HomeMy WebLinkAboutInv# 2025-00000696 - FLORIDA MUNICIPAL INSURANCE TRUST - 07/30/2025STATUS COVERAGE TYPEPLAN NAME TIER PREMIUM ADJUSTMENT TOTAL First Name Middle Name Last Name Last Name Total Monthly Premium
BROWN KENNETH R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Kenneth Sean Brown BROWN 732.24 $0.00
BROWN LOUIS R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE LOUIS BROWN BROWN 732.24 $0.00
BRUNNEMER MIKAL R Medical UHC Plan 2 Employee + 1 $1,443.85 $0.00 $1,443.85 TRUE Mikal Brunnemer BRUNNEMER 1443.85 $0.00
CARUSO BRUCE R Medical UHC Plan 2 Employee + 1 $1,443.85 $0.00 $1,443.85 TRUE BRUCE CARUSO CARUSO 1443.85 $0.00
CHANDLER CHRISTOPHER R Medical UHC Plan 2 Employee + Family $2,215.63 $0.00 $2,215.63 TRUE Christopher Chandler CHANDLER 2215.63 $0.00
CONNOLLY ROBERT R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Robert Connolly Connolly 732.24 $0.00
DARA MICHAEL R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Michael Frank Dara DARA 732.24 $0.00
GARCIA GONZALO R Medical UHC Plan 2 Employee + Family $2,215.63 $0.00 $2,215.63 TRUE GONZALO GARCIA GARCIA 2215.63 $0.00
GONZAGA LIVANIA R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Livania Gonzaga GONZAGA 1/1/1902 $0.00
HENG PETER R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Peter Heng HENG 732.24 $0.00
HUSOSKY JOSEPH R Medical UHC Plan 2 Employee + Family $2,215.63 $0.00 $2,215.63 TRUE JOSEPH A HUSOSKY HUSOSKY 2215.63 $0.00
JOHNSON ANTHONY R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE ANTHONY JOHNSON JOHNSON 732.24 $0.00
KENON FLOYD R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE FLOYD KENON KENON 732.24 $0.00
LAVINA ARMENIO R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Armenio Lavina LAVINA 732.24 $0.00
LEXA JOHN R Medical UHC Plan 2 Employee + Family $2,215.63 $0.00 $2,215.63 TRUE JOHN LEXA LEXA 2215.63 $0.00
LIEM BRUCE R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Bruce Liem LIEM 732.24 $0.00
LORBER RICHARD R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Richard Glenn Lorber LORBER 732.24 $0.00
MACE ANGELINA R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Angelina Deloris Mace MACE 732.24 $0.00
MARIANI JENNIFER R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Jennifer E Mariani MARIANI 732.24 $0.00
MCDONALD MARY R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE MARY L MCDONALD MCDONALD 732.24 $0.00
MUSTELIER LISA R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Lisa M Mustelier MUSTELIER 732.24 $0.00
NEAL TODD R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Todd Michael Neal NEAL 732.24 $0.00
PARRA ROBERT R Medical UHC Plan 2 Employee + 1 $1,443.85 $0.00 $1,443.85 TRUE Robert Parra PARRA 1443.85 $0.00
PATTERSON DIANNA R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE DIANNA L PATTERSON PATTERSON 732.24 $0.00
PELLECER SERGIO R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE SERGIO PELLECER PELLECER 732.24 $0.00
PETRUZZELLI JAMES R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE James H Petruzzelli PETRUZZELLI 732.24 $0.00
PHIPPS BRIAN R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Brian Phipps PHIPPS 732.24 $0.00
PLATT WILLIAM R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE William A Platt Platt 732.24 $0.00
QUIGLEY TIMOTHY R Medical UHC Plan 5 Employee Only $632.68 $0.00 $632.68 TRUE Timothy Quigley Quigley 632.68 $0.00
REBOUR JEAN-PAUL R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Jean-Paul Rebour Rebour 732.24 $0.00
REID JAMES R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE James Reid Reid 732.24 $0.00
RIVIERE LETICIA R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Leticia Riviere RIVIERE 732.24 $0.00
ROSE MARY R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 FALSE Terminated
ROSS LUISA R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Luisa P Ross ROSS 732.24 $0.00
RUDBECK BENJAMIN R Medical UHC Plan 2 Employee + Family $2,215.63 $0.00 $2,215.63 TRUE Benjamin Clinton Rudbeck RUDBECK 2215.63 $0.00
SALGADO JOSE R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE JOSE F SALGADO Salgado 732.24 $0.00
SATTERFIELD NICKI R Medical UHC Plan 2 Employee + 1 $1,443.85 $0.00 $1,443.85 TRUE NICKI J SATTERFIELD SATTERFIELD 1443.85 $0.00
SIEB RICHARD R Medical UHC Plan 5 Employee Only $632.68 $0.00 $632.68 TRUE Richard Sieb SIEB 632.68 $0.00
SNELL ARNOLD R Medical UHC Plan 2 Employee + Family $2,215.63 $0.00 $2,215.63 TRUE Arnold J Snell SNELL 2215.63 $0.00
STUBBS DANIEL R Medical UHC Plan 2 Employee + 1 $1,443.85 $0.00 $1,443.85 TRUE DANIEL STUBBS STUBBS 1443.85 $0.00
SULLIVAN DARIN R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Darin Sullivan SULLIVAN 732.24 $0.00
URTECHO JOSE R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE JOSE B URTECHO URTECHO 732.24 $0.00
WALTERS IRISH R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE Irish Gean Walters WALTERS 732.24 $0.00
WENTWORTH JEAN R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE JEAN WENTWORTH WENTWORTH 732.24 $0.00
WILLIAMSON JOHN R Medical UHC Plan 2 Employee Only $732.24 $0.00 $732.24 TRUE John E Williamson WILLIAMSON 732.24 $0.00
45 $0.00 $45,210.07 44,477.83
This was already updated for July - just double check
EMPLOYEE NAME
Invoice Bentek Retiree report