Enrollee Detail Report Print Date Policy Information Policy Number Policy Name Policy Status Enrollee Information - JEFFREY EPSTEIN Original Eff Date Termination Date Termination Reason Relationship Date of Birth Address 1 Address 2 City, State, Zip Home Phone Employee Information - JEFFREY EPSTEIN Social Security # Alternate ID Coverage Information Type MEDICAL DENTAL LIFE 09/08/2015 Last Update Date 04/21/2014 0272605 SOUTHERN TRUST COMPANY ACTIVE Policy Anniversary 11/01 11/01/2002 Status ACTIVE Employee Gender MALE 01/20/1953 6100 RED HOOK QUARTER B-3 ST THOMAS, VI, 00802 (340) 774-1611 “#4 ** 3348 Date of Hire 01/01/2000 854905597 Retirement Date Description Begin Date End Date CHOICE+/INS 05/01/2014 Dental Indemnity-l0016 05/01/2014 Flat Life 05/01/2014 COBRA / State Benefit Continuation Information Effective Date Enrollee Type EFTA00299013