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Last Name - (Required) Field Instruction

Last Name

Required, alphanumeric, 25 positions maximum

Enter the enrollee's last name.

Note: If the enrollee has a title (e.g., Jr., Sr., I, II, or III) it should be entered after the last name without punctuation.

OR

If the enrollee has only one name, enter that one name in this field.

See Also

Field Descriptions/Instructions

# - Field Description

% (Matching Records) - Field Description

Accepted - Field Description

Action - Field Description

Action Code - Field Instruction

Address - Carrier Field Description

Address - Payroll Office Field Description

Address Line 1 - Carrier Contact Field Description

Address Line 1 - Carrier Field Description

Address Line 1 - Carrier Plan Contact Field Description

Address Line 1 - Coordinator Field Description

Address Line 1 - Enrollee Field Description

Address Line 1 - Enrollee/Survivor Field Description

Address Line 1 - Form 2809 Add (Part A) Field Instruction

Address Line 1 - Form 2809 Add (Part I) Field Instruction

Address Line 1 - Form 2810 Add (Part A) Field Instruction

Address Line 1 - Form 2810 Add (Parts B through F) Field Instruction

Address Line 1 - Payroll Office Contact Field Description

Address Line 1 - Payroll Office Contacts Add Field Instruction

Address Line 1 - Payroll Office Field Description

Address Line 1 - Personnel Office Contact Field Description

Address Line 1 - Personnel Office Contacts Add Field Instruction

Address Line 2 - Carrier Contact Field Description

Address Line 2 - Carrier Field Description

Address Line 2 - Carrier Plan Contact Field Description

Address Line 2 - Coordinator Field Description

Address Line 2 - Enrollee Field Description

Address Line 2 - Enrollee/Survivor Field Description

Address Line 2 - Form 2809 Add (Part A) Field Instruction

Address Line 2 - Form 2809 Add (Part I) Field Instruction

Address Line 2 - Form 2810 Add (Part A) Field Instruction

Address Line 2 - Form 2810 Add (Parts B through F) Field Instruction

Address Line 2 - Payroll Office Contact Field Description

Address Line 2 - Payroll Office Contacts Add Field Instruction

Address Line 2 - Payroll Office Field Description

Address Line 2 - Personnel Office Contact Field Description

Address Line 2 - Personnel Office Contacts Add Field Instruction

Address Line 3 - Carrier Contact Field Description

Address Line 3 - Carrier Field Description

Address Line 3 - Carrier Plan Contact Field Description

Address Line 3 - Coordinator Field Description

Address Line 3 - Enrollee Field Description

Address Line 3 - Enrollee/Survivor Field Description

Address Line 3 - Form 2809 Add (Part A) Field Instruction

Address Line 3 - Form 2809 Add (Part I) Field Instruction

Address Line 3 - Form 2810 Add (Part A) Field Instruction

Address Line 3 - Form 2810 Add (Parts B through F) Field Instruction

Address Line 3 - Payroll Office Contact Field Description

Address Line 3 - Payroll Office Contacts Add Field Instruction

Address Line 3 - Payroll Office Field Description

Address Line 3 - Personnel Office Contact Field Description

Address Line 3 - Personnel Office Contacts Add Field Instruction

Affects - Field Description

Affects Carrier - Field Description

Affects Payroll - Field Description

Agcy Field Description

Agency - Enrollee Field Description

Agency - Enrollee Field Instruction

Agency - Field Instruction

Agency - with Note (No Example) Field Description

Agency ID - Field Description

Agency ID - Field Instruction

Agency Name - Field Description

Agency Name - Form 2809 Add (Part I) Field Instruction

Agency Use - Field Description

Agency Use - Field Instruction

Amount - Field Description

Amount - Field Instruction

Amount - Pay Period Field Description

Amount Received - Field Description

Amount Sent - Field Description

Annuitant Indicator - Field Description

Annuity Claim # - Form 2810 Add (Part A) Field Instruction

Annuity Claim # - Form 2810 View (Part A) Field Description

As of Date - (Required) Field Instruction

As of Date - Carrier Transmissions Field Description

As of Date - Field Description

As of Date for Pay Period Transmission From - Field Instruction

As of Date for Pay Period Transmission To - Field Instruction

As of Date From - (Required) Field Instruction

As of Date From - Field Instruction

As of Date To - (Required) Field Instruction

As of Date To - Field Instruction

Authorized Official - First Name (SF 2809) Field Description

Authorized Official - Initial (SF 2809) Field Description

Authorized Official - Last Name (SF 2809) Field Description

Authorized Official Date Signed - Form 2810 Add (Part H) Field Instruction

Authorized Official Date Signed - Form 2810 View (Part H) Field Description

Authorized Official First Name - Form 2809 Add (Part I) Field Instruction

Authorized Official Initial - Form 2809 Add (Part I) Field Instruction

Authorized Official Last Name - Form 2809 Add (Part I) Field Instruction

Carr - Field Description

Carrier - (Drop-down - Required) Field Instruction

Carrier - (Drop-down) Field Instruction

Carrier - Field Description

Carrier - Field Instruction

Carrier Code - Field Description

Carrier Comments - Field Description

Carrier Comments - Field Instruction

Carrier Eff. Date - Field Description

Carrier Errors - Field Description

Carrier ID - (Carrier Enrollees) Field Instruction

Carrier ID - (Select - Required) Field Instruction

Carrier ID - Field Description

Carrier ID - Field Instruction

Carrier Name - Field Description

Carrier Social Security Number (SSN) - Field Description

Change (#) - Field Description

Change (%) - Field Description

Change Actual - Field Description

Change Password - Field Instruction

Change Percent - Field Description

Check Box to Create Report Without Totals - Field Instruction

City - Carrier Contact Field Description

City - Carrier Field Description

City - Carrier Field Instruction

City - Carrier Plan Contact Field Description

City - Coordinator Field Description

City - Enrollee Field Description

City - Enrollee/Survivor Field Description

City - Form 2809 Add (Part I) Field Instruction

City - Form 2809/2810 Add (Part A) Field Instruction

City - Form 2810 Add (Parts B thru F) Field Instruction

City - Payroll Office Field Description

City - Payroll Office Field Instruction

City - Personnel Office Contact Field Description

City - Personnel Office Contacts Add Field Instruction

Code - (Form 2809 Part A Continued) Field Instruction

Code - Carrier Enrollment Code Field Description

Code - Carrier Transmissions Search Results Field Description

Code - Carrier Transmissions View Field Description

Code - Enrollment Payroll Field Description

Code - Field Description

Code - Form 2809 View (Part A Continued) Field Description

Code - Number Field Description

Code - Payroll Office Transmission Search Results Field Description

Confirmed Errors - Field Description

Contact (Payroll) First Name - Field Description

Contact (Payroll) First Name - Form 2809 Add (Part I) Field Instruction

Contact (Payroll) Initial - Field Description

Contact (Payroll) Initial - Form 2809 Add (Part I) Field Instruction

Contact (Payroll) Last Name - Field Description

Contact (Payroll) Last Name - Form 2809 Add (Part I) Field Instruction

Contact (Payroll) Phone - Field Description

Contact (Payroll) Phone - Form 2809 Add (Part I) Field Instruction

Contact (Personnel) First Name - Field Description

Contact (Personnel) First Name - Form 2809 Add (Part I) Field Instruction

Contact (Personnel) Initial - Field Description

Contact (Personnel) Initial - Form 2809 Add (Part I) Field Instruction

Contact (Personnel) Last Name - Field Description

Contact (Personnel) Last Name - Form 2809 Add (Part I) Field Instruction

Contact (Personnel) Phone - Field Description

Contact (Personnel) Phone - Form 2809 Add (Part I) Field Instruction

Corrective Action (Code) - Field Description

Corrective Action - Field Description

Corrective Action - Field Instruction

Corrective Actions % - Field Description

Corrective Actions Unvalidated - Field Description

Corrective Actions Validated - Field Description

Country - (Payroll Office Contacts Add) Field Instruction

Country - Personnel Office Contacts Add Field Instruction

Cut Off Date - Field Description

Date - Form 2809 Add (Part D) Field Instruction

Date - Form 2809 Update (Part D) Field Instruction

Date - Form 2809 View (Parts C and D) Field Description

Date Due - Field Description

Date of Action - Field Description

Date of Action - Form 2809 Add (Part H) Field Instruction

Date of Birth (Enrollee) - Field Description

Date of Birth (Enrollee/Survivor) - Field Description

Date of Birth - (Form 2809 Part A Continued) Field Instruction

Date of Birth - Form 2809 View (Part A Continued) Field Description

Date of Birth - Form 2809/2810 Add (Part A) Field Instruction

Date of Birth - Form 2810 Add (Parts B thru F) Field Instruction

Date of Death - Field Description

Date of Death - Form 2810 Add (Parts G and H) Field Instruction

Date Processed - (Processed Run) Field Description

Date Processed - Field Description

Date Received - Form 2809 Add (Part I) Field Instruction

Date Received - Form 2809 View (Part I) Field Description

Deceased Annuitant SSN - Field Description

Deceased Annuitant SSN - Field Instruction

Description - (Enrollment) Field Description

Description - (System Codes) Field Description

Discrepancies # - Field Description

Discrepancies % - Field Description

Discrepancies - Field Description

Discrepancies Recon - Field Description

Discrepancy - (Explain/Duplicate - Code 166) Field Description

Discrepancy - (No Note) Field Description

Display - (All Records) Field Instruction

Display - (All) Field Instruction

Display - (Carrier Code) Field Instruction

Display - (Payroll Office Contact) Field Instruction

Display - (Personnel Office Contact) Field Instruction

Display - (System Codes) Field Instruction

Display - Field Instruction

Display - Payroll Office Contact Field Instruction

Display Total Payment Amounts - (Report 13) Field Instruction

Disputed Errors - Field Description

Eff. Date - (Carrier) Field Description

Eff. Date - (Payroll) Field Description

Effective Date - (Action) Field Description

Effective Date - Field Description

Effective Date - Form 2809 View (Part I) Field Instruction

Effective Date - Form 2810 Add Field Instruction

Effective Date of Coverage - Field Description

Effective Date of Coverage - Field Instruction

Email - (Carrier Contact) Field Description

Email - (Carrier Plan Contact) Field Description

Email Address - (Carrier Contact) Field Description

Email Address - (Carrier Plan Contact) Field Description

Email Address - (Payroll Office Contact) Field Description

Email Address - (Payroll Office Contacts Add) Field Instruction

Email Address - (Personnel Office Contact) Field Description

Email Address - (Personnel Office Contact) Field Description

Email Address - (Personnel Office Contacts Add) Field Instruction

Email Date - Field Description

Email Time - Field Description

Employee/Annuitant Indicator - Field Description

Employee/Annuitant Indicator - Field Instruction

End Date - (Carrier Enrollment Code) Field Description

End Date - (Carrier Plan) Field Description

End Date - (Carrier) Field Description

End Date - (Payroll Office) Field Description

Enrollee - (Carrier) Field Description

Enrollee SSN - Field Description

Enrollees (Left/Drop) - Field Description

Enrollees (New/Add) - Field Description

Enrollees - Field Description

Enrollment Changes % - (Added) Field Description

Enrollment Changes % - (Dropped) Field Description

Enrollment Changes Added - Field Description

Enrollment Changes Dropped - Field Description

Enrollment Code - (Drop-down) Field Instruction

Enrollment Code - (Optional) Field Instruction

Enrollment Code - (Required) Field Instruction

Enrollment Code - Field Description

Enrollment Code - Field Instruction

Enrollment ID - Field Description

Enrollment ID - Field Instruction

Error Code - (Select) Field Instruction

Error Threshold - (Carrier) Field Description

Error Threshold - (Payroll Office) Field Description

Errors - Field Description

Errors Reconciled - Field Description

Event That Permits Change - Field Description

Event That Permits Change - Form 2809 (Part D) Field Instruction

Event That Permits Change - Form 2809 Update (Part D) Field Instruction

Explanation - Field Description

Fail Count - Field Description

Fail Count From - Field Instruction

Fail Count To - Field Instruction

Fax Number - (Carrier Contact) Field Description

Fax Number - (Carrier Plan Contact) Field Description

Fax Number - (Payroll Office Contact) Field Description

Fax Number - (Payroll Office Contacts Add) Field Instruction

Fax Number - (Personnel Office Contacts Add) Field Instruction

Fax Number - (Personnel Office Contact) Field Description

First Name - (Enrollee New/Survivor) Field Description

First Name - (Form 2809 Part A Continued) Field Instruction

First Name - (Required) Enrollee Field Instruction

First Name - Enrollee Field Description

First Name - Enrollee Field Instruction

First Name - Form 2809 View (Part A Continued) Field Description

First Name - Form 2810 Add (Part E) Field Instruction

Foreign Country (Carrier Plan Contact) - Field Description

Foreign Country - (Carrier Contact) Field Description

Foreign Country - (Carrier) Field Description

Foreign Country - (Enrollee Point of Contact) Field Description

Foreign Country - (Enrollee) Field Description

Foreign Country - (Enrollee/Survivor) Field Description

Foreign Country - (Payroll Office) Field Description

Foreign Country - (Personnel Office) Field Description

Foreign Country - Form 2809 Add (Part I) Field Instruction

Foreign Country - Form 2809 View (Part A) Field Description

Foreign Country - Form 2809/2810 Add (Part A) Field Instruction

Foreign Country - Form 2810 Add (Parts B thru F) Field Instruction

From (Quarter/Year - Carrier) - Field Description

From (Quarter/Year - Code) - Field Description

From (Quarter/Year) - Field Description

ID - (Payroll Office) Field Description

ID - Field Description

Indicator - Field Description

Initial - (Enrollee New/Survivor) Field Description

Initial - (Form 2809 Part A Continued) Field Instruction

Initial - Field Description

Initial - Field Instruction

Initial - Form 2809 View (Part A Continued) Field Description

Initial - Form 2810 Add (Part E) Field Instruction

Last Carrier Update Date - Field Description

Last Carrier Update ID - Field Description

Last Carrier Update Time - Field Description

Last Changed Date - (Payroll Office) Field Description

Last Changed Date - Field Description

Last Changed ID - (Payroll Office) Field Description

Last Changed ID - Field Description

Last Changed Time - (Payroll Office) Field Description

Last Changed Time - Field Description

Last CL10 Date - Field Description

Last CL10 Time - Field Description

Last CL20 Date - Field Description

Last CL20 Time - Field Description

Last CL30 Date - Field Description

Last CL30 Time - Field Description

Last CL40 Date - Field Instruction

Last CL40 Time - Field Description

Last CL50 Date - Field Description

Last CL50 Time - Field Description

Last CL60 Date - Field Description

Last CL60 Time - Field Description

Last CL70 Date - Field Instruction

Last CL70 Time - Field Description

Last CL70 Date Field Instruction

Last CL80 Date - Field Description

Last CL80 Time - Field Description

Last CL90 Date - Field Description

Last CL90 Time - Field Description

Last Name - (Enrollee/Survivor) Field Description

Last Name - (Form 2809 Part A Continued) Field Instruction

Last Name - Enrollee Field Description

Last Name - Enrollee Field Instruction

Last Name - Form 2809 View (Part A Continued) Field Description

Last Name - Form 2810 Add (Part E) Field Instruction

Last Payroll Update Date - Field Description

Last Payroll Update ID - Field Description

Last Payroll Update Time - Field Description

Last Validate Date - Field Description

Last Validate ID - Field Description

Last Validate Time - Field Description

Married - (Enrollee - Required) Field Instruction

Married - (Enrollee) Field Description

Match - Field Description

Medicare Spouse - (Enrollee) Field Instruction

Medicare Spouse - Field Description

Medicare You - (Enrollee) Field Instruction

Medicare You - Field Description

Middle Name - Enrollee Field Description

Middle Name - Enrollee Field Instruction

Middle Name - Field Instruction

Name - (Carrier Contact) Field Description

Name - (Carrier) Field Instruction

Name - (Payroll Office) Field Description

Name - (Payroll Office) Field Instruction

Name - Carrier Field Description

Name - Carrier Plan Contact Field Description

Name - Enrollee Carrier Field Description

Name - Enrollee Field Description

Name - Enrollee Payroll Field Description

Name - Payroll Office Contact Field Description

Name - Personnel Office Contact Field Description

Name - Personnel Office Contacts Add Field Instruction

Nature of Action - Field Description

Nature of Action - Field Instruction

New Enrollment Code - Field Description

New Enrollment Code - Form 2809 Add (Part C) Field Instruction

New Enrollment Code - Form 2809 Update (Part C) Field Instruction

New Enrollment Code Number - (Survivor Annuitant) Field Description

New Enrollment Code Number - Form 2810 Add (Part F) Field Instruction

New Plan Name - Field Description

New Plan Name - Form 2809 Add (Part C) Field Instruction

New Plan Name - Form 2809 Update (Part C) Field Instruction

Not Received - Field Description

Options - (View Only) Field Description

Options - (View, Activate, Update) Field Description

Options - (View, Activate, Update, Delete) Field Description

Options - (View, List, Add) Field Description

Options - (View, Reconcile) Field Description

Options - (View, Update, Cancel) Field Description

Options - (View, Update, Delete) Field Description

Options - (View, Update, Release) Field Description

Options - (View, Validate) Field Description

Order By - (Agency ID) Field Instruction

Order By - (Carrier - Code Sort) Field Instruction

Order By - (Carrier - Plan Sort) Field Instruction

Order By - (Carrier ID - Type Sort) Field Instruction

Order By - (Carrier, Name, City, State Sorts) Field Instruction

Order By - (ID - Year/Quarter - Pay Cycle) Field Instruction

Order By - (Payroll Office Contact) Field Instruction

Order By - (Payroll Office Contact) Field Instruction

Order By - (Payroll Office Information) Field Instruction

Order By - (Personnel Office Contact) Field Instruction

Order By - (Transmission) Field Instruction

Order By 1st - (Carrier - Action Code) Field Instruction

Order By 1st - (Carrier - Agency) Field Instruction

Order By 1st - (Carrier - Reason Code) Field Instruction

Order By 1st - (Carrier ID) Field Instruction

Order By 1st - (Enrollee) Field Instruction

Order By 1st - (Payroll Office) Field Instruction

Order By 1st - (Report - Name Enrollment Code) Field Instruction

Order By 1st - (Report 12) Field Instruction

Order By 1st - (Report 13) Field Instruction

Order By 2nd - (Carrier - Action Code) Field Instruction

Order By 2nd - (Carrier - Agency) Field Instruction

Order By 2nd - (Carrier ID) Field Instruction

Order By 2nd - (Carrier) Field Instruction

Order By 2nd - (Enrollee) Field Instruction

Order By 2nd - (Payroll Office) Field Instruction

Order By 2nd - (Report - SSNO Enrollment Code) Field Instruction

Order By 2nd - (Report 13) Field Instruction

Order By 2nd - Field Instruction

Order By 3rd - (Carrier - Action Code) Field Instruction

Order By 3rd - (Carrier - Agency) Field Instruction

Order By 3rd - (Carrier ID) Field Instruction

Order By 3rd - (Carrier) Field Instruction

Order By 3rd - (Enrollee) Field Instruction

Order By 3rd - (Payroll Office) Field Instruction

Order By 3rd - (Report - Enrollment Code) Field Instruction

Order By 3rd - (Report 13) Field Instruction

Order By 3rd - Field Instruction

Order By 4th - (Carrier - Action Code) Field Instruction

Order By 4th - (Carrier - Agency) Field Instruction

Order By 4th - (Carrier) Field Instruction

Order By 4th - (Enrollee) Field Instruction

Order By 4th - (Report - Enrollment Code) Field Instruction

Order By 4th - (Report 13) Field Instruction

Order By 4th - Field Instruction

Order By 5th - (Carrier - Action Code) Field Instruction

Order By 5th - (Carrier) Field Instruction

Order By 5th - (Enrollee) Field Instruction

Order By 5th - (Report - Enrollment Code) Field Instruction

Order By 5th - (Report 13) Field Instruction

Order By 5th - Field Instruction

Order By 6th - (Carrier - Action Code) Field Instruction

Order By 6th - (Carrier) Field Instruction

Order By 6th - (Enrollee) Field Instruction

Order By 6th - (Report - Enrollment Code) Field Instruction

Order By 6th - Field Instruction

Order By 7th - Agency Field Instruction

Order By 8th - Agency Field Instruction

Order by 9th - Agency Field Instruction

Other (Name) - Field Description

Other - (Enrollee) Field Instruction

Other - Field Description

Other Carrier ID - Field Description

Other Carrier ID - Field Description

Other ID - Field Description

Other ID From - Field Instruction

Other ID To - Field Instruction

Other Insurance - (Enrollee - Required) Field Instruction

Other Insurance - Field Description

Other Payroll ID - Field Description

Other Payroll ID - Field Instruction

Part B - Termination - Field Description

Part B - Termination - Field Instruction

Part C - Transfer In - Field Description

Part C - Transfer In - Field Instruction

Part D - Reinstatement - Field Description

Part D - Reinstatement - Field Instruction

Part E - Change of Enrollee Information - Field Description

Part E - Change of Enrollee Information - Field Instruction

Part F - Change in Enrollment/Survivor Annuitant - Field Description

Part F - Change in Enrollment/Survivor Annuitant - Field Instruction

Password - Field Instruction

Pay Cycle - (Biweekly, Monthly, Other) Field Description

Pay Cycle - (Optional) Field Instruction

Pay Cycle - (Required) Field Instruction

Pay Cycle - Field Description

Pay Ofc - Field Description

Payroll Office - Field Description

Payroll Office - Field Instruction

Payroll Office Code - Field Description

Payroll Office Comments - Field Description

Payroll Office Comments - Field Instruction

Payroll Office Discrepancy - Field Description

Payroll Office Eff. Date - Field Description

Payroll Office Fail Count - Field Description

Payroll Office ID - (Optional) Field Instruction

Payroll Office ID - (Select - Optional) Field Instruction

Payroll Office ID - (Select - Required) Field Instruction

Payroll Office ID - Field Description

Payroll Office Name - Field Description

Payroll Office Number - Field Description

Payroll Office Payroll ID - Field Description

Percent Discrepancies Reconciled - Field Description

Personnel Office ID - (Optional) Field Instruction

Personnel Office ID - (Required) Field Instruction

Personnel Office ID - Enrollee Field Description

Personnel Office ID - Field Description

Phone - (Carrier Contact) Field Description

Phone - (Enrollee) Field Description

Phone - (Payroll Office Contact) Field Description

Phone - (Personnel Office Contact) Field Description

Phone - Form 2809 (Part H) Field Instruction

Phone Number - (Carrier Plan Contact) Field Description

Phone Number - (Payroll Office Contact) Field Description

Phone Number - (Payroll Office Contacts Add) Field Instruction

Phone Number - (Personnel Office Contact) Field Description

Phone Number - Personnel Office Contacts Add Field Instruction

Plan - (Carrier) Field Description

Plan - Field Instruction

POI - (Personnel Office Contact) Field Description

POI - (Required) Field Instruction

POI - Field Description

POI - Payroll Office Enrollee Field Instruction

POI - With Note Field Description

Policyholder First Name - (Enrollee) Field Instruction

Policyholder First Name - Field Description

Policyholder Initial - (Enrollee) Field Instruction

Policyholder Initial - Field Description

Policyholder Last Name - (Enrollee) Field Instruction

Policyholder Last Name - Field Description

Present Enrollment Code - (Enrollee) Field Description

Present Enrollment Code - Form 2809 Add (Part B) Field Instruction

Present Enrollment Code - Form 2809 Update (Part B) Field Description

Present Plan Name - Field Description

Present Plan Name - Form 2809 Add (Part B) Field Instruction

Present Plan Name - Form 2809 Update (Part B) Field Instruction

Processed Date - Field Description

Processed Time - Field Description

Processing Code - Field Description

Processing Code - Field Instruction

Pseudo SSN - Field Description

Pseudo SSN - Field Instruction

Qtr - Field Description

Quarter - (Error Statistics) Field Description

Quarter - (Quarter Transmission Record) Field Description

Quarter - (Reconciliation 2810 Form) Field Description

Quarter - (Reconciliation Quarter) Field Description

Quarter - (Select - Reconciliation) Field Instruction

Quarter - (Select) Field Instruction

Quarter - Field Description

Quarter - Field Instruction

Quarter - Payroll Office Transmissions Search Results Field Description

Quarter From - Field Instruction

Quarter To - Field Instruction

Reason - Field Description

Reason Code - Field Description

Reason Code - Field Instruction

Reconciliation Action - Field Description

Reconciliation Action - Field Instruction

Reconciliation Date - Field Description

Reconciliation Date From - Field Instruction

Reconciliation Date To - Field Instruction

Reconciliation Fail Count - Field Description

Reconciliation Reason - Field Description

Reconciliation Reason - Field Instruction

Reconciliation Total Records - Field Description

Reconciliation User ID - Field Description

Reconciliation With Errors - Field Description

Reconciliation Without Errors - Field Description

Records - Field Description

Records Processed - Field Description

Records Received - Field Description

Records Reconciled - Field Description

Records Sent - Field Description

Records With Errors - (Payroll Office) Field Description

Records With Warnings - (Payroll Office) Field Description

Region - Field Description

Rejected - Field Description

Release Date - (Form 2809 Search Results) Field Description

Release Date - (Online Entries) Field Description

Released By - Field Description

Released Date - Field Description

Released ID - Field Description

Released Time - Field Description

Remarks - (400 Max) Field Instruction

Remarks - Field Description

Remarks - Field Instruction

Report # - Field Description

Report # - Field Instruction

Response Reminder Date - Field Description

Role - (Carrier Contact) Field Description

Role - (Carrier Plan Contact) Field Description

Role - (Payroll Office Contact) Field Description

Role - (Payroll Office Contacts Add) Field Instruction

Role - (Personnel Office Contact) Field Description

Role - (Personnel Office Contacts Add) Field Instruction

Sex - (Enrollee - Required) Field Instruction

Sex - (Enrollee) Field Description

Sex - (Enrollee/Survivor) Field Description

Sex - (Form 2809 Part A Continued) Field Instruction

Sex - Form 2809 View (Part A Continued) Field Description

Sex - Form 2810 Add (Part E) Field Instruction

Source - Field Description

SSN - (Enrollee) Field Description

SSN - (Enrollee/Survivor) Field Description

SSN - (Form 2809 Part A Continued) Field Instruction

SSN - (Required) Field Instruction

SSN - Field Instruction

SSN - Form 2809 View (Part A Continued) Field Description

SSN - Form 2810 Add (Part E) Field Instruction

SSN From - Field Instruction

SSN To - Field Instruction

Start Date - (Carrier Enrollment Code) Field Description

Start Date - (Carrier Plan) Field Description

Start Date - (Carrier) Field Description

Start Date - (Processed) Field Description

Start Date - Payroll Office Field Description

State - (Carrier Contact) Field Description

State - (Carrier Plan Contact) Field Description

State - (Carrier) Field Description

State - (Carrier) Field Instruction

State - (Coordinator) Field Description

State - (Enrollee) Field Description

State - (Enrollee) Field Instruction

State - (Enrollee/Survivor) Field Description

State - (Payroll Office) Field Instruction

State - (Personnel Office Contact) Field Description

State - Form 2809 Add (Part I) Field Instruction

State - Payroll Office Field Description

State - Personnel Office Contacts Add Field Instruction

Status - (Active/Inactive) Field Description

Status - (Payroll Office Contacts) Search Results Field Description

Status - (Payroll Office Errors) View Field Description

Status - (Processed, Canceled, Released, Not Released) Field Description

Status - (Transmission Carrier) Field Description

Status - (Transmission Payroll Office) Field Description

Submission - (Number) Field Description

Submission - (Payroll Office Enrollees) Reconcile Field Description

Submission - Field Description

Submission Date - (Carrier Transmissions) Search Results Field Description

Submission Date - (Carrier) Field Description

Submission Date - (Payroll) Field Description

Submission Date - Field Description

Submission Reminder Date - Field Description

Submitter Use #1 - Field Description

Submitter Use #1 - Field Description

Submitter Use #2 - Field Description

Submitter Use #2 - Field Instruction

Submitter Use #3 - Field Description

Submitter Use #3 - Field Instruction

Survivor Annuity Claim # - Field Description

Survivor Annuity Claim # - Field Instruction

Threshold Type - (Payroll Office) Field Description

Threshold Type - Field Description

Time Processed - (Process Run) Field Description

Time Processed - Field Description

To (Quarter/Year - Carrier) - Field Description

To (Quarter/Year - Code) - Field Description

To (Quarter/Year) - Field Description

Total - (Reconciliation Action Codes) Field Description

Total - (Reconciliation Reason Codes) Field Description

Total - (Transmission Records) Field Description

Total Discrepancies Found - Field Description

Total Discrepancies Reconciled - Field Description

Total Enrollee Records - Field Description

Total Errors - (Total Field) Field Description

Total Errors - Field Description

Total Matches Found - Field Description

Total Records - (Enrollee) Field Description

Total Records - (Records) Field Description

Total Warnings - Field Description

Transmission File Name - (Payroll Office) Field Description

Transmission Type - (Optional) Field Instruction

Transmission Type - (Required) Field Instruction

Transmission Type - Field Description

Transmissions - Field Instruction

TRICARE/CHAMPUS - (Enrollee) Field Instruction

TRICARE/CHAMPUS - Field Description

Type - (Carrier Contact) Field Description

Type - (Carrier Contact) Field Instruction

Type - (Carrier Plan Contact) Field Description

Type - (Payroll Office Contact) Field Description

Type - (Payroll Office Contact) Field Instruction

Type - (Payroll Office Contacts Add) Field Instruction

Type - (Personnel Office Contact - Optional) Field Instruction

Type - (Personnel Office Contact) Field Description

Type - Personnel Office Contacts Field Instruction

Type - Personnel Office Contacts Search Results Field Description

Unrecon - Field Description

User ID - (Form) Field Instruction

User ID - (Reconciliation) Field Description

User ID - (Report) Field Instruction

Validation - Field Description

Validation Date - Field Description

Validation Date From - Field Instruction

Validation Date To - Field Instruction

Warning Code - (Select) Field Instruction

Warnings - Field Description

Whld Amt - Field Description

Year - (Error Statistics) Field Description

Year - (Payroll Office Enrollees) Search Results Field Description

Year - (Reconciliation Year for Transmission Record) Field Instruction

Year - (Reconciliation Year) Field Description

Year - (Reconciliation) 2810 Form Field Description

Year - (Required) Field Instruction

Year - (Transmission Year Record) Field Description

Year - Field Description

Year - Field Instruction

Year From - (Range - Required) Field Instruction

Year To - (Range - Required) Field Instruction

Year/Quarter - Field Description

Year/Quarter From - Field Description

Year/Quarter To - Field Description

ZIP - (Carrier Contact) Field Description

ZIP - (Carrier Plan Contact) Field Description

ZIP - (Carrier) Field Description

ZIP - (Coordinator) Field Description

ZIP - (Coordinator) Field Instruction

ZIP - (Enrollee) Field Description

ZIP - (Enrollee) Field Description

ZIP - (Enrollee/Survivor) Field Description

Zip - (Form 2809 Part A Continued) Field Instruction

ZIP - (Payroll Office Contacts Add) Field Instruction

ZIP - (Personnel Office Contact) Field Description

ZIP - Personnel Office Contacts Add Field Instruction

ZIP - Form 2809 View (Part A Continued) Field Description

ZIP - Payroll Office Field Description