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_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	4	001	MyOption Vision	15.30	2			2				17a;17b;
H0028	004	0	1	01	01	H0028_004_0	4	002	MyOption Enhanced Dental HMO	35.50	1	1500.00	3	2				16a;16b;
H0028	008	1	1	01	01	H0028_008_1	4	001	MyOption Dental Enriched HMO	28.30	1	1500.00	3	2				16a;16b;
H0028	008	2	1	01	01	H0028_008_2	4	001	MyOption Dental Enriched HMO	20.80	1	1500.00	3	2				16a;16b;
H0294	002	0	1	04	01	H0294_002_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H0294	004	0	1	04	01	H0294_004_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H0351	030	0	1	01	01	H0351_030_0	3	001	Gold Package # 1	49.00	2			2			7b;13a;16a;16b;17a;17b;	
H0351	030	0	1	01	01	H0351_030_0	3	002	Gold Package # 2	25.00	2			2				16a;16b;17a;17b;
H0351	038	0	1	01	01	H0351_038_0	4	001	Gold Package # 3	45.00	2			2			7b;13a;16a;16b;	
H0351	038	0	1	01	01	H0351_038_0	4	002	Gold Package # 4	21.00	2			1	50.00	16a;16b;		16a;16b;
H0351	040	0	1	01	01	H0351_040_0	4	001	Gold Package # 1	49.00	2			2			7b;13a;16a;16b;17a;17b;	
H0351	040	0	1	01	01	H0351_040_0	4	002	Gold Package # 2	25.00	2			2				16a;16b;17a;17b;
H0351	041	0	1	01	01	H0351_041_0	4	001	Gold Package # 5	9.00	2			2			7b;13a;17a;17b;	
H0351	042	0	1	01	01	H0351_042_0	4	001	Gold Package # 3	45.00	2			2			7b;13a;16a;16b;	
H0351	042	0	1	01	01	H0351_042_0	4	002	Gold Package # 4	21.00	2			1	50.00	16a;16b;		16a;16b;
H0351	043	1	1	01	01	H0351_043_1	4	001	Gold Package # 1	49.00	2			2			7b;13a;16a;16b;17a;17b;	
H0351	043	1	1	01	01	H0351_043_1	4	002	Gold Package # 2	25.00	2			2				16a;16b;17a;17b;
H0351	043	4	1	01	01	H0351_043_4	7	001	Gold Package # 1	49.00	2			2			7b;13a;16a;16b;17a;17b;	
H0351	043	4	1	01	01	H0351_043_4	7	002	Gold Package # 2	25.00	2			2				16a;16b;17a;17b;
H0351	044	1	1	01	01	H0351_044_1	4	001	Gold Package # 1	49.00	2			2			7b;13a;16a;16b;17a;17b;	
H0351	044	1	1	01	01	H0351_044_1	4	002	Gold Package # 2	25.00	2			2				16a;16b;17a;17b;
H0351	044	2	1	01	01	H0351_044_2	4	001	Gold Package # 1	49.00	2			2			7b;13a;16a;16b;17a;17b;	
H0351	044	2	1	01	01	H0351_044_2	4	002	Gold Package # 2	25.00	2			2				16a;16b;17a;17b;
H0351	044	3	1	01	01	H0351_044_3	4	001	Gold Package #1	49.00	2			2			7b;13a;16a;16b;17a;17b;	
H0351	044	3	1	01	01	H0351_044_3	4	002	Gold Package #2	25.00	2			2				16a;16b;17a;17b;
H0354	001	0	1	01	01	H0354_001_0	5	001	Cigna Dental Care Plan	20.00	2			2			16a;16b;	
H0354	024	0	1	01	01	H0354_024_0	5	001	Cigna Dental Care Plan	20.00	2			2			16a;16b;	
H0354	027	0	1	01	01	H0354_027_0	6	001	Cigna Dental Care Plan	20.00	2			2			16a;16b;	
H0504	015	0	1	01	01	H0504_015_0	5	001	Dental HMO	12.90	2			2			16a;16b;	
H0504	015	0	1	01	01	H0504_015_0	5	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0504	017	0	1	01	01	H0504_017_0	4	001	Dental HMO	12.90	2			2			16a;16b;	
H0504	017	0	1	01	01	H0504_017_0	4	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0504	021	0	1	01	01	H0504_021_0	6	001	Dental HMO	12.90	2			2				16a;16b;
H0504	021	0	1	01	01	H0504_021_0	6	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0504	026	0	1	01	01	H0504_026_0	4	001	Dental HMO	12.90	2			2			16a;16b;	
H0504	026	0	1	01	01	H0504_026_0	4	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0504	028	0	1	01	01	H0504_028_0	4	001	Dental HMO	12.90	2			2			16a;16b;	
H0504	028	0	1	01	01	H0504_028_0	4	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0504	029	0	1	01	01	H0504_029_0	4	001	Dental HMO	12.90	2			2			16a;16b;	
H0504	029	0	1	01	01	H0504_029_0	4	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0504	031	0	1	01	01	H0504_031_0	4	001	Dental HMO	12.90	2			2			16a;16b;	
H0504	031	0	1	01	01	H0504_031_0	4	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0504	037	0	1	01	01	H0504_037_0	4	001	Dental HMO	12.90	2			2			16a;16b;	
H0504	037	0	1	01	01	H0504_037_0	4	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H0523	002	0	1	01	01	H0523_002_0	4	001	DMO Dental	12.40	2			2			16a;16b;	
H0523	002	0	1	01	01	H0523_002_0	4	002	DMO Dental Plus EyeWear and Hearing Aids	22.40	2			2			16a;16b;17b;18b;	
H0523	022	0	1	01	01	H0523_022_0	4	001	DMO Dental	12.40	2			2			16a;16b;	
H0523	022	0	1	01	01	H0523_022_0	4	002	DMO Dental Plus Hearing Aids	15.40	2			2			16a;16b;18b;	
H0523	031	0	1	01	01	H0523_031_0	5	001	DMO Dental	12.40	2			2			16a;16b;	
H0523	031	0	1	01	01	H0523_031_0	5	002	DMO Dental Plus Hearing Aids	15.40	2			2			16a;16b;18b;	
H0523	052	0	1	01	01	H0523_052_0	4	001	DMO Dental	12.40	2			2			16a;16b;	
H0523	052	0	1	01	01	H0523_052_0	4	002	DMO Dental Plus EyeWear	19.40	2			2			16a;16b;17b;	
H0523	060	0	1	01	01	H0523_060_0	4	001	DMO Dental	12.40	2			2			16a;16b;	
H0523	061	0	1	01	01	H0523_061_0	5	001	DMO Dental	12.40	2			2			16a;16b;	
H0523	061	0	1	01	01	H0523_061_0	5	002	DMO Dental Plus Hearing Aids	15.40	2			2			16a;16b;18b;	
H0524	002	0	2	01	01	H0524_002_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	003	0	1	01	01	H0524_003_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	008	0	1	01	01	H0524_008_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	010	0	2	01	01	H0524_010_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	013	0	1	01	01	H0524_013_0	8	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	015	0	1	01	01	H0524_015_0	9	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	031	0	1	01	01	H0524_031_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	032	0	1	01	01	H0524_032_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	033	0	1	01	01	H0524_033_0	7	001	Advantage Plus	20.00	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			14c;16a;16b;18a;18b;	17b;
H0524	035	0	1	01	01	H0524_035_0	7	001	Advantage Plus	20.00	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			14c;16a;16b;18a;18b;	17b;
H0524	037	0	1	01	01	H0524_037_0	6	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	038	0	1	01	01	H0524_038_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	039	0	1	01	01	H0524_039_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	040	0	1	01	01	H0524_040_0	6	001	Advantage Plus	20.00	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			14c;16a;16b;18a;18b;	17b;
H0524	042	0	1	01	01	H0524_042_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	043	0	1	01	01	H0524_043_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	046	0	1	01	01	H0524_046_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0524	051	0	1	01	01	H0524_051_0	7	001	Advantage Plus	20.00	2			2			14c;16a;16b;18a;18b;	17b;
H0543	001	0	1	01	01	H0543_001_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	001	0	1	01	01	H0543_001_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	004	0	1	01	01	H0543_004_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	004	0	1	01	01	H0543_004_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	007	0	1	01	01	H0543_007_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	007	0	1	01	01	H0543_007_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	013	0	1	01	01	H0543_013_0	5	001	High Option Dental Rider	11.00	2			2				16a;16b;
H0543	013	0	1	01	01	H0543_013_0	5	002	Fitness Rider	18.00	2			2			14c;	
H0543	022	0	1	01	01	H0543_022_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	022	0	1	01	01	H0543_022_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	029	0	1	01	01	H0543_029_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	029	0	1	01	01	H0543_029_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	036	0	1	01	01	H0543_036_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H0543	060	0	1	01	01	H0543_060_0	5	001	High Option Dental Rider	11.00	2			2				16a;16b;
H0543	060	0	1	01	01	H0543_060_0	5	002	Fitness Rider	18.00	2			2			14c;	
H0543	070	0	1	01	01	H0543_070_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	070	0	1	01	01	H0543_070_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	089	0	1	01	01	H0543_089_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H0543	138	0	1	01	01	H0543_138_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	138	0	1	01	01	H0543_138_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	140	0	1	01	01	H0543_140_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H0543	140	0	1	01	01	H0543_140_0	5	002	Fitness Rider	18.00	2			2			14c;	
H0543	144	0	1	01	01	H0543_144_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	144	0	1	01	01	H0543_144_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	145	0	1	01	01	H0543_145_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	145	0	1	01	01	H0543_145_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	146	0	1	01	01	H0543_146_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H0543	151	0	1	01	01	H0543_151_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	151	0	1	01	01	H0543_151_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	152	0	1	01	01	H0543_152_0	5	001	High Option Dental Rider	14.00	2			2				16a;16b;
H0543	152	0	1	01	01	H0543_152_0	5	002	Optional Dental Rider	3.00	2			2				16a;16b;
H0543	152	0	1	01	01	H0543_152_0	5	003	Fitness Rider	18.00	2			2			14c;	
H0544	002	0	1	01	01	H0544_002_0	8	001	Optional Dental	9.00	2			2				16a;16b;
H0544	004	0	1	01	01	H0544_004_0	9	001	Optional Dental	9.00	2			2				16a;16b;
H0544	005	0	1	01	01	H0544_005_0	9	001	Optional Dental	9.00	2			2				16a;16b;
H0544	007	0	1	01	01	H0544_007_0	9	001	Optional Dental	9.00	2			2				16a;16b;
H0544	008	0	1	01	01	H0544_008_0	7	001	Optional Dental	9.00	2			2				16a;16b;
H0544	010	0	1	01	01	H0544_010_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	012	0	1	01	01	H0544_012_0	7	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	013	0	1	01	01	H0544_013_0	8	001	Optional Dental	9.00	2			2				16a;16b;
H0544	014	0	1	01	01	H0544_014_0	8	001	Optional Dental	9.00	2			2				16a;16b;
H0544	019	0	1	01	01	H0544_019_0	7	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	021	0	1	01	01	H0544_021_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	024	0	1	01	01	H0544_024_0	7	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	025	0	1	01	01	H0544_025_0	9	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	027	0	1	01	01	H0544_027_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	031	0	1	01	01	H0544_031_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	032	0	1	01	01	H0544_032_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	036	0	1	01	01	H0544_036_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	037	0	1	01	01	H0544_037_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	038	0	1	01	01	H0544_038_0	8	001	Optional Dental	9.00	2			2			16a;16b;	
H0544	050	0	1	01	01	H0544_050_0	7	001	Optional Dental	9.00	2			2			16a;16b;	
H0545	001	0	1	01	01	H0545_001_0	11	001	Enhanced Dental	11.50	1	2000.00	3	2				16a;16b;
H0562	009	0	1	01	01	H0562_009_0	4	001	Buy-Up #6: Comp DPPO+Eyewear+Chiro/Acu+Fitness	30.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	012	0	1	01	01	H0562_012_0	4	001	Buy Up #7 Eyewear+Chiro/Acupuncture	12.00	2			2			7b;13a;17b;	
H0562	039	0	1	01	01	H0562_039_0	4	001	Buy-Up #9: Eyewear+Chiro/Acupuncture+Fitness	20.00	2			2			7b;13a;14c;17b;	
H0562	045	0	1	01	01	H0562_045_0	3	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	045	0	1	01	01	H0562_045_0	3	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0562	068	0	1	01	01	H0562_068_0	5	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	068	0	1	01	01	H0562_068_0	5	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0562	079	0	1	01	01	H0562_079_0	4	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	079	0	1	01	01	H0562_079_0	4	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0562	084	0	1	01	01	H0562_084_0	4	001	Buy Up #9: Eyewear+Chiro/Acupuncture+fitness	20.00	2			2			7b;13a;14c;17b;	
H0562	090	0	1	01	01	H0562_090_0	4	001	DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	090	0	1	01	01	H0562_090_0	4	002	DPPO+Eyewear+Chiro/Acupunture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0562	095	0	1	01	01	H0562_095_0	6	001	DPPO+Eyewear+Chiro/Acupuncture+Fitness	30.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	097	0	1	01	01	H0562_097_0	4	001	Buy Up 8: DHMO+Chiro/Acupuncture+Fitness	23.00	2			2			7b;13a;14c;16a;16b;	
H0562	100	1	1	01	01	H0562_100_1	4	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	100	1	1	01	01	H0562_100_1	4	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0562	100	2	1	01	01	H0562_100_2	5	001	DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	100	2	1	01	01	H0562_100_2	5	002	DPPO+Eyewear+Chiro/Acupuncture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0562	101	1	1	01	01	H0562_101_1	4	001	Buy-Up #7: Eyewear+Chiro/Acupuncture	12.00	2			2			7b;13a;17b;	
H0562	101	2	1	01	01	H0562_101_2	4	001	Buy-Up #7: Eyewear+Chiro/Acupuncture	12.00	2			2			7b;13a;17b;	
H0562	103	0	1	01	01	H0562_103_0	4	001	DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	103	0	1	01	01	H0562_103_0	4	002	DPPO+Eyewear+Chiro/Acupuncture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0562	113	0	1	01	01	H0562_113_0	4	001	Buy-Up #1: DHMO+Eyewear+Chiro/Acupuncture+Fitness	25.00	2			2			7b;13a;14c;16a;16b;17b;	
H0562	113	0	1	01	01	H0562_113_0	4	002	Buy-Up #2: DPPO+Eyewear+Chiro/Acupuncture+Fitness	35.00	2			2			7b;13a;14c;17b;	16a;16b;
H0564	060	0	1	01	01	H0564_060_0	8	001	Preventive Dental Package	12.00	2			2				16a;
H0564	060	0	1	01	01	H0564_060_0	8	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	060	0	1	01	01	H0564_060_0	8	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	061	0	1	01	01	H0564_061_0	7	001	Preventive Dental Package	12.00	2			2				16a;
H0564	061	0	1	01	01	H0564_061_0	7	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	061	0	1	01	01	H0564_061_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	062	0	1	01	01	H0564_062_0	8	001	Preventive Dental Package	12.00	2			2				16a;
H0564	062	0	1	01	01	H0564_062_0	8	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	062	0	1	01	01	H0564_062_0	8	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	063	0	1	01	01	H0564_063_0	8	001	Preventive Dental Package	12.00	2			2				16a;
H0564	063	0	1	01	01	H0564_063_0	8	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	063	0	1	01	01	H0564_063_0	8	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	067	1	1	01	01	H0564_067_1	9	001	Preventive Dental Package	12.00	2			2				16a;
H0564	067	1	1	01	01	H0564_067_1	9	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	067	1	1	01	01	H0564_067_1	9	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	067	2	1	01	01	H0564_067_2	10	001	Preventive Dental Package	12.00	2			2				16a;
H0564	067	2	1	01	01	H0564_067_2	10	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	067	2	1	01	01	H0564_067_2	10	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	068	0	1	01	01	H0564_068_0	8	001	Preventive Dental Package	12.00	2			2				16a;
H0564	068	0	1	01	01	H0564_068_0	8	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	068	0	1	01	01	H0564_068_0	8	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	069	0	1	01	01	H0564_069_0	7	001	Preventive Dental Package	12.00	2			2				16a;
H0564	069	0	1	01	01	H0564_069_0	7	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	069	0	1	01	01	H0564_069_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	070	0	1	01	01	H0564_070_0	7	001	Preventive Dental Package	12.00	2			2				16a;
H0564	070	0	1	01	01	H0564_070_0	7	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	070	0	1	01	01	H0564_070_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	071	0	1	01	01	H0564_071_0	7	001	Preventive Dental Package	12.00	2			2				16a;
H0564	071	0	1	01	01	H0564_071_0	7	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	071	0	1	01	01	H0564_071_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	072	0	1	01	01	H0564_072_0	8	001	Preventive Dental Package	12.00	2			2				16a;
H0564	072	0	1	01	01	H0564_072_0	8	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	072	0	1	01	01	H0564_072_0	8	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	074	0	1	01	01	H0564_074_0	7	001	Preventive Dental Package	12.00	2			2				16a;
H0564	074	0	1	01	01	H0564_074_0	7	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	074	0	1	01	01	H0564_074_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	076	0	1	01	01	H0564_076_0	9	001	Preventive Dental Package	12.00	2			2				16a;
H0564	076	0	1	01	01	H0564_076_0	9	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	076	0	1	01	01	H0564_076_0	9	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0564	077	0	1	01	01	H0564_077_0	9	001	Preventive Dental Package	12.00	2			2				16a;
H0564	077	0	1	01	01	H0564_077_0	9	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H0564	077	0	1	01	01	H0564_077_0	9	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H0571	001	0	1	01	01	H0571_001_0	6	001	Dental Plan	16.00	2			2			16a;16b;	
H0602	001	0	1	18	06	H0602_001_0	6	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	001	0	1	18	06	H0602_001_0	6	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	003	0	1	18	06	H0602_003_0	5	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	003	0	1	18	06	H0602_003_0	5	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	007	0	1	18	06	H0602_007_0	5	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	007	0	1	18	06	H0602_007_0	5	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	009	0	1	18	06	H0602_009_0	5	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	009	0	1	18	06	H0602_009_0	5	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	017	0	1	18	06	H0602_017_0	8	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	017	0	1	18	06	H0602_017_0	8	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	019	0	1	18	06	H0602_019_0	9	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	019	0	1	18	06	H0602_019_0	9	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	020	0	1	18	06	H0602_020_0	9	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	020	0	1	18	06	H0602_020_0	9	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	022	0	1	18	06	H0602_022_0	9	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	022	0	1	18	06	H0602_022_0	9	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	027	0	1	18	06	H0602_027_0	6	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	027	0	1	18	06	H0602_027_0	6	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	039	0	1	18	06	H0602_039_0	10	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	039	0	1	18	06	H0602_039_0	10	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	042	0	1	18	06	H0602_042_0	5	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	042	0	1	18	06	H0602_042_0	5	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0602	043	0	1	18	06	H0602_043_0	9	001	Dental Services	20.00	1	1500.00	3	1	50.00	16a;16b;	16a;16b;	
H0602	043	0	1	18	06	H0602_043_0	9	002	Vision Services	12.00	1	130.00	3	2			17b;	
H0609	002	0	1	01	01	H0609_002_0	4	001	Dental 260 Rider	13.00	2			2				16a;16b;
H0609	007	0	1	01	01	H0609_007_0	4	001	Dental 260 Rider	13.00	2			2				16a;16b;
H0609	012	0	1	01	01	H0609_012_0	4	001	Dental 260 Rider	13.00	2			2				16a;16b;
H0609	015	0	1	01	01	H0609_015_0	3	001	Dental 260 Rider	13.00	2			2				16a;16b;
H0609	018	0	1	01	01	H0609_018_0	3	001	Dental 260 Rider	13.00	2			2				16a;16b;
H0609	020	0	1	01	01	H0609_020_0	4	001	Dental 260 Rider	13.00	2			2				16a;16b;
H0609	025	0	1	01	01	H0609_025_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H0609	026	0	1	01	01	H0609_026_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H0609	027	0	1	01	01	H0609_027_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H0630	013	0	1	01	01	H0630_013_0	10	001	Advantage Plus - Option 1	35.00	2			2			16a;16b;17b;18b;	
H0630	013	0	1	01	01	H0630_013_0	10	002	Advantage Plus - Option 2	20.00	2			2			7b;10b;13a;18b;	
H0630	015	0	1	01	01	H0630_015_0	12	001	Advantage Plus - Option 1	35.00	2			2			16b;18b;	16a;17b;
H0630	015	0	1	01	01	H0630_015_0	12	002	Advantage Plus - Option 2	20.00	2			2			7b;10b;13a;18b;	
H0630	016	0	1	01	01	H0630_016_0	12	001	Advantage Plus - Option 1	35.00	2			2			16b;18b;	16a;17b;
H0630	016	0	1	01	01	H0630_016_0	12	002	Advantage Plus - Option 2	20.00	2			2			7b;13a;18b;	10b;
H0630	017	0	1	01	01	H0630_017_0	12	001	Advantage Plus - Option 1	35.00	2			2			16a;16b;17b;18b;	
H0630	017	0	1	01	01	H0630_017_0	12	002	Advantage Plus - Option 2	20.00	2			2			7b;10b;13a;18b;	
H0630	018	0	1	01	01	H0630_018_0	12	001	Advantage Plus - Option 1	35.00	2			2			16b;18b;	16a;17b;
H0630	018	0	1	01	01	H0630_018_0	12	002	Advantage Plus - Option 2	20.00	2			2			7b;13a;18b;	10b;
H0630	020	0	1	01	01	H0630_020_0	12	001	Advantage Plus - Option 1	35.00	2			2			16a;16b;17b;18b;	
H0630	020	0	1	01	01	H0630_020_0	12	002	Advantage Plus - Option 2	20.00	2			2			7b;10b;13a;18b;	
H0630	021	0	1	01	01	H0630_021_0	13	001	Advantage Plus - Option 1	35.00	2			2			16b;18b;	16a;17b;
H0630	021	0	1	01	01	H0630_021_0	13	002	Advantage Plus - Option 2	20.00	2			2			7b;10b;13a;18b;	
H0735	001	0	1	04	01	H0735_001_0	11	001	Choice Dental	18.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H0735	002	0	1	04	01	H0735_002_0	8	001	Choice Dental	18.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H0755	030	0	1	01	01	H0755_030_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H0755	031	0	1	01	01	H0755_031_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H0755	032	0	1	01	01	H0755_032_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H0755	033	0	1	01	01	H0755_033_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H1035	002	0	1	02	01	H1035_002_0	7	001	Optional Point of Service Benefit	70.00	2			2			POS;	
H1035	007	0	1	02	01	H1035_007_0	4	001	Optional Point of Service Benefit	70.00	2			2			POS;	
H1035	011	0	1	02	01	H1035_011_0	5	001	Optional Point of Service Benefit	70.00	2			2			POS;	
H1036	137	0	1	01	01	H1036_137_0	5	001	MyOption Dental - High PPO	22.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1036	138	0	1	01	01	H1036_138_0	5	001	MyOption Dental Advantage HMO	31.30	1	1500.00	3	2				16a;16b;
H1036	151	0	1	01	01	H1036_151_0	4	001	MyOption Enhanced Dental HMO	22.80	1	1500.00	3	2				16a;16b;
H1036	153	0	1	01	01	H1036_153_0	4	001	MyOption Enhanced Dental HMO	31.60	1	1500.00	3	2				16a;16b;
H1036	171	0	1	01	01	H1036_171_0	4	001	MyOption Dental - High PPO	19.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1036	219	0	1	01	01	H1036_219_0	5	001	MyOption Dental - High PPO	27.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1036	219	0	1	01	01	H1036_219_0	5	002	MyOption Platinum Dental	28.20	1	2000.00	3	2				16a;16b;
H1036	233	0	1	01	01	H1036_233_0	5	001	MyOption Enhanced Dental HMO	29.60	1	1500.00	3	2				16a;16b;
H1109	005	0	1	01	01	H1109_005_0	5	001	DMO Dental	13.10	2			2			16a;16b;	
H1109	005	0	1	01	01	H1109_005_0	5	002	DMO Dental Plus Hearing Aids	16.10	2			2			16a;16b;18b;	
H1111	006	0	1	01	01	H1111_006_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H1170	002	0	1	01	01	H1170_002_0	12	001	Advantage Plus	20.00	2			2			16a;16b;17b;18a;18b;	
H1170	008	0	1	01	01	H1170_008_0	11	001	Advantage Plus	20.00	2			2			16a;16b;18a;18b;	17b;
H1170	009	0	1	01	01	H1170_009_0	11	001	Advantage Plus	20.00	2			2			16a;16b;17b;18a;18b;	
H1230	001	0	1	01	01	H1230_001_0	13	001	Advantage Plus	19.00	2			2			16a;17b;18a;18b;	
H1230	001	0	1	01	01	H1230_001_0	13	002	Advantage Plus Complete	43.00	2			2				16a;16b;17b;18a;18b;
H1230	003	0	1	01	01	H1230_003_0	14	001	Advantage Plus	19.00	2			2			16a;17b;18a;18b;	
H1230	003	0	1	01	01	H1230_003_0	14	002	Advantage Plus Complete	43.00	2			2				16a;16b;17b;18a;18b;
H1230	013	0	1	01	01	H1230_013_0	14	001	Advantage Plus	19.00	2			2			16a;17b;18a;18b;	
H1230	013	0	1	01	01	H1230_013_0	14	002	Advantage Plus Complete	43.00	2			2				16a;16b;17b;18a;18b;
H1230	014	0	1	01	01	H1230_014_0	15	001	Advantage Plus	19.00	2			2			16a;17b;18a;18b;	
H1230	014	0	1	01	01	H1230_014_0	15	002	Advantage Plus Complete	43.00	2			2				16a;16b;17b;18a;18b;
H1302	004	0	1	04	01	H1302_004_0	2	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1304	001	0	1	04	01	H1304_001_0	6	001	Dental Option	27.00	1	1000.00	3	2			16b;	
H1304	002	0	1	04	01	H1304_002_0	6	001	Dental Option	27.00	1	1000.00	3	2			16b;	
H1304	004	0	1	04	01	H1304_004_0	6	001	Dental Option	27.00	1	1000.00	3	2			16b;	
H1304	008	0	1	04	01	H1304_008_0	5	001	Dental Option	27.00	1	1000.00	3	2			16b;	
H1304	009	0	1	04	01	H1304_009_0	6	001	Dental Option	27.00	1	1000.00	3	2			16b;	
H1304	010	0	1	04	01	H1304_010_0	6	001	Dental Option	27.00	1	1000.00	3	2			16b;	
H1350	006	0	1	01	01	H1350_006_0	2	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1350	015	1	1	01	01	H1350_015_1	6	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1350	015	2	1	01	01	H1350_015_2	6	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1350	016	1	1	01	01	H1350_016_1	6	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1350	016	2	1	01	01	H1350_016_2	6	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1350	019	1	1	01	01	H1350_019_1	6	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1350	019	2	1	01	01	H1350_019_2	6	001	Healthy Smiles Plus Dental	28.70	1	1000.00	3	1	50.00	16a;16b;		16a;16b;
H1394	003	0	1	01	01	H1394_003_0	7	001	Preventive Dental Package	10.00	2			2				16a;
H1394	003	0	1	01	01	H1394_003_0	7	002	Dental and Vision Package	27.00	2			2				16a;16b;17b;
H1394	003	0	1	01	01	H1394_003_0	7	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
H1394	009	0	1	01	01	H1394_009_0	8	001	Preventive Dental Package	10.00	2			2				16a;
H1394	009	0	1	01	01	H1394_009_0	8	002	Dental and Vision Package	27.00	2			2				16a;16b;17b;
H1394	009	0	1	01	01	H1394_009_0	8	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
H1406	013	0	1	01	01	H1406_013_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H1406	022	0	1	01	01	H1406_022_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H1406	022	0	1	01	01	H1406_022_0	4	002	MyOption Dental Advantage HMO	30.60	1	1500.00	3	2				16a;16b;
H1406	026	0	1	01	01	H1406_026_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H1406	026	0	1	01	01	H1406_026_0	4	002	MyOption Dental Enriched HMO	28.90	1	1500.00	3	2				16a;16b;
H1406	028	0	1	01	01	H1406_028_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H1415	013	0	1	01	01	H1415_013_0	4	001	Enhanced Dental	18.40	1	1000.00	3	2			16a;16b;	
H1415	021	0	1	02	01	H1415_021_0	4	001	Enhanced Vision and Enhanced Dental	20.90	1	1000.00	3	2			16a;16b;17a;17b;	
H1468	007	0	1	01	01	H1468_007_0	5	001	MyOption Vision	15.30	2			2				17a;17b;
H1468	007	0	1	01	01	H1468_007_0	5	002	MyOption Enhanced Dental HMO	27.20	1	1500.00	3	2				16a;16b;
H1510	004	0	1	04	01	H1510_004_0	3	001	MyOption Enhanced Dental PPO	21.70	1	1500.00	3	2				16a;16b;
H1510	005	0	1	04	01	H1510_005_0	3	001	MyOption Enhanced Dental PPO	21.70	1	1500.00	3	2				16a;16b;
H1517	007	0	1	04	01	H1517_007_0	7	001	Preventive Dental Package	18.00	2			2				16a;
H1517	007	0	1	04	01	H1517_007_0	7	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H1517	007	0	1	04	01	H1517_007_0	7	003	Enhanced Dental and Vision Package	41.00	2			2				16a;16b;17b;
H1607	012	0	1	04	01	H1607_012_0	7	001	Preventive Dental Package	19.00	2			2				16a;
H1607	012	0	1	04	01	H1607_012_0	7	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H1607	012	0	1	04	01	H1607_012_0	7	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
H1608	016	0	1	04	01	H1608_016_0	5	001	Coventry Medicare Advantage PPO Dental Plan	17.00	1	1000.00	3	1	50.00	16b;	16a;16b;	
H1608	016	0	1	04	01	H1608_016_0	5	002	Coventry Medicare Advantage PPO Dental/Vision Plan	32.00	1	1250.00	3	1	50.00	16b;	16a;16b;17b;	
H1608	017	0	1	04	01	H1608_017_0	4	001	Coventry Medicare Advantage PPO Dental Plan	17.00	1	1000.00	3	1	50.00	16b;	16a;16b;	
H1608	017	0	1	04	01	H1608_017_0	4	002	Coventry Medicare Advantage PPO Dental/Vision Plan	32.00	1	1250.00	3	1	50.00	16b;	16a;16b;17b;	
H1651	008	0	1	18	06	H1651_008_0	2	001	Out of Network Benefit	20.00	2			2				13d;
H1651	009	0	1	18	06	H1651_009_0	2	001	Out of Network Benefit	20.00	2			2				13d;
H1659	001	0	1	04	01	H1659_001_0	10	001	Dental High Option	42.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H1659	001	0	1	04	01	H1659_001_0	10	002	Dental Low Option	19.30	1	750.00	3	1	75.00	16b;		16a;16b;
H1659	002	0	1	04	01	H1659_002_0	10	001	Dental High Option	42.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H1659	002	0	1	04	01	H1659_002_0	10	002	Dental Low Option	19.30	1	750.00	3	1	75.00	16b;		16a;16b;
H1659	003	0	1	04	01	H1659_003_0	10	001	Dental High Option	42.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H1659	003	0	1	04	01	H1659_003_0	10	002	Dental Low Option	19.30	1	750.00	3	1	75.00	16b;		16a;16b;
H1716	021	0	1	04	01	H1716_021_0	3	001	MyOption Platinum Dental	25.90	1	2000.00	3	2			16a;16b;	
H1846	004	0	1	04	01	H1846_004_0	10	001	Dental	24.00	1	1000.00	3	2			16a;16b;	
H1849	018	0	1	01	01	H1849_018_0	7	001	Preventive Dental Package	15.00	2			2				16a;
H1849	018	0	1	01	01	H1849_018_0	7	002	Dental and Vision Package	22.00	2			2				16a;16b;17b;
H1849	018	0	1	01	01	H1849_018_0	7	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H1944	014	0	1	01	01	H1944_014_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H1944	015	0	1	01	01	H1944_015_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H1944	016	0	1	01	01	H1944_016_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H1944	020	0	1	01	01	H1944_020_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H1951	013	0	1	01	01	H1951_013_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H1951	013	0	1	01	01	H1951_013_0	4	002	MyOption Enhanced Dental HMO	24.10	1	1500.00	3	2				16a;16b;
H1951	025	0	1	01	01	H1951_025_0	4	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1951	028	0	1	01	01	H1951_028_0	4	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1951	030	0	1	01	01	H1951_030_0	3	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1951	038	0	1	01	01	H1951_038_0	4	001	MyOption Enhanced Dental HMO	24.10	1	1500.00	3	2				16a;16b;
H1951	039	0	1	01	01	H1951_039_0	4	001	MyOption Enhanced Dental HMO	24.10	1	1500.00	3	2				16a;16b;
H1951	047	1	1	01	01	H1951_047_1	4	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1951	047	2	1	01	01	H1951_047_2	4	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1951	048	1	1	01	01	H1951_048_1	4	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1951	048	2	1	01	01	H1951_048_2	4	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H1969	002	0	1	01	01	H1969_002_0	6	001	DVH Option	39.00	1	1600.00	3	2			16a;16b;17b;18a;18b;	
H1969	003	0	1	01	01	H1969_003_0	6	001	DH Option	38.00	1	1500.00	3	2			16a;16b;18a;18b;	
H1994	001	0	1	01	01	H1994_001_0	7	001	SelectHealth Dental Comprehensive Benefit	35.00	1	1000.00	3	2			16a;16b;	
H1994	001	0	1	01	01	H1994_001_0	7	002	SelectHealth Dental Comprehensive Plus Eyewear	40.00	1	1200.00	3	2			16a;16b;17b;	
H1994	002	0	1	01	01	H1994_002_0	7	001	SelectHealth Dental Comprehensive Benefit	35.00	1	1000.00	3	2			16a;16b;	
H1994	002	0	1	01	01	H1994_002_0	7	002	SelectHealth Dental Comprehensive Plus Eyewear	40.00	1	1200.00	3	2			16a;16b;17b;	
H1994	003	0	1	01	01	H1994_003_0	6	001	Delta Dental Comprehensive Benefit	45.00	1	1000.00	3	2			16a;16b;	
H1994	003	0	1	01	01	H1994_003_0	6	002	Delta Dental Comprehensive Plus Eyewear	50.00	1	1200.00	3	2			16a;16b;17b;	
H1994	004	0	1	01	01	H1994_004_0	6	001	Delta Dental Comprehensive Benefit	45.00	1	1000.00	3	2			16a;16b;	
H1994	004	0	1	01	01	H1994_004_0	6	002	Delta Dental Comprehensive Plus Eyewear	50.00	1	1200.00	3	2			16a;16b;17b;	
H1994	005	0	1	01	01	H1994_005_0	8	001	SelectHealth Dental Comprehensive Benefit	35.00	1	1000.00	3	2			16a;16b;	
H1994	005	0	1	01	01	H1994_005_0	8	002	SelectHealth Dental Comprehensive Plus Eyewear	40.00	1	1200.00	3	2			16a;16b;17b;	
H1994	006	0	1	01	01	H1994_006_0	6	001	Delta Dental Comprehensive Benefit	45.00	1	1000.00	3	2			16a;16b;	
H1994	006	0	1	01	01	H1994_006_0	6	002	Delta Dental Comprehensive Plus Eyewear	50.00	1	1200.00	3	2			16a;16b;17b;	
H1994	007	0	1	01	01	H1994_007_0	9	001	SelectHealth Dental Comprehensive Benefit	35.00	1	1000.00	3	2			16a;16b;	
H1994	007	0	1	01	01	H1994_007_0	9	002	SelectHealth Dental Comprehensive Plus Eyewear	40.00	1	1200.00	3	2			16a;16b;17b;	
H1994	008	0	1	01	01	H1994_008_0	7	001	Delta Dental Comprehensive Benefit	45.00	1	1000.00	3	2			16a;16b;	
H1994	008	0	1	01	01	H1994_008_0	7	002	Delta Dental Comprehensive Plus Eyewear	50.00	1	1200.00	3	2			16a;16b;17b;	
H1997	002	0	1	01	01	H1997_002_0	6	001	DVH Option	40.00	1	1600.00	3	2			16a;16b;17b;18a;18b;	
H2001	001	0	1	04	01	H2001_001_0	5	001	Fitness Rider	18.00	2			2			14c;	
H2012	003	0	1	01	01	H2012_003_0	4	001	MyOption Dental Enriched HMO	20.20	1	1500.00	3	2				16a;16b;
H2012	006	0	1	01	01	H2012_006_0	4	001	MyOption Dental Advantage HMO	26.40	1	1500.00	3	2				16a;16b;
H2012	016	0	1	01	01	H2012_016_0	4	001	MyOption Dental - High PPO	20.60	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	021	0	1	01	01	H2012_021_0	3	001	MyOption Dental - High PPO	21.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	021	0	1	01	01	H2012_021_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H2012	021	0	1	01	01	H2012_021_0	3	003	MyOption Plus	20.30	2			1	50.00	16b;		16a;16b;17a;17b;
H2012	022	0	1	01	01	H2012_022_0	4	001	MyOption Dental Enriched HMO	28.50	1	1500.00	3	2				16a;16b;
H2012	029	0	1	01	01	H2012_029_0	5	001	MyOption Enhanced Dental HMO	27.30	1	1500.00	3	2				16a;16b;
H2012	030	0	1	01	01	H2012_030_0	4	001	MyOption Dental - High PPO	24.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	030	0	1	01	01	H2012_030_0	4	002	MyOption Platinum Dental	27.50	1	2000.00	3	2				16a;16b;
H2012	031	0	1	01	01	H2012_031_0	5	001	MyOption Dental Advantage HMO	47.10	1	1500.00	3	2				16a;16b;
H2012	033	0	1	01	01	H2012_033_0	5	001	MyOption Dental - High PPO	37.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	033	0	1	01	01	H2012_033_0	5	002	MyOption Platinum Dental	33.70	1	2000.00	3	2				16a;16b;
H2012	035	0	1	01	01	H2012_035_0	5	001	MyOption Enhanced Dental HMO	38.10	1	1500.00	3	2				16a;16b;
H2012	037	0	1	01	01	H2012_037_0	5	001	MyOption Enhanced Dental HMO	38.10	1	1500.00	3	2				16a;16b;
H2012	039	0	1	01	01	H2012_039_0	6	001	MyOption Dental - High PPO	37.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	039	0	1	01	01	H2012_039_0	6	002	MyOption Platinum Dental	33.70	1	2000.00	3	2				16a;16b;
H2012	082	0	1	01	01	H2012_082_0	5	001	MyOption Vision	15.30	2			2				17a;17b;
H2012	087	0	1	01	01	H2012_087_0	3	001	MyOption Dental - High PPO	20.60	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	087	0	1	01	01	H2012_087_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H2012	088	0	1	01	01	H2012_088_0	5	001	MyOption Dental Enriched HMO	38.30	1	1500.00	3	2				16a;16b;
H2012	090	0	1	01	01	H2012_090_0	5	001	MyOption Enhanced Dental HMO	38.10	1	1500.00	3	2				16a;16b;
H2012	096	0	1	01	01	H2012_096_0	4	001	MyOption Enhanced Dental HMO	24.70	1	1500.00	3	2				16a;16b;
H2012	097	0	1	01	01	H2012_097_0	4	001	MyOption Dental - High PPO	17.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	099	1	1	01	01	H2012_099_1	5	001	MyOption Vision	15.30	2			2				17a;17b;
H2012	099	2	1	01	01	H2012_099_2	5	001	MyOption Vision	15.30	2			2				17a;17b;
H2012	100	4	1	01	01	H2012_100_4	6	001	MyOption Dental Advantage HMO	26.40	1	1500.00	3	2				16a;16b;
H2012	100	5	1	01	01	H2012_100_5	6	001	MyOption Dental Advantage HMO	26.40	1	1500.00	3	2				16a;16b;
H2012	101	1	1	01	01	H2012_101_1	5	001	MyOption Dental - High PPO	20.60	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	101	2	1	01	01	H2012_101_2	5	001	MyOption Dental - High PPO	20.60	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2012	106	0	1	01	01	H2012_106_0	5	001	MyOption Platinum Dental	33.70	1	2000.00	3	2			16a;16b;	
H2012	107	0	1	01	01	H2012_107_0	3	001	MyOption Platinum Dental	27.50	1	2000.00	3	2			16a;16b;	
H2012	108	0	1	01	01	H2012_108_0	4	001	MyOption Platinum Dental	33.70	1	2000.00	3	2			16a;16b;	
H2012	109	0	1	01	01	H2012_109_0	4	001	MyOption Dental Advantage HMO	26.40	1	1500.00	3	2				16a;16b;
H2108	022	0	1	01	01	H2108_022_0	7	001	Enhanced Dental - Preventive Plus	13.00	1	800.00	3	2			16b;	
H2108	028	0	1	01	01	H2108_028_0	7	001	Enhanced Dental - Preventive Plus	13.00	1	800.00	3	2			16b;	
H2108	029	0	1	01	01	H2108_029_0	7	001	Enhanced Dental - Preventive Plus	13.00	1	800.00	3	2			16b;	
H2108	030	0	1	01	01	H2108_030_0	7	001	Enhanced Dental - Preventive Plus	13.00	1	800.00	3	2			16b;	
H2108	032	0	1	01	01	H2108_032_0	7	001	Enhanced Dental - Preventive and Preventive Plus	20.20	1	800.00	3	2			16a;16b;	
H2108	033	0	1	01	01	H2108_033_0	7	001	Enhanced Dental - Preventive and Preventive Plus	20.20	1	800.00	3	2			16a;16b;	
H2165	005	0	1	01	01	H2165_005_0	4	001	Enhanced Dental - Comprehensive	29.30	1	1000.00	3	2			16b;	
H2171	001	0	1	01	01	H2171_001_0	8	001	Dental Rider	20.00	2			2			16a;16b;	
H2171	001	0	1	01	01	H2171_001_0	8	002	Combination Rider (Dental, Hearing, and Vision)	35.00	2			2			16a;16b;18a;18b;	17a;17b;
H2228	018	0	1	04	01	H2228_018_0	6	001	Fitness Rider	18.00	2			2			14c;	
H2228	019	0	1	04	01	H2228_019_0	7	001	Dental Platinum Rider	32.00	2			1	100.00	16b;		16a;16b;
H2228	020	0	1	04	01	H2228_020_0	7	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2228	021	0	1	04	01	H2228_021_0	7	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2228	022	0	1	04	01	H2228_022_0	7	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2228	023	0	1	04	01	H2228_023_0	7	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2228	024	0	1	04	01	H2228_024_0	6	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2228	025	0	1	04	01	H2228_025_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2228	029	0	1	04	01	H2228_029_0	6	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2228	029	0	1	04	01	H2228_029_0	6	002	Fitness Rider	18.00	2			2			14c;	
H2228	039	0	1	04	01	H2228_039_0	7	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2256	001	1	1	01	01	H2256_001_1	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	001	2	1	01	01	H2256_001_2	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	001	6	1	01	01	H2256_001_6	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	015	1	1	01	01	H2256_015_1	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	015	2	1	01	01	H2256_015_2	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	015	6	1	01	01	H2256_015_6	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	016	1	1	01	01	H2256_016_1	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	016	2	1	01	01	H2256_016_2	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	016	6	1	01	01	H2256_016_6	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	018	1	1	01	01	H2256_018_1	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	018	7	1	01	01	H2256_018_7	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	018	8	1	01	01	H2256_018_8	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	019	1	1	01	01	H2256_019_1	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	019	7	1	01	01	H2256_019_7	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	019	8	1	01	01	H2256_019_8	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	026	1	1	01	01	H2256_026_1	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	026	2	1	01	01	H2256_026_2	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	026	3	1	01	01	H2256_026_3	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	028	0	1	01	01	H2256_028_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	033	0	1	01	01	H2256_033_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	034	0	1	01	01	H2256_034_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	036	0	1	01	01	H2256_036_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	039	0	1	01	01	H2256_039_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	040	0	1	01	01	H2256_040_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	041	0	1	01	01	H2256_041_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2256	042	0	1	01	01	H2256_042_0	15	001	Delta Dental Option	54.00	2			2				16a;16b;
H2320	007	0	1	02	01	H2320_007_0	11	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	008	0	1	02	01	H2320_008_0	11	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	011	0	1	02	01	H2320_011_0	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	012	0	1	02	01	H2320_012_0	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	013	0	1	02	01	H2320_013_0	11	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	015	0	1	02	01	H2320_015_0	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	016	0	1	02	01	H2320_016_0	11	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	018	0	1	02	01	H2320_018_0	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	019	0	1	02	01	H2320_019_0	11	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	021	0	1	02	01	H2320_021_0	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H2320	022	1	1	02	01	H2320_022_1	8	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H2320	022	2	1	02	01	H2320_022_2	8	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H2320	022	3	1	02	01	H2320_022_3	8	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H2320	022	4	1	02	01	H2320_022_4	8	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H2320	022	5	1	02	01	H2320_022_5	8	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H2322	004	0	1	04	01	H2322_004_0	4	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2322	004	0	1	04	01	H2322_004_0	4	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2322	008	0	1	04	01	H2322_008_0	4	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2322	008	0	1	04	01	H2322_008_0	4	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2354	015	0	1	01	01	H2354_015_0	4	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2354	015	0	1	01	01	H2354_015_0	4	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2354	018	0	1	01	01	H2354_018_0	5	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2354	018	0	1	01	01	H2354_018_0	5	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2354	019	0	1	01	01	H2354_019_0	4	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2354	019	0	1	01	01	H2354_019_0	4	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2354	020	0	1	02	01	H2354_020_0	4	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2354	020	0	1	02	01	H2354_020_0	4	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2354	021	0	1	02	01	H2354_021_0	4	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2354	021	0	1	02	01	H2354_021_0	4	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2354	022	0	1	02	01	H2354_022_0	4	001	Delta Dental Option 1	25.70	1	800.00	3	2				16a;16b;
H2354	022	0	1	02	01	H2354_022_0	4	002	Delta Dental Option 2	50.70	1	1500.00	3	2				16a;16b;
H2450	001	0	1	18	06	H2450_001_0	7	001	Medica SeniorDental	62.90	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H2450	002	0	1	18	06	H2450_002_0	7	001	Medica SeniorDental	62.90	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H2450	002	0	1	18	06	H2450_002_0	7	002	Wisconsin Rider	39.00	1	30000.00	3	2				2;6;12;
H2450	016	0	1	18	06	H2450_016_0	7	001	Medica SeniorDental	62.90	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H2450	017	0	1	18	06	H2450_017_0	7	001	Medica SeniorDental	62.90	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H2450	017	0	1	18	06	H2450_017_0	7	002	Wisconsin Rider	39.00	1	30000.00	3	2				2;6;12;
H2450	022	0	1	18	06	H2450_022_0	7	001	Medica SeniorDental	62.90	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H2450	023	0	1	18	06	H2450_023_0	7	001	Medica SeniorDental	62.90	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H2459	001	0	1	02	01	H2459_001_0	7	001	Choice Dental	18.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H2459	002	0	1	02	01	H2459_002_0	8	001	Classic Choice Dental	22.00	1	1200.00	3	1	50.00	16b;	16b;	
H2459	013	0	1	02	01	H2459_013_0	11	001	Choice Dental	18.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H2459	019	0	1	02	01	H2459_019_0	9	001	Choice Dental	18.00	1	1000.00	3	1	75.00	16b;		16a;16b;
H2462	007	0	1	18	06	H2462_007_0	4	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16b;	16b;	
H2462	008	0	1	18	06	H2462_008_0	4	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16b;	16b;	
H2462	010	0	1	18	06	H2462_010_0	4	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16b;	16b;	16a;
H2462	011	0	1	18	06	H2462_011_0	6	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16b;	16b;	16a;
H2462	012	0	1	18	06	H2462_012_0	5	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16b;	16b;	16a;
H2462	018	0	1	18	06	H2462_018_0	4	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16a;16b;		16a;16b;
H2462	019	0	1	18	06	H2462_019_0	4	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16a;16b;		16a;16b;
H2462	020	0	1	18	06	H2462_020_0	3	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16a;16b;		16a;16b;
H2462	021	0	1	18	06	H2462_021_0	4	001	Freedom Comprehensive Dental Benefit	39.90	1	1100.00	3	1	50.00	16a;16b;		16a;16b;
H2486	003	0	1	01	01	H2486_003_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H2486	003	0	1	01	01	H2486_003_0	3	002	MyOption Plus	21.40	2			1	50.00	16b;	16a;16b;	17a;17b;
H2486	003	0	1	01	01	H2486_003_0	3	003	MyOption Platinum Dental	26.40	1	2000.00	3	2				16a;16b;
H2649	021	0	1	01	01	H2649_021_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H2649	021	0	1	01	01	H2649_021_0	3	002	MyOption Platinum Dental	21.40	1	2000.00	3	2			16a;16b;	
H2649	029	0	1	01	01	H2649_029_0	5	001	MyOption Dental - High PPO	22.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	029	0	1	01	01	H2649_029_0	5	002	MyOption Vision	15.30	2			2			17a;17b;	
H2649	029	0	1	01	01	H2649_029_0	5	003	MyOption Plus	21.40	2			1	50.00	16b;		16a;16b;17a;17b;
H2649	030	0	1	01	01	H2649_030_0	5	001	MyOption Dental - High PPO	22.00	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	031	0	1	01	01	H2649_031_0	4	001	MyOption Dental - High PPO	22.00	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	031	0	1	01	01	H2649_031_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H2649	031	0	1	01	01	H2649_031_0	4	003	MyOption Plus	21.40	2			1	50.00	16b;		16a;16b;17a;17b;
H2649	032	0	1	01	01	H2649_032_0	5	001	MyOption Dental - High PPO	22.00	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	032	0	1	01	01	H2649_032_0	5	002	MyOption Vision	15.30	2			2				17a;17b;
H2649	032	0	1	01	01	H2649_032_0	5	003	MyOption Plus	21.40	2			1	50.00	16b;		16a;16b;17a;17b;
H2649	033	0	1	01	01	H2649_033_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H2649	033	0	1	01	01	H2649_033_0	4	002	MyOption Enhanced Dental HMO	26.50	1	1500.00	3	2				16a;16b;
H2649	034	0	1	01	01	H2649_034_0	4	001	MyOption Dental - High PPO	22.00	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	034	0	1	01	01	H2649_034_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H2649	034	0	1	01	01	H2649_034_0	4	003	MyOption Plus	21.40	2			1	50.00	16b;		16a;16b;17a;17b;
H2649	039	0	1	01	01	H2649_039_0	4	001	MyOption Enhanced Dental HMO	26.50	1	1500.00	3	2				16a;16b;
H2649	043	0	1	01	01	H2649_043_0	5	001	MyOption Dental - High PPO	24.70	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	045	0	1	01	01	H2649_045_0	6	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	046	0	1	01	01	H2649_046_0	6	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	047	0	1	01	01	H2649_047_0	5	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	049	0	1	01	01	H2649_049_0	5	001	MyOption Dental Advantage HMO	22.60	1	1500.00	3	2				16a;16b;
H2649	051	0	1	01	01	H2649_051_0	5	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	052	0	1	01	01	H2649_052_0	5	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	055	0	1	01	01	H2649_055_0	5	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	055	0	1	01	01	H2649_055_0	5	002	MyOption Fitness	15.00	2			2			14c;	
H2649	059	1	1	01	01	H2649_059_1	4	001	MyOption Dental - High PPO	19.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	059	1	1	01	01	H2649_059_1	4	002	MyOption Vision	15.30	2			2				17a;17b;
H2649	059	1	1	01	01	H2649_059_1	4	003	MyOption Plus	19.80	2			1	50.00	16b;		16a;16b;17a;17b;
H2649	059	2	1	01	01	H2649_059_2	4	001	MyOption Dental - High PPO	19.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2649	059	2	1	01	01	H2649_059_2	4	002	MyOption Vision	15.30	2			2				17a;17b;
H2649	059	2	1	01	01	H2649_059_2	4	003	MyOption Plus	19.80	2			1	50.00	16b;		16a;16b;17a;17b;
H2649	061	1	1	01	01	H2649_061_1	5	001	MyOption Vision	15.30	2			2			17a;17b;	
H2649	061	2	1	01	01	H2649_061_2	5	001	MyOption Vision	15.30	2			2			17a;17b;	
H2663	015	0	1	02	01	H2663_015_0	5	001	Coventry Medicare Advantage HMO Dental Plan	15.00	1	1000.00	3	1	50.00	16b;	16a;16b;	
H2663	015	0	1	02	01	H2663_015_0	5	002	Coventry Medicare Advantage HMO Dental/Vision Plan	29.00	1	1250.00	3	1	50.00	16b;	16a;16b;17b;	
H2663	026	0	1	01	01	H2663_026_0	4	001	Coventry Medicare Advantage HMO Dental Plan	15.00	1	1000.00	3	1	50.00	16b;	16a;16b;	
H2663	026	0	1	01	01	H2663_026_0	4	002	Coventry Medicare Advantage HMO Dental/Vision Plan	30.00	1	1250.00	3	1	50.00	16b;	16a;16b;17b;	
H2663	027	0	1	01	01	H2663_027_0	4	001	Coventry Medicare Advantage HMO Dental Plan	15.00	1	1000.00	3	1	50.00	16b;	16a;16b;	
H2663	027	0	1	01	01	H2663_027_0	4	002	Coventry Medicare Advantage HMO Dental/Vision Plan	30.00	1	1250.00	3	1	50.00	16b;	16a;16b;17b;	
H2802	007	0	1	01	01	H2802_007_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	008	0	1	01	01	H2802_008_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	010	0	1	01	01	H2802_010_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	012	0	1	01	01	H2802_012_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	016	0	1	01	01	H2802_016_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	018	0	1	01	01	H2802_018_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	020	0	1	01	01	H2802_020_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	023	0	1	01	01	H2802_023_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	024	0	1	01	01	H2802_024_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	025	0	1	01	01	H2802_025_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	025	0	1	01	01	H2802_025_0	4	002	Fitness Rider	18.00	2			2			14c;	
H2802	028	0	1	01	01	H2802_028_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	029	0	1	01	01	H2802_029_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	030	0	1	01	01	H2802_030_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	031	0	1	01	01	H2802_031_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	032	0	1	01	01	H2802_032_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	033	0	1	01	01	H2802_033_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	034	0	1	01	01	H2802_034_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H2802	035	0	1	01	01	H2802_035_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	037	0	1	01	01	H2802_037_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	039	0	1	01	01	H2802_039_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	041	0	1	01	01	H2802_041_0	8	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2802	045	0	1	01	01	H2802_045_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H2906	005	0	1	04	01	H2906_005_0	18	001	Comprehensive Dental 70	33.00	1	2500.00	3	1	100.00	16a;16b;		16a;16b;
H2906	005	0	1	04	01	H2906_005_0	18	002	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2906	006	0	1	04	01	H2906_006_0	12	001	Comprehensive Dental 70	33.00	1	2500.00	3	1	100.00	16a;16b;		16a;16b;
H2906	006	0	1	04	01	H2906_006_0	12	002	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2906	007	0	1	04	01	H2906_007_0	12	001	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2906	007	0	1	04	01	H2906_007_0	12	002	Preventive Dental Only	20.00	2			2				16a;
H2906	008	0	1	04	01	H2906_008_0	8	001	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2906	008	0	1	04	01	H2906_008_0	8	002	Preventive Dental Only	20.00	2			2				16a;
H2944	004	0	1	09	04	H2944_004_0	3	001	MyOption Dental - High PPO	21.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2944	004	0	1	09	04	H2944_004_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H2944	004	0	1	09	04	H2944_004_0	3	003	MyOption Plus	20.30	2			1	50.00	16b;		16a;16b;17a;17b;
H2944	013	0	1	09	04	H2944_013_0	3	001	MyOption Dental - High PPO	19.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2944	013	0	1	09	04	H2944_013_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H2944	013	0	1	09	04	H2944_013_0	3	003	MyOption Plus	19.80	2			1	50.00	16b;		16a;16b;17a;17b;
H2944	013	0	1	09	04	H2944_013_0	3	004	MyOption Fitness	15.00	2			2			14c;	
H2944	114	0	1	09	04	H2944_114_0	3	001	MyOption Dental - High PPO	20.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H2944	124	0	1	09	04	H2944_124_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H2944	124	0	1	09	04	H2944_124_0	3	002	MyOption Platinum Dental	23.90	1	2000.00	3	2			16a;16b;	
H2944	127	0	1	09	04	H2944_127_0	3	001	MyOption Platinum Dental	22.10	1	2000.00	3	2			16a;16b;	
H2944	197	0	1	09	04	H2944_197_0	2	001	MyOption Vision	15.30	2			2			17a;17b;	
H2944	197	0	1	09	04	H2944_197_0	2	002	MyOption Fitness	15.00	2			2			14c;	
H2949	012	0	1	01	01	H2949_012_0	4	001	MyOption Enhanced Dental HMO	28.50	1	1500.00	3	2				16a;16b;
H2949	013	0	1	01	01	H2949_013_0	6	001	MyOption Enhanced Dental HMO	28.50	1	1500.00	3	2				16a;16b;
H2949	014	0	1	01	01	H2949_014_0	5	001	MyOption Enhanced Dental HMO	28.50	1	1500.00	3	2				16a;16b;
H2960	004	0	1	01	01	H2960_004_0	12	001	Comprehensive Dental 70	33.00	1	2500.00	3	1	100.00	16a;16b;		16a;16b;
H2960	004	0	1	01	01	H2960_004_0	12	002	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2960	009	0	1	01	01	H2960_009_0	9	001	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2960	009	0	1	01	01	H2960_009_0	9	002	Preventive Dental Only	20.00	2			2				16a;
H2960	012	0	1	01	01	H2960_012_0	12	001	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2960	012	0	1	01	01	H2960_012_0	12	002	Preventive Dental Only	20.00	2			2				16a;
H2960	018	0	1	01	01	H2960_018_0	11	001	Comprehensive Dental 70	33.00	1	2500.00	3	1	100.00	16a;16b;		16a;16b;
H2960	018	0	1	01	01	H2960_018_0	11	002	Comprehensive Dental 100	39.00	1	2500.00	3	1	100.00	16b;		16a;16b;
H2968	001	0	1	04	01	H2968_001_0	10	001	Memorial Hermann Advantage Pack	49.00	1	2250.00	3	2				4c;7b;16a;16b;17b;18b;
H3152	022	0	1	01	01	H3152_022_0	4	001	DMO Dental	14.70	2			2			16a;16b;	
H3152	045	0	1	01	01	H3152_045_0	3	001	DMO Dental	14.70	2			2			16a;16b;	
H3152	045	0	1	01	01	H3152_045_0	3	002	DMO Dental Plus Eye Wear and Hearing Aids	24.70	2			2			16a;16b;17b;18b;	
H3152	080	0	1	01	01	H3152_080_0	3	001	DMO Dental	14.70	2			2			16a;16b;	
H3152	080	0	1	01	01	H3152_080_0	3	002	DMO Dental Plus Eye Wear and Hearing Aids	24.70	2			2			16a;16b;17b;18b;	
H3251	002	0	1	01	01	H3251_002_0	8	001	Optional Supplemental	33.90	1	2150.00	6	2			16a;16b;17a;17b;18a;18b;	
H3312	002	0	1	01	01	H3312_002_0	4	001	DMO Dental	17.20	2			2			16a;16b;	
H3312	002	0	1	01	01	H3312_002_0	4	002	DMO Dental Plus Eye Wear and Hearing Aids	27.20	2			2			16a;16b;17b;18b;	
H3312	018	0	1	01	01	H3312_018_0	3	001	DMO Dental	17.20	2			2			16a;16b;	
H3312	018	0	1	01	01	H3312_018_0	3	002	DMO Dental Plus Eye Wear and Hearing Aids	27.20	2			2			16a;16b;17b;18b;	
H3312	060	0	1	01	01	H3312_060_0	3	001	DMO Dental	17.20	2			2			16a;16b;	
H3312	060	0	1	01	01	H3312_060_0	3	002	DMO Dental Plus Eye Wear and Hearing Aids	27.20	2			2			16a;16b;17b;18b;	
H3342	019	0	1	04	01	H3342_019_0	6	001	Preventive Dental Package	18.00	2			2				16a;
H3342	019	0	1	04	01	H3342_019_0	6	002	Dental and Vision Package	28.00	2			2				16a;16b;17b;
H3342	019	0	1	04	01	H3342_019_0	6	003	Enhanced Dental and Vision Package	38.00	2			2				16a;16b;17b;
H3379	039	0	1	01	01	H3379_039_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3384	013	0	1	01	01	H3384_013_0	7	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2				16a;16b;
H3384	013	0	1	01	01	H3384_013_0	7	002	Optional Supplemental Dental Enhanced	34.00	1	1000.00	3	2				16a;16b;
H3384	019	0	1	01	01	H3384_019_0	6	001	Optional Supplemental Dental Basic	17.00	1	500.00	3	2				16a;16b;
H3384	019	0	1	01	01	H3384_019_0	6	002	Optional Supplemental Dental Enhanced	31.00	1	1000.00	3	2				16a;16b;
H3384	022	0	1	01	01	H3384_022_0	6	001	Optional Supplemental Dental Basic	17.00	1	500.00	3	2				16a;16b;
H3384	022	0	1	01	01	H3384_022_0	6	002	Optional Supplemental Dental Enhanced	31.00	1	1000.00	3	2				16a;16b;
H3384	058	0	1	01	01	H3384_058_0	7	001	Optional Supplemental Dental Basic	17.00	1	500.00	3	2				16a;16b;
H3384	058	0	1	01	01	H3384_058_0	7	002	Optional Supplemental Dental Enhanced	31.00	1	1000.00	3	2				16a;16b;
H3384	059	0	1	02	01	H3384_059_0	5	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2				16a;16b;
H3384	059	0	1	02	01	H3384_059_0	5	002	Optional Supplemental Dental Enhanced	34.00	1	1000.00	3	2				16a;16b;
H3528	001	0	1	02	01	H3528_001_0	7	001	Dental	34.00	1	1000.00	3	1	100.00	16b;	16a;16b;	
H3528	002	0	1	01	01	H3528_002_0	7	001	Dental	34.00	1	1000.00	3	1	100.00	16b;	16a;16b;	
H3528	003	0	1	01	01	H3528_003_0	4	001	Dental	34.00	1	1000.00	3	1	100.00	16b;	16a;16b;	
H3528	006	0	1	02	01	H3528_006_0	7	001	Dental	34.00	1	1000.00	3	1	100.00	16b;	16a;16b;	
H3528	008	0	1	02	01	H3528_008_0	8	001	Dental	34.00	1	1000.00	3	1	100.00	16b;	16a;16b;	
H3528	010	0	1	01	01	H3528_010_0	7	001	Dental	34.00	1	1000.00	3	1	100.00	16b;	16a;16b;	
H3533	001	0	1	01	01	H3533_001_0	4	001	MyOption Enhanced Dental HMO	28.60	1	1500.00	3	2				16a;16b;
H3533	001	0	1	01	01	H3533_001_0	4	002	MyOption Fitness	15.00	2			2			14c;	
H3533	006	0	1	01	01	H3533_006_0	4	001	MyOption Enhanced Dental HMO	28.60	1	1500.00	3	2				16a;16b;
H3533	010	0	1	01	01	H3533_010_0	3	001	MyOption Dental - High PPO	24.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H3533	020	0	1	01	01	H3533_020_0	4	001	MyOption Dental - High PPO	24.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H3536	002	0	1	01	01	H3536_002_0	9	001	Preventive Dental Package	15.00	2			2				16a;
H3536	002	0	1	01	01	H3536_002_0	9	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H3536	002	0	1	01	01	H3536_002_0	9	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H3536	003	0	1	01	01	H3536_003_0	6	001	Preventive Dental Package	15.00	2			2				16a;
H3536	003	0	1	01	01	H3536_003_0	6	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H3536	003	0	1	01	01	H3536_003_0	6	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H3653	004	0	1	01	01	H3653_004_0	8	001	SUPPLEMENTAL DENTAL BENEFIT	18.70	1	500.00	3	2			16a;16b;	
H3653	015	0	1	01	01	H3653_015_0	9	001	SUPPLEMENTAL DENTAL BENEFIT	18.70	1	500.00	3	2			16a;16b;	
H3653	018	0	1	01	01	H3653_018_0	5	001	SUPPLEMENTAL DENTAL BENEFIT	18.70	1	500.00	3	2			16a;16b;	
H3655	032	0	1	01	01	H3655_032_0	8	001	Preventive Dental Package	14.00	2			2				16a;
H3655	032	0	1	01	01	H3655_032_0	8	002	Dental and Vision Package	24.00	2			2				16a;16b;17b;
H3655	032	0	1	01	01	H3655_032_0	8	003	Enhanced Dental and Vision Package	31.00	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				16a;16b;
H3660	029	0	1	02	01	H3660_029_0	9	001	Optional Supplemental Dental	25.00	1	1000.00	3	2				16a;16b;
H3660	044	0	1	01	01	H3660_044_0	13	001	Optional Supplemental Dental	25.00	1	1000.00	3	2				16a;16b;
H3660	047	0	1	01	01	H3660_047_0	13	001	Optional Supplemental Dental	25.00	1	1000.00	3	2				16a;16b;
H3660	048	0	1	02	01	H3660_048_0	10	001	Optional Supplemental Dental	25.00	1	1000.00	3	2				16a;16b;
H3660	049	0	1	01	01	H3660_049_0	13	001	Optional Supplemental Dental	25.00	1	1000.00	3	2				16a;16b;
H3660	050	0	1	01	01	H3660_050_0	13	001	Optional Supplemental Dental	25.00	1	1000.00	3	2				16a;16b;
H3668	005	0	1	01	01	H3668_005_0	13	001	Dental	16.00	1	1000.00	3	2			16b;	
H3668	011	0	1	01	01	H3668_011_0	12	001	Dental	16.00	1	1000.00	3	2			16b;	
H3668	013	0	1	01	01	H3668_013_0	8	001	Dental	16.00	1	1000.00	3	2			16b;	
H3668	014	0	1	01	01	H3668_014_0	16	001	Dental	16.00	1	1000.00	3	2			16b;	
H3668	015	0	1	01	01	H3668_015_0	16	001	Dental	16.00	1	1000.00	3	2			16b;	
H3668	016	0	1	01	01	H3668_016_0	16	001	Dental	16.00	1	1000.00	3	2			16b;	
H3668	017	0	1	01	01	H3668_017_0	16	001	Dental	16.00	1	1000.00	3	2			16b;	
H3749	001	0	1	01	01	H3749_001_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H3749	017	0	1	01	01	H3749_017_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H3749	018	0	1	01	01	H3749_018_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3805	001	0	1	01	01	H3805_001_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H3805	001	0	1	01	01	H3805_001_0	5	002	Fitness Rider	18.00	2			2			14c;	
H3805	007	0	1	01	01	H3805_007_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H3805	012	0	1	01	01	H3805_012_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3805	012	0	1	01	01	H3805_012_0	5	002	Fitness Rider	18.00	2			2			14c;	
H3805	013	0	1	01	01	H3805_013_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3805	013	0	1	01	01	H3805_013_0	5	002	Fitness Rider	18.00	2			2			14c;	
H3805	014	0	1	01	01	H3805_014_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H3805	015	0	1	01	01	H3805_015_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H3805	016	0	1	01	01	H3805_016_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3805	017	0	1	01	01	H3805_017_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3805	018	0	1	01	01	H3805_018_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3805	019	0	1	01	01	H3805_019_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3805	020	0	1	01	01	H3805_020_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H3813	001	0	1	04	01	H3813_001_0	2	001	Moda Health Extra Care	12.00	1	500.00	3	2			14c;	7b;13a;17b;18a;18b;
H3813	006	0	1	04	01	H3813_006_0	5	001	Moda Health Extra Care	12.00	1	500.00	3	2			14c;	7b;13a;17b;18a;18b;
H3815	011	0	1	01	01	H3815_011_0	8	001	Plus Option	14.00	2			2			14c;16a;16b;	10b;
H3817	007	1	1	04	01	H3817_007_1	7	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H3817	007	2	1	04	01	H3817_007_2	7	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H3817	008	1	1	04	01	H3817_008_1	8	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H3817	008	2	1	04	01	H3817_008_2	8	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H3817	009	1	1	04	01	H3817_009_1	8	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H3817	009	2	1	04	01	H3817_009_2	8	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H3822	002	0	1	01	01	H3822_002_0	10	001	Optional Supplemental	33.20	1	2150.00	6	2			16a;16b;17a;17b;18a;18b;	
H3822	007	0	1	02	01	H3822_007_0	11	001	Optional Supplemental	37.50	1	2150.00	6	2			16a;16b;17a;17b;18a;18b;	
H3864	002	0	1	01	01	H3864_002_0	5	001	Preventive Dental	28.00	2			2			16a;	
H3864	006	0	1	01	01	H3864_006_0	6	001	Preventive Dental	28.00	2			2			16a;	
H3864	014	0	1	02	01	H3864_014_0	9	001	Preventive Dental	28.00	2			2			16a;	
H3864	021	0	1	01	01	H3864_021_0	6	001	Preventive Dental	22.00	2			2			16a;	
H3864	022	0	1	01	01	H3864_022_0	6	001	Preventive Dental	28.00	2			2			16a;	
H3864	023	0	1	01	01	H3864_023_0	6	001	Preventive Dental	22.00	2			2			16a;	
H3864	024	0	1	02	01	H3864_024_0	9	001	Preventive Dental	22.00	2			2			16a;	
H3864	026	1	1	01	01	H3864_026_1	6	001	Preventive Dental	28.00	2			2			16a;	
H3864	026	2	1	01	01	H3864_026_2	7	001	Preventive Dental	28.00	2			2			16a;	
H3864	027	0	1	01	01	H3864_027_0	11	001	Preventive Dental	28.00	2			2			16a;	
H3890	001	0	1	04	01	H3890_001_0	7	001	Dental	28.00	1	1200.00	3	2				16b;
H3890	002	0	1	04	01	H3890_002_0	7	001	Dental	28.00	1	1200.00	3	2				16b;
H3924	059	3	1	04	01	H3924_059_3	4	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	4	1	04	01	H3924_059_4	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	6	1	04	01	H3924_059_6	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	7	1	04	01	H3924_059_7	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	8	1	04	01	H3924_059_8	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	059	9	1	04	01	H3924_059_9	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	3	1	04	01	H3924_060_3	4	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	4	1	04	01	H3924_060_4	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	6	1	04	01	H3924_060_6	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	7	1	04	01	H3924_060_7	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	8	1	04	01	H3924_060_8	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3924	060	9	1	04	01	H3924_060_9	5	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3931	055	0	1	01	01	H3931_055_0	3	001	DMO Dental	12.80	2			2			16a;16b;	
H3931	064	0	1	01	01	H3931_064_0	4	001	DMO Dental	12.80	2			2			16a;16b;	
H3931	064	0	1	01	01	H3931_064_0	4	002	DMO Dental Plus Eye Wear and Hearing Aids	22.80	2			2			16a;16b;17b;18b;	
H3931	092	0	1	01	01	H3931_092_0	4	001	DMO Dental	12.80	2			2			16a;16b;	
H3931	092	0	1	01	01	H3931_092_0	4	002	DMO Dental Plus EyeWear and Hearing Aids	22.80	2			2			16a;16b;17b;18b;	
H3931	093	0	1	01	01	H3931_093_0	4	001	DMO Dental	12.40	2			2			16a;16b;	
H3931	093	0	1	01	01	H3931_093_0	4	002	DMO Dental Plus EyeWear and Hearing Aids	22.40	2			2			16a;16b;17b;18b;	
H3931	094	0	1	01	01	H3931_094_0	4	001	DMO Dental	17.50	2			2			16a;16b;	
H3931	094	0	1	01	01	H3931_094_0	4	002	DMO Dental Plus Hearing Aids	20.50	2			2			16a;16b;18b;	
H3931	095	0	1	01	01	H3931_095_0	5	001	DMO Dental	13.40	2			2			16a;16b;	
H3931	095	0	1	01	01	H3931_095_0	5	002	DMO Dental Plus Eye Wear and Hearing Aids	23.40	2			2			16a;16b;17b;18b;	
H3931	106	0	1	01	01	H3931_106_0	3	001	DMO Dental	20.30	2			2			16a;16b;	
H3931	106	0	1	01	01	H3931_106_0	3	002	DMO Dental Plus EyeWear and Hearing Aids	30.30	2			2			16a;16b;17b;18b;	
H3931	107	0	1	01	01	H3931_107_0	4	001	DMO Dental	16.20	2			2			16a;16b;	
H3931	107	0	1	01	01	H3931_107_0	4	002	DMO Dental Plus Eye Wear and Hearing Aids	26.20	2			2			16a;16b;17b;18b;	
H3931	108	0	1	01	01	H3931_108_0	4	001	DMO Dental	16.20	2			2			16a;16b;	
H3931	108	0	1	01	01	H3931_108_0	4	002	DMO Dental Plus Eye Wear and Hearing Aids	26.20	2			2			16a;16b;17b;18b;	
H3931	109	0	1	01	01	H3931_109_0	5	001	DMO Dental	16.20	2			2			16a;16b;	
H3931	109	0	1	01	01	H3931_109_0	5	002	DMO Dental Plus Eye Wear and Hearing Aids	26.20	2			2			16a;16b;17b;18b;	
H3931	110	0	1	01	01	H3931_110_0	4	001	DMO Dental	16.20	2			2			16a;16b;	
H3931	110	0	1	01	01	H3931_110_0	4	002	DMO Dental Plus Eye Wear and Hearing Aids	26.20	2			2			16a;16b;17b;18b;	
H3931	115	0	1	01	01	H3931_115_0	3	001	DMO Dental	17.50	2			2			16a;16b;	
H3931	115	0	1	01	01	H3931_115_0	3	002	DMO Dental Plus Eyewear and Hearing Aids	27.50	2			2			16a;16b;17b;18b;	
H3945	003	0	1	02	01	H3945_003_0	5	001	Enhanced Vision and Enhanced Dental	21.00	1	1000.00	3	2			16a;16b;17a;17b;	
H3949	013	0	1	01	01	H3949_013_0	7	001	Enhanced Dental - Comprehensive	10.00	1	800.00	3	2			16b;	
H3949	024	0	1	01	01	H3949_024_0	5	001	Enhanced Dental - Comprehensive	10.00	1	800.00	3	2			16b;	
H3949	026	0	1	01	01	H3949_026_0	4	001	Enhanced Dental - Preventive and Comprehensive	12.60	1	800.00	3	2			16a;16b;	
H3949	028	0	1	01	01	H3949_028_0	5	001	Enhanced Dental - Preventive and Comprehensive	12.60	1	800.00	3	2			16a;16b;	
H3949	030	0	1	01	01	H3949_030_0	5	001	Enhanced Dental - Comprehensive	10.00	1	800.00	3	2			16b;	
H3952	048	0	1	01	01	H3952_048_0	3	001	Choice Program	6.00	2			2			16a;17a;17b;18a;18b;	
H3952	049	0	1	01	01	H3952_049_0	5	001	Choice Program	6.00	2			2			16a;17a;17b;18a;18b;	
H3952	050	0	1	01	01	H3952_050_0	2	001	Choice Program	6.00	2			2			16a;17a;17b;18a;18b;	
H3952	051	0	1	01	01	H3952_051_0	4	001	Choice Program	6.00	2			2			16a;17a;17b;18a;18b;	
H3952	053	0	1	01	01	H3952_053_0	4	001	Choice Program	6.00	2			2			16a;17a;17b;18a;18b;	
H3952	054	0	1	01	01	H3952_054_0	4	001	Choice Program	6.00	2			2			16a;17a;17b;18a;18b;	
H3954	158	1	1	01	01	H3954_158_1	6	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3954	158	2	1	01	01	H3954_158_2	6	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3954	158	3	1	01	01	H3954_158_3	6	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3954	158	4	1	01	01	H3954_158_4	6	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3954	158	5	1	01	01	H3954_158_5	6	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H3954	158	6	1	01	01	H3954_158_6	6	001	Geisinger Gold Health+	38.00	2			2			14c;16a;16b;17a;17b;18a;18b;	
H4036	008	0	1	04	01	H4036_008_0	7	001	Preventive Dental Package	20.00	2			2				16a;
H4036	008	0	1	04	01	H4036_008_0	7	002	Dental and Vision Package	28.00	2			2				16a;16b;17b;
H4036	008	0	1	04	01	H4036_008_0	7	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
H4036	009	0	1	04	01	H4036_009_0	5	001	Preventive Dental Package	20.00	2			2				16a;
H4036	009	0	1	04	01	H4036_009_0	5	002	Dental and Vision Package	28.00	2			2				16a;16b;17b;
H4036	009	0	1	04	01	H4036_009_0	5	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
H4141	001	0	1	01	01	H4141_001_0	4	001	MyOption Enhanced Dental HMO	18.00	1	1500.00	3	2				16a;16b;
H4141	004	0	1	01	01	H4141_004_0	4	001	MyOption Enhanced Dental HMO	18.00	1	1500.00	3	2				16a;16b;
H4141	015	0	1	01	01	H4141_015_0	4	001	MyOption Enhanced Dental HMO	18.00	1	1500.00	3	2				16a;16b;
H4152	004	0	1	01	01	H4152_004_0	9	001	Dental Rider	22.70	1	1000.00	3	2			16a;16b;	
H4152	005	0	1	01	01	H4152_005_0	11	001	Dental Rider	22.70	1	1000.00	3	2			16a;16b;	
H4152	007	0	1	02	01	H4152_007_0	11	001	Dental Rider	22.70	1	1000.00	3	2				16a;16b;
H4152	013	0	1	01	01	H4152_013_0	11	001	Dental Rider	22.70	1	1000.00	3	2			16a;16b;	
H4152	016	0	1	02	01	H4152_016_0	11	001	Dental Rider	22.70	1	1000.00	3	2				16a;16b;
H4152	017	0	1	01	01	H4152_017_0	11	001	Dental Rider	22.70	1	1000.00	3	2			16a;16b;	
H4152	018	0	1	02	01	H4152_018_0	11	001	Dental Rider	22.70	1	1000.00	3	2				16a;16b;
H4407	025	1	1	01	01	H4407_025_1	4	001	Enhanced Dental - Comprehensive	26.40	1	1500.00	3	2			16b;	
H4407	025	2	1	01	01	H4407_025_2	4	001	Enhanced Dental - Comprehensive	26.40	1	1500.00	3	2			16b;	
H4454	031	0	1	01	01	H4454_031_0	4	001	Enhanced Dental - Comprehensive	35.70	1	1000.00	3	2			16b;	
H4454	037	1	1	01	01	H4454_037_1	4	001	Enhanced Dental - Preventive	20.20	2			2			16a;	
H4454	037	1	1	01	01	H4454_037_1	4	002	Enhanced Dental - Preventive and Comprehensive	55.90	1	1000.00	3	2			16a;16b;	
H4454	037	2	1	01	01	H4454_037_2	4	001	Enhanced Dental - Preventive	20.20	2			2			16a;	
H4454	037	2	1	01	01	H4454_037_2	4	002	Enhanced Dental - Preventive and Comprehensive	55.90	1	1000.00	3	2			16a;16b;	
H4461	030	1	1	01	01	H4461_030_1	5	001	MyOption Vision	15.30	2			2				17a;17b;
H4461	030	1	1	01	01	H4461_030_1	5	002	MyOption Enhanced Dental HMO	22.50	1	1500.00	3	2				16a;16b;
H4461	030	2	1	01	01	H4461_030_2	5	001	MyOption Vision	15.30	2			2				17a;17b;
H4461	030	2	1	01	01	H4461_030_2	5	002	MyOption Enhanced Dental HMO	22.50	1	1500.00	3	2				16a;16b;
H4461	030	3	1	01	01	H4461_030_3	4	001	MyOption Vision	15.30	2			2				17a;17b;
H4461	030	3	1	01	01	H4461_030_3	4	002	MyOption Enhanced Dental HMO	22.50	1	1500.00	3	2				16a;16b;
H4461	031	1	1	01	01	H4461_031_1	5	001	MyOption Vision	15.30	2			2				17a;17b;
H4461	031	1	1	01	01	H4461_031_1	5	002	MyOption Enhanced Dental HMO	22.50	1	1500.00	3	2				16a;16b;
H4461	031	2	1	01	01	H4461_031_2	5	001	MyOption Vision	15.30	2			2				17a;17b;
H4461	031	2	1	01	01	H4461_031_2	5	002	MyOption Enhanced Dental HMO	22.50	1	1500.00	3	2				16a;16b;
H4461	031	3	1	01	01	H4461_031_3	5	001	MyOption Vision	15.30	2			2				17a;17b;
H4461	031	3	1	01	01	H4461_031_3	5	002	MyOption Enhanced Dental HMO	22.50	1	1500.00	3	2				16a;16b;
H4497	001	1	1	04	01	H4497_001_1	10	001	Optional Dental and Vision	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H4497	001	2	1	04	01	H4497_001_2	10	001	Optional Dental and Vision	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H4497	002	1	1	04	01	H4497_002_1	10	001	Optional Dental and Vision	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H4497	002	2	1	04	01	H4497_002_2	10	001	Optional Dental and Vision	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H4514	007	0	1	01	01	H4514_007_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H4527	002	0	1	01	01	H4527_002_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H4527	037	0	1	01	01	H4527_037_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H4564	001	0	1	18	06	H4564_001_0	7	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	002	0	1	18	06	H4564_002_0	8	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	004	0	1	18	06	H4564_004_0	8	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	005	0	1	18	06	H4564_005_0	8	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	010	0	1	18	06	H4564_010_0	6	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	011	0	1	18	06	H4564_011_0	8	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	012	0	1	18	06	H4564_012_0	8	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	015	0	1	18	06	H4564_015_0	10	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	016	0	1	18	06	H4564_016_0	7	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	017	0	1	18	06	H4564_017_0	8	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4564	018	0	1	18	06	H4564_018_0	8	001	Dental Services	13.00	1	2000.00	3	2				16a;16b;
H4590	012	0	1	01	01	H4590_012_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H4590	025	0	1	01	01	H4590_025_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H4590	027	0	1	01	01	H4590_027_0	3	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H4605	001	0	1	04	01	H4605_001_0	5	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H4605	002	0	1	04	01	H4605_002_0	6	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H4605	004	0	1	04	01	H4605_004_0	6	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H4754	004	0	1	04	01	H4754_004_0	7	001	Preventive Dental	28.00	2			2			16a;	
H4754	006	0	1	04	01	H4754_006_0	4	001	Preventive Dental	22.00	2			2			16a;	
H4754	007	0	1	04	01	H4754_007_0	6	001	Preventive Dental	28.00	2			2			16a;	
H4754	008	0	1	04	01	H4754_008_0	4	001	Preventive Dental	28.00	2			2			16a;	
H4754	009	0	1	04	01	H4754_009_0	6	001	Preventive Dental	22.00	2			2			16a;	
H4754	011	0	1	04	01	H4754_011_0	6	001	Preventive Dental	22.00	2			2			16a;	
H4754	012	0	1	04	01	H4754_012_0	4	001	Preventive Dental	22.00	2			2			16a;	
H4875	016	1	1	04	01	H4875_016_1	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	016	2	1	04	01	H4875_016_2	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	016	3	1	04	01	H4875_016_3	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	016	4	1	04	01	H4875_016_4	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	016	5	1	04	01	H4875_016_5	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	017	1	1	04	01	H4875_017_1	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	017	2	1	04	01	H4875_017_2	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	017	3	1	04	01	H4875_017_3	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	017	4	1	04	01	H4875_017_4	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	017	5	1	04	01	H4875_017_5	9	001	Enhanced Vision, Dental and Hearing	20.50	1	2100.00	6	2			16b;17a;17b;18a;18b;	16a;
H4875	018	1	1	04	01	H4875_018_1	9	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H4875	018	2	1	04	01	H4875_018_2	9	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H4875	018	3	1	04	01	H4875_018_3	9	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H4875	018	4	1	04	01	H4875_018_4	9	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H4875	018	5	1	04	01	H4875_018_5	9	001	Enhanced Vision, Dental and Hearing	29.00	1	2100.00	6	2			16a;16b;17a;17b;18a;18b;	
H4909	014	0	1	04	01	H4909_014_0	7	001	Preventive Dental Package	21.00	2			2				16a;
H4909	014	0	1	04	01	H4909_014_0	7	002	Dental and Vision Package	30.00	2			2				16a;16b;17b;
H4909	014	0	1	04	01	H4909_014_0	7	003	Enhanced Dental and Vision Package	40.00	2			2				16a;16b;17b;
H4922	005	1	1	01	01	H4922_005_1	6	001	Preventive and Comprehensive Dental	13.50	2			2			16a;16b;	
H4922	005	2	1	01	01	H4922_005_2	5	001	Preventive and Comprehensive Dental	13.50	2			2			16a;16b;	
H5009	001	0	1	04	01	H5009_001_0	5	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H5009	002	0	1	04	01	H5009_002_0	8	001	Dental Option	28.00	1	1000.00	3	2			16b;	
H5010	001	0	1	04	01	H5010_001_0	6	001	Dental Option	26.00	1	1000.00	3	2			16b;	
H5010	002	0	1	04	01	H5010_002_0	8	001	Dental Option	26.00	1	1000.00	3	2			16b;	
H5010	004	0	1	04	01	H5010_004_0	8	001	Dental Option	26.00	1	1000.00	3	2			16b;	
H5050	001	0	1	01	01	H5050_001_0	7	001	Dental HMO	54.00	1	1500.00	3	2			16a;16b;	
H5050	004	0	1	01	01	H5050_004_0	7	001	Dental HMO	54.00	1	1500.00	3	2			16a;16b;	
H5050	009	0	1	01	01	H5050_009_0	8	001	Dental HMO	54.00	1	1500.00	3	2			16a;16b;	
H5050	013	0	1	01	01	H5050_013_0	8	001	Dental HMO	54.00	1	1500.00	3	2			16a;16b;	
H5050	017	0	1	01	01	H5050_017_0	7	001	Dental HMO	54.00	1	1500.00	3	2			16a;16b;	
H5050	019	0	1	01	01	H5050_019_0	8	001	Dental HMO	54.00	1	1500.00	3	2			16a;16b;	
H5050	021	0	1	01	01	H5050_021_0	8	001	Dental HMO	54.00	1	1500.00	3	2			16a;16b;	
H5216	001	0	1	04	01	H5216_001_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H5216	001	0	1	04	01	H5216_001_0	3	002	MyOption Enhanced Dental PPO	29.50	1	1500.00	3	2				16a;16b;
H5216	006	0	1	04	01	H5216_006_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H5216	006	0	1	04	01	H5216_006_0	3	002	MyOption Enhanced Dental PPO	29.50	1	1500.00	3	2				16a;16b;
H5216	009	0	1	04	01	H5216_009_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H5216	009	0	1	04	01	H5216_009_0	3	002	MyOption Enhanced Dental PPO	27.50	1	1500.00	3	2				16a;16b;
H5216	011	0	1	04	01	H5216_011_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H5216	011	0	1	04	01	H5216_011_0	4	002	MyOption Dental Advantage PPO	29.10	1	1500.00	3	2				16a;16b;
H5216	012	0	1	04	01	H5216_012_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H5216	012	0	1	04	01	H5216_012_0	3	002	MyOption Dental Advantage PPO	33.10	1	1500.00	3	2				16a;16b;
H5216	013	0	1	04	01	H5216_013_0	4	001	MyOption Enhanced Dental PPO	22.30	1	1500.00	3	2				16a;16b;
H5216	014	0	1	04	01	H5216_014_0	3	001	MyOption Dental - High PPO	18.20	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5216	014	0	1	04	01	H5216_014_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H5216	014	0	1	04	01	H5216_014_0	3	003	MyOption Plus	18.60	2			1	50.00	16b;		16a;16b;17a;17b;
H5253	004	0	1	01	01	H5253_004_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	011	0	1	01	01	H5253_011_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	021	0	1	01	01	H5253_021_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	030	0	1	01	01	H5253_030_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	033	0	1	01	01	H5253_033_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	034	0	1	01	01	H5253_034_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	035	0	1	02	01	H5253_035_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	037	0	1	01	01	H5253_037_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	038	0	1	01	01	H5253_038_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	039	0	1	01	01	H5253_039_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	040	0	1	01	01	H5253_040_0	3	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	044	0	1	01	01	H5253_044_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	045	0	1	01	01	H5253_045_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	046	0	1	01	01	H5253_046_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	046	0	1	01	01	H5253_046_0	4	002	Fitness Rider	18.00	2			2			14c;	
H5253	047	0	1	02	01	H5253_047_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	048	0	1	02	01	H5253_048_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	049	0	1	01	01	H5253_049_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	050	0	1	01	01	H5253_050_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	052	0	1	01	01	H5253_052_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	053	0	1	01	01	H5253_053_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	056	0	1	01	01	H5253_056_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	057	0	1	01	01	H5253_057_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	062	0	1	01	01	H5253_062_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	067	0	1	01	01	H5253_067_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	072	0	1	01	01	H5253_072_0	5	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	073	0	1	01	01	H5253_073_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	074	0	1	01	01	H5253_074_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	075	0	1	01	01	H5253_075_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	076	0	1	01	01	H5253_076_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	077	0	1	01	01	H5253_077_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	078	0	1	02	01	H5253_078_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	079	0	1	01	01	H5253_079_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	080	0	1	01	01	H5253_080_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	081	0	1	01	01	H5253_081_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	082	0	1	01	01	H5253_082_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5253	083	0	1	01	01	H5253_083_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H5253	084	0	1	01	01	H5253_084_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H5256	004	0	1	18	06	H5256_004_0	2	001	Out of Network Benefit	20.00	2			2				13d;
H5410	018	0	1	02	01	H5410_018_0	5	001	Enhanced Dental - Comprehensive	46.10	1	1500.00	3	2			16b;	
H5415	077	0	1	04	01	H5415_077_0	3	001	MyOption Enhanced Dental PPO	17.80	1	1500.00	3	2				16a;16b;
H5422	008	0	1	01	01	H5422_008_0	7	001	Preventive Dental Package	13.00	2			2				16a;
H5422	008	0	1	01	01	H5422_008_0	7	002	Dental and Vision Package	25.00	2			2				16a;16b;17b;
H5422	008	0	1	01	01	H5422_008_0	7	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H5422	009	0	1	01	01	H5422_009_0	10	001	Preventive Dental Package	13.00	2			2				16a;
H5422	009	0	1	01	01	H5422_009_0	10	002	Dental and Vision Package	25.00	2			2				16a;16b;17b;
H5422	009	0	1	01	01	H5422_009_0	10	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H5425	001	0	1	01	01	H5425_001_0	7	001	Basic Dental	8.00	2			2				16a;16b;
H5425	001	0	1	01	01	H5425_001_0	7	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	004	0	1	01	01	H5425_004_0	5	001	Basic Dental	8.00	2			2				16a;16b;
H5425	004	0	1	01	01	H5425_004_0	5	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	005	0	1	01	01	H5425_005_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	005	0	1	01	01	H5425_005_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	006	0	1	01	01	H5425_006_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	006	0	1	01	01	H5425_006_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	007	0	1	01	01	H5425_007_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	007	0	1	01	01	H5425_007_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	008	0	1	01	01	H5425_008_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	008	0	1	01	01	H5425_008_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	009	0	1	01	01	H5425_009_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	009	0	1	01	01	H5425_009_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	019	0	1	01	01	H5425_019_0	5	001	Basic Dental	8.00	2			2				16a;16b;
H5425	019	0	1	01	01	H5425_019_0	5	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	020	0	1	01	01	H5425_020_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	020	0	1	01	01	H5425_020_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	020	0	1	01	01	H5425_020_0	6	003	Vision Plan	5.00	1	200.00	3	2				17b;
H5425	028	0	1	01	01	H5425_028_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	028	0	1	01	01	H5425_028_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	033	0	1	01	01	H5425_033_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	033	0	1	01	01	H5425_033_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	034	0	1	01	01	H5425_034_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	034	0	1	01	01	H5425_034_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	046	0	1	01	01	H5425_046_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	046	0	1	01	01	H5425_046_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	047	0	1	01	01	H5425_047_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	047	0	1	01	01	H5425_047_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	048	0	1	01	01	H5425_048_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	048	0	1	01	01	H5425_048_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	052	0	1	01	01	H5425_052_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	052	0	1	01	01	H5425_052_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	053	0	1	01	01	H5425_053_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	053	0	1	01	01	H5425_053_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	054	0	1	01	01	H5425_054_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	054	0	1	01	01	H5425_054_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	055	0	1	01	01	H5425_055_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	055	0	1	01	01	H5425_055_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	056	0	1	01	01	H5425_056_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	056	0	1	01	01	H5425_056_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	061	0	1	01	01	H5425_061_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	061	0	1	01	01	H5425_061_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5425	064	0	1	01	01	H5425_064_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H5425	064	0	1	01	01	H5425_064_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H5520	001	0	1	04	01	H5520_001_0	4	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	001	0	1	04	01	H5520_001_0	4	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	002	0	1	04	01	H5520_002_0	4	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	002	0	1	04	01	H5520_002_0	4	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	003	0	1	04	01	H5520_003_0	3	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	003	0	1	04	01	H5520_003_0	3	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	004	0	1	04	01	H5520_004_0	6	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	004	0	1	04	01	H5520_004_0	6	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	012	1	1	04	01	H5520_012_1	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	012	1	1	04	01	H5520_012_1	5	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	012	1	1	04	01	H5520_012_1	5	003	Routine Vision	6.00	1	250.00	2	2			17a;17b;	
H5520	012	2	1	04	01	H5520_012_2	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	012	2	1	04	01	H5520_012_2	5	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	012	2	1	04	01	H5520_012_2	5	003	Routine Vision	6.00	1	250.00	2	2			17a;17b;	
H5520	012	3	1	04	01	H5520_012_3	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	012	3	1	04	01	H5520_012_3	5	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	012	3	1	04	01	H5520_012_3	5	003	Routine Vision	6.00	1	250.00	2	2			17a;17b;	
H5520	012	4	1	04	01	H5520_012_4	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	012	4	1	04	01	H5520_012_4	5	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	012	4	1	04	01	H5520_012_4	5	003	Routine Vision	6.00	1	250.00	2	2			17a;17b;	
H5520	014	0	1	04	01	H5520_014_0	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	014	0	1	04	01	H5520_014_0	5	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	014	0	1	04	01	H5520_014_0	5	003	Routine Vision	6.00	1	250.00	2	2			17a;17b;	
H5520	015	1	1	04	01	H5520_015_1	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	015	1	1	04	01	H5520_015_1	5	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5520	015	2	1	04	01	H5520_015_2	5	001	Comprehensive Dental PPO	39.00	1	1000.00	3	1	50.00	16a;16b;	16a;16b;	
H5520	015	2	1	04	01	H5520_015_2	5	002	Preventive & Diagnostic Plus Dental PPO	15.00	1	500.00	3	1	35.00	16a;		16a;
H5525	004	0	1	04	01	H5525_004_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H5525	004	0	1	04	01	H5525_004_0	3	002	MyOption Enhanced Dental PPO	22.30	1	1500.00	3	2				16a;16b;
H5525	006	0	1	04	01	H5525_006_0	6	001	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
H5525	015	0	1	04	01	H5525_015_0	3	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5525	020	0	1	04	01	H5525_020_0	3	001	MyOption Dental - High PPO	17.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5525	020	0	1	04	01	H5525_020_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H5525	020	0	1	04	01	H5525_020_0	3	003	MyOption Plus	18.20	2			1	50.00	16b;		16a;16b;17a;17b;
H5525	022	0	1	04	01	H5525_022_0	6	001	MyOption Platinum Dental	22.10	1	2000.00	3	2			16a;16b;	
H5525	023	0	1	04	01	H5525_023_0	6	001	MyOption Enhanced Dental PPO	21.60	1	1500.00	3	2				16a;16b;
H5525	024	0	1	04	01	H5525_024_0	3	001	MyOption Enhanced Dental PPO	20.80	1	1500.00	3	2				16a;16b;
H5525	025	0	1	04	01	H5525_025_0	4	001	MyOption Platinum Dental	23.10	1	2000.00	3	2			16a;16b;	
H5525	026	0	1	04	01	H5525_026_0	3	001	MyOption Dental - High PPO	22.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5525	027	0	1	04	01	H5525_027_0	3	001	MyOption Dental - High PPO	22.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5525	027	0	1	04	01	H5525_027_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H5525	027	0	1	04	01	H5525_027_0	3	003	MyOption Plus	19.70	2			1	50.00	16b;		16a;16b;17a;17b;
H5526	004	0	1	04	01	H5526_004_0	6	001	Optional Supplemental Dental Basic	17.00	1	500.00	3	2				16a;16b;
H5526	004	0	1	04	01	H5526_004_0	6	002	Optional Supplemental Dental Enhanced	31.00	1	1000.00	3	2				16a;16b;
H5526	016	0	1	04	01	H5526_016_0	4	001	Optional Supplemental Dental Basic	17.00	1	500.00	3	2				16a;16b;
H5526	016	0	1	04	01	H5526_016_0	4	002	Optional Supplemental Dental Enhanced	31.00	1	1000.00	3	2				16a;16b;
H5526	017	0	1	04	01	H5526_017_0	5	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2				16a;16b;
H5526	017	0	1	04	01	H5526_017_0	5	002	Optional Supplemental Dental Enhanced	34.00	1	1000.00	3	2				16a;16b;
H5526	018	0	1	04	01	H5526_018_0	5	001	Optional Supplemental Dental Basic	19.00	1	500.00	3	2				16a;16b;
H5526	018	0	1	04	01	H5526_018_0	5	002	Optional Supplemental Dental Enhanced	34.00	1	1000.00	3	2				16a;16b;
H5526	019	0	1	04	01	H5526_019_0	8	001	Optional Supplemental Dental Basic	17.00	1	500.00	3	2				16a;16b;
H5526	019	0	1	04	01	H5526_019_0	8	002	Optional Supplemental Dental Enhanced	31.00	1	1000.00	3	2				16a;16b;
H5530	006	1	1	04	01	H5530_006_1	9	001	Preventive Dental Package	16.00	2			2				16a;
H5530	006	1	1	04	01	H5530_006_1	9	002	Dental and Vision Package	24.00	2			2				16a;16b;17b;
H5530	006	1	1	04	01	H5530_006_1	9	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
H5530	006	2	1	04	01	H5530_006_2	9	001	Preventive Dental Package	16.00	2			2				16a;
H5530	006	2	1	04	01	H5530_006_2	9	002	Dental and Vision Package	24.00	2			2				16a;16b;17b;
H5530	006	2	1	04	01	H5530_006_2	9	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
H5609	001	0	1	01	01	H5609_001_0	5	001	Dental HMO	12.90	2			2			16a;16b;	
H5609	001	0	1	01	01	H5609_001_0	5	002	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;		16a;16b;
H5609	004	0	1	01	01	H5609_004_0	5	001	Dental PPO	33.40	1	1500.00	6	1	50.00	16b;	16a;16b;	
H5613	001	0	1	07	02	H5613_001_0	7	001	Optional Supplemental Rider	20.00	2			2				14c;16a;17a;17b;18a;18b;
H5613	002	0	1	07	02	H5613_002_0	6	001	Optional Supplemental Rider	20.00	2			2				14c;16a;17a;17b;18a;18b;
H5613	801	0	1	07	02	H5613_801_0	3	001	Optional Supplemental Rider		2			2				14c;16a;17a;17b;18a;18b;
H5613	802	0	1	07	02	H5613_802_0	3	001	Optional Supplemental Rider		2			2				14c;16a;17a;17b;18a;18b;
H5619	001	0	1	01	01	H5619_001_0	4	001	MyOption Fitness	15.00	2			2			14c;	
H5619	012	0	1	01	01	H5619_012_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	012	0	1	01	01	H5619_012_0	5	002	MyOption Vision	15.30	2			2			17a;17b;	
H5619	012	0	1	01	01	H5619_012_0	5	003	MyOption Plus	24.50	2			1	50.00	16b;		16a;16b;17a;17b;
H5619	012	0	1	01	01	H5619_012_0	5	004	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	013	0	1	01	01	H5619_013_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	013	0	1	01	01	H5619_013_0	5	002	MyOption Vision	15.30	2			2			17a;17b;	
H5619	013	0	1	01	01	H5619_013_0	5	003	MyOption Plus	24.50	2			1	50.00	16b;		16a;16b;17a;17b;
H5619	013	0	1	01	01	H5619_013_0	5	004	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	015	0	1	01	01	H5619_015_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	015	0	1	01	01	H5619_015_0	5	002	MyOption Vision	15.30	2			2			17a;17b;	
H5619	015	0	1	01	01	H5619_015_0	5	003	MyOption Plus	24.50	2			1	50.00	16b;		16a;16b;17a;17b;
H5619	015	0	1	01	01	H5619_015_0	5	004	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	016	0	1	01	01	H5619_016_0	5	001	MyOption Dental Enriched HMO	34.00	1	1500.00	3	2				16a;16b;
H5619	021	0	1	01	01	H5619_021_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	021	0	1	01	01	H5619_021_0	5	002	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	023	0	1	01	01	H5619_023_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	023	0	1	01	01	H5619_023_0	5	002	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	026	0	1	01	01	H5619_026_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	026	0	1	01	01	H5619_026_0	5	002	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	029	0	1	01	01	H5619_029_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	029	0	1	01	01	H5619_029_0	5	002	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	032	0	1	01	01	H5619_032_0	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	032	0	1	01	01	H5619_032_0	5	002	MyOption Vision	15.30	2			2				17a;17b;
H5619	032	0	1	01	01	H5619_032_0	5	003	MyOption Plus	24.50	2			1	50.00	16b;		16a;16b;17a;17b;
H5619	032	0	1	01	01	H5619_032_0	5	004	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	037	0	1	01	01	H5619_037_0	6	001	MyOption Dental Advantage HMO	37.30	1	1500.00	3	2				16a;16b;
H5619	038	0	1	01	01	H5619_038_0	7	001	MyOption Enhanced Dental HMO	33.40	1	1500.00	3	2				16a;16b;
H5619	039	1	1	01	01	H5619_039_1	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	039	1	1	01	01	H5619_039_1	5	002	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	039	2	1	01	01	H5619_039_2	5	001	MyOption Dental - High PPO	27.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	039	2	1	01	01	H5619_039_2	5	002	MyOption Platinum Dental	34.10	1	2000.00	3	2				16a;16b;
H5619	040	1	1	01	01	H5619_040_1	4	001	MyOption Dental - High PPO	32.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	040	1	1	01	01	H5619_040_1	4	002	MyOption Fitness	15.00	2			2			14c;	
H5619	040	2	1	01	01	H5619_040_2	4	001	MyOption Dental - High PPO	32.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5619	040	2	1	01	01	H5619_040_2	4	002	MyOption Fitness	15.00	2			2			14c;	
H5628	007	0	1	01	01	H5628_007_0	13	001	HA+ Optional Dental and Vision	40.00	1	1450.00	6	2			16a;16b;17a;17b;	
H5746	016	0	1	01	01	H5746_016_0	7	001	Preventive Dental Package	7.00	2			2				16a;
H5746	016	0	1	01	01	H5746_016_0	7	002	Dental and Vision Package	19.00	2			2				16a;16b;17b;
H5746	016	0	1	01	01	H5746_016_0	7	003	Enhanced Dental and Vision Package	28.00	2			2				16a;16b;17b;
H5774	005	0	1	01	01	H5774_005_0	11	001	Comprehensive Dental, Eyewear and Hearing	5.90	2			2			16b;18a;18b;	17b;
H5854	007	0	1	01	01	H5854_007_0	7	001	Preventive Dental Package	15.00	2			2				16a;
H5854	007	0	1	01	01	H5854_007_0	7	002	Dental and Vision Package	28.00	2			2				16a;16b;17b;
H5854	007	0	1	01	01	H5854_007_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H5854	009	0	1	01	01	H5854_009_0	7	001	Preventive Dental Package	15.00	2			2				16a;
H5854	009	0	1	01	01	H5854_009_0	7	002	Dental and Vision Package	28.00	2			2				16a;16b;17b;
H5854	009	0	1	01	01	H5854_009_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H5883	001	1	1	02	01	H5883_001_1	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	001	2	1	02	01	H5883_001_2	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	001	3	1	02	01	H5883_001_3	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	001	4	1	02	01	H5883_001_4	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	001	5	1	02	01	H5883_001_5	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	002	1	1	02	01	H5883_002_1	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	002	2	1	02	01	H5883_002_2	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	002	3	1	02	01	H5883_002_3	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	002	4	1	02	01	H5883_002_4	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	002	7	1	02	01	H5883_002_7	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	003	1	1	02	01	H5883_003_1	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	003	2	1	02	01	H5883_003_2	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	003	3	1	02	01	H5883_003_3	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	003	4	1	02	01	H5883_003_4	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	003	5	1	02	01	H5883_003_5	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;18a;18b;	17b;
H5883	004	1	1	02	01	H5883_004_1	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	004	2	1	02	01	H5883_004_2	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	004	3	1	02	01	H5883_004_3	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	004	4	1	02	01	H5883_004_4	7	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	004	5	1	02	01	H5883_004_5	6	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	007	0	1	01	01	H5883_007_0	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	008	1	1	01	01	H5883_008_1	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	008	2	1	01	01	H5883_008_2	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	009	1	1	01	01	H5883_009_1	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	009	2	1	01	01	H5883_009_2	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5883	009	3	1	01	01	H5883_009_3	5	001	Supplemental Dental, Vision, Hearing	19.90	1	1700.00	6	2			16b;17b;18a;18b;	
H5970	001	0	1	04	01	H5970_001_0	4	001	MyOption Enhanced Dental PPO	26.10	1	1500.00	3	2				16a;16b;
H5970	008	0	1	04	01	H5970_008_0	8	001	MyOption Dental - High PPO	24.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H5970	014	1	1	04	01	H5970_014_1	4	001	MyOption Enhanced Dental PPO	26.10	1	1500.00	3	2				16a;16b;
H5970	014	2	1	04	01	H5970_014_2	4	001	MyOption Enhanced Dental PPO	26.10	1	1500.00	3	2				16a;16b;
H6237	003	1	1	01	01	H6237_003_1	9	001	DH Option	39.00	1	1500.00	3	2			16a;16b;18a;18b;	
H6237	003	2	1	01	01	H6237_003_2	9	001	DH Option	39.00	1	1500.00	3	2			16a;16b;18a;18b;	
H6298	010	1	1	01	01	H6298_010_1	10	001	Optional Vision and Dental Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6298	010	2	1	01	01	H6298_010_2	9	001	Optional Vision and Dental Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6298	011	1	1	01	01	H6298_011_1	8	001	Optional Vision and Dental Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6298	011	2	1	01	01	H6298_011_2	8	001	Optional Vision and Dental Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6298	012	1	1	01	01	H6298_012_1	8	001	Optional Vision and Dental Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6298	012	2	1	01	01	H6298_012_2	8	001	Optional Vision and Dental Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6328	001	0	1	04	01	H6328_001_0	8	001	Dental Rider	20.00	2			2			16b;	16a;
H6328	001	0	1	04	01	H6328_001_0	8	002	Combination Rider (Dental, Hearing, and Vision)	35.00	2			2			16b;	16a;17a;17b;18b;
H6328	002	0	1	04	01	H6328_002_0	7	001	Dental Rider	20.00	2			2			16a;16b;	
H6328	002	0	1	04	01	H6328_002_0	7	002	Combination Rider (Dental, Hearing, and Vision)	35.00	2			2			16a;16b;18a;18b;	17a;17b;
H6328	003	0	1	04	01	H6328_003_0	8	001	Dental Rider	20.00	2			2			16a;16b;	
H6328	003	0	1	04	01	H6328_003_0	8	002	Combination Rider (Dental, Hearing, and Vision)	35.00	2			2			16a;16b;17a;17b;18a;18b;	
H6328	005	0	1	04	01	H6328_005_0	6	001	Dental Rider	20.00	2			2			16b;	16a;
H6328	005	0	1	04	01	H6328_005_0	6	002	Combination Rider (Dental, Hearing, and Vision)	35.00	2			2			16b;	16a;17a;17b;18a;18b;
H6609	003	0	1	04	01	H6609_003_0	3	001	MyOption Dental - High PPO	21.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	003	0	1	04	01	H6609_003_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H6609	003	0	1	04	01	H6609_003_0	3	003	MyOption Plus	20.30	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	004	0	1	04	01	H6609_004_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	004	0	1	04	01	H6609_004_0	4	002	MyOption Enhanced Dental PPO	32.50	1	1500.00	3	2				16a;16b;
H6609	009	0	1	04	01	H6609_009_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	009	0	1	04	01	H6609_009_0	4	002	MyOption Plus	24.00	2			1	50.00	16b;	16a;16b;	17a;17b;
H6609	009	0	1	04	01	H6609_009_0	4	003	MyOption Platinum Dental	28.20	1	2000.00	3	2				16a;16b;
H6609	012	0	1	04	01	H6609_012_0	2	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	012	0	1	04	01	H6609_012_0	2	002	MyOption Dental Enriched PPO	31.90	1	1500.00	3	2				16a;16b;
H6609	013	0	1	04	01	H6609_013_0	3	001	MyOption Dental - High PPO	37.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	013	0	1	04	01	H6609_013_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	013	0	1	04	01	H6609_013_0	3	003	MyOption Plus	27.00	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	017	0	1	04	01	H6609_017_0	3	001	MyOption Dental Enriched PPO	22.40	1	1500.00	3	2				16a;16b;
H6609	029	0	1	04	01	H6609_029_0	3	001	MyOption Dental - High PPO	22.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	029	0	1	04	01	H6609_029_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H6609	029	0	1	04	01	H6609_029_0	3	003	MyOption Plus	19.70	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	073	0	1	04	01	H6609_073_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	073	0	1	04	01	H6609_073_0	3	002	MyOption Dental Enriched PPO	31.90	1	1500.00	3	2				16a;16b;
H6609	078	0	1	04	01	H6609_078_0	7	001	MyOption Enhanced Dental PPO	22.50	1	1500.00	3	2				16a;16b;
H6609	084	0	1	04	01	H6609_084_0	4	001	MyOption Platinum Dental	24.10	1	2000.00	3	2			16a;16b;	
H6609	085	0	1	04	01	H6609_085_0	4	001	MyOption Enhanced Dental PPO	22.50	1	1500.00	3	2				16a;16b;
H6609	088	0	1	04	01	H6609_088_0	3	001	MyOption Dental - High PPO	18.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	088	0	1	04	01	H6609_088_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	088	0	1	04	01	H6609_088_0	3	003	MyOption Plus	19.20	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	089	0	1	04	01	H6609_089_0	3	001	MyOption Dental - High PPO	18.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	089	0	1	04	01	H6609_089_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	089	0	1	04	01	H6609_089_0	3	003	MyOption Plus	19.20	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	090	0	1	04	01	H6609_090_0	3	001	MyOption Dental - High PPO	18.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	090	0	1	04	01	H6609_090_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	090	0	1	04	01	H6609_090_0	3	003	MyOption Plus	19.20	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	091	0	1	04	01	H6609_091_0	3	001	MyOption Dental - High PPO	18.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	091	0	1	04	01	H6609_091_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	091	0	1	04	01	H6609_091_0	3	003	MyOption Plus	19.20	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	092	0	1	04	01	H6609_092_0	4	001	MyOption Dental - High PPO	20.60	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	095	0	1	04	01	H6609_095_0	5	001	MyOption Platinum Dental	24.70	1	2000.00	3	2			16a;16b;	
H6609	096	0	1	04	01	H6609_096_0	5	001	MyOption Platinum Dental	24.70	1	2000.00	3	2			16a;16b;	
H6609	097	0	1	04	01	H6609_097_0	4	001	MyOption Dental - High PPO	17.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	097	0	1	04	01	H6609_097_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	097	0	1	04	01	H6609_097_0	4	003	MyOption Plus	18.20	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	100	0	1	04	01	H6609_100_0	5	001	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
H6609	102	0	1	04	01	H6609_102_0	5	001	MyOption Platinum Dental	30.60	1	2000.00	3	2			16a;16b;	
H6609	103	0	1	04	01	H6609_103_0	5	001	MyOption Platinum Dental	28.10	1	2000.00	3	2			16a;16b;	
H6609	104	0	1	04	01	H6609_104_0	3	001	MyOption Dental - High PPO	17.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	104	0	1	04	01	H6609_104_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	104	0	1	04	01	H6609_104_0	3	003	MyOption Plus	17.70	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	105	0	1	04	01	H6609_105_0	3	001	MyOption Dental - High PPO	19.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	106	0	1	04	01	H6609_106_0	3	001	MyOption Dental - High PPO	19.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	108	0	1	04	01	H6609_108_0	5	001	MyOption Dental Advantage PPO	21.30	1	1500.00	3	2				16a;16b;
H6609	111	0	1	04	01	H6609_111_0	3	001	MyOption Enhanced Dental PPO	26.70	1	1500.00	3	2				16a;16b;
H6609	112	0	1	04	01	H6609_112_0	4	001	MyOption Dental - High PPO	24.70	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	115	0	1	04	01	H6609_115_0	4	001	MyOption Dental - High PPO	22.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	117	0	1	04	01	H6609_117_0	5	001	MyOption Enhanced Dental PPO	21.60	1	1500.00	3	2				16a;16b;
H6609	118	0	1	04	01	H6609_118_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	119	0	1	04	01	H6609_119_0	4	001	MyOption Dental - High PPO	17.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	119	0	1	04	01	H6609_119_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	119	0	1	04	01	H6609_119_0	4	003	MyOption Plus	18.20	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	120	0	1	04	01	H6609_120_0	4	001	MyOption Platinum Dental	23.10	1	2000.00	3	2			16a;16b;	
H6609	121	0	1	04	01	H6609_121_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	122	0	1	04	01	H6609_122_0	3	001	MyOption Dental - High PPO	20.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	124	0	1	04	01	H6609_124_0	4	001	MyOption Enhanced Dental PPO	22.30	1	1500.00	3	2				16a;16b;
H6609	126	0	1	04	01	H6609_126_0	4	001	MyOption Dental - High PPO	19.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	126	0	1	04	01	H6609_126_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	126	0	1	04	01	H6609_126_0	4	003	MyOption Plus	19.80	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	126	0	1	04	01	H6609_126_0	4	004	MyOption Fitness	15.00	2			2			14c;	
H6609	127	0	1	04	01	H6609_127_0	3	001	MyOption Plus	19.90	2			1	50.00	16b;	16a;16b;	17a;17b;
H6609	127	0	1	04	01	H6609_127_0	3	002	MyOption Platinum Dental	23.10	1	2000.00	3	2				16a;16b;
H6609	128	0	1	04	01	H6609_128_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H6609	128	0	1	04	01	H6609_128_0	3	002	MyOption Plus	21.40	2			1	50.00	16b;	16a;16b;	17a;17b;
H6609	128	0	1	04	01	H6609_128_0	3	003	MyOption Platinum Dental	26.40	1	2000.00	3	2				16a;16b;
H6609	129	0	1	04	01	H6609_129_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	129	0	1	04	01	H6609_129_0	3	002	MyOption Dental Enriched PPO	27.30	1	1500.00	3	2				16a;16b;
H6609	130	0	1	04	01	H6609_130_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	130	0	1	04	01	H6609_130_0	3	002	MyOption Enhanced Dental PPO	28.30	1	1500.00	3	2				16a;16b;
H6609	131	0	1	04	01	H6609_131_0	3	001	MyOption Dental - High PPO	25.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	131	0	1	04	01	H6609_131_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	131	0	1	04	01	H6609_131_0	3	003	MyOption Plus	23.00	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	132	0	1	04	01	H6609_132_0	3	001	MyOption Dental - High PPO	25.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	132	0	1	04	01	H6609_132_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H6609	132	0	1	04	01	H6609_132_0	3	003	MyOption Plus	23.00	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	133	0	1	04	01	H6609_133_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	133	0	1	04	01	H6609_133_0	3	002	MyOption Enhanced Dental PPO	24.30	1	1500.00	3	2				16a;16b;
H6609	135	0	1	04	01	H6609_135_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H6609	135	0	1	04	01	H6609_135_0	3	002	MyOption Dental Enriched PPO	24.70	1	1500.00	3	2				16a;16b;
H6609	137	0	1	04	01	H6609_137_0	7	001	MyOption Enhanced Dental PPO	32.20	1	1500.00	3	2				16a;16b;
H6609	138	0	1	04	01	H6609_138_0	3	001	MyOption Dental - High PPO	18.20	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	138	0	1	04	01	H6609_138_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H6609	138	0	1	04	01	H6609_138_0	3	003	MyOption Plus	18.60	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	140	0	1	04	01	H6609_140_0	5	001	MyOption Dental - High PPO	18.20	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	140	0	1	04	01	H6609_140_0	5	002	MyOption Vision	15.30	2			2			17a;17b;	
H6609	140	0	1	04	01	H6609_140_0	5	003	MyOption Plus	18.60	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	140	0	1	04	01	H6609_140_0	5	004	MyOption Fitness	15.00	2			2			14c;	
H6609	143	0	1	04	01	H6609_143_0	5	001	MyOption Dental - High PPO	37.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	143	0	1	04	01	H6609_143_0	5	002	MyOption Vision	15.30	2			2			17a;17b;	
H6609	143	0	1	04	01	H6609_143_0	5	003	MyOption Plus	25.40	2			1	50.00	16b;		16a;16b;17a;17b;
H6609	144	1	1	04	01	H6609_144_1	5	001	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
H6609	144	2	1	04	01	H6609_144_2	5	001	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
H6609	148	1	1	04	01	H6609_148_1	4	001	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
H6609	148	2	1	04	01	H6609_148_2	4	001	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
H6609	150	0	1	04	01	H6609_150_0	4	001	MyOption Dental Enriched PPO	32.10	1	1500.00	3	2				16a;16b;
H6609	151	0	1	04	01	H6609_151_0	5	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H6609	152	1	1	04	01	H6609_152_1	3	001	MyOption Enhanced Dental PPO	25.80	1	1500.00	3	2				16a;16b;
H6609	152	2	1	04	01	H6609_152_2	3	001	MyOption Enhanced Dental PPO	25.80	1	1500.00	3	2				16a;16b;
H6622	001	0	1	01	01	H6622_001_0	5	001	MyOption Vision	15.30	2			2				17a;17b;
H6622	001	0	1	01	01	H6622_001_0	5	002	MyOption Dental Advantage HMO	36.40	1	1500.00	3	2				16a;16b;
H6622	002	0	1	01	01	H6622_002_0	3	001	MyOption Enhanced Dental HMO	32.40	1	1500.00	3	2				16a;16b;
H6622	007	0	1	01	01	H6622_007_0	5	001	MyOption Dental Enriched HMO	25.30	1	1500.00	3	2				16a;16b;
H6622	010	0	1	01	01	H6622_010_0	4	001	MyOption Platinum Dental	30.60	1	2000.00	3	2			16a;16b;	
H6622	011	0	1	01	01	H6622_011_0	3	001	MyOption Fitness	15.00	2			2			14c;	
H6622	022	0	1	01	01	H6622_022_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H6622	022	0	1	01	01	H6622_022_0	3	002	MyOption Platinum Dental	24.10	1	2000.00	3	2			16a;16b;	
H6723	001	1	1	01	01	H6723_001_1	10	001	Optional Dental and Vision Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6723	001	2	1	01	01	H6723_001_2	10	001	Optional Dental and Vision Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6723	002	1	1	01	01	H6723_002_1	8	001	Optional Dental and Vision Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6723	002	2	1	01	01	H6723_002_2	8	001	Optional Dental and Vision Rider	25.00	1	1250.00	3	2			16b;	16a;17a;17b;
H6786	002	0	1	04	01	H6786_002_0	7	001	Preventive Dental Package	22.00	2			2				16a;
H6786	002	0	1	04	01	H6786_002_0	7	002	Dental and Vision Package	32.00	2			2				16a;16b;17b;
H6786	002	0	1	04	01	H6786_002_0	7	003	Enhanced Dental and Vision Package	40.00	2			2				16a;16b;17b;
H6815	003	1	1	01	01	H6815_003_1	4	001	Comprehensive Dental PPO and Hearing Aids	40.00	1	2000.00	3	2			16a;16b;18a;18b;	
H6815	003	1	1	01	01	H6815_003_1	4	002	P & D Plus Dental PPO and Hearing Aids	16.00	1	1500.00	3	2			18a;18b;	16a;
H6815	003	2	1	01	01	H6815_003_2	4	001	Comprehensive Dental PPO and Hearing Aids	40.00	1	2000.00	3	2			16a;16b;18a;18b;	
H6815	003	2	1	01	01	H6815_003_2	4	002	P & D Plus Dental PPO and Hearing Aids	16.00	1	1500.00	3	2			18a;18b;	16a;
H6815	004	1	1	01	01	H6815_004_1	3	001	DPPO Extended Comprehensive Dental	24.00	1	750.00	3	1	75.00	16a;16b;	16a;16b;	
H6815	004	2	1	01	01	H6815_004_2	3	001	DPPO Extended Comprehensive Dental	24.00	1	750.00	3	1	75.00	16a;16b;	16a;16b;	
H6951	002	0	1	04	01	H6951_002_0	14	001	Eyewear	9.60	1	250.00	6	2			17b;	
H7006	003	0	1	04	01	H7006_003_0	8	001	Preventive Dental, Eye Exams, and Eyewear	27.00	2			2			16a;17a;17b;	
H7020	003	1	1	01	01	H7020_003_1	4	001	Enhanced Dental - Preventive	21.50	2			2			16a;	
H7020	003	2	1	01	01	H7020_003_2	4	001	Enhanced Dental - Preventive	21.50	2			2			16a;	
H7115	001	0	1	01	01	H7115_001_0	10	001	Memorial Hermann Advantage Pack	49.00	1	2600.00	3	2				4c;7b;16a;16b;17b;18b;
H7220	002	0	1	01	01	H7220_002_0	10	001	Dental Basic 750	3.40	1	750.00	3	1	10.00	16b;	16b;	
H7220	002	0	1	01	01	H7220_002_0	10	002	Dental Enhanced 1000	5.30	1	1000.00	3	1	10.00	16b;	16b;	
H7220	002	0	1	01	01	H7220_002_0	10	003	Dental Enhanced 1500	7.40	1	1500.00	3	1	10.00	16b;	16b;	
H7220	003	0	1	01	01	H7220_003_0	12	001	Dental Basic 750	3.40	1	750.00	3	1	10.00	16b;	16b;	
H7220	003	0	1	01	01	H7220_003_0	12	002	Dental Enhanced 1000	5.30	1	1000.00	3	1	10.00	16b;	16b;	
H7220	003	0	1	01	01	H7220_003_0	12	003	Dental Enhanced 1500	7.40	1	1500.00	3	1	10.00	16b;	16b;	
H7220	004	0	1	02	01	H7220_004_0	12	001	Dental Basic 750	3.40	1	750.00	3	1	10.00	16b;	16b;	
H7220	004	0	1	02	01	H7220_004_0	12	002	Dental Enhanced 1000	5.30	1	1000.00	3	1	10.00	16b;	16b;	
H7220	004	0	1	02	01	H7220_004_0	12	003	Dental Enhanced 1500	7.40	1	1500.00	3	1	10.00	16b;	16b;	
H7245	001	0	1	01	01	H7245_001_0	16	001	Optional Dental Plan	26.00	2			2			16a;	
H7728	002	0	1	04	01	H7728_002_0	9	001	Preventive Dental Package	21.00	2			2				16a;
H7728	002	0	1	04	01	H7728_002_0	9	002	Dental and Vision Package	28.00	2			2				16a;16b;17b;
H7728	002	0	1	04	01	H7728_002_0	9	003	Enhanced Dental and Vision Package	40.00	2			2				16a;16b;17b;
H8133	012	0	1	02	01	H8133_012_0	8	001	Optional Supplemental	34.00	1	2150.00	6	2			16a;16b;17a;17b;18a;18b;	
H8133	013	0	1	02	01	H8133_013_0	8	001	Optional Supplemental	31.20	1	2150.00	6	2			16a;16b;17a;17b;18a;18b;	
H8133	014	0	1	02	01	H8133_014_0	8	001	Optional Supplemental	30.10	1	2150.00	6	2			16a;16b;17a;17b;18a;18b;	
H8145	003	0	1	09	04	H8145_003_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H8145	003	0	1	09	04	H8145_003_0	3	002	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
H8145	004	0	1	09	04	H8145_004_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H8145	004	0	1	09	04	H8145_004_0	3	002	MyOption Platinum Dental	24.70	1	2000.00	3	2			16a;16b;	
H8145	006	0	1	09	04	H8145_006_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
H8145	006	0	1	09	04	H8145_006_0	3	002	MyOption Enhanced Dental PPO	27.50	1	1500.00	3	2				16a;16b;
H8145	008	0	1	09	04	H8145_008_0	3	001	MyOption Dental - High PPO	21.80	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	008	0	1	09	04	H8145_008_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H8145	008	0	1	09	04	H8145_008_0	3	003	MyOption Plus	19.10	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	011	0	1	09	04	H8145_011_0	3	001	MyOption Plus	19.80	2			1	50.00	16b;	16a;16b;	17a;17b;
H8145	011	0	1	09	04	H8145_011_0	3	002	MyOption Platinum Dental	23.90	1	2000.00	3	2				16a;16b;
H8145	021	0	1	09	04	H8145_021_0	4	001	MyOption Vision	15.30	2			2			17a;17b;	
H8145	032	0	1	09	04	H8145_032_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H8145	042	0	1	09	04	H8145_042_0	3	001	MyOption Plus	20.10	2			1	50.00	16b;	16a;16b;17a;17b;	
H8145	042	0	1	09	04	H8145_042_0	3	002	MyOption Platinum Dental	24.70	1	2000.00	3	2				16a;16b;
H8145	050	0	1	09	04	H8145_050_0	2	001	MyOption Platinum Dental	22.80	1	2000.00	3	2			16a;16b;	
H8145	051	0	1	09	04	H8145_051_0	4	001	MyOption Platinum Dental	22.80	1	2000.00	3	2			16a;16b;	
H8145	052	0	1	09	04	H8145_052_0	3	001	MyOption Vision	15.30	2			2			17a;17b;	
H8145	052	0	1	09	04	H8145_052_0	3	002	MyOption Platinum Dental	26.10	1	2000.00	3	2			16a;16b;	
H8145	053	0	1	09	04	H8145_053_0	4	001	MyOption Plus	20.20	2			1	50.00	16b;	16a;16b;17a;17b;	
H8145	053	0	1	09	04	H8145_053_0	4	002	MyOption Platinum Dental	26.10	1	2000.00	3	2				16a;16b;
H8145	055	0	1	09	04	H8145_055_0	2	001	MyOption Plus	20.20	2			1	50.00	16b;	16a;16b;17a;17b;	
H8145	055	0	1	09	04	H8145_055_0	2	002	MyOption Platinum Dental	26.10	1	2000.00	3	2				16a;16b;
H8145	063	0	1	09	04	H8145_063_0	3	001	MyOption Dental - High PPO	22.40	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	069	0	1	09	04	H8145_069_0	4	001	MyOption Platinum Dental	23.10	1	2000.00	3	2			16a;16b;	
H8145	075	0	1	09	04	H8145_075_0	4	001	MyOption Dental - High PPO	17.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	075	0	1	09	04	H8145_075_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H8145	075	0	1	09	04	H8145_075_0	4	003	MyOption Plus	18.20	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	084	0	1	09	04	H8145_084_0	3	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	084	0	1	09	04	H8145_084_0	3	002	MyOption Fitness	15.00	2			2			14c;	
H8145	089	0	1	09	04	H8145_089_0	3	001	MyOption Dental - High PPO	37.50	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	089	0	1	09	04	H8145_089_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H8145	089	0	1	09	04	H8145_089_0	3	003	MyOption Plus	25.40	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	089	0	1	09	04	H8145_089_0	3	004	MyOption Fitness	15.00	2			2			14c;	
H8145	091	0	1	09	04	H8145_091_0	4	001	MyOption Dental - High PPO	20.60	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	091	0	1	09	04	H8145_091_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H8145	091	0	1	09	04	H8145_091_0	4	003	MyOption Plus	20.10	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	091	0	1	09	04	H8145_091_0	4	004	MyOption Fitness	15.00	2			2			14c;	
H8145	093	0	1	09	04	H8145_093_0	3	001	MyOption Dental - High PPO	27.30	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	093	0	1	09	04	H8145_093_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
H8145	093	0	1	09	04	H8145_093_0	3	003	MyOption Plus	23.60	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	103	0	1	09	04	H8145_103_0	3	001	MyOption Dental - High PPO	22.00	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	103	0	1	09	04	H8145_103_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
H8145	103	0	1	09	04	H8145_103_0	3	003	MyOption Plus	21.40	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	108	0	1	09	04	H8145_108_0	2	001	MyOption Dental - High PPO	20.60	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	108	0	1	09	04	H8145_108_0	2	002	MyOption Vision	15.30	2			2				17a;17b;
H8145	108	0	1	09	04	H8145_108_0	2	003	MyOption Plus	20.10	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	120	0	1	09	04	H8145_120_0	3	001	MyOption Fitness	15.00	2			2			14c;	
H8145	121	0	1	09	04	H8145_121_0	2	001	MyOption Vision	15.30	2			2				17a;17b;
H8145	121	0	1	09	04	H8145_121_0	2	002	MyOption Enhanced Dental PPO	27.50	1	1500.00	3	2				16a;16b;
H8145	123	0	1	09	04	H8145_123_0	12	001	MyOption Enhanced Dental PPO	26.70	1	1500.00	3	2				16a;16b;
H8145	123	0	1	09	04	H8145_123_0	12	002	MyOption Fitness	15.00	2			2			14c;	
H8145	125	0	1	09	04	H8145_125_0	4	001	MyOption Dental - High PPO	19.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	125	0	1	09	04	H8145_125_0	4	002	MyOption Vision	15.30	2			2				17a;17b;
H8145	125	0	1	09	04	H8145_125_0	4	003	MyOption Plus	19.80	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	126	0	1	09	04	H8145_126_0	2	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	126	0	1	09	04	H8145_126_0	2	002	MyOption Fitness	15.00	2			2			14c;	
H8145	155	0	1	09	04	H8145_155_0	6	001	MyOption Dental - High PPO	18.20	1	1500.00	3	1	50.00	16b;	16a;16b;	
H8145	155	0	1	09	04	H8145_155_0	6	002	MyOption Vision	15.30	2			2			17a;17b;	
H8145	155	0	1	09	04	H8145_155_0	6	003	MyOption Plus	18.60	2			1	50.00	16b;		16a;16b;17a;17b;
H8145	155	0	1	09	04	H8145_155_0	6	004	MyOption Fitness	15.00	2			2			14c;	
H8237	001	0	1	01	01	H8237_001_0	11	001	Dental Services	17.00	1	2000.00	3	2				16a;16b;
H8237	003	0	1	02	01	H8237_003_0	11	001	Dental Services	17.00	1	2000.00	3	2				16a;16b;
H8432	003	0	1	01	01	H8432_003_0	6	001	Preventive Dental Package	15.00	2			2				16a;
H8432	003	0	1	01	01	H8432_003_0	6	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H8432	003	0	1	01	01	H8432_003_0	6	003	Enhanced Dental and Vision Package	38.00	2			2				16a;16b;17b;
H8432	004	0	1	01	01	H8432_004_0	7	001	Preventive Dental Package	15.00	2			2				16a;
H8432	004	0	1	01	01	H8432_004_0	7	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H8432	004	0	1	01	01	H8432_004_0	7	003	Enhanced Dental and Vision Package	38.00	2			2				16a;16b;17b;
H8506	001	0	1	02	01	H8506_001_0	5	001	Moda Health Extra Care	12.00	1	500.00	3	2			14c;	7b;13a;17b;18a;18b;
H8552	020	0	1	04	01	H8552_020_0	8	001	Preventive Dental Package	21.00	2			2				16a;
H8552	020	0	1	04	01	H8552_020_0	8	002	Dental and Vision Package	32.00	2			2				16a;16b;17b;
H8552	020	0	1	04	01	H8552_020_0	8	003	Enhanced Dental and Vision Package	41.00	2			2				16a;16b;17b;
H8552	021	0	1	04	01	H8552_021_0	8	001	Preventive Dental Package	21.00	2			2				16a;
H8552	021	0	1	04	01	H8552_021_0	8	002	Dental and Vision Package	32.00	2			2				16a;16b;17b;
H8552	021	0	1	04	01	H8552_021_0	8	003	Enhanced Dental and Vision Package	41.00	2			2				16a;16b;17b;
H8748	002	0	1	01	01	H8748_002_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8748	008	0	1	01	01	H8748_008_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H8748	010	0	1	01	01	H8748_010_0	4	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
H8748	012	0	1	01	01	H8748_012_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8748	013	0	1	01	01	H8748_013_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8748	014	0	1	01	01	H8748_014_0	5	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8748	015	0	1	01	01	H8748_015_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8748	017	0	1	01	01	H8748_017_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8748	018	0	1	01	01	H8748_018_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8748	019	0	1	01	01	H8748_019_0	3	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
H8764	001	0	1	01	01	H8764_001_0	5	001	Enhanced Health	29.00	2			2				16b;17b;18a;18b;
H8764	002	0	1	02	01	H8764_002_0	7	001	Enhanced Health	29.00	2			2				16b;17b;18a;18b;
H8764	003	0	1	01	01	H8764_003_0	5	001	Enhanced Health	33.00	2			2				16a;16b;17a;17b;18a;18b;
H8908	001	0	1	01	01	H8908_001_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
H8908	001	0	1	01	01	H8908_001_0	4	002	MyOption Enhanced Dental HMO	28.60	1	1500.00	3	2				16a;16b;
H8908	002	0	1	01	01	H8908_002_0	5	001	MyOption Vision	15.30	2			2				17a;17b;
H8908	002	0	1	01	01	H8908_002_0	5	002	MyOption Dental Advantage HMO	31.70	1	1500.00	3	2				16a;16b;
H9003	001	0	1	01	01	H9003_001_0	17	001	ADVANTAGE PLUS	44.00	1	1250.00	3	1	50.00	16b;	16a;17b;18b;	16b;
H9003	006	0	1	01	01	H9003_006_0	17	001	ADVANTAGE PLUS	44.00	1	1250.00	3	1	50.00	16b;	16a;17b;18b;	16b;
H9047	001	0	1	01	01	H9047_001_0	12	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	001	0	1	01	01	H9047_001_0	12	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9047	013	0	2	01	01	H9047_013_0	10	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	013	0	2	01	01	H9047_013_0	10	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9047	024	0	1	02	01	H9047_024_0	11	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	024	0	1	02	01	H9047_024_0	11	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9047	033	0	1	01	01	H9047_033_0	8	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	033	0	1	01	01	H9047_033_0	8	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9047	035	0	1	02	01	H9047_035_0	8	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	035	0	1	02	01	H9047_035_0	8	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9047	037	0	1	02	01	H9047_037_0	11	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	037	0	1	02	01	H9047_037_0	11	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9047	037	0	1	02	01	H9047_037_0	11	003	Routine Vision	8.80	2			2				17a;17b;
H9047	038	0	1	02	01	H9047_038_0	10	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	038	0	1	02	01	H9047_038_0	10	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9047	039	0	1	02	01	H9047_039_0	11	001	Basic Dental	33.70	1	1000.00	3	1	150.00	16b;		16a;16b;
H9047	039	0	1	02	01	H9047_039_0	11	002	Enhanced Dental	48.20	1	1500.00	3	1	150.00	16b;		16a;16b;
H9104	006	0	1	01	01	H9104_006_0	6	001	Basic Dental	8.00	2			2				16a;16b;
H9104	006	0	1	01	01	H9104_006_0	6	002	Enhanced Dental	16.00	2			2				16a;16b;
H9408	001	0	1	04	01	H9408_001_0	9	001	Essential Dental	33.30	1	1000.00	3	2			16a;16b;	
H9408	002	0	1	04	01	H9408_002_0	8	001	Enhanced Dental	28.00	1	1000.00	3	2			16b;	
H9525	004	0	1	01	01	H9525_004_0	7	001	Preventive Dental Package	15.00	2			2				16a;
H9525	004	0	1	01	01	H9525_004_0	7	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H9525	004	0	1	01	01	H9525_004_0	7	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H9525	005	0	1	01	01	H9525_005_0	7	001	Preventive Dental Package	15.00	2			2				16a;
H9525	005	0	1	01	01	H9525_005_0	7	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H9525	005	0	1	01	01	H9525_005_0	7	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H9525	006	0	1	01	01	H9525_006_0	7	001	Preventive Dental Package	15.00	2			2				16a;
H9525	006	0	1	01	01	H9525_006_0	7	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
H9525	006	0	1	01	01	H9525_006_0	7	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H9725	001	0	1	01	01	H9725_001_0	5	001	Enhanced Dental - Preventive	21.50	2			2			16a;	
H9808	004	0	1	04	01	H9808_004_0	8	001	Dental Rider	22.00	2			2			16a;16b;	
H9808	004	0	1	04	01	H9808_004_0	8	002	Combination Rider (Dental, Hearing, and Vision)	36.70	2			2			16a;16b;17b;18a;18b;	
H9808	005	0	1	04	01	H9808_005_0	7	001	Dental Rider	22.00	2			2			16a;16b;	
H9808	005	0	1	04	01	H9808_005_0	7	002	Combination Rider (Dental, Hearing, and Vision)	36.70	2			2			16a;16b;18a;18b;	17a;17b;
H9886	004	0	1	01	01	H9886_004_0	7	001	Preventive Dental Package	16.00	2			2				16a;
H9886	004	0	1	01	01	H9886_004_0	7	002	Dental and Vision Package	23.00	2			2				16a;16b;17b;
H9886	004	0	1	01	01	H9886_004_0	7	003	Enhanced Dental and Vision Package	37.00	2			2				16a;16b;17b;
H9947	006	0	1	04	01	H9947_006_0	7	001	Preventive Dental Package	17.00	2			2				16a;
H9947	006	0	1	04	01	H9947_006_0	7	002	Dental and Vision Package	27.00	2			2				16a;16b;17b;
H9947	006	0	1	04	01	H9947_006_0	7	003	Enhanced Dental and Vision Package	40.00	2			2				16a;16b;17b;
H9954	002	0	1	01	01	H9954_002_0	7	001	Preventive Dental Package	14.00	2			2				16a;
H9954	002	0	1	01	01	H9954_002_0	7	002	Dental and Vision Package	24.00	2			2				16a;16b;17b;
H9954	002	0	1	01	01	H9954_002_0	7	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H9954	005	0	1	01	01	H9954_005_0	7	001	Preventive Dental Package	14.00	2			2				16a;
H9954	005	0	1	01	01	H9954_005_0	7	002	Dental and Vision Package	24.00	2			2				16a;16b;17b;
H9954	005	0	1	01	01	H9954_005_0	7	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
H9954	006	0	1	01	01	H9954_006_0	6	001	Preventive Dental Package	14.00	2			2				16a;
H9954	006	0	1	01	01	H9954_006_0	6	002	Dental and Vision Package	24.00	2			2				16a;16b;17b;
H9954	006	0	1	01	01	H9954_006_0	6	003	Enhanced Dental and Vision Package	36.00	2			2				16a;16b;17b;
R3444	009	0	1	31	11	R3444_009_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
R3444	012	0	1	31	11	R3444_012_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
R5342	001	0	1	31	11	R5342_001_0	7	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
R5342	001	0	1	31	11	R5342_001_0	7	002	Fitness Rider	18.00	2			2			14c;	
R5342	002	0	1	31	11	R5342_002_0	7	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
R5342	005	0	1	31	11	R5342_005_0	6	001	Dental Platinum Rider	36.00	2			1	100.00	16b;		16a;16b;
R5826	001	0	1	31	11	R5826_001_0	4	001	MyOption Dental - High PPO	18.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
R5826	006	0	1	31	11	R5826_006_0	6	001	MyOption Vision	15.30	2			2				17a;17b;
R5826	006	0	1	31	11	R5826_006_0	6	002	MyOption Enhanced Dental PPO	27.50	1	1500.00	3	2				16a;16b;
R5826	009	0	1	31	11	R5826_009_0	3	001	MyOption Dental - High PPO	27.20	1	1500.00	3	1	50.00	16b;	16a;16b;	
R5826	009	0	1	31	11	R5826_009_0	3	002	MyOption Vision	15.30	2			2			17a;17b;	
R5826	009	0	1	31	11	R5826_009_0	3	003	MyOption Plus	23.00	2			1	50.00	16b;		16a;16b;17a;17b;
R5826	010	0	1	31	11	R5826_010_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
R5826	012	0	1	31	11	R5826_012_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
R5826	012	0	1	31	11	R5826_012_0	4	002	MyOption Fitness	15.00	2			2			14c;	
R5826	013	0	1	31	11	R5826_013_0	3	001	MyOption Vision	15.30	2			2				17a;17b;
R5826	013	0	1	31	11	R5826_013_0	3	002	MyOption Platinum Dental	22.60	1	2000.00	3	2			16a;16b;	
R5826	014	0	1	31	11	R5826_014_0	3	001	MyOption Dental - High PPO	22.00	1	1500.00	3	1	50.00	16b;	16a;16b;	
R5826	014	0	1	31	11	R5826_014_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
R5826	014	0	1	31	11	R5826_014_0	3	003	MyOption Plus	21.40	2			1	50.00	16b;		16a;16b;17a;17b;
R5826	023	0	1	31	11	R5826_023_0	6	001	MyOption Vision	15.30	2			2				17a;17b;
R5826	023	0	1	31	11	R5826_023_0	6	002	MyOption Dental Enriched PPO	30.30	1	1500.00	3	2				16a;16b;
R5826	026	0	1	31	11	R5826_026_0	4	001	MyOption Dental - High PPO	16.90	1	1500.00	3	1	50.00	16b;	16a;16b;	
R5826	026	0	1	31	11	R5826_026_0	4	002	MyOption Fitness	15.00	2			2			14c;	
R5826	053	0	1	31	11	R5826_053_0	4	001	MyOption Vision	15.30	2			2				17a;17b;
R5826	053	0	1	31	11	R5826_053_0	4	002	MyOption Dental Advantage PPO	29.10	1	1500.00	3	2				16a;16b;
R5826	062	0	1	31	11	R5826_062_0	6	001	MyOption Enhanced Dental PPO	25.00	1	1500.00	3	2				16a;16b;
R5826	063	0	1	31	11	R5826_063_0	3	001	MyOption Enhanced Dental PPO	25.80	1	1500.00	3	2				16a;16b;
R5826	064	0	1	31	11	R5826_064_0	4	001	MyOption Dental Advantage PPO	23.80	1	1500.00	3	2				16a;16b;
R5826	069	0	1	31	11	R5826_069_0	4	001	MyOption Enhanced Dental PPO	20.90	1	1500.00	3	2				16a;16b;
R5826	070	0	1	31	11	R5826_070_0	3	001	MyOption Dental - High PPO	22.00	1	1500.00	3	1	50.00	16b;	16a;16b;	
R5826	070	0	1	31	11	R5826_070_0	3	002	MyOption Vision	15.30	2			2				17a;17b;
R5826	070	0	1	31	11	R5826_070_0	3	003	MyOption Plus	21.40	2			1	50.00	16b;		16a;16b;17a;17b;
R5826	077	0	1	31	11	R5826_077_0	3	001	MyOption Dental Advantage PPO	23.80	1	1500.00	3	2				16a;16b;
R5826	078	0	1	31	11	R5826_078_0	4	001	MyOption Dental - High PPO	19.10	1	1500.00	3	1	50.00	16b;	16a;16b;	
R5826	079	0	1	31	11	R5826_079_0	3	001	MyOption Plus	21.00	2			1	50.00	16b;	16a;16b;	17a;17b;
R5826	079	0	1	31	11	R5826_079_0	3	002	MyOption Platinum Dental	25.80	1	2000.00	3	2				16a;16b;
R5826	091	0	1	31	11	R5826_091_0	6	001	MyOption Fitness	15.00	2			2			14c;	
R5941	014	0	1	31	11	R5941_014_0	7	001	Preventive Dental Package	19.00	2			2				16a;
R5941	014	0	1	31	11	R5941_014_0	7	002	Dental and Vision Package	26.00	2			2				16a;16b;17b;
R5941	014	0	1	31	11	R5941_014_0	7	003	Enhanced Dental and Vision Package	34.00	2			2				16a;16b;17b;
R5941	015	0	1	31	11	R5941_015_0	7	001	Preventive Dental Package	18.00	2			2				16a;
R5941	015	0	1	31	11	R5941_015_0	7	002	Dental and Vision Package	25.00	2			2				16a;16b;17b;
R5941	015	0	1	31	11	R5941_015_0	7	003	Enhanced Dental and Vision Package	39.00	2			2				16a;16b;17b;
R7444	001	0	1	31	11	R7444_001_0	6	001	Fitness Rider	18.00	2			2			14c;	
R7444	008	0	1	31	11	R7444_008_0	4	001	Dental Platinum Rider	33.00	2			1	100.00	16b;		16a;16b;
