HomeMy WebLinkAboutInv# 166861582 - Fidelity Security Life Insurance Company - 07/31/2025FULL ROSTER
ROSTER LISTING FOR:The City of Dania Beach
BILLING PERIOD:July, 2025
INVOICE NUMBER:166861582 To view dependent members, please see the Enrollment Report at
eyemed.com/eyemanage
RETRO ADJUSTMENTS LIST
EM Subscriber ID Last Name First Name Plan Start Period Date End Period Date Retro Period Rate Division CodeLocation Code Company Code
35480934600 MURPHY SHAWN Benefit Level 1 06/01/2025 06/30/2025 06/2025 $4.39 Retiree
Total Retro Adjustments for 06/2025 $4.39
Total Retro Adjustments for the Month of July, 2025 $4.39
ROSTER REPORT