MINUTEMAN AGENCY, INC.

PRINT & FAX TO (856) 767-0554

GROUP NAME:

CONTRACT TYPE CODES:

EO = EMPLOYEE ONLY

E/SP = EMPLOYEE & SPOUSE

E/CH = EMPLOYEE & CHILD

E/CHX=EMPLOYEE & CHILDREN

F=FAMILY

STATUS CODES:

ENR = ENROLLING IN PLAN

W=WAIVING COVERAGE W/COVERAGE ELSEWHERE

R=REFUSING COVERAGE W/NO EXISTING COVERAGE

C=COVERED UNDER COBRA

NJC=COVERED UNDER NJ CONTINUATION

CENSUS

	EMPLOYEE NAME	D.O.B. OR AGE	SEX	CONTRACT TYPE	STATUS
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132
133
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135
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137
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141
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143
144
145
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149
150