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nsurance Connector, unless waived from the health insurance requirement based on affordability or individual hardship. For more information call the Connector at 1-877-MA-ENROLL or visit the Connector website (www.mahealthconnector.orq). This plan Is not intended to provide comprehensive health care coverag

Y $15.15 DesalptIon GROCERIES/SUND 07/14/12 ORBITZ MANKATO MN $409.20 UNITED AIRLINES From: To: Carrier. Class: ST THOMAS CYRIL E N.Y. NEWARK INTL A UA N/A YY 00 N/A YY 00 N/A YY 00 Ticket Number: 01670903543131 Date of Departure:07/21 Passenger Name:DERBY/FRANCIS Document Type: PASS

nsurance Connector, unless waived from the health insurance requirement based on affordability or individual hardship. For more information call the Connector at 1-877-MA-ENROLL or visit the Connector website (www.mahealthconnector.orq). This plan is not intended to provide comprehensive health care coverag

5.15 212-737-2850 Description GROCERIES/SONO ORBITZ MANKATO MN $409.20 UNITED AIRLINES From: To: Carrier. Class: ST THOMAS CYRIL E N.Y. NEWARK INTL A UA U N/A YY 00 N/A YY 00 N/A YY 00 Ticket Number: 01 7 1 1 Date of Departure:07/21 Passenger Name: Document Type: PASSENGER TICKET O

nsurance Connector. unless waived from the health insurance requirement based on affordability or individual hardship. For more information call the Connector at 1.977-MA-ENROLL or visit the Connector website (vniov.mahealthconnector.org). This plan is not intended to provide comprehensive health care cover

ing Date 05/25/12 p 13/16 Account Ending 8-42008 Detail Continued Amount 05/22/12 UNITED AIRLINES NEWARK NJ UNITED AIRLINES Front To: N.Y. NEWARK INTL A PARG CHARLES DEG N/A N/A N/A Ticket Number:01629283379356 Passenger Name: /FIRST CLASS PL Document Type: SPECIAL SERVICE TICKET Carrier. Cl

nsurance Connector. unless waived from the health insurance requirement based on affordability or individual hardship. For more information call the Connector at 1.977-MA-ENROLL or visit the Connector website (vnitw.mahealthconnector.orq). This plan is not intended to provide comprehensive health care cover

67.80 05/03/12 ST THOMAS JET CENTERST THOMAS VI 340-777-9177 $1,77336 05/04/12 UNITED AIRLINES HOUSTON TX UNIT ED AIRLINES From: To: N.Y. NEWARK INTL A PALM BEACH INTERNA N/A N/A N/A Ticket Number: Passenger Name: VISOSKIAARRYPMR Document Type: SPECIAL SERVICE TICKET Carrier: Claw UA 00 Y

nsurance Connector, unless waived from the health insurance requirement based on affordability or individual hardship. For more Information call the Connector at 1-871-MA-ENROLL or visit the Connector webslte (ynvw.mahealthconnector.org). This plan rs not intended to provide comprehensive health care covera

te of Departure. 05/24 05/21/12 AMERICAN EXPRESS TVLPHOENIX AZ $3,835.30 UNITED AIRLINES From: To: Carrier. Class: TEL AVIV BEN GURIO N.Y. NEWARK INTL A WA WA WA Ticket Number: 01670624950875 Passenger Name: EPSTEIWJEFFREY E Document Type: PASSENGER TICKET UA YY 00 VY 00 YY 00 Date of De