COBRA Qualifying event sample Extract

Summary:

Hi

I am writing a extract for benefits Strategies for COBRA Qualifying event. Does anyone have a sample extract that I can use.

If not can someone share what, user entities to use for this interface.

Content (please ensure you mask any confidential information):

sample file that i will be writing looks like this:

[QB],TestClient,TestDivision,,John,,Doe,999-99-1111,,,6039999999,,967 Elm St,,Manchester,NH,03101,,T,,,,,,,M,07/07/1995,Unknown,Unknown,Unknown,,COUPONBOOK,False,True,,,,,,
[QBEVENT],TERMINATION,01/27/2017,01/01/2015,999-99-1111,John Doe,,
[QBPLANINITIAL],HP PPO Medical,EE+FAMILY,
[QBPLANINITIAL],Aetna Dental,EE+SPOUSE,
[QBPLANINITIAL],VSP Vision,EE+SPOUSE,
[QBPLANINITIAL],BSLLC Flexible Spending Account,EE