				16a;16b;
H6622	054	0	1	01	01	H6622_054_0	4	001	MyOption Enhanced Dental HMO	21.20	1	2000.00	3	2	2				16a;16b;
H6622	054	0	1	01	01	H6622_054_0	4	002	MyOption Total Dental HMO	25.50	1	2000.00	3	2	2				16a;16b;
H6622	055	0	1	01	01	H6622_055_0	4	001	MyOption Enhanced Dental HMO	22.20	1	2000.00	3	2	2				16a;16b;
H6622	055	0	1	01	01	H6622_055_0	4	002	MyOption Total Dental HMO	26.80	1	2000.00	3	2	2				16a;16b;
H6622	057	0	1	01	01	H6622_057_0	5	001	MyOption Enhanced Dental HMO	26.30	1	2000.00	3	2	2				16a;16b;
H6622	057	0	1	01	01	H6622_057_0	5	002	MyOption Total Dental HMO	30.90	1	2000.00	3	2	2				16a;16b;
H6622	058	0	1	01	01	H6622_058_0	4	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H6622	058	0	1	01	01	H6622_058_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H6622	058	0	1	01	01	H6622_058_0	4	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H6723	001	1	1	01	01	H6723_001_1	12	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H6723	001	2	1	01	01	H6723_001_2	9	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H6723	002	1	1	01	01	H6723_002_1	8	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H6723	002	2	1	01	01	H6723_002_2	8	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H6723	003	1	1	01	01	H6723_003_1	8	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H6723	003	2	1	01	01	H6723_003_2	8	001	Optional Dental and Vision Rider	25.00	2			2	2			16b;	16a;17b;
H6786	002	0	1	04	01	H6786_002_0	6	001	Preventive Dental Package	23.00	2			2	2				16a;
H6786	002	0	1	04	01	H6786_002_0	6	002	Dental and Vision Package	35.00	2			2	2				16a;16b;17b;
H6786	002	0	1	04	01	H6786_002_0	6	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H6815	003	1	1	01	01	H6815_003_1	3	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H6815	003	1	1	01	01	H6815_003_1	3	002	P & D Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;	;	16a;
H6815	003	2	1	01	01	H6815_003_2	3	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H6815	003	2	1	01	01	H6815_003_2	3	002	P & D Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;	;	16a;
H6815	003	3	1	01	01	H6815_003_3	4	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H6815	003	3	1	01	01	H6815_003_3	4	002	P & D Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;	;	16a;
H6815	005	0	1	01	01	H6815_005_0	6	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H6815	005	0	1	01	01	H6815_005_0	6	002	P & D Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;	;	16a;
H6815	006	0	1	01	01	H6815_006_0	3	001	Comprehensive Dental PPO	39.00	1	1000.00	3	2	1	50.00	16a;16b;	16a;16b;	
H6815	006	0	1	01	01	H6815_006_0	3	002	P & D Plus Dental PPO	19.00	1	500.00	3	2	1	35.00	16a;		16a;
H7006	003	0	1	04	01	H7006_003_0	12	001	Preventive Dental, Eye Exams, and Eyewear	31.00	2			2	2			16a;17a;17b;	
H7020	004	0	1	01	01	H7020_004_0	4	001	Enhanced Dental - Comprehensive	47.60	1	1000.00	3	2	2			16b;	
H7020	005	0	1	01	01	H7020_005_0	4	001	Enhanced Dental - Comprehensive	47.60	1	1000.00	3	2	2			16b;	
H7220	002	0	1	01	01	H7220_002_0	3	001	Dental Basic 750	6.00	1	750.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	002	0	1	01	01	H7220_002_0	3	002	Dental Enhanced 1000	12.00	1	1000.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	002	0	1	01	01	H7220_002_0	3	003	Dental Enhanced 1500	18.00	1	1500.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	004	0	1	02	01	H7220_004_0	6	001	Dental Basic 750	6.00	1	750.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	004	0	1	02	01	H7220_004_0	6	002	Dental Enhanced 1000	12.00	1	1000.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	004	0	1	02	01	H7220_004_0	6	003	Dental Enhanced 1500	18.00	1	1500.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	1	1	01	01	H7220_009_1	4	001	Dental Basic 750	6.00	1	750.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	1	1	01	01	H7220_009_1	4	002	Dental Enhanced 1000	12.00	1	1000.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	1	1	01	01	H7220_009_1	4	003	Dental Enhanced 1500	18.00	1	1500.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	2	1	01	01	H7220_009_2	4	001	Dental Basic 750	6.00	1	750.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	2	1	01	01	H7220_009_2	4	002	Dental Enhanced 1000	12.00	1	1000.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	2	1	01	01	H7220_009_2	4	003	Dental Enhanced 1500	18.00	1	1500.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	3	1	01	01	H7220_009_3	4	001	Dental Basic 750	6.00	1	750.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	3	1	01	01	H7220_009_3	4	002	Dental Enhanced 1000	12.00	1	1000.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7220	009	3	1	01	01	H7220_009_3	4	003	Dental Enhanced 1500	18.00	1	1500.00	3	2	1	10.00	16a;16b;	16b;	16a;
H7245	001	0	1	01	01	H7245_001_0	11	001	Optional Dental Plan	26.00	2			2	2			16a;	
H7245	006	0	1	01	01	H7245_006_0	11	001	Optional Dental Plan	26.00	2			2	2			16a;	
H7404	001	0	1	04	01	H7404_001_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H7404	002	0	1	04	01	H7404_002_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H7404	005	0	1	04	01	H7404_005_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H7404	006	0	1	04	01	H7404_006_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H7621	002	0	1	01	01	H7621_002_0	5	001	MyOption Enhanced Dental HMO	31.80	1	2000.00	3	2	2				16a;16b;
H7621	002	0	1	01	01	H7621_002_0	5	002	MyOption Total Dental HMO	39.30	1	2000.00	3	2	2				16a;16b;
H7621	003	0	1	01	01	H7621_003_0	4	001	MyOption Enhanced Dental HMO	31.80	1	2000.00	3	2	2				16a;16b;
H7680	001	0	1	01	01	H7680_001_0	8	001	Comprehensive Dental	23.00	1	1000.00	3	2	2			16b;	
H7680	002	0	1	01	01	H7680_002_0	8	001	Comprehensive Dental	22.00	1	1000.00	3	2	2			16b;	
H7728	002	0	1	04	01	H7728_002_0	5	001	Preventive Dental Package	23.00	2			2	2				16a;
H7728	002	0	1	04	01	H7728_002_0	5	002	Dental and Vision Package	30.00	2			2	2				16a;16b;17b;
H7728	002	0	1	04	01	H7728_002_0	5	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H7728	004	1	1	04	01	H7728_004_1	7	001	Preventive Dental Package	17.00	2			2	2				16a;
H7728	004	1	1	04	01	H7728_004_1	7	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H7728	004	1	1	04	01	H7728_004_1	7	003	Enhanced Dental and Vision Package	49.00	2			2	2				16a;16b;17b;
H7728	004	2	1	04	01	H7728_004_2	7	001	Preventive Dental Package	17.00	2			2	2				16a;
H7728	004	2	1	04	01	H7728_004_2	7	002	Dental and Vision Package	25.00	2			2	2				16a;16b;17b;
H7728	004	2	1	04	01	H7728_004_2	7	003	Enhanced Dental and Vision Package	49.00	2			2	2				16a;16b;17b;
H7728	005	0	1	04	01	H7728_005_0	7	001	Preventive Dental Package	18.00	2			2	2				16a;
H7728	005	0	1	04	01	H7728_005_0	7	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H7728	005	0	1	04	01	H7728_005_0	7	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H7728	006	0	1	04	01	H7728_006_0	6	001	Preventive Dental Package	18.00	2			2	2				16a;
H7728	006	0	1	04	01	H7728_006_0	6	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H7728	006	0	1	04	01	H7728_006_0	6	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H7853	001	0	1	01	01	H7853_001_0	9	001	CO HMO Comprehensive Dental	34.00	1	1000.00	3	2	2			16b;	
H7853	002	0	1	01	01	H7853_002_0	9	001	CO HMO Comprehensive Dental	34.00	1	1000.00	3	2	2			16b;	
H7853	003	0	1	02	01	H7853_003_0	9	001	CO HMO Comprehensive Dental	34.00	1	1000.00	3	2	2			16b;	
H7853	003	0	1	02	01	H7853_003_0	9	002	CO HMO Vision Materials	4.00	2			2	2			17b;	
H7853	004	0	1	02	01	H7853_004_0	9	001	CO HMO Comprehensive Dental	34.00	1	1000.00	3	2	2			16b;	
H8087	001	0	1	04	01	H8087_001_0	4	001	MyOption Dental High PPO	23.30	1	2000.00	3	2	2			16a;16b;	
H8087	001	0	1	04	01	H8087_001_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8087	001	0	1	04	01	H8087_001_0	4	003	MyOption Platinum Dental	28.30	1	2000.00	3	2	2				16a;16b;
H8145	003	0	1	09	04	H8145_003_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	003	0	1	09	04	H8145_003_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H8145	003	0	1	09	04	H8145_003_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H8145	004	0	1	09	04	H8145_004_0	5	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	004	0	1	09	04	H8145_004_0	5	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H8145	004	0	1	09	04	H8145_004_0	5	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H8145	006	0	1	09	04	H8145_006_0	5	001	MyOption Vision	15.30	2			2	2				17a;17b;
H8145	006	0	1	09	04	H8145_006_0	5	002	MyOption Enhanced Dental PPO	29.40	1	2000.00	3	2	2				16a;16b;
H8145	008	0	1	09	04	H8145_008_0	5	001	MyOption Dental High PPO	19.60	1	2000.00	3	2	2			16a;16b;	
H8145	008	0	1	09	04	H8145_008_0	5	002	MyOption Vision	15.30	2			2	2				17a;17b;
H8145	008	0	1	09	04	H8145_008_0	5	003	MyOption Plus	19.90	2			2	1	50.00	16b;		17a;17b;16a;16b;
H8145	011	0	1	09	04	H8145_011_0	5	001	MyOption Dental High PPO	21.10	1	2000.00	3	2	2			16a;16b;	
H8145	011	0	1	09	04	H8145_011_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	011	0	1	09	04	H8145_011_0	5	003	MyOption Platinum Dental	25.00	1	2000.00	3	2	2				16a;16b;
H8145	021	0	1	09	04	H8145_021_0	3	001	MyOption Dental High PPO	20.70	1	2000.00	3	2	2			16a;16b;	
H8145	021	0	1	09	04	H8145_021_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	021	0	1	09	04	H8145_021_0	3	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H8145	032	0	1	09	04	H8145_032_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	032	0	1	09	04	H8145_032_0	4	002	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
H8145	032	0	1	09	04	H8145_032_0	4	003	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
H8145	042	0	1	09	04	H8145_042_0	4	001	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	042	0	1	09	04	H8145_042_0	4	002	MyOption Plus	21.40	2			2	1	50.00	16b;	16a;16b;	17a;17b;
H8145	042	0	1	09	04	H8145_042_0	4	003	MyOption Platinum Dental	25.30	1	2000.00	3	2	2				16a;16b;
H8145	050	0	1	09	04	H8145_050_0	2	001	MyOption Dental High PPO	20.70	1	2000.00	3	2	2			16a;16b;	
H8145	050	0	1	09	04	H8145_050_0	2	002	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H8145	051	0	1	09	04	H8145_051_0	3	001	MyOption Dental High PPO	20.70	1	2000.00	3	2	2			16a;16b;	
H8145	051	0	1	09	04	H8145_051_0	3	002	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
H8145	052	0	1	09	04	H8145_052_0	5	001	MyOption Dental High PPO	18.90	1	2000.00	3	2	2			16a;16b;	
H8145	052	0	1	09	04	H8145_052_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	052	0	1	09	04	H8145_052_0	5	003	MyOption Platinum Dental	23.00	1	2000.00	3	2	2				16a;16b;
H8145	055	0	1	09	04	H8145_055_0	3	001	MyOption Dental High PPO	18.90	1	2000.00	3	2	2			16a;16b;	
H8145	055	0	1	09	04	H8145_055_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	055	0	1	09	04	H8145_055_0	3	003	MyOption Platinum Dental	23.00	1	2000.00	3	2	2				16a;16b;
H8145	063	0	1	09	04	H8145_063_0	5	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
H8145	063	0	1	09	04	H8145_063_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	063	0	1	09	04	H8145_063_0	5	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H8145	069	0	1	09	04	H8145_069_0	4	001	MyOption Dental High PPO	17.80	1	2000.00	3	2	2			16a;16b;	
H8145	069	0	1	09	04	H8145_069_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	069	0	1	09	04	H8145_069_0	4	003	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H8145	069	0	1	09	04	H8145_069_0	4	004	MyOption Platinum Dental	22.00	1	2000.00	3	2	2				16a;16b;
H8145	075	0	1	09	04	H8145_075_0	4	001	MyOption Dental High PPO	15.20	1	2000.00	3	2	2			16a;16b;	
H8145	084	0	1	09	04	H8145_084_0	5	001	MyOption Dental High PPO	16.60	1	2000.00	3	2	2			16a;16b;	
H8145	084	0	1	09	04	H8145_084_0	5	002	MyOption Plus	19.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H8145	084	0	1	09	04	H8145_084_0	5	003	MyOption Fitness	15.00	2			2	2			14c;	
H8145	084	0	1	09	04	H8145_084_0	5	004	MyOption Platinum Dental	20.30	1	2000.00	3	2	2				16a;16b;
H8145	089	0	1	09	04	H8145_089_0	5	001	MyOption Dental High PPO	30.50	1	2000.00	3	2	2			16a;16b;	
H8145	089	0	1	09	04	H8145_089_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	089	0	1	09	04	H8145_089_0	5	003	MyOption Plus	26.00	2			2	1	50.00	16b;		17a;17b;16a;16b;
H8145	091	0	1	09	04	H8145_091_0	4	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H8145	091	0	1	09	04	H8145_091_0	4	002	MyOption Fitness	15.00	2			2	2			14c;	
H8145	103	0	1	09	04	H8145_103_0	6	001	MyOption Dental High PPO	26.60	1	2000.00	3	2	2			16a;16b;	
H8145	103	0	1	09	04	H8145_103_0	6	002	MyOption Vision	15.30	2			2	2				17a;17b;
H8145	103	0	1	09	04	H8145_103_0	6	003	MyOption Plus	22.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
H8145	108	0	1	09	04	H8145_108_0	2	001	MyOption Dental High PPO	21.40	1	2000.00	3	2	2			16a;16b;	
H8145	120	0	1	09	04	H8145_120_0	2	001	MyOption Fitness	15.00	2			2	2			14c;	
H8145	121	0	1	09	04	H8145_121_0	3	001	MyOption Vision	15.30	2			2	2				17a;17b;
H8145	121	0	1	09	04	H8145_121_0	3	002	MyOption Dental Enriched PPO	23.30	1	2000.00	3	2	2				16a;16b;
H8145	123	0	1	09	04	H8145_123_0	4	001	MyOption Enhanced Dental PPO	25.10	1	2000.00	3	2	2				16a;16b;
H8145	123	0	1	09	04	H8145_123_0	4	002	MyOption Fitness	15.00	2			2	2			14c;	
H8145	125	0	1	09	04	H8145_125_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
H8145	126	0	1	09	04	H8145_126_0	4	001	MyOption Dental High PPO	16.60	1	2000.00	3	2	2			16a;16b;	
H8145	126	0	1	09	04	H8145_126_0	4	002	MyOption Fitness	15.00	2			2	2			14c;	
H8145	155	0	1	09	04	H8145_155_0	4	001	MyOption Dental High PPO	17.30	1	2000.00	3	2	2			16a;16b;	
H8145	155	0	1	09	04	H8145_155_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
H8145	155	0	1	09	04	H8145_155_0	4	003	MyOption Plus	20.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
H8211	001	0	1	04	01	H8211_001_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8211	002	0	1	04	01	H8211_002_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8211	003	0	1	04	01	H8211_003_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8211	004	0	1	04	01	H8211_004_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8280	001	0	1	01	01	H8280_001_0	9	001	AL HMO Comprehensive Dental	21.00	1	1500.00	3	2	1	100.00	16b;	16b;	
H8280	002	0	1	01	01	H8280_002_0	11	001	AL HMO Comprehensive Dental	21.00	1	1500.00	3	2	1	100.00	16b;	16b;	
H8280	003	0	1	02	01	H8280_003_0	9	001	AL HMO Comprehensive Dental	21.00	1	1500.00	3	2	1	100.00	16b;	16b;	
H8280	003	0	1	02	01	H8280_003_0	9	002	AL HMO Vision Materials	4.00	2			2	2			17b;	
H8280	004	0	1	02	01	H8280_004_0	11	001	AL HMO Comprehensive Dental	21.00	1	1500.00	3	2	1	100.00	16b;	16b;	
H8432	005	0	1	02	01	H8432_005_0	6	001	Preventive Dental Package	16.00	2			2	2				16a;
H8432	005	0	1	02	01	H8432_005_0	6	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H8432	005	0	1	02	01	H8432_005_0	6	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H8432	006	0	1	02	01	H8432_006_0	6	001	Preventive Dental Package	16.00	2			2	2				16a;
H8432	006	0	1	02	01	H8432_006_0	6	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H8432	006	0	1	02	01	H8432_006_0	6	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H8432	008	5	1	01	01	H8432_008_5	5	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	008	5	1	01	01	H8432_008_5	5	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	008	5	1	01	01	H8432_008_5	5	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	008	6	1	01	01	H8432_008_6	5	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	008	6	1	01	01	H8432_008_6	5	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	008	6	1	01	01	H8432_008_6	5	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	008	7	1	01	01	H8432_008_7	5	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	008	7	1	01	01	H8432_008_7	5	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	008	7	1	01	01	H8432_008_7	5	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	009	0	1	01	01	H8432_009_0	6	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	009	0	1	01	01	H8432_009_0	6	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	009	0	1	01	01	H8432_009_0	6	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	010	0	1	01	01	H8432_010_0	6	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	010	0	1	01	01	H8432_010_0	6	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	010	0	1	01	01	H8432_010_0	6	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	011	0	1	01	01	H8432_011_0	6	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	011	0	1	01	01	H8432_011_0	6	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	011	0	1	01	01	H8432_011_0	6	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	012	0	1	01	01	H8432_012_0	4	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	012	0	1	01	01	H8432_012_0	4	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	012	0	1	01	01	H8432_012_0	4	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	013	0	1	01	01	H8432_013_0	5	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	013	0	1	01	01	H8432_013_0	5	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	013	0	1	01	01	H8432_013_0	5	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	014	0	1	02	01	H8432_014_0	6	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	014	0	1	02	01	H8432_014_0	6	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	014	0	1	02	01	H8432_014_0	6	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	015	0	1	02	01	H8432_015_0	5	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	015	0	1	02	01	H8432_015_0	5	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	015	0	1	02	01	H8432_015_0	5	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	017	0	1	01	01	H8432_017_0	6	001	Preventive Dental Package	14.00	2			2	2				16a;
H8432	017	0	1	01	01	H8432_017_0	6	002	Dental and Vision Package	24.00	2			2	2				16a;16b;17b;
H8432	017	0	1	01	01	H8432_017_0	6	003	Enhanced Dental and Vision Package	38.00	2			2	2				16a;16b;17b;
H8432	031	1	1	01	01	H8432_031_1	5	001	Preventive Dental Package	16.00	2			2	2				16a;
H8432	031	1	1	01	01	H8432_031_1	5	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H8432	031	1	1	01	01	H8432_031_1	5	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H8432	031	2	1	01	01	H8432_031_2	6	001	Preventive Dental Package	16.00	2			2	2				16a;
H8432	031	2	1	01	01	H8432_031_2	6	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
H8432	031	2	1	01	01	H8432_031_2	6	003	Enhanced Dental and Vision Package	47.00	2			2	2				16a;16b;17b;
H8506	001	0	1	01	01	H8506_001_0	10	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H8506	002	0	1	01	01	H8506_002_0	8	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H8506	003	0	1	01	01	H8506_003_0	11	001	Moda Health Extra Care	6.00	1	500.00	3	2	2			13a;14c;	7b;
H8552	020	0	1	04	01	H8552_020_0	10	001	Preventive Dental Package	22.00	2			2	2				16a;
H8552	020	0	1	04	01	H8552_020_0	10	002	Dental and Vision Package	35.00	2			2	2				16a;16b;17b;
H8552	020	0	1	04	01	H8552_020_0	10	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
H8634	003	0	1	04	01	H8634_003_0	7	001	Optional Supplemental	38.00	1	2150.00	6	2	2			16a;16b;17b;18a;18b;	
H8748	002	0	1	01	01	H8748_002_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	008	0	1	02	01	H8748_008_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H8748	010	0	1	02	01	H8748_010_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H8748	012	0	1	01	01	H8748_012_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	013	0	1	01	01	H8748_013_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	014	0	1	01	01	H8748_014_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	015	0	1	01	01	H8748_015_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	017	0	1	01	01	H8748_017_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	018	0	1	01	01	H8748_018_0	3	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	019	0	1	01	01	H8748_019_0	2	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	020	0	1	01	01	H8748_020_0	4	001	Dental Platinum Rider	34.00	2			2	1	100.00	16b;		16a;16b;
H8748	022	0	1	02	01	H8748_022_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H8764	001	0	1	01	01	H8764_001_0	11	001	Enhanced Benefits-Option A	44.90	2			2	2				16a;16b;17a;17b;
H8764	001	0	1	01	01	H8764_001_0	11	002	Enhanced Benefits-Option B	49.90	2			2	2			13c;	10b;16a;16b;17a;17b;18a;18b;
H8764	002	0	1	02	01	H8764_002_0	11	001	Enhanced Benefits-Option A	44.90	2			2	2				16a;16b;17a;17b;
H8764	002	0	1	02	01	H8764_002_0	11	002	Enhanced Benefits-Option B	49.90	2			2	2			13c;	10b;16a;16b;17a;17b;18a;18b;
H8764	003	0	1	01	01	H8764_003_0	11	001	Enhanced Benefits-Option A	44.90	2			2	2				16a;16b;17a;17b;
H8764	003	0	1	01	01	H8764_003_0	11	002	Enhanced Benefits-Option B	49.90	2			2	2			13c;	10b;16a;16b;17a;17b;18a;18b;
H8768	001	0	1	04	01	H8768_001_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H8768	002	0	1	04	01	H8768_002_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
H8768	003	0	1	04	01	H8768_003_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8768	004	0	1	04	01	H8768_004_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8768	005	0	1	04	01	H8768_005_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8768	006	0	1	04	01	H8768_006_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8768	007	0	1	04	01	H8768_007_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
H8783	001	0	1	04	01	H8783_001_0	6	001	Choice Dental	21.00	1	1000.00	3	2	1	75.00	16b;		16a;16b;
H8783	002	0	1	04	01	H8783_002_0	5	001	Choice Dental	21.00	1	1000.00	3	2	1	75.00	16b;		16a;16b;
H8908	001	0	1	01	01	H8908_001_0	3	001	MyOption Enhanced Dental Plus HMO	32.90	1	2000.00	3	2	2				16a;16b;
H8908	001	0	1	01	01	H8908_001_0	3	002	MyOption Total Dental Plus HMO	38.20	1	2000.00	3	2	2				16a;16b;
H8908	002	0	1	01	01	H8908_002_0	4	001	MyOption Enhanced Dental HMO	25.80	1	2000.00	3	2	2				16a;16b;
H8908	002	0	1	01	01	H8908_002_0	4	002	MyOption Total Dental HMO	31.10	1	2000.00	3	2	2				16a;16b;
H8908	004	0	1	01	01	H8908_004_0	4	001	MyOption Enhanced Dental HMO	25.80	1	2000.00	3	2	2				16a;16b;
H8908	004	0	1	01	01	H8908_004_0	4	002	MyOption Total Dental HMO	31.10	1	2000.00	3	2	2				16a;16b;
H9003	001	0	1	01	01	H9003_001_0	6	001	ADVANTAGE PLUS	44.00	1	1250.00	3	2	2			16a;16b;17b;18b;	
H9003	006	0	1	01	01	H9003_006_0	6	001	ADVANTAGE PLUS	44.00	1	1250.00	3	2	2			16a;16b;17b;18b;	
H9047	001	0	1	01	01	H9047_001_0	6	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	001	0	1	01	01	H9047_001_0	6	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	013	0	2	01	01	H9047_013_0	7	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	013	0	2	01	01	H9047_013_0	7	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	024	0	1	02	01	H9047_024_0	6	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	024	0	1	02	01	H9047_024_0	6	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	033	0	1	01	01	H9047_033_0	5	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	033	0	1	01	01	H9047_033_0	5	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	035	0	1	02	01	H9047_035_0	5	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	035	0	1	02	01	H9047_035_0	5	002	Enhanced Dental	46.50	1	1500.00	3	1	1	150.00	16b;		16a;16b;
H9047	037	0	1	01	01	H9047_037_0	6	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	037	0	1	01	01	H9047_037_0	6	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	038	0	1	02	01	H9047_038_0	6	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	038	0	1	02	01	H9047_038_0	6	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	039	0	1	02	01	H9047_039_0	6	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	039	0	1	02	01	H9047_039_0	6	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	045	0	1	01	01	H9047_045_0	6	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	045	0	1	01	01	H9047_045_0	6	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9047	047	0	1	02	01	H9047_047_0	7	001	Washington Basic Dental	35.50	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	047	0	1	02	01	H9047_047_0	7	002	Washington Enhanced Dental	49.60	1	1500.00	3	2	1	150.00	16a;16b;		16a;16b;
H9047	049	0	1	01	01	H9047_049_0	7	001	Washington Basic Dental	35.50	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	049	0	1	01	01	H9047_049_0	7	002	Washington Enhanced Dental	49.60	1	1500.00	3	2	1	150.00	16a;16b;		16a;16b;
H9047	054	0	1	01	01	H9047_054_0	7	001	Basic Dental	33.70	1	1000.00	3	2	1	150.00	16b;		16a;16b;
H9047	054	0	1	01	01	H9047_054_0	7	002	Enhanced Dental	46.50	1	1500.00	3	2	1	150.00	16b;		16a;16b;
H9070	001	0	1	04	01	H9070_001_0	3	001	MyOption Enhanced Dental PPO	19.70	1	2000.00	3	2	2				16a;16b;
H9104	006	0	1	01	01	H9104_006_0	5	001	Basic Dental	6.00	2			2	2				16a;16b;
H9104	006	0	1	01	01	H9104_006_0	5	002	Enhanced Dental	16.00	2			2	2				16a;16b;
H9287	001	0	1	01	01	H9287_001_0	5	001	Gold Package #3	45.00	2			2	2			7b;13a;16a;16b;	
H9287	001	0	1	01	01	H9287_001_0	5	002	Gold Package #4	21.00	2			2	1	50.00	16a;16b;		16a;16b;
H9431	002	0	1	04	01	H9431_002_0	3	001	Aetna Medicare Advantage PPO Dental Plan	20.00	1	1000.00	3	2	1	50.00	16b;	16a;16b;	
H9460	001	0	1	01	01	H9460_001_0	4	001	Enhanced Dental & Vision	46.10	1	1000.00	3	2	2			16b;17a;17b;	
H9460	002	0	1	01	01	H9460_002_0	3	001	Enhanced Dental & Vision	46.10	1	1000.00	3	2	2			16b;17a;17b;	
H9516	001	0	1	04	01	H9516_001_0	11	001	NY PPO Comprehensive Dental	18.00	1	1000.00	3	2	2			16b;	
H9525	004	0	1	01	01	H9525_004_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H9525	004	0	1	01	01	H9525_004_0	11	002	Dental and Vision Package	23.00	2			2	2				16a;16b;17b;
H9525	004	0	1	01	01	H9525_004_0	11	003	Enhanced Dental and Vision Package	37.00	2			2	2				16a;16b;17b;
H9525	006	0	1	01	01	H9525_006_0	11	001	Preventive Dental Package	12.00	2			2	2				16a;
H9525	006	0	1	01	01	H9525_006_0	11	002	Dental and Vision Package	23.00	2			2	2				16a;16b;17b;
H9525	006	0	1	01	01	H9525_006_0	11	003	Enhanced Dental and Vision Package	37.00	2			2	2				16a;16b;17b;
H9525	008	0	1	01	01	H9525_008_0	11	001	Preventive Dental Package	16.00	2			2	2				16a;
H9525	008	0	1	01	01	H9525_008_0	11	002	Dental and Vision Package	23.00	2			2	2				16a;16b;17b;
H9525	008	0	1	01	01	H9525_008_0	11	003	Enhanced Dental and Vision Package	45.00	2			2	2				16a;16b;17b;
H9572	001	1	1	04	01	H9572_001_1	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	001	2	1	04	01	H9572_001_2	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	001	3	1	04	01	H9572_001_3	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	001	4	1	04	01	H9572_001_4	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	001	6	1	04	01	H9572_001_6	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	002	1	1	04	01	H9572_002_1	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	002	2	1	04	01	H9572_002_2	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	002	3	1	04	01	H9572_002_3	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	002	4	1	04	01	H9572_002_4	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	002	6	1	04	01	H9572_002_6	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	003	1	1	04	01	H9572_003_1	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	003	2	1	04	01	H9572_003_2	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	003	3	1	04	01	H9572_003_3	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	003	4	1	04	01	H9572_003_4	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	003	6	1	04	01	H9572_003_6	4	001	Optional Dental and Vision	23.00	1	2900.00	6	2	2			16a;16b;	17b;
H9572	004	1	1	04	01	H9572_004_1	4	001	Optional Dental and Vision	28.50	1	3000.00	6	2	2			16a;16b;17b;	
H9572	004	2	1	04	01	H9572_004_2	4	001	Optional Dental and Vision	28.50	1	3000.00	6	2	2			16a;16b;17b;	
H9572	004	3	1	04	01	H9572_004_3	4	001	Optional Dental and Vision	28.50	1	3000.00	6	2	2			16a;16b;17b;	
H9572	004	4	1	04	01	H9572_004_4	4	001	Optional Dental and Vision	28.50	1	3000.00	6	2	2			16a;16b;17b;	
H9572	004	6	1	04	01	H9572_004_6	4	001	Optional Dental and Vision	28.50	1	3000.00	6	2	2			16a;16b;17b;	
H9630	001	0	1	01	01	H9630_001_0	4	001	Dental Package A	23.00	1	1000.00	3	2	2			16b;	
H9725	001	0	1	01	01	H9725_001_0	4	001	Enhanced Dental - Comprehensive	46.20	1	1000.00	3	2	2			16b;	
H9725	005	0	1	01	01	H9725_005_0	3	001	Enhanced Dental - Comprehensive	46.20	1	1000.00	3	2	2			16b;	
H9808	004	0	1	04	01	H9808_004_0	7	001	Dental Rider	25.00	2			2	2			16b;	
H9808	005	0	1	04	01	H9808_005_0	7	001	Dental Rider	25.00	1	750.00	3	2	2			16b;	
H9808	006	0	1	04	01	H9808_006_0	7	001	Dental Rider	25.00	2			2	2			16b;	
H9808	007	0	1	04	01	H9808_007_0	7	001	Dental Rider	25.00	1	750.00	3	2	2			16b;	
H9811	005	0	1	01	01	H9811_005_0	6	001	Comprehensive Dental	13.00	1	1000.00	3	2	1	50.00	16b;	16b;	
H9878	001	0	1	04	01	H9878_001_0	11	001	OH PPO Vision Materials	4.00	2			2	2			17b;	
H9878	001	0	1	04	01	H9878_001_0	11	002	OH PPO Comprehensive Dental	18.00	1	1000.00	3	2	2			16b;	
H9878	002	0	1	04	01	H9878_002_0	11	001	OH PPO Comprehensive Dental	18.00	1	1000.00	3	2	2			16b;	
R0110	002	0	1	31	11	R0110_002_0	4	001	MyOption Dental High PPO	25.80	1	2000.00	3	2	2			16a;16b;	
R0110	003	0	1	31	11	R0110_003_0	5	001	MyOption Total Dental Plus PPO	37.80	1	2000.00	3	2	2				16a;16b;
R0865	001	0	1	31	11	R0865_001_0	4	001	MyOption Enhanced Dental PPO	21.10	1	2000.00	3	2	2				16a;16b;
R0865	001	0	1	31	11	R0865_001_0	4	002	MyOption Total Dental PPO	25.00	1	2000.00	3	2	2				16a;16b;
R0865	003	0	1	31	11	R0865_003_0	3	001	MyOption Vision	15.30	2			2	2				17a;17b;
R0865	003	0	1	31	11	R0865_003_0	3	002	MyOption Platinum Dental	25.00	1	2000.00	3	2	2			16a;16b;	
R0923	001	0	1	31	11	R0923_001_0	4	001	MyOption Enhanced Dental Plus PPO	27.70	1	2000.00	3	2	2				16a;16b;
R0923	001	0	1	31	11	R0923_001_0	4	002	MyOption Total Dental Plus PPO	31.20	1	2000.00	3	2	2				16a;16b;
R0923	002	0	1	31	11	R0923_002_0	4	001	MyOption Dental High PPO	20.70	1	2000.00	3	2	2			16a;16b;	
R0923	002	0	1	31	11	R0923_002_0	4	002	MyOption Vision	15.30	2			2	2			17a;17b;	
R0923	002	0	1	31	11	R0923_002_0	4	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
R1390	001	0	1	31	11	R1390_001_0	5	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
R1390	001	0	1	31	11	R1390_001_0	5	002	MyOption Vision	15.30	2			2	2				17a;17b;
R1390	001	0	1	31	11	R1390_001_0	5	003	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
R1390	002	0	1	31	11	R1390_002_0	6	001	MyOption Dental High PPO	21.70	1	2000.00	3	2	2			16a;16b;	
R1390	002	0	1	31	11	R1390_002_0	6	002	MyOption Plus	22.50	2			2	1	50.00	16b;		17a;17b;16a;16b;
R1390	002	0	1	31	11	R1390_002_0	6	003	MyOption Platinum Dental	25.70	1	2000.00	3	2	2				16a;16b;
R1532	002	0	1	31	11	R1532_002_0	4	001	MyOption Vision	15.30	2			2	2				17a;17b;
R3392	002	0	1	31	11	R3392_002_0	4	001	MyOption Enhanced Dental PPO	17.80	1	2000.00	3	2	2				16a;16b;
R3444	009	0	1	31	11	R3444_009_0	3	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R3444	012	0	1	31	11	R3444_012_0	3	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R3887	001	0	1	31	11	R3887_001_0	4	001	MyOption Dental Enriched PPO	23.30	1	2000.00	3	2	2				16a;16b;
R3887	001	0	1	31	11	R3887_001_0	4	002	MyOption Total Dental PPO	28.30	1	2000.00	3	2	2				16a;16b;
R3887	002	0	1	31	11	R3887_002_0	6	001	MyOption Dental Enriched PPO	23.30	1	2000.00	3	2	2				16a;16b;
R3887	002	0	1	31	11	R3887_002_0	6	002	MyOption Total Dental PPO	28.30	1	2000.00	3	2	2				16a;16b;
R4182	001	0	1	31	11	R4182_001_0	4	001	MyOption Fitness	15.00	2			2	2			14c;	
R4182	003	0	1	31	11	R4182_003_0	4	001	MyOption Fitness	15.00	2			2	2			14c;	
R4182	004	0	1	31	11	R4182_004_0	4	001	MyOption Dental High PPO	16.60	1	2000.00	3	2	2			16a;16b;	
R4182	004	0	1	31	11	R4182_004_0	4	002	MyOption Fitness	15.00	2			2	2			14c;	
R4487	001	0	1	31	11	R4487_001_0	9	001	Preventive Dental Package	19.00	2			2	2				16a;
R4487	001	0	1	31	11	R4487_001_0	9	002	Dental and Vision Package	27.00	2			2	2				16a;16b;17b;
R4487	001	0	1	31	11	R4487_001_0	9	003	Enhanced Dental and Vision Package	50.00	2			2	2				16a;16b;17b;
R4845	002	0	1	31	11	R4845_002_0	3	001	MyOption Vision	15.30	2			2	2				17a;17b;
R4845	002	0	1	31	11	R4845_002_0	3	002	MyOption Platinum Dental	23.70	1	2000.00	3	2	2			16a;16b;	
R5329	001	0	1	31	11	R5329_001_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R5342	001	0	1	31	11	R5342_001_0	4	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
R5342	002	0	1	31	11	R5342_002_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R5342	005	0	1	31	11	R5342_005_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R5342	006	0	1	31	11	R5342_006_0	4	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R5361	001	0	1	31	11	R5361_001_0	5	001	MyOption Vision	15.30	2			2	2				17a;17b;
R5361	001	0	1	31	11	R5361_001_0	5	002	MyOption Dental Enriched PPO	29.40	1	2000.00	3	2	2				16a;16b;
R5361	002	0	1	31	11	R5361_002_0	5	001	MyOption Dental High PPO	29.40	1	2000.00	3	2	2			16a;16b;	
R5361	002	0	1	31	11	R5361_002_0	5	002	MyOption Vision	15.30	2			2	2			17a;17b;	
R5361	002	0	1	31	11	R5361_002_0	5	003	MyOption Plus	24.80	2			2	1	50.00	16b;		17a;17b;16a;16b;
R5495	001	0	1	31	11	R5495_001_0	5	001	MyOption Enhanced Dental PPO	19.90	1	2000.00	3	2	2				16a;16b;
R5495	001	0	1	31	11	R5495_001_0	5	002	MyOption Total Dental PPO	24.20	1	2000.00	3	2	2				16a;16b;
R5495	002	0	1	31	11	R5495_002_0	3	001	MyOption Dental High PPO	19.90	1	2000.00	3	2	2			16a;16b;	
R5495	002	0	1	31	11	R5495_002_0	3	002	MyOption Vision	15.30	2			2	2			17a;17b;	
R5495	002	0	1	31	11	R5495_002_0	3	003	MyOption Platinum Dental	24.20	1	2000.00	3	2	2				16a;16b;
R5941	013	0	1	31	11	R5941_013_0	8	001	Preventive Dental Package	20.00	2			2	2				16a;
R5941	013	0	1	31	11	R5941_013_0	8	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
R5941	013	0	1	31	11	R5941_013_0	8	003	Enhanced Dental and Vision Package	42.00	2			2	2				16a;16b;17b;
R5941	014	0	1	31	11	R5941_014_0	8	001	Preventive Dental Package	20.00	2			2	2				16a;
R5941	014	0	1	31	11	R5941_014_0	8	002	Dental and Vision Package	28.00	2			2	2				16a;16b;17b;
R5941	014	0	1	31	11	R5941_014_0	8	003	Enhanced Dental and Vision Package	42.00	2			2	2				16a;16b;17b;
R6801	009	0	1	31	11	R6801_009_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
R6801	012	0	1	31	11	R6801_012_0	3	001	Dental Platinum Rider	39.00	2			2	1	100.00	16b;		16a;16b;
R7220	001	0	1	31	11	R7220_001_0	5	001	MyOption Vision	15.30	2			2	2				17a;17b;
R7220	001	0	1	31	11	R7220_001_0	5	002	MyOption Enhanced Dental PPO	26.60	1	2000.00	3	2	2				16a;16b;
R7220	002	0	1	31	11	R7220_002_0	5	001	MyOption Dental High PPO	26.60	1	2000.00	3	2	2			16a;16b;	
R7220	002	0	1	31	11	R7220_002_0	5	002	MyOption Vision	15.30	2			2	2				17a;17b;
R7220	002	0	1	31	11	R7220_002_0	5	003	MyOption Plus	22.70	2			2	1	50.00	16b;		17a;17b;16a;16b;
R7315	002	0	1	31	11	R7315_002_0	4	001	MyOption Dental High PPO	19.30	1	2000.00	3	2	2			16a;16b;	
R7444	001	0	1	31	11	R7444_001_0	5	001	Fitness Rider	18.00	2			2	2			14c;	
R7444	001	0	1	31	11	R7444_001_0	5	002	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R7444	008	0	1	31	11	R7444_008_0	3	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
R7444	010	0	1	31	11	R7444_010_0	3	001	Dental Platinum Rider	32.00	2			2	1	100.00	16b;		16a;16b;
