14-Exhibit D-3 - 2026 Census - 8.12.2026.pdf

PDF 608 KB Posted

Attached to
27-002V Stop Loss Insurance
Solicitation number
27-002V
Issued by
Savannah CDP, Texas

About this file

Written by GovTribe AI ·

Summary

This document is a 2026 Census Exhibit prepared for the Schertz-Cibolo-Universal City Independent School District (ISD) in Texas in connection with a stop loss insurance solicitation. The exhibit appears to serve as a supporting document detailing census data relevant to the District's employee population, which would be used by responding insurance carriers to underwrite and price stop loss insurance coverage. The census information likely includes employee counts, age distributions, salary information, claims history, and other demographic data necessary for insurers to evaluate risk and develop proposals for the requested stop loss coverage.

The document functions as a critical data resource for potential bidders responding to the District's RFP for stop loss insurance, with Foundation Risk Partners, d/b/a Corporate Synergies, serving as the District's consultant managing the solicitation process. As an exhibit rather than a standalone document, specific pricing, contract terms, renewal options, award dates, and response deadlines would be contained in the primary solicitation documents rather than this census data file. The census data provided in this exhibit enables insurance companies licensed in Texas to accurately assess the District's risk profile and submit competitive proposals aligned with the actual employee population characteristics.

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District SSN - Last 4 Digits

EE Name EE DOB EE Gender

Marital Status

Employee Date Of Hire

Relationship Depende nt SSN - Last 4 Digits

Dep DOB Dep Gender

ZIP City State Enrolled Plan Name Coverage Tier

Effective Date

Termination Date

Employer Monthly Cost

Employee Monthly Cost

Monthly Prem Combined

Application Date

Schertz Cibolo Universal City 5065 EMPLOYEE 1/11/1987 F Married 8/4/2022 Employee 5065 1/11/1987 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 6114 EMPLOYEE 7/20/1976 F Married 8/8/2018 Employee 6114 7/20/1976 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4847 EMPLOYEE 12/10/1965 F Unknown 8/14/2014 Employee 4847 12/10/1965 F 78232 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 7592 EMPLOYEE 1/27/1980 F Married 3/7/2022 Employee 7592 1/27/1980 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7592 EMPLOYEE 1/27/1980 F Married 3/7/2022 Child 3065 3/26/2010 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7592 EMPLOYEE 1/27/1980 F Married 3/7/2022 Child 3780 1/8/2013 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7963 EMPLOYEE 5/14/1987 F Unknown 8/4/2025 Employee 7963 5/14/1987 F 78124 MARION TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7963 EMPLOYEE 5/14/1987 F Unknown 8/4/2025 Child 2794 4/28/2015 F 78124 MARION TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 8575 EMPLOYEE 12/16/1991 M Unknown 8/5/2024 Employee 8575 12/16/1991 M 78412 Corpus Christi TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4461 EMPLOYEE 12/17/1974 F Married 3/8/2023 Employee 4461 12/17/1974 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 5104 EMPLOYEE 12/11/1990 F Unknown 8/15/2013 Employee 5104 12/11/1990 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EO 2/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8096 EMPLOYEE 2/5/1973 F Married 8/7/2023 Employee 8096 2/5/1973 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4583 EMPLOYEE 6/27/1979 M Married 9/1/2021 Employee 4583 6/27/1979 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 2575 EMPLOYEE 7/9/1971 F Unknown 8/16/2017 Employee 2575 7/9/1971 F 78132 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4534 EMPLOYEE 7/9/1973 F Married 8/5/2024 Employee 4534 7/9/1973 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2058 EMPLOYEE 5/30/2004 M Unknown 8/14/2024 Employee 2058 5/30/2004 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 6/30/2026 $765.56 $72.30 $837.86 6/11/2026 Schertz Cibolo Universal City 4615 EMPLOYEE 1/19/1960 F Married 9/23/2025 Employee 4615 1/19/1960 F 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 7807 EMPLOYEE 12/4/1960 M Married 11/1/2021 Employee 7807 12/4/1960 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 6888 EMPLOYEE 2/12/1973 F Married 8/15/2013 Employee 6888 2/12/1973 F 78133 CANYON LAKE TX Aetna Baptist ACO Plan 3 ES 1/1/2026 $1,118.54 $568.80 $1,687.34 1/29/2026 Schertz Cibolo Universal City 6888 EMPLOYEE 2/12/1973 F Married 8/15/2013 Spouse 7807 7/26/1976 M 78133 CANYON LAKE TX Aetna Baptist ACO Plan 3 ES 1/1/2026 $1,118.54 $568.80 $1,687.34 1/29/2026 Schertz Cibolo Universal City 0093 EMPLOYEE 10/8/1974 M Unknown 10/11/2004 Employee 0093 10/8/1974 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8746 EMPLOYEE 3/14/1975 F Married 8/5/2021 Employee 8746 3/14/1975 F 78223 SAN ANTONIO TX Aetna Baptist ACO Plan 3 FA 1/1/2026 $1,534.24 $1,029.61 $2,563.85 1/29/2026 Schertz Cibolo Universal City 8746 EMPLOYEE 3/14/1975 F Married 8/5/2021 Spouse 4076 3/22/1975 M 78223 SAN ANTONIO TX Aetna Baptist ACO Plan 3 FA 1/1/2026 $1,534.24 $1,029.61 $2,563.85 1/29/2026 Schertz Cibolo Universal City 8746 EMPLOYEE 3/14/1975 F Married 8/5/2021 Child 0878 2/1/2010 F 78223 SAN ANTONIO TX Aetna Baptist ACO Plan 3 FA 1/1/2026 $1,534.24 $1,029.61 $2,563.85 1/29/2026 Schertz Cibolo Universal City 2997 EMPLOYEE 4/13/1970 F Single 8/8/2023 Employee 2997 4/13/1970 F 78154 SELMA TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8798 EMPLOYEE 5/27/1994 F Unknown 8/4/2025 Employee 8798 5/27/1994 F 78161 SUTHERLAND SPRING TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 8798 EMPLOYEE 5/27/1994 F Unknown 8/4/2025 Child 0426 11/11/2013 M 78161 SUTHERLAND SPRING TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 8798 EMPLOYEE 5/27/1994 F Unknown 8/4/2025 Child 2347 1/28/2022 F 78161 SUTHERLAND SPRING TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 1851 EMPLOYEE 11/5/1982 F Married 8/4/2022 Employee 1851 11/5/1982 F 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 1851 EMPLOYEE 11/5/1982 F Married 8/4/2022 Child 9221 8/22/2013 M 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 1851 EMPLOYEE 11/5/1982 F Married 8/4/2022 Child 4179 12/25/2015 M 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7109 EMPLOYEE 5/30/1980 F Unknown 7/9/2018 Employee 7109 5/30/1980 F 78209 San Antonio TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8388 EMPLOYEE 4/24/1971 F Married 8/7/2024 Employee 8388 4/24/1971 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/13/2026 Schertz Cibolo Universal City 8388 EMPLOYEE 4/24/1971 F Married 8/7/2024 Child 5085 7/9/2000 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 7/31/2026 $1,040.08 $368.33 $1,408.41 7/13/2026 Schertz Cibolo Universal City 8388 EMPLOYEE 4/24/1971 F Married 8/7/2024 Child 9512 6/13/2004 M 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/13/2026 Schertz Cibolo Universal City 8388 EMPLOYEE 4/24/1971 F Married 8/7/2024 Child 2440 3/30/2008 M 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/13/2026 Schertz Cibolo Universal City 8388 EMPLOYEE 4/24/1971 F Married 8/7/2024 Child 9927 11/15/2016 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/13/2026 Schertz Cibolo Universal City 8388 EMPLOYEE 4/24/1971 F Married 8/7/2024 Child 2519 9/1/2018 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/13/2026 Schertz Cibolo Universal City 8388 EMPLOYEE 4/24/1971 F Married 8/7/2024 Child 9947 12/2/2019 M 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/13/2026 Schertz Cibolo Universal City 2686 EMPLOYEE 10/8/1989 F Married 8/5/2024 Employee 2686 10/8/1989 F 78130 NEW BRAUNFELS TX Aetna HDHP Plan 1 FA 1/1/2026 $1,445.91 $989.61 $2,435.52 1/29/2026 Schertz Cibolo Universal City 2686 EMPLOYEE 10/8/1989 F Married 8/5/2024 Spouse 5242 2/27/1991 M 78130 NEW BRAUNFELS TX Aetna HDHP Plan 1 FA 1/1/2026 $1,445.91 $989.61 $2,435.52 1/29/2026 Schertz Cibolo Universal City 2686 EMPLOYEE 10/8/1989 F Married 8/5/2024 Child 4085 3/19/2024 F 78130 NEW BRAUNFELS TX Aetna HDHP Plan 1 FA 1/1/2026 $1,445.91 $989.61 $2,435.52 1/29/2026 Schertz Cibolo Universal City 7261 EMPLOYEE 10/23/1981 F Married 8/4/2022 Employee 7261 10/23/1981 F 78247 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7261 EMPLOYEE 10/23/1981 F Married 8/4/2022 Child 3129 8/4/2011 M 78247 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 0881 EMPLOYEE 10/7/1983 F Unknown 2/13/2023 Employee 0881 10/7/1983 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.30 $837.86 8/31/2026 Schertz Cibolo Universal City 4758 EMPLOYEE 11/15/1974 F Married 8/8/2019 Employee 4758 11/15/1974 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4758 EMPLOYEE 11/15/1974 F Married 8/8/2019 Child 3351 11/12/2006 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4758 EMPLOYEE 11/15/1974 F Married 8/8/2019 Child 1298 12/16/2007 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 1799 EMPLOYEE 2/17/1989 F Married 1/3/2017 Employee 1799 2/17/1989 F 78244 San Antonio TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2062 EMPLOYEE 9/2/1971 F Married 8/5/2025 Employee 2062 9/2/1971 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.30 $837.86 8/31/2026 Schertz Cibolo Universal City 8007 EMPLOYEE 11/7/1972 M Married 8/4/2025 Employee 8007 11/7/1972 M 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 8/31/2026 $1,040.08 $368.33 $1,408.41 8/31/2026 Schertz Cibolo Universal City 8007 EMPLOYEE 11/7/1972 M Married 8/4/2025 Child 1938 11/11/2007 M 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 8/31/2026 $1,040.08 $368.33 $1,408.41 8/31/2026 Schertz Cibolo Universal City 6619 EMPLOYEE 12/27/1990 F Unknown 7/28/2022 Employee 6619 12/27/1990 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 9192 EMPLOYEE 12/25/1997 F Unknown 10/24/2024 Employee 9192 12/25/1997 F 78259 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5684 EMPLOYEE 6/6/1967 F Married 8/15/2008 Employee 5684 6/6/1967 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 7906 EMPLOYEE 8/29/1971 F Unknown 8/15/2018 Employee 7906 8/29/1971 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 1906 EMPLOYEE 1/9/1969 F Unknown 8/8/2019 Employee 1906 1/9/1969 F 78130 New Braunfels TX Aetna HDHP Plan 1 EC 1/1/2026 $988.54 $348.33 $1,336.87 1/29/2026 Schertz Cibolo Universal City 1906 EMPLOYEE 1/9/1969 F Unknown 8/8/2019 Child 3462 3/6/2012 M 78130 New Braunfels TX Aetna HDHP Plan 1 EC 1/1/2026 $988.54 $348.33 $1,336.87 1/29/2026 Schertz Cibolo Universal City 7099 EMPLOYEE 9/18/1986 F Married 8/8/2023 Employee 7099 9/18/1986 F 78155 SEGUIN TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 1611 EMPLOYEE 9/13/1994 M Unknown 9/20/2021 Employee 1611 9/13/1994 M 78218 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 2/28/2026 $765.56 $72.30 $837.86 2/20/2026 Schertz Cibolo Universal City 0902 EMPLOYEE 1/3/1997 F Married 8/3/2026 Employee 0902 1/3/1997 F 78148 UNIVERSAL CITY TX Aetna HDHP Plan 1 EO 9/1/2026 $733.20 $62.29 $795.49 8/10/2026 Schertz Cibolo Universal City 2882 EMPLOYEE 2/4/2001 F Single 8/3/2026 Employee 2882 2/4/2001 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 9/1/2026 $1,040.08 $368.33 $1,408.41 8/6/2026 Schertz Cibolo Universal City 2882 EMPLOYEE 2/4/2001 F Single 8/3/2026 Child 4684 5/27/2020 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 9/1/2026 $1,040.08 $368.33 $1,408.41 8/6/2026 Schertz Cibolo Universal City 3168 EMPLOYEE 12/22/1991 M Unknown 7/12/2010 Employee 3168 12/22/1991 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 8527 EMPLOYEE 3/30/1998 F Unknown 9/4/2020 Employee 8527 3/30/1998 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 9600 EMPLOYEE 10/31/1976 F Unknown 6/8/2015 Employee 9600 10/31/1976 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 7686 EMPLOYEE 11/17/1973 F Unknown 7/30/2025 Employee 7686 11/17/1973 F 78247 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5614 EMPLOYEE 10/30/1974 F Married 2/27/2012 Employee 5614 10/30/1974 F 78266 GARDEN RIDGE TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 3662 EMPLOYEE 2/7/1967 F Unknown 8/15/2008 Employee 3662 2/7/1967 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4362 EMPLOYEE 4/20/1962 F Unknown 3/20/2023 Employee 4362 4/20/1962 F 78109 Converse TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.29 $837.85 8/31/2026 Schertz Cibolo Universal City 5952 EMPLOYEE 7/26/1985 M Married 12/19/2017 Employee 5952 7/26/1985 M 78132 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 5731 EMPLOYEE 1/5/1966 F Married 8/7/2006 Employee 5731 1/5/1966 F 78201 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4887 EMPLOYEE 2/12/1994 F Single 8/3/2023 Employee 4887 2/12/1994 F 78233 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.29 $837.85 8/31/2026 Schertz Cibolo Universal City 7112 EMPLOYEE 4/21/1966 F Unknown 4/27/2015 Employee 7112 4/21/1966 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026

EXHIBIT D-3: 2026 CENSUS THRU AUGUST 12, 2026

Digits

EE Name EE DOB EE Gender

Marital Status

Employee Date Of Hire

Relationship Depende nt SSN - Last 4 Digits

Dep DOB Dep Gender

ZIP City State Enrolled Plan Name Coverage Tier

Effective Date

Termination Date

Employer Monthly Cost

Employee Monthly Cost

Monthly Prem Combined

Application Date

Schertz Cibolo Universal City 8068 EMPLOYEE 5/15/1969 M Married 8/4/2025 Employee 8068 5/15/1969 M 78155 Seguin TX Aetna Baptist ACO Plan 3 FA 1/1/2026 8/31/2026 $1,534.24 $1,029.61 $2,563.85 8/31/2026 Schertz Cibolo Universal City 8068 EMPLOYEE 5/15/1969 M Married 8/4/2025 Spouse 1114 5/25/1971 F 78155 Seguin TX Aetna Baptist ACO Plan 3 FA 1/1/2026 8/31/2026 $1,534.24 $1,029.61 $2,563.85 8/31/2026 Schertz Cibolo Universal City 8068 EMPLOYEE 5/15/1969 M Married 8/4/2025 Child 1054 4/17/2007 M 78155 Seguin TX Aetna Baptist ACO Plan 3 FA 1/1/2026 8/31/2026 $1,534.24 $1,029.61 $2,563.85 8/31/2026 Schertz Cibolo Universal City 8068 EMPLOYEE 5/15/1969 M Married 8/4/2025 Child 1251 7/15/2010 M 78155 Seguin TX Aetna Baptist ACO Plan 3 FA 1/1/2026 8/31/2026 $1,534.24 $1,029.61 $2,563.85 8/31/2026 Schertz Cibolo Universal City 8068 EMPLOYEE 5/15/1969 M Married 8/4/2025 Child 1252 7/15/2010 F 78155 Seguin TX Aetna Baptist ACO Plan 3 FA 1/1/2026 8/31/2026 $1,534.24 $1,029.61 $2,563.85 8/31/2026 Schertz Cibolo Universal City 1720 EMPLOYEE 8/23/1990 M Unknown 8/23/2024 Employee 1720 8/23/1990 M 78666 MARCOS TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/7/2026 Schertz Cibolo Universal City 1720 EMPLOYEE 8/23/1990 M Unknown 8/23/2024 Child 6973 11/12/2012 M 78666 MARCOS TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/7/2026 Schertz Cibolo Universal City 1720 EMPLOYEE 8/23/1990 M Unknown 8/23/2024 Child 4858 12/9/2024 M 78666 MARCOS TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/7/2026 Schertz Cibolo Universal City 1720 EMPLOYEE 8/23/1990 M Unknown 8/23/2024 Child 1746 6/3/2026 M 78666 MARCOS TX Aetna Baptist ACO Plan 3 EC 7/1/2026 $1,040.08 $368.33 $1,408.41 7/7/2026 Schertz Cibolo Universal City 2915 EMPLOYEE 6/22/1969 M Married 2/16/2016 Employee 2915 6/22/1969 M 78154 Schertz TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2295 EMPLOYEE 5/15/1992 F Married 8/4/2022 Employee 2295 5/15/1992 F 78130 NEW BRAUNFELS TX Aetna HDHP Plan 1 EC 1/1/2026 $988.54 $348.33 $1,336.87 1/29/2026 Schertz Cibolo Universal City 2295 EMPLOYEE 5/15/1992 F Married 8/4/2022 Child 5/1/2025 F 78130 NEW BRAUNFELS TX Aetna HDHP Plan 1 EC 1/1/2026 $988.54 $348.33 $1,336.87 1/29/2026 Schertz Cibolo Universal City 7222 EMPLOYEE 8/24/1971 F Unknown 1/29/2018 Employee 7222 8/24/1971 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 3666 EMPLOYEE 6/25/1984 F Unknown 8/5/2024 Employee 3666 6/25/1984 F 78108 SCHERTZ TX Aetna HDHP Plan 1 EO 1/1/2026 8/31/2026 $733.20 $62.29 $795.49 8/31/2026 Schertz Cibolo Universal City 8092 EMPLOYEE 11/5/1973 F Unknown 8/13/2015 Employee 8092 11/5/1973 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.29 $837.85 8/31/2026 Schertz Cibolo Universal City 9046 EMPLOYEE 7/9/1961 F Married 8/18/2015 Employee 9046 7/9/1961 F 78155 Seguin TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.30 $795.50 1/29/2026 Schertz Cibolo Universal City 3072 EMPLOYEE 12/27/1973 F Married 8/13/2009 Employee 3072 12/27/1973 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 3072 EMPLOYEE 12/27/1973 F Married 8/13/2009 Child 1754 9/7/2003 M 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9140 EMPLOYEE 8/23/1997 F Unknown 8/5/2021 Employee 9140 8/23/1997 F 78155 Seguin TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9140 EMPLOYEE 8/23/1997 F Unknown 8/5/2021 Child 3/27/2025 M 78155 Seguin TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9060 EMPLOYEE 1/12/1986 M Married 8/6/2020 Employee 9060 1/12/1986 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5153 EMPLOYEE 6/19/1989 M Married 8/21/2023 Employee 5153 6/19/1989 M 78233 Live Oak TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 7852 EMPLOYEE 4/2/1963 F Married 8/28/2017 Employee 7852 4/2/1963 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 9828 EMPLOYEE 1/8/1983 F Married 8/12/2021 Employee 9828 1/8/1983 F 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 7459 EMPLOYEE 8/25/1978 M Married 8/16/2017 Employee 7459 8/25/1978 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 6/1/2026 $765.56 $72.29 $837.85 5/13/2026 Schertz Cibolo Universal City 2557 EMPLOYEE 3/26/1989 F Unknown 8/15/2016 Employee 2557 3/26/1989 F 78130 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5973 EMPLOYEE 3/10/1986 M Married 8/16/2012 Employee 5973 3/10/1986 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 4/30/2026 $765.56 $72.29 $837.85 4/20/2026 Schertz Cibolo Universal City 0280 EMPLOYEE 4/19/1987 F Married 8/19/2013 Employee 0280 4/19/1987 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 0280 EMPLOYEE 4/19/1987 F Married 8/19/2013 Child 0240 1/18/2015 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 0280 EMPLOYEE 4/19/1987 F Married 8/19/2013 Child 5003 2/28/2019 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 5150 EMPLOYEE 2/18/1975 M Married 8/9/2004 Employee 5150 2/18/1975 M 78212 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 0231 EMPLOYEE 5/29/1986 F Married 8/16/2017 Employee 0231 5/29/1986 F 78266 GARDEN RIDGE TX Aetna HDHP Plan 1 EO 1/1/2026 8/31/2026 $733.20 $62.29 $795.49 8/31/2026 Schertz Cibolo Universal City 5012 EMPLOYEE 7/30/1990 M Married 8/14/2014 Employee 5012 7/30/1990 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 5012 EMPLOYEE 7/30/1990 M Married 8/14/2014 Child 4423 7/12/2019 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 5012 EMPLOYEE 7/30/1990 M Married 8/14/2014 Child 1016 7/28/2022 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 6852 EMPLOYEE 10/4/1967 F Unknown 7/31/2023 Employee 6852 10/4/1967 F 78108 Schertz TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 9136 EMPLOYEE 8/3/1973 M Married 8/15/2013 Employee 9136 8/3/1973 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 1/31/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9136 EMPLOYEE 8/3/1973 M Married 8/15/2013 Child 4921 1/20/2005 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 1/31/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9136 EMPLOYEE 8/3/1973 M Married 8/15/2013 Child 5967 9/26/2008 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 1/31/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4773 EMPLOYEE 9/25/1998 F Unknown 10/28/2019 Employee 4773 9/25/1998 F 78163 Bulverde TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 3872 EMPLOYEE 9/12/1977 F Married 8/4/2025 Employee 3872 9/12/1977 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 3872 EMPLOYEE 9/12/1977 F Married 8/4/2025 Child 0878 12/23/2012 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 3872 EMPLOYEE 9/12/1977 F Married 8/4/2025 Child 6504 7/11/2014 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 6157 EMPLOYEE 4/4/1989 F Unknown 8/4/2022 Employee 6157 4/4/1989 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 6157 EMPLOYEE 4/4/1989 F Unknown 8/4/2022 Child 8928 9/9/2012 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 6381 EMPLOYEE 1/30/1987 M Married 5/31/2016 Employee 6381 1/30/1987 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8712 EMPLOYEE 7/27/1992 F Unknown 8/4/2022 Employee 8712 7/27/1992 F 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8762 EMPLOYEE 12/15/1966 F Unknown 1/5/2026 Employee 8762 12/15/1966 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 2/1/2026 5/31/2026 $765.56 $72.30 $837.86 5/31/2026 Schertz Cibolo Universal City 6430 EMPLOYEE 12/29/1972 F Married 8/8/2019 Employee 6430 12/29/1972 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5337 EMPLOYEE 2/4/2000 F Unknown 8/4/2022 Employee 5337 2/4/2000 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 7984 EMPLOYEE 1/4/2000 F Unknown 1/2/2023 Employee 7984 1/4/2000 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.29 $837.85 8/31/2026 Schertz Cibolo Universal City 3730 EMPLOYEE 7/4/1980 F Married 8/5/2021 Employee 3730 7/4/1980 F 78233 LIVE OAK TX Aetna HDHP Plan 1 EC 1/1/2026 $988.54 $348.33 $1,336.87 1/29/2026 Schertz Cibolo Universal City 3730 EMPLOYEE 7/4/1980 F Married 8/5/2021 Child 0489 8/13/2013 F 78233 LIVE OAK TX Aetna HDHP Plan 1 EC 1/1/2026 $988.54 $348.33 $1,336.87 1/29/2026 Schertz Cibolo Universal City 3730 EMPLOYEE 7/4/1980 F Married 8/5/2021 Child 9062 8/14/2015 F 78233 LIVE OAK TX Aetna HDHP Plan 1 EC 1/1/2026 $988.54 $348.33 $1,336.87 1/29/2026 Schertz Cibolo Universal City 5026 EMPLOYEE 9/20/1975 F Unknown 8/1/2024 Employee 5026 9/20/1975 F 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 0599 EMPLOYEE 11/27/1969 M Married 8/4/2022 Employee 0599 11/27/1969 M 78163 BULVERDE TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 9661 EMPLOYEE 12/20/1957 F Unknown 11/10/1997 Employee 9661 12/20/1957 F 78219 KIRBY TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 1396 EMPLOYEE 3/3/1967 F Unknown 8/11/2005 Employee 1396 3/3/1967 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 1212 EMPLOYEE 1/20/1975 F Unknown 1/19/2026 Employee 1212 1/20/1975 F 78203 HELOTES TX Aetna Baptist ACO Plan 3 EO 2/1/2026 2/28/2026 $765.56 $72.30 $837.86 2/28/2026 Schertz Cibolo Universal City 3481 EMPLOYEE 4/7/1966 F Married 7/14/2025 Employee 3481 4/7/1966 F 78247 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2480 EMPLOYEE 12/3/1978 F Married 7/31/2025 Employee 2480 12/3/1978 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5949 EMPLOYEE 8/12/1997 F Unknown 8/8/2023 Employee 5949 8/12/1997 F 78124 MARION TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 9501 EMPLOYEE 6/30/1985 F Married 8/13/2015 Employee 9501 6/30/1985 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2557 EMPLOYEE 6/28/1977 F Unknown 8/11/2003 Employee 2557 6/28/1977 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 9911 EMPLOYEE 2/14/1976 F Married 8/5/2021 Employee 9911 2/14/1976 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 1840 EMPLOYEE 3/16/1990 F Unknown 12/12/2016 Employee 1840 3/16/1990 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.29 $837.85 8/31/2026 Schertz Cibolo Universal City 6352 EMPLOYEE 8/29/1978 M Married 8/6/2020 Employee 6352 8/29/1978 M 78233 San Antonio TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 3897 EMPLOYEE 1/13/1992 F Married 11/7/2022 Employee 3897 1/13/1992 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.34 $1,408.42 1/29/2026 Schertz Cibolo Universal City 3897 EMPLOYEE 1/13/1992 F Married 11/7/2022 Child 6421 10/23/2013 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.34 $1,408.42 1/29/2026 Schertz Cibolo Universal City 3897 EMPLOYEE 1/13/1992 F Married 11/7/2022 Child 5573 10/23/2013 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.34 $1,408.42 1/29/2026 Schertz Cibolo Universal City 2651 EMPLOYEE 2/2/1976 F Married 10/15/2024 Employee 2651 2/2/1976 F 78121 LA VERNIA TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5768 EMPLOYEE 9/18/1970 F Married 7/9/2009 Employee 5768 9/18/1970 F 78155 SEGUIN TX Aetna Baptist ACO Plan 3 ES 1/1/2026 8/31/2026 $1,118.54 $568.80 $1,687.34 8/31/2026 Schertz Cibolo Universal City 5768 EMPLOYEE 9/18/1970 F Married 7/9/2009 Spouse 6376 10/3/1970 M 78155 SEGUIN TX Aetna Baptist ACO Plan 3 ES 1/1/2026 8/31/2026 $1,118.54 $568.80 $1,687.34 8/31/2026 Schertz Cibolo Universal City 4267 EMPLOYEE 3/21/1983 F Married 8/23/2010 Employee 4267 3/21/1983 F 78124 Marion TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 3/3/2026

Digits

EE Name EE DOB EE Gender

Marital Status

Employee Date Of Hire

Relationship Depende nt SSN - Last 4 Digits

Dep DOB Dep Gender

ZIP City State Enrolled Plan Name Coverage Tier

Effective Date

Termination Date

Employer Monthly Cost

Employee Monthly Cost

Monthly Prem Combined

Application Date

Schertz Cibolo Universal City 4267 EMPLOYEE 3/21/1983 F Married 8/23/2010 Child 6621 5/29/2007 M 78124 Marion TX Aetna Baptist ACO Plan 3 EC 3/1/2026 $1,040.08 $368.33 $1,408.41 3/3/2026 Schertz Cibolo Universal City 4267 EMPLOYEE 3/21/1983 F Married 8/23/2010 Child 2250 12/12/2013 M 78124 Marion TX Aetna Baptist ACO Plan 3 EC 3/1/2026 $1,040.08 $368.33 $1,408.41 3/3/2026 Schertz Cibolo Universal City 4267 EMPLOYEE 3/21/1983 F Married 8/23/2010 Child 9892 6/5/2016 M 78124 Marion TX Aetna Baptist ACO Plan 3 EC 3/1/2026 $1,040.08 $368.33 $1,408.41 3/3/2026 Schertz Cibolo Universal City 3465 EMPLOYEE 1/7/1963 F Married 10/16/2020 Employee 3465 1/7/1963 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 1359 EMPLOYEE 3/8/1991 F Married 7/18/2022 Employee 1359 3/8/1991 F 78233 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2696 EMPLOYEE 3/27/2001 F Unknown 8/5/2024 Employee 2696 3/27/2001 F 78148 Universal City TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 0109 EMPLOYEE 11/12/1976 F Unknown 10/20/2025 Employee 0109 11/12/1976 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.34 $1,408.42 1/29/2026 Schertz Cibolo Universal City 0109 EMPLOYEE 11/12/1976 F Unknown 10/20/2025 Child 1323 8/10/2001 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.34 $1,408.42 1/29/2026 Schertz Cibolo Universal City 0109 EMPLOYEE 11/12/1976 F Unknown 10/20/2025 Child 0336 2/13/2014 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.34 $1,408.42 1/29/2026 Schertz Cibolo Universal City 2185 EMPLOYEE 12/9/1981 M Married 8/16/2017 Employee 2185 12/9/1981 M 78155 SEGUIN TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.29 $837.85 8/5/2026 Schertz Cibolo Universal City 9736 EMPLOYEE 2/19/1972 F Married 8/8/2019 Employee 9736 2/19/1972 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 9824 EMPLOYEE 1/12/1983 M Married 8/13/2009 Employee 9824 1/12/1983 M 78130 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9824 EMPLOYEE 1/12/1983 M Married 8/13/2009 Child 0650 7/2/2014 M 78130 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9824 EMPLOYEE 1/12/1983 M Married 8/13/2009 Child 9667 4/17/2018 F 78130 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 5658 EMPLOYEE 10/5/1966 F Unknown 8/8/2023 Employee 5658 10/5/1966 F 78212 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 6666 EMPLOYEE 2/17/1965 F Unknown 1/4/2017 Employee 6666 2/17/1965 F 78109 Converse TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 7933 EMPLOYEE 8/31/2000 M Unknown 8/3/2022 Employee 7933 8/31/2000 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 7170 EMPLOYEE 2/23/1974 F Married 8/14/2014 Employee 7170 2/23/1974 F 78154 Schertz TX Aetna HDHP Plan 1 ES 1/1/2026 8/31/2026 $1,058.74 $543.80 $1,602.54 8/31/2026 Schertz Cibolo Universal City 7170 EMPLOYEE 2/23/1974 F Married 8/14/2014 Spouse 2754 5/19/1966 M 78154 Schertz TX Aetna HDHP Plan 1 ES 1/1/2026 8/31/2026 $1,058.74 $543.80 $1,602.54 8/31/2026 Schertz Cibolo Universal City 9092 EMPLOYEE 3/21/1982 F Married 8/4/2025 Employee 9092 3/21/1982 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8348 EMPLOYEE 2/4/1989 F Unknown 8/4/2025 Employee 8348 2/4/1989 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 0973 EMPLOYEE 11/12/1999 F Unknown 8/4/2022 Employee 0973 11/12/1999 F 78132 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 9464 EMPLOYEE 10/22/1976 F Married 8/5/2021 Employee 9464 10/22/1976 F 78108 CIBOLO TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 0649 EMPLOYEE 4/16/1992 F Unknown 8/3/2022 Employee 0649 4/16/1992 F 78154 SELMA TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4892 EMPLOYEE 3/4/1979 M Married 8/6/2020 Employee 4892 3/4/1979 M 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4892 EMPLOYEE 3/4/1979 M Married 8/6/2020 Child 2092 7/27/2006 F 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4892 EMPLOYEE 3/4/1979 M Married 8/6/2020 Child 3794 7/6/2009 M 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4892 EMPLOYEE 3/4/1979 M Married 8/6/2020 Child 6627 2/10/2014 F 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4686 EMPLOYEE 7/21/1980 F Married 1/2/2023 Employee 4686 7/21/1980 F 78108 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 3899 EMPLOYEE 1/10/1992 M Married 8/5/2021 Employee 3899 1/10/1992 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 6662 EMPLOYEE 7/17/2000 F Married 8/8/2023 Employee 6662 7/17/2000 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 6662 EMPLOYEE 7/17/2000 F Married 8/8/2023 Child 12/25/2025 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 8286 EMPLOYEE 7/24/1976 F Unknown 8/10/2016 Employee 8286 7/24/1976 F 78148 UNIVERSAL CITY TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 0624 EMPLOYEE 8/18/1979 M Unknown 8/8/2018 Employee 0624 8/18/1979 M 78239 ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4998 EMPLOYEE 1/19/1991 F Married 8/4/2022 Employee 4998 1/19/1991 F 78154 SELMA TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4998 EMPLOYEE 1/19/1991 F Married 8/4/2022 Child 8470 12/29/2009 M 78154 SELMA TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4998 EMPLOYEE 1/19/1991 F Married 8/4/2022 Child 3989 2/25/2014 M 78154 SELMA TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 4998 EMPLOYEE 1/19/1991 F Married 8/4/2022 Child 4517 10/8/2015 F 78154 SELMA TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7806 EMPLOYEE 3/11/1989 F Unknown 9/18/2023 Employee 7806 3/11/1989 F 78233 LIVE OAK TX Aetna Baptist ACO Plan 3 EO 1/1/2026 8/31/2026 $765.56 $72.29 $837.85 8/31/2026 Schertz Cibolo Universal City 7617 EMPLOYEE 5/21/2001 F Unknown 12/19/2023 Employee 7617 5/21/2001 F 78132 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 1221 EMPLOYEE 4/8/2000 F Married 8/4/2022 Employee 1221 4/8/2000 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 0816 EMPLOYEE 6/1/1992 M Unknown 8/4/2025 Employee 0816 6/1/1992 M 78026 JOURDANTON TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5779 EMPLOYEE 3/30/1969 M Unknown 4/1/2024 Employee 5779 3/30/1969 M 78108 Cibolo TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 0042 EMPLOYEE 9/4/1968 M Married 12/22/2025 Employee 0042 9/4/1968 M 78121 LA VERNIA TX Aetna HDHP Plan 1 ES 1/1/2026 $1,058.74 $543.80 $1,602.54 1/29/2026 Schertz Cibolo Universal City 0042 EMPLOYEE 9/4/1968 M Married 12/22/2025 Spouse 8295 6/26/1968 F 78121 LA VERNIA TX Aetna HDHP Plan 1 ES 1/1/2026 $1,058.74 $543.80 $1,602.54 1/29/2026 Schertz Cibolo Universal City 7873 EMPLOYEE 9/8/1971 M Married 1/14/2022 Employee 7873 9/8/1971 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2971 EMPLOYEE 5/1/1988 F Married 8/5/2021 Employee 2971 5/1/1988 F 78108 CIBOLO TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 8538 EMPLOYEE 3/17/1996 F Unknown 7/31/2025 Employee 8538 3/17/1996 F 78155 Seguin TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 7723 EMPLOYEE 1/6/1977 F Married 10/21/2022 Employee 7723 1/6/1977 F 78108 Schertz TX Aetna Baptist ACO Plan 3 FA 1/1/2026 $1,534.24 $1,029.61 $2,563.85 1/29/2026 Schertz Cibolo Universal City 7723 EMPLOYEE 1/6/1977 F Married 10/21/2022 Spouse 4455 10/31/1978 M 78108 Schertz TX Aetna Baptist ACO Plan 3 FA 1/1/2026 $1,534.24 $1,029.61 $2,563.85 1/29/2026 Schertz Cibolo Universal City 7723 EMPLOYEE 1/6/1977 F Married 10/21/2022 Child 1632 12/31/2004 M 78108 Schertz TX Aetna Baptist ACO Plan 3 FA 1/1/2026 $1,534.24 $1,029.61 $2,563.85 1/29/2026 Schertz Cibolo Universal City 7723 EMPLOYEE 1/6/1977 F Married 10/21/2022 Child 7670 1/15/2010 F 78108 Schertz TX Aetna Baptist ACO Plan 3 FA 1/1/2026 $1,534.24 $1,029.61 $2,563.85 1/29/2026 Schertz Cibolo Universal City 6783 EMPLOYEE 11/12/1961 F Married 8/15/2008 Employee 6783 11/12/1961 F 78132 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 ES 1/1/2026 $1,118.54 $568.80 $1,687.34 1/29/2026 Schertz Cibolo Universal City 6783 EMPLOYEE 11/12/1961 F Married 8/15/2008 Spouse 2369 9/17/1962 M 78132 NEW BRAUNFELS TX Aetna Baptist ACO Plan 3 ES 1/1/2026 $1,118.54 $568.80 $1,687.34 1/29/2026 Schertz Cibolo Universal City 0294 EMPLOYEE 5/22/1977 M Married 8/6/2020 Employee 0294 5/22/1977 M 78247 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 0294 EMPLOYEE 5/22/1977 M Married 8/6/2020 Child 8495 9/11/2003 M 78247 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9378 EMPLOYEE 1/22/1970 M Married 8/6/2020 Employee 9378 1/22/1970 M 78108 Cibolo TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 2907 EMPLOYEE 2/11/1985 F Unknown 8/4/2022 Employee 2907 2/11/1985 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5406 EMPLOYEE 4/20/1999 M Unknown 8/4/2025 Employee 5406 4/20/1999 M 78108 Schertz TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 9798 EMPLOYEE 7/18/1985 F Married 8/14/2014 Employee 9798 7/18/1985 F 78232 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 4/13/2026 Schertz Cibolo Universal City 9798 EMPLOYEE 7/18/1985 F Married 8/14/2014 Child 4228 2/25/2018 M 78232 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 3/31/2026 $765.56 $72.29 $837.85 4/13/2026 Schertz Cibolo Universal City 9798 EMPLOYEE 7/18/1985 F Married 8/14/2014 Child 8709 11/27/2020 M 78232 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 3/31/2026 $765.56 $72.29 $837.85 4/13/2026 Schertz Cibolo Universal City 9798 EMPLOYEE 7/18/1985 F Married 8/14/2014 Child 1489 11/27/2020 M 78232 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 3/31/2026 $765.56 $72.29 $837.85 4/13/2026 Schertz Cibolo Universal City 5645 EMPLOYEE 12/8/1983 F Married 8/15/2013 Employee 5645 12/8/1983 F 78124 MARION TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 0651 EMPLOYEE 9/22/1976 F Married 10/26/2023 Employee 0651 9/22/1976 F 78108 CIBOLO TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.30 $795.50 1/29/2026 Schertz Cibolo Universal City 3921 EMPLOYEE 1/17/2004 F Unknown 8/5/2024 Employee 3921 1/17/2004 F 78108 Cibolo TX Aetna Baptist ACO Plan 3 EO 1/1/2026 3/31/2026 $765.56 $72.30 $837.86 3/27/2026 Schertz Cibolo Universal City 4826 EMPLOYEE 4/25/1975 M Unknown 8/8/2019 Employee 4826 4/25/1975 M 78124 Marion TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 3786 EMPLOYEE 4/5/1986 M Married 7/21/2022 Employee 3786 4/5/1986 M 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 6/30/2026 $1,040.08 $368.34 $1,408.42 6/30/2026 Schertz Cibolo Universal City 3786 EMPLOYEE 4/5/1986 M Married 7/21/2022 Child 9292 5/28/2010 M 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 6/30/2026 $1,040.08 $368.34 $1,408.42 6/30/2026 Schertz Cibolo Universal City 3786 EMPLOYEE 4/5/1986 M Married 7/21/2022 Child 0777 2/5/2013 F 78154 Schertz TX Aetna Baptist ACO Plan 3 EC 1/1/2026 6/30/2026 $1,040.08 $368.34 $1,408.42 6/30/2026 Schertz Cibolo Universal City 3447 EMPLOYEE 4/29/1977 F Married 10/30/2023 Employee 3447 4/29/1977 F 78154 SCHERTZ TX Aetna HDHP Plan 1 EO 1/1/2026 8/31/2026 $733.20 $62.29 $795.49 8/31/2026 Schertz Cibolo Universal City 3388 EMPLOYEE 2/2/1992 F Unknown 9/20/2021 Employee 3388 2/2/1992 F 78629 GONZALES TX Aetna Baptist ACO Plan 3 EO 1/1/2026 7/31/2026 $765.56 $72.29 $837.85 7/30/2026 Schertz Cibolo Universal City 2622 EMPLOYEE 5/23/1986 F Unknown 10/15/2024 Employee 2622 5/23/1986 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 2622 EMPLOYEE 5/23/1986 F Unknown 10/15/2024 Child 2684 9/12/2011 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026

Digits

EE Name EE DOB EE Gender

Marital Status

Employee Date Of Hire

Relationship Depende nt SSN - Last 4 Digits

Dep DOB Dep Gender

ZIP City State Enrolled Plan Name Coverage Tier

Effective Date

Termination Date

Employer Monthly Cost

Employee Monthly Cost

Monthly Prem Combined

Application Date

Schertz Cibolo Universal City 2622 EMPLOYEE 5/23/1986 F Unknown 10/15/2024 Child 2225 6/27/2014 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 2622 EMPLOYEE 5/23/1986 F Unknown 10/15/2024 Child 1532 2/2/2017 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 0501 EMPLOYEE 2/2/1990 F Unknown 8/5/2021 Employee 0501 2/2/1990 F 78154 SELMA TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 6283 EMPLOYEE 7/24/1974 M Married 8/7/2006 Employee 6283 7/24/1974 M 78266 San Antonio TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 8037 EMPLOYEE 1/11/2000 M Single 8/4/2025 Employee 8037 1/11/2000 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 8445 EMPLOYEE 12/30/1993 F Married 8/8/2023 Employee 8445 12/30/1993 F 78133 CANYON LAKE TX Aetna Baptist ACO Plan 3 EO 1/1/2026 7/31/2026 $765.56 $72.29 $837.85 7/31/2026 Schertz Cibolo Universal City 3936 EMPLOYEE 8/13/2002 M Married 1/31/2025 Employee 3936 8/13/2002 M 78152 SAINT HEDWIG TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 8415 EMPLOYEE 5/21/1976 M Married 8/16/2012 Employee 8415 5/21/1976 M 78132 New Braunfels TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 4786 EMPLOYEE 6/21/1985 F Married 8/8/2018 Employee 4786 6/21/1985 F 78233 LIVE OAK TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 5177 EMPLOYEE 8/3/1994 M Married 7/17/2023 Employee 5177 8/3/1994 M 78133 CANYON LAKE TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 5177 EMPLOYEE 8/3/1994 M Married 7/17/2023 Child 2794 8/14/2020 M 78133 CANYON LAKE TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 5031 EMPLOYEE 4/5/1988 F Married 8/3/2026 Employee 5031 4/5/1988 F 77657 Lumberton TX Aetna Baptist ACO Plan 3 EO 9/1/2026 $765.56 $72.29 $837.85 8/10/2026 Schertz Cibolo Universal City 5298 EMPLOYEE 12/28/2001 M Married 5/11/2026 Employee 5298 12/28/2001 M 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 ES 6/1/2026 $1,118.54 $568.80 $1,687.34 5/20/2026 Schertz Cibolo Universal City 5298 EMPLOYEE 12/28/2001 M Married 5/11/2026 Spouse 5708 11/11/2002 F 78148 UNIVERSAL CITY TX Aetna Baptist ACO Plan 3 ES 6/1/2026 $1,118.54 $568.80 $1,687.34 5/20/2026 Schertz Cibolo Universal City 0230 EMPLOYEE 6/16/1975 M Married 12/2/2019 Employee 0230 6/16/1975 M 78109 CONVERSE TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 0072 EMPLOYEE 4/7/1983 F Married 2/13/2023 Employee 0072 4/7/1983 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 6878 EMPLOYEE 6/14/1973 F Married 8/4/1998 Employee 6878 6/14/1973 F 78209 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 6878 EMPLOYEE 6/14/1973 F Married 8/4/1998 Child 1877 8/3/2013 F 78209 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9216 EMPLOYEE 1/23/1983 F Married 8/3/2022 Employee 9216 1/23/1983 F 78233 Live Oak TX Aetna HDHP Plan 1 EO 1/1/2026 $733.20 $62.29 $795.49 1/29/2026 Schertz Cibolo Universal City 9586 EMPLOYEE 5/29/1975 F Unknown 8/16/2012 Employee 9586 5/29/1975 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 9586 EMPLOYEE 5/29/1975 F Unknown 8/16/2012 Child 1898 6/12/2012 M 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 5853 EMPLOYEE 2/18/1971 F Married 8/5/2024 Employee 5853 2/18/1971 F 78109 Converse TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 7/16/2026 Schertz Cibolo Universal City 5853 EMPLOYEE 2/18/1971 F Married 8/5/2024 Child 2005 11/5/2004 M 78109 Converse TX Aetna Baptist ACO Plan 3 EC 8/1/2026 $1,040.08 $368.33 $1,408.41 7/16/2026 Schertz Cibolo Universal City 2258 EMPLOYEE 3/21/1973 F Married 7/31/2024 Employee 2258 3/21/1973 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 2258 EMPLOYEE 3/21/1973 F Married 7/31/2024 Child 7850 4/5/2004 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 2258 EMPLOYEE 3/21/1973 F Married 7/31/2024 Child 3078 1/15/2008 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 3860 EMPLOYEE 7/14/1983 F Married 2/12/2018 Employee 3860 7/14/1983 F 78154 SELMA TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 3860 EMPLOYEE 7/14/1983 F Married 2/12/2018 Child 3942 5/3/2013 F 78154 SELMA TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 7851 EMPLOYEE 6/6/1967 F Married 8/22/2011 Employee 7851 6/6/1967 F 78108 CIBOLO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.29 $837.85 1/29/2026 Schertz Cibolo Universal City 0792 EMPLOYEE 12/26/1976 F Unknown 8/3/2026 Employee 0792 12/26/1976 F 78155 SEGUIN TX Aetna Baptist ACO Plan 3 EO 9/1/2026 $765.56 $72.29 $837.85 8/6/2026 Schertz Cibolo Universal City 2799 EMPLOYEE 9/8/1962 F Unknown 10/24/2022 Employee 2799 9/8/1962 F 78244 SAN ANTONIO TX Aetna Baptist ACO Plan 3 EO 1/1/2026 $765.56 $72.30 $837.86 1/29/2026 Schertz Cibolo Universal City 2246 EMPLOYEE 4/28/1981 F Single 8/18/2022 Employee 2246 4/28/1981 F 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 2246 EMPLOYEE 4/28/1981 F Single 8/18/2022 Child 6605 6/4/2003 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 2246 EMPLOYEE 4/28/1981 F Single 8/18/2022 Child 8126 5/8/2008 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.33 $1,408.41 1/29/2026 Schertz Cibolo Universal City 2246 EMPLOYEE 4/28/1981 F Single 8/18/2022 Child 1129 8/14/2009 M 78154 SCHERTZ TX Aetna Baptist ACO Plan 3 EC 1/1/2026 $1,040.08 $368.

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