{"text_format":"1","workbook":"xlsx","n_sheets":3,"sheets":["Welcome Page","00000000 - Census","Legend"],"not_rendered":{"charts":0,"images":3,"macros":1,"external_links":0,"defined_names":0,"comments":1,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

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["The Guardian Life Insurance Company of America, New York, NY 10004."]

{"sheet":"00000000 - Census","index":1,"n_rows":10,"n_cols":30,"rows_kept":10,"cut":false,"hidden":false,"merged":[]}
[]
[null,null,null,null,null,"Save Time by using the Validate Data button frequently to check your entries  "]
["Plan Number :",0,"Group Name :",null,"Sales Office :"]
["Member SSN","Last Name","First Name","MI","Title","Relationship","Date of Birth","Gender","Marital Status","Domestic Partner","Status (student/disabled/non standard dependent)","Address","City","State","Zip","Email Address","Phone","Job Title","Date of Full Time Hire","Hours Worked per Week","Work Status","Termination Date","Reason Code","Coverage Extension","Class","Division","Dental Selected","Dental Fam Ind","Dental Descriptor","Dental Waiver"]
["REQUIRED\n(xxxxxxxxx)","SMITH","JOHN","J","JR","M","1967-01-01","M","M",null,null,"123 MAIN ST","ANYTOWN","WI",11111,"ABC@123.COM","999-999-9999","VP","2009-08-15",40,"A",null,null,null,1,1,"Y","B","PPO"]
["REQUIRED\n(xxxxxxxxx)","SMITH","JENNA","C",null,"W","1969-12-12","F"]
["REQUIRED\n(xxxxxxxxx)","JONES","PENNY","A",null,"M","1980-11-01","F","S",null,null,"1 SOUTH ST","CITY","WI",22222,"ABC@123.COM","999-999-9999","OFFICE","2009-09-14",40,"A",null,null,null,1,1,"Y","C","VALUE"]
["REQUIRED\n(xxxxxxxxx)","WEBER","BETH","P","P","M","1979-06-25","F","S",null,null,"1 NORTH ST","TOWN","WA",33333,null,"999-999-9999","LABOR","2009-08-25",37.5,"A",null,null,null,2,1,"Y","C","VALUE"]
["Please use examples above as a guide to entry"]
["Begin entering data below this line"]

{"sheet":"Legend","index":2,"n_rows":193,"n_cols":3,"rows_kept":193,"cut":false,"hidden":false,"merged":[]}
[]
["COLUMN TITLE","COLUMN DESCRIPTION","SAMPLE"]
[]
[]
["Member SSN","*Member SSN = Member's 9 digit Social Security Number (with or without dashes)","xxx-xx-xxxx"]
["Dependent SSN","**Dependent SSN = Dependent's 9 digit Social Security Number (with or without dashes) GPL Coverage only","xxx-xx-xxxx"]
["Last Name","*Last Name = Member & Dependent's Last Name  (19 alpha character max - Dependent's Last Name does not need to be entered when same as the member)","ABCDEF"]
[" First Name","*First Name = Member or Dependent's First Name (10 alpha character max)","ABC"]
[" MI","**MI = Middle Initial"]
["Title","**Title = Member & Dependent Title (5 character max - Sr, Jr, Dr)"]
["Relationship","*Relationship = Member or Dependent's Relationship to member (Entered as: M = Member, W = Wife, H = Husband, D = Daughter, S = Son)","W"]
["Date of Birth","*Date of Birth = Member or Dependent's Date of Birth (MM/DD/CCYY format - Entered as: 11/10/1955)","2000-01-01"]
[" Gender","*Gender = Member or Dependent's Gender (Entered as: Male or Female, M or F)","F"]
["Marital Status","**Marital Status = Member Maritial Status (Entered as -  M =  Married, I = Single, S = Separated, D = Divorced, W = Widowed) ","I"]
["Domestic Partner","**Domestic Partner = Entered on Dependent's row for Spouses only (Entered as Y or blank)","Y"]
["Status (student/disabled/non standard dependent)","**Status (student/disabled/non standard dependent) = Dependent Student/Age Limit Exception (Entered as: S = Student, X = Disabled)","S"]
["Address","*Address = Member's Address "]
["Address 2","Employees address continuation"]
["City","*City = Member's City"]
["State","*State = Member's 2 character State Code (New York entered as NY)","AZ"]
["Zip","*Zip = Member's 5 digit Zip Code",58965]
["Country","Employee Country name","USA"]
["Email Address","**Email Address = Member's Email address - 50 character max"]
["Phone","**Phone = Member's Home Phone Number - 10 digits (with or without dashes)","(516) 521-9994"]
["Job Title","**Job Title = Member's job title or occupation - 38 character max"]
["Date of Full Time Hire","**Date of Full Time Hire = Member's Employment Date (MM/DD/CCYY format - Entered as: 12/10/2005)","2000-01-01"]
["Hours Worked per Week","**Hours Worked per Week = Number of hours worked per week by the member - 3 digit max (Entered as 40.0 or 37.5) ",25.5]
["Work Status","**Work Status = Member's eligibility status - 1 character ( Enter as: A = Active, T = Terminated, R = Retired)  ","A"]
["Termination Date","**Termination Date = Member's Employment Termination Date (MM/DD/CCYY format - Entered as: 12/10/2005)","2000-01-01"]
["Reason Code","**Reason Code = Member's Employment Termination Reason Code - 2 characters (Enter as: CB = COBRA or ST = State Continuation) ","ST"]
["Coverage Extension","**Coverage Extension = Member & Dependent's Coverage Extension -  1 character (Entered as: Y = Yes, N or Blank = No) "," Y "]
["Salary","**Salary = Member's Salary - 11 digits (Entered as: 55636.92 or 53000.00)",9999999999]
["Salary Mode","**Salary Mode = Member's Salary per pay period - 1 character (Entered as: A = Annual, M = Monthly, H = Hourly, W = Weekly,  B = Bi-Weekly, S = Semi-Monthly)","M"]
["Class","**Class = Member's assigned class number based on job title and/or level of benefits  (4 digit number max - Entered as:1 or 0001)",1]
["Division","**Division = Member's assigned division number (4 digit number max - Entered as: 1 or 0001) ",1]
["Division Name","Employees Name of his/her division","Text 75 Characters max."]
["Billing Work Location","**Billing Work Location = Member's billing work location code (8 characters max - alpha numeric)","A507897"]
["Dental Selected","*Dental Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["Dental Fam Ind","*Den Fam IND = Member & Dependents electing coverage family indicator code - Entered as: A = Family, B = Member & Spouse, C= Member only, D = Member & Child, G=Children Only (Data Entered on Member Row Only)  ","C"]
["Dental Descriptor","**Dental Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["Dental Waiver","**Dental Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)   ","O"]
["Dental PCD Number","**Dental PCD Number = Primary Care Dentist Code (Data Entered on Member & Dependent Row)   "]
["Vision Selected","*Vision Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["Vision Fam Ind","*Vision Fam Ind = Member & Dependents electing coverage family indicator code - Entered as: A = Family, B = Member & Spouse, C= Member only, D = Member & Child (Data Entered on Member Row Only)  ","F"]
["Vision Descriptor","**Vision Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["Vision Waiver","**Vision Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)   ","O"]
["Life/ADD Selected","*Life/ADD Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["Life/ADD Descriptor","**Life/ADD Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["Life/ADD Waiver","**Life/ADD Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)   ","O"]
["Dep Life Selected","*Dep Life Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["Dep Life Fam Ind","*Dep Life Fam Ind = Dependents electing coverage family indicator code - Entered as: E = Spouse & Child, F = Spouse Only, G = Children Only   (Data Entered on Member Row Only)  ","B"]
["Dep Life Descriptor","**Dep Life Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["Dep Life Waiver","**Dep Life Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)   ","O"]
["STD Selected","*STD Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["STD Volume Elected","STD Volume Elected= Enter amount of STD elected for members electing the DI Choice STD benefit.  The volume does not need to be entered for members electing non-DI Choice STD. (Data entered on member row only).",9999999999]
["STD Descriptor","**STD Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["STD Waiver","**STD Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)   ","O"]
["LTD Selected","*LTD Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["LTD Descriptor","**LTD Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["LTD Waiver","**LTD Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)   ","O"]
["VLT Selected","*VLT Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["VLT Plan ID","**VLT Plan ID = Voluntary LTD ID Selected (Member Row Only)   "]
["VLT Volume Elected","**VLT Volume Elected = Enter Amount of Member Optional Life Elected  (Data Entered on Member Row Only)",9999999999]
["VLT Descriptor","**VLT Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["VLT Waiver","**VLT Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)   ","O"]
["MOL Selected","*MOL Selected = Member Optional Life - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["MOL Volume Elected","*MOL Volume Elected = Enter Amount of Member Optional Life Elected  (Data Entered on Member Row Only)",9999999999]
["MOL Descriptor","**MOL Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["Smoker Code","**Smoker Code - M = Member Smokes, S = Spouse Smokes, B = Member and Spouse Smokes, N = Neither Smokes or leave blank when not applicable  (Data Entered on Member Row Only)   "," M "]
["Health Question","**Health Question = Additional Amt or Conditional Amt Answer for Member, Spouse and Child Optional Life (Entered as Y or N on Member & Dependent Row)"," Y "]
["SOL Selected","*SOL Selected = Spouse Optional Life - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["SOL Volume Elected","*SOL Volume Elected = Enter Amount of Spouse Optional Life Elected (Data Entered on Member Row Only)",9999999999]
["SOL Descriptor","**SOL Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["COL Selected","*COL Selected = Child Optional Life - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["COL Volume Elected","*COL Volume Elected = Enter Amount of Child Optional Life Elected (Data Entered on Member Row Only)",9999999999]
["COL Descriptor","**COL Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["AVM Selected","*AVM Selected = Voluntary Accidental Death Member benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["AVM Volume Elected","*AVM Volume Elected = Voluntary Accidental Death Member benefit - Enter Amount of Member Voluntary Accidental Death benefit Elected  (Data Entered on Member Row Only)",9999999999]
["AVM Descriptor","**AVM Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["AVS Selected","*AVS Selected = Voluntary Accidental Death Spouse benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["AVS Volume Elected","*AVS Volume Elected = Voluntary Accidental Death Spouse benefit - Enter Amount of Spouse Voluntary Accidental Death benefit Elected  (Data Entered on Member Row Only)",9999999999]
["AVS Descriptor","**AVS Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["AVC Selected","*AVC Selected = Voluntary Accidental Death Child benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["AVC Volume Elected","*AVC Volume Elected = Voluntary Accidental Death Child benefit - Enter Amount of Child Voluntary Accidental Death benefit Elected  (Data Entered on Member Row Only)",9999999999]
["AVC Descriptor","**AVC Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["CIM \nSelected","*CIM Selected = Critical Illness Member - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["CIM Volume Elected","*CIM Volume Elected = Enter Amount of Critical Illness Member Elected (Data Entered on Member Row Only)",9999999999]
["CIM Descriptor","**CIM Descriptor = Coverage Description - Entered as coverage description (i.e \"Core\" or \"Buyup\" - Member Row Only)","Plan 1"]
["CVM \nSelected","*CVM Selected = Critical Illness Member - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["CVM Volume Elected","*CVM Volume Elected = Enter Amount of Critical Illness Member Elected (Data Entered on Member Row Only)",9999999999]
["CVM Descriptor","**CVM Descriptor = Coverage Description - Entered as coverage description (i.e \"Core\" or \"Buyup\" - Member Row Only)","Plan 1"]
["Disease Question","*Disease Question= For conditional amount plans only, Use on both Member and Dependent lines. How was question answered? Y=Yes N=NO","Y"]
["Heart Question","**Heart Question = Conditional Amt Answer for Member, Spouse and Child Critical Illness (Entered as Y or N on Member & Dependent Row)"," Y "]
["Blood Pressure Question","**Blood Pressure Question = Conditional Amt Answer for Member, Spouse and Child Critical Illness (Entered as Y or N on Member & Dependent Row)"," Y "]
["Aids Question","**Aids Question=Conditional Amount for Member, Spouse and Child Critical Illness(entered as Y or N on member and Dependent Row)"," Y "]
["Neurological Disease Question","** Neurological Disease Question=Use only if multiple plan types available for this coverage.  Example:   Core or  Buy-up plan","Y"]
["CIS Selected","*CIS Selected = Critical Illness Spouse - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only) "," Y "]
["CIS Volume Elected","*CIS Volume Elected = Enter Amount of Critical Illnes Spouse Elected (Data Entered on Member Row Only)",9999999999]
["CIS Descriptor","**CIS Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["CIC \nSelected","*CIC Selected = Critical Illness Child - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["CIC Volume Elected","*CIC Volume Elected = Enter Amount of Critical Illness Child Elected (Data Entered on Member Row Only)",9999999999]
["CIC Descriptor","**CIC Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["CVS \nSelected","*CVS Selected = Critical Illness Spouse - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only) "," Y "]
["CVS Volume Elected","*CVS Volume Elected = Enter Amount of Critical Illnes Spouse Elected (Data Entered on Member Row Only)",9999999999]
["CVS Descriptor","**CVS Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["CVC \nSelected","*CVC Selected = Critical Illness Child - Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["CVC Volume Elected","*CVC Volume Elected = Enter Amount of Critical Illness Child Elected (Data Entered on Member Row Only)",9999999999]
["CVC Descriptor","**CVC Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["AKM Selected","*AKM Selected = Accident Member benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)","Yes/No"]
["AKM Descriptor","**AKM Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)  ","Plan 1"]
["AKS Selected","*AKS Selected = Accident Spouse benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)","Yes/No"]
["AKS Descriptor","**AKS Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["AKC Selected","*AKC Selected = Accident Child benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)","Yes/No"]
["AKC Descriptor","**AKC Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only) ","Plan 1"]
["CAM Selected","*CAM Selected = Cancer Member benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)","Yes/No"]
["CAM Descriptor","**CAM Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["Cancer Question","**Cancer Question = Conditional Amt Answer for Member, Spouse and Child Critical Illness (Entered as Y or N on Member & Dependent Row)"," Y "]
["CAS Selected","*CAS Selected = Cancer Spouse benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)","Yes/No"]
["CAS Descriptor","**CAS Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["CAC Selected","*CAC Selected = Cancer Child benefit- Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)","Yes/No"]
["CAC Descriptor","**CAC Descriptor = Coverage Descprition - Entered as coverage description (i.e. \"Core\" or \"Buyup\" - Member Row Only)  ","Plan 1"]
["GPL Smoker","*GPL Smoker - Y = Person electing GPL Smokes, N = Person electing GPL does not smoke (Entered for Member and Dependent row)","N"]
["Health Question","*Health Question = Additional or Conditional Amt Answer for Member, Spouse or Child (Entered as Y or N on Member & Dependent rows)","N"]
["Spouse Term Volume","*Spouse Term Volume = Enter Amount elected for spouse (7 positions)",500000]
["GPL Volume Elected","*GPL Volume Elected = Enter Amount of GPL elected for Member or Dependent (7 positions)",1000000]
["Child Term Volume","*Child Term Volume = Enter Amount elected for child (5 positions)",10000]
["Acc Death Rider"," *Acc Death Rider = Accidental Death Rider - Enter Y if selected.  \"N or blank if rider not elected","N"]
["GPL Primary Beneficiary 1 Last Name","*GPL Primary Beneficiary 1 Last Name = Beneficiarys Last Name 19 alpha character max","Jones"]
["GPL Primary Beneficiary 1 First Name","*GPL Primary Beneficiary 1 First Name = Beneficiarys First Name 10 alpha character max","Mary"]
["GPL Primary Beneficiary 1 Percent ","*GPL Primary Beneficiary 1 Percent = Percentage of GPL benefit this beneficairy is to receive (1-100)",50]
["GPL Primary Beneficiary 1 SSN","*GPL Primary Beneficiary 1 SSN = Beneficiarys 9 digit Social Security Number (with or without dashes)","xxx-xx-xxxx"]
["GPL Primary Beneficiary 1 Address","*GPL Primary Beneficiary 1 Address = Beneficiarys Address"]
["GPL Primary Beneficiary 1 City","*GPL Primary Beneficiary 1 City = Beneficiarys City"]
["GPL Primary Beneficiary 1 State","* GPL Primary Beneficiary 1 State = Beneficiarys 2 character State Code (New York enterend as NY)","PA"]
["GPL Primary Beneficiary 1 Zip Code","*GPL Primary Beneficiary 1 Zip Code = Beneficiarys 5 digit Zip Code",18017]
["GPL Primary Beneficiary 1 Date of Birth","*GPL Primary Beneficiary 1 Date of Birth = Beneficiarys Date of Birth (MM/DD/CCYY format - Entered as 11/10/1955)","1999-01-01"]
["GPL Primary Beneficiary 1 Phone No","*GPL Primary Beneficiary 1 Phone No = Beneficiarys Phone Number - 10 digits (with or without dashes)","(610) 807-8166"]
["GPL Primary Beneficiary 1 Relationship","Free Form text"]
["GPL Primary Beneficiary 2 Last Name","*GPL Primary Beneficiary 2 Last Name = Beneficiarys Last Name 19 alpha character max","Jones"]
["GPL Primary Beneficiary 2 First Name","*GPL Primary Beneficiary 2 First Name = Beneficiarys First Name 10 alpha character max","Sam"]
["GPL Primary Beneficiary 2 Percent ","*GPL Primary Beneficiary 2 Percent = Percentage of GPL benefit this beneficairy is to receive (1-100)",50]
["GPL Primary Beneficiary 2 SSN","*GPL Primary Beneficiary 2 SSN = Beneficiarys 9 digit Social Security Number (with or without dashes)","xxx-xx-xxxx"]
["GPL Primary Beneficiary 2 Address","*GPL Primary Beneficiary 2 Address = Beneficiarys Address"]
["GPL Primary Beneficiary 2 City","*GPL Primary Beneficiary 2 City = Beneficiarys City"]
["GPL Primary Beneficiary 2 State","* GPL Primary Beneficiary 2 State = Beneficiarys 2 character State Code (New York enterend as NY)","PA"]
["GPL Primary Beneficiary 2 Zip Code","*GPL Primary Beneficiary 2 Zip Code = Beneficiarys 5 digit Zip Code",18017]
["GPL Primary Beneficiary 2 Date of Birth","*GPL Primary Beneficiary 2 Date of Birth = Beneficiarys Date of Birth (MM/DD/CCYY format - Entered as 11/10/1955)","1999-01-01"]
["GPL Primary Beneficiary 2 Phone No","*GPL Primary Beneficiary 2 Phone No = Beneficiarys Phone Number - 10 digits (with or without dashes)","(610) 807-8166"]
["GPL Primary Beneficiary 2 Relationship","Free Form text"]
["GPL Contingent Beneficiary Last Name","*GPL Contingent Beneficiary  Last Name = Beneficiarys Last Name 19 alpha character max","Jones"]
["GPL Contingent Beneficiary First Name","*GPL Contingent Beneficiary  First Name = Beneficiarys First Name 10 alpha character max","Sara"]
["GPL Contingent Beneficiary Percent ","*GPL Contingent Beneficiary  Percent = Percentage of GPL benefit this beneficairy is to receive (1-100)",100]
["GPL Contingent Beneficiary SSN","*GPL Contingent Beneficiary  SSN = Beneficiarys 9 digit Social Security Number (with or without dashes)","xxx-xx-xxxx"]
["GPL Contingent Beneficiary Address","*GPL Contingent Beneficiary  Address = Beneficiarys Address"]
["GPL Contingent Beneficiary City","*GPL Contingent Beneficiary  City = Beneficiarys City"]
["GPL Contingent Beneficiary State","* GPL Contingent Beneficiary  State = Beneficiarys 2 character State Code (New York enterend as NY)","PA"]
["GPL Contingent Beneficiary Zip Code","*GPL Contingent Beneficiary  Zip Code = Beneficiarys 5 digit Zip Code",18017]
["GPL Contingent Beneficiary Date of Birth","*GPL Contingent Beneficiary  Date of Birth = Beneficiarys Date of Birth (MM/DD/CCYY format - Entered as 11/10/1955)","1999-01-01"]
["GPL Contingent Beneficiary Phone No","*GPL Contingent Beneficiary  Phone No = Beneficiarys Phone Number - 10 digits (with or without dashes)","(610) 807-8166"]
["HI Selected","*HI Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)","Y"]
["HI Fam Ind","*HI Fam IND = Member & Dependents electing coverage family indicator code - Entered as: A = Family, B = Member & Spouse, C= Member only, D = Member & Child, G=Children Only (Data Entered on Member Row Only)","C"]
["Hi Descriptor","**HI Descriptor = Coverage Description - Entered as coverage description","Plan 1"]
["HI Waiver","**HI Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data Entered on Member Row Only)","O"]
["GPL Money Purchase","*GPL Money Purchase",1500]
["Medical Selected","*Medical Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["Medical Fam Ind","*Medical Fam Ind = Member & Dependents electing coverage family indicator code - Entered as: A = Family, B = Member & Spouse, C= Member only, D = Member & Child (Data Entered on Member Row Only)  ","A"]
["Medical Descriptor","**Medical Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["Medical Waiver","**Medical Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data entered on Member Row Only)   ","O"]
["RX Card Selected","*RXD Selected = Enter \"Y\" if Coverage Selected, \"N\" or leave blank for Coverage Waived (Data Entered on Member Row Only)"," Y "]
["RX Card Fam Ind","*RXD Fam Ind = Member & Dependents electing coverage family indicator code - Entered as: A = Family, B = Member & Spouse, C= Member only, D = Member & Child (Data Entered on Member Row Only)  ","C"]
["RX Card Descriptor","**RXD Descriptor = Coverage Description - Entered as coverage description (i.e.\"Core\" or \"Buyup\" - Member Row Only)   ","Plan 1"]
["RX Card Waiver","**RXD Waiver = Coverage Waived Reason - Entered as: I = Other Insurance, O = No reason given or leave blank (Data entered on Member Row Only)   ","O"]
[" FMLA Work Address 1","Location of where individual reports to work","1200 Main Street"]
["FML Employee Work Phone Number","Employees Work phone number","845-555-5000"]
["FML Employee Work Extension","Extension assigned to Employee by company",2563]
["FML Union Number","Employees Union number, if any","a2113"]
["FML Union","Is the Employee part of trade group","Union or non union"]
["FML Is Employee Working Full Time","How is the employee classified by payroll? If Full Time answer Y for Yes, If Part Time answer N for No","Yes"]
["FML 50 Employees in 75 Mile Radius","If invoking the 50/75 rule, does the employee work at a location that has 50 or more employees in a 75 mile radius?  If not invoking the rule, no data is required.","YES/NO"]
["FML Employer Contact SUPR EE SSN","SSN of member's Supervisor Employer Contact, if contact is an actual ee.  If not an ee, leave blank.","xxx-xx-xxxx"]
["FML Employer Contact SUPR First Name","First name of member's Supervisor Employer Contact, if not an actual employee.  Leave blank if contact is an actual ee.","Ann"]
["FML Employer Contact SUPR Last Name","Last name of member's Supervisor Employer Contact, if not an actual employee.  Leave blank if contact is an actual ee.","Robertson"]
["FML Employer Contact SUPR Email Address","Email address of member's Supervisor Employer Contact, if not an actual employee.  Leave blank if contact is an actual ee.","canderson@act.com"]
[" FML Employer Contact HMRS EE SSN","SSN of member’s Human Resource Employer Contact, if contact is an actual ee.  If not an ee, leave blank.","xxx-xx-xxxx"]
["FML Employer Contact HMRS First Name","First name of member's Human Resource Employer Contact, if not an actual employee.  Leave blank if contact is an actual ee.","Ann"]
["FML Employer Contact HMRS Last Name","Column Description: Last name of member's Human Resource Employer Contact, if not an actual employee.  Leave blank if contact is an actual ee.","Robertson"]
["FML Employer Contact HMRS Email Address","Email address of Member's Human Resource Employer Contact, if not an actual employee.  Leave Blank if contact is an actual employee","canderson@act.com"]
["STD or State Mandated Disability Elected","Enter Y for Guardian STD or Guardian State Mandated elected or N for not elected?","Yes/No"]
["STD or State Mandated Dis eff Date of Benefits","Date Guardian benefit is to be active  (Entered as: 12/10/2005 )","Date value higher than 1/1/1900"]
["Guardian FML Administration","Enter Y for Guardian FML Administration elected or N for not elected","Yes/No"]
["Guardian FML Administration Effective Date","Date Guardian FML service is to be active  ( Entered as: 12/10/2005 )","Date value higher than 1/1/1900"]
["GPL Contingent Beneficiary Relationship","Free Form text"]
["Medical Coverage ?","** Medical Coverage = Use on both Member and Dependent Lines. Does medical coverage exists? Y=Yes N=No","Y"]