HomeMy WebLinkAboutInv# Dec2023 - FLORIDA MUNICIPAL INSURANCE TRUST - 12/20/2023 (3)STATUS COVERAGE TYPEPLAN NAMETIER PREMIUM ADJUSTMENT TOTAL First Name Middle Name Last Name Last Name
ANSBRO NOAH R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Noah Blue Ansbro ANSBRO
BAKER ERIC R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE ERIC J BAKER BAKER
BROWN KENNETH R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Kenneth Sean Brown BROWN
BRUNNEMER MIKAL R Medical UHC Plan 2 Employee + 1 $1,529.50 $0.00 $1,529.50 TRUE Mikal Brunnemer BRUNNEMER NEW
CARUSO BRUCE R Medical UHC Plan 2 Employee + Family $2,347.07 $0.00 $2,347.07 TRUE BRUCE CARUSO CARUSO
CHANDLER CHRISTOPHER R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Christopher Chandler CHANDLER
CONNOLLY ROBERT R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Robert Connolly Connolly
DARA MICHAEL R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Michael Frank Dara DARA
FELICETTY MARK R -1551.36 UHC Plan 2 Employee + Family $2,347.07 $0.00 $2,347.07 TRUE FELICETTY Credit for switch to Medicare
GARCIA GONZALO R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE GONZALO GARCIA GARCIA
GONZAGA LIVANIA R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Livania Gonzaga GONZAGA
HENG PETER R Medical UHC Plan 2 Employee + Family $2,347.07 $0.00 $2,347.07 TRUE Peter A Heng HENG
HUSOSKY JOSEPH R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE JOSEPH HUSOSKY HUSOSKY
JOHNSON ANTHONY R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE ANTHONY JOHNSON JOHNSON
KENON FLOYD R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE FLOYD KENON KENON
LAVINA ARMENIO R Medical UHC Plan 2 Employee + Family $2,347.07 $0.00 $2,347.07 TRUE Armenio Lavina LAVINA
LEXA JOHN R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE JOHN LEXA LEXA
LIEM BRUCE R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Bruce Glenn Liem LIEM
LORBER RICHARD R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Richard Deloris Lorber LORBER
MACE ANGELINA R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Angelina E Mace MACE
MARIANI JENNIFER R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Jennifer L Mariani MARIANI
MCDONALD MARY R Medical UHC Plan 2 Employee + 1 $1,529.50 $0.00 $1,529.50 TRUE MARY MCDONALD MCDONALD
MUSTELIER JR. ENRIQUE R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE ENRIQUE Michael MUSTELIER JR MUSTELIER JR.
NEAL TODD R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Todd Neal NEAL
PARRA ROBERT R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Robert L Parra PARRA NEW
PATTERSON DIANNA R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE DIANNA PATTERSON PATTERSON
PELLECER SERGIO R Medical UHC Plan 2 Employee Only $670.21 $678.35 $670.21 TRUE SERGIO PELLECER PELLECER
PHIPPS BRIAN R Medical UHC Plan 2 Employee + 1 $1,529.50 $0.00 $1,529.50 TRUE Brian Phipps PHIPPS
QUIGLEY TIMOTHY R Medical UHC Plan 5 Employee Only $775.68 $0.00 $775.68 TRUE Timothy A Quigley Quigley
RIVIERE JOSEPH R Medical UHC Plan 2 Employee + 1 $1,529.50 $0.00 $1,529.50 TRUE JOSEPH RIVIERE RIVIERE
RODRIGUEZ JOSE R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Jose Rodriguez RODRIGUEZ
ROSE MARY R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Mary P Rose ROSE
ROSS LUISA R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Luisa Clinton Ross ROSS
RUDBECK BENJAMIN R Medical UHC Plan 2 Employee + 1 $1,529.50 $0.00 $1,529.50 TRUE Benjamin Jean Rudbeck RUDBECK
RUETH PATRICIA R Medical UHC Plan 2 Employee Only $670.21 $0.00 $670.21 TRUE Patricia J Rueth RUETH
SATTERFIELD NICKI R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE NICKI SATTERFIELD SATTERFIELD
SIEB RICHARD R Medical UHC Plan 5 Employee Only $775.68 $0.00 $775.68 TRUE Richard Sieb SIEB
SLADE CURTIS R Medical UHC Plan 2 Employee + Family $2,347.07 $0.00 $2,347.07 TRUE CURTIS W SLADE SLADE
SMITH MICHAEL R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE MICHAEL J SMITH SMITH
SNELL ARNOLD R Medical UHC Plan 2 Employee + 1 $1,529.50 $0.00 $1,529.50 TRUE Arnold Snell SNELL
SOMERS PATRICIA R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Patricia Somers SOMERS
STUBBS DANIEL R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE DANIEL STUBBS STUBBS
SULLIVAN DARIN R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Darin Ann Sullivan SULLIVAN
TARMEY LORI R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Lori Tarmey TARMEY
TRAVAGLIO-WILLIAMS CHER R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Cher B Travaglio-WilliamsTRAVAGLIO-WILLIAMS
URTECHO JOSE R Medical UHC Plan 2 Employee Only 775.68 0 $775.68 TRUE JOSE Gean URTECHO URTECHO
WALTERS IRISH R Medical UHC Plan 2 Employee Only $775.68 $0.00 $775.68 TRUE Irish Walters WALTERS
WENTWORTH JEAN R Medical UHC Plan 2 Employee Only $775.68 $775.68 TRUE JEAN E WENTWORTH WENTWORTH
WILLIAMSON JOHN R Medical UHC Plan 2 Employee Only $775.68 $775.68 TRUE John Williamson WILLIAMSON
$50,177.25
EMPLOYEE NAME
Invoice Retiree report