Report Date Plan Year HICN Transaction ID Date of the First FIR in the Series First Failed Transmission Date Last Failed Transmission Date Last Successful Transmission Date Date of Last Transmission Next Scheduled Automated Transmission Date Failed Pre-F Indicator Fail Age Number of Pre-F's for this Series Date of last Pre-F Contract Send Count Sequence Send Count Number of Automated Tries Left Processor Name Contract ID PBP ID BIN PCN Group ID Cardholder ID Date of Birth Reject Code Reject Description Transaction Type LIS Indicator Non-Plan of Record Non-Plan of Record Effective Date Non-Plan of Record Termination Date Plan Of Record Contract ID 1 Contract ID 2 Contract ID 3 Contract ID 4 Contract ID 5 Contract ID 6 Contract ID 7 Contract ID 8 Contract ID 9 Contract ID 10 Contract ID 11 Contract ID 12 Contract ID 13 Contract ID 14 Contract ID 15 Contract ID 16 Gender Current MBI Effective Date MBI Effective Date Termination Date MBI Effective Date Termination Date MBI Effective Date Termination Date MBI Effective Date Termination Date MBI Effective Date Termination Date 20170725 2017 FIRTESTZ1AA 201706125320900102 20170331 20170612 20170612 20170428 20170612 20170727 N 43 0 9 9 15 Unknown A0001 001 010000 PCN FIRTESTZ1AA CARDEA 19390415 52 Unexpected reject code F1 N Y A0001 B0001 1 MBI00009900 20170101 MBI00009902 20160101 20161231 20170725 2017 FIRTESTZ2AA 201706125320900202 20170331 20170612 20170612 20170428 20170612 20170727 N 43 0 9 9 15 Unknown A0001 001 010000 PCN1 FIRTESTZ2AA CARDEA 19390415 52 Unexpected reject code F1 N Y A0001 A0001 1 20170725 2017 FIRTESTZ2AA 201704285316300202 20170331 20170428 20170428 20170421 20170612 20170727 Y 88 3 20170612 6 9 15 Unknown A0001 002 020000 PCN2 FIRTESTZ2AA CARDEB 19390415 52 Unexpected reject code F2 N Y A0001 A0001 1 20170725 2017 FIRTESTZ3AA 201706125320900302 20170331 20170612 20170612 20170428 20170612 20170727 N 43 0 9 9 15 Unknown A0001 001 010000 PCN FIRTESTZ3AA CARDEA 19390415 52 Unexpected reject code F1 N Y A0001 B0001 1 20170725 2017 FIRTESTZ4AA 201706125320900402 20170331 20170612 20170612 20170428 20170612 20170727 N 43 0 9 9 15 Unknown A0001 001 010000 PCN1 FIRTESTZ4AA CARDEA 19390415 52 Unexpected reject code F1 N Y A0001 A0001 1 20170725 2017 FIRTESTZ4AA 201704285316300402 20170331 20170331 20170428 20170612 20170727 Y 116 3 20170612 6 9 15 Unknown A0001 002 020000 PCN2 FIRTESTZ4AA CARDEB 19390415 52 Unexpected reject code F2 N Y A0001 A0001 1 20170725 2017 FIRTESTZ5AA 201706245321900102 20170413 20170420 20170624 20170413 20170624 20170808 N 96 0 8 8 15 Unknown A0001 002 020000 PCN2 FIRTESTZ5AA CARDEB 19390415 52 Unexpected reject code F1 N Y A0001 A0001 1 20170725 2017 FIRTESTZ5AA 201704135310000102 20170413 20170413 20170413 20170624 20170808 Y 103 7 20170624 1 8 15 Unknown A0001 001 010000 PCN1 FIRTESTZ5AA CARDEA 19390415 52 Unexpected reject code F2 N Y A0001 A0001 1