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Home My WebLink AboutInv# 2023-00000718 - FLORIDA MUNICIPAL INSURANCE TRUST - 08/29/2023 (4)STATUS COVERAGE PLAN NAM TIER PREMIUM ADJUSTME TOTAL First Name Middle Name Last Name ANSBRO NOAH R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Noah Blue Ansbro BAKER ERIC R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE ERIC J BAKER BERTUCCIO JOSEPH R Medical Plan 2 Employee + 1 $1,548.08 $0.00 $1,548.08 FALSE 7/1/2023 refunded on August invoice BROWN KENNETH R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Kenneth Sean Brown CARUSO BRUCE R Medical Plan 2 Employee + 1 $1,548.08 $0.00 $1,548.08 TRUE BRUCE CARUSO CHANDLER CHRISTOPHER R Medical Plan 2 Employee + Family $2,375.58 $0.00 $2,375.58 TRUE Christopher Chandler DARA MICHAEL R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Michael Frank Dara GARCIA GONZALO R Medical Plan 2 Employee + Family $2,375.58 $0.00 $2,375.58 TRUE GONZALO GARCIA GONZAGA LIVANIA R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Livania Gonzaga HANSEN DONALD R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 FALSE 7/1/2023 refunded on August invoice HENG PETER R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Peter Heng HUSOSKY JOSEPH R Medical Plan 2 Employee + Family $2,375.58 $0.00 $2,375.58 TRUE JOSEPH A HUSOSKY JOHNSON ANTHONY R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE ANTHONY JOHNSON JOHNSON STANLEY R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE STANLEY JOHNSON KENON FLOYD R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE FLOYD KENON LAVINA ARMENIO R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Armenio Lavina LEXA JOHN R Medical Plan 2 Employee + Family $2,375.58 $0.00 $2,375.58 TRUE JOHN LEXA LIEM BRUCE R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Bruce Liem LORBER RICHARD R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Richard Glenn Lorber MACE ANGELINA R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Angelina Deloris Mace MARIANI JENNIFER R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Jennifer E Mariani MCDONALD MARY R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE MARY L MCDONALD MUSTELIER JR ENRIQUE R Medical Plan 2 Employee + 1 $1,548.08 $0.00 $1,548.08 TRUE ENRIQUE MUSTELIER JR NEAL TODD R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Todd Michael Neal PATTERSON DIANNA R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE DIANNA L PATTERSON PELLECER SERGIO R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE SERGIO PELLECER PHIPPS BRIAN R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Brian Phipps RIVIERE JOSEPH R Medical Plan 2 Employee + 1 $1,548.08 $0.00 $1,548.08 TRUE JOSEPH A RIVIERE RODRIGUEZ JOSE R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Jose Rodriguez ROSE MARY R Medical Plan 2 Employee + 1 $1,548.08 $0.00 $1,548.08 TRUE Mary Rose ROSS LUISA R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Luisa P Ross RUDBECK BENJAMIN R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Benjamin Clinton Rudbeck RUETH PATRICIA R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Patricia Jean Rueth SATTERFIELD NICKI R Medical Plan 2 Employee + 1 $1,548.08 $0.00 $1,548.08 TRUE NICKI J SATTERFIELD SIEB RICHARD R Medical Plan 5 Employee Only $678.35 $0.00 $678.35 TRUE Richard Sieb SLADE CURTIS R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE CURTIS SLADE SMITH MICHAEL R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE MICHAEL W SMITH SNELL ARNOLD R Medical Plan 2 Employee + Family $2,375.58 $0.00 $2,375.58 TRUE Arnold J Snell SOMERS PATRICIA R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Patricia Somers STUBBS DANIEL R Medical Plan 2 Employee + 1 $1,548.08 $0.00 $1,548.08 TRUE DANIEL STUBBS SULLIVAN DARIN R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Darin Sullivan TARMEY LORI R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Lori Ann Tarmey TRAVAGLIO-WILLIAMS CHER R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Cher Travaglio-Williams URTECHO JOSE R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE JOSE B URTECHO WALTERS IRISH R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE Irish Gean Walters WENTWORTH JEAN R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE JEAN WENTWORTH WILLIAMSON JOHN R Medical Plan 2 Employee Only $785.10 $0.00 $785.10 TRUE John E Williamson $50,086.21 $0.00 $50,086.21 EMPLOYEE NAME Invoice Retiree report