Reconciliation Reason Codes Table
Reconciliation reason codes are used by Agencies to explain the cause of a discrepancy. After an Agency researches a discrepancy, it will enter one of the following codes into CLER to describe the reason the discrepancy occurred. The table below lists reconciliation reason codes for CLER .
Code |
Description |
Explanation |
---|---|---|
501 |
Payroll/Personnel Office Did Not Process 2809 Or 2810 |
Use this code when the 2809, 2810, or Employee Express transaction was not received or not processed by the payroll office. Once the payroll/personnel office has processed the change, it needs to be transmitted to the carrier. |
502 |
Payroll/Personnel Office Did Not Process 2809 Or 2810 Correctly |
Use this code when the 2809, 2810, or Employee Express transaction was created but was either entered into the system incorrectly or was not properly processed by the payroll/personnel office. Once the payroll/personnel office has processed the change, it needs to be transmitted to the carrier. |
520 |
Carrier Did Not Process 2809 Or 2810 |
Use this code when the 2809, 2810, or Employee Express transaction was either not received or not processed by the carrier. The payroll/personnel office should then use CLER to create a 2809/2810 transaction that will be sent to the carrier. The 2809/2810 may be faxed or mailed to the carrier in lieu of using CLER . The 2809/2810 provided to the carrier is a reissue of the initial form. |
521 |
Carrier Did Not Process 2809 Or 2810 Correctly |
Use this code when the 2809, 2810, or Employee Express transaction was not received or processed correctly by the carrier. The payroll/personnel office should then use CLER to create a 2809/2810 transaction that will be sent to the carrier. The 2809/2810 may be faxed or mailed to the carrier in lieu of using CLER . The 2809/2810 provided to the carrier is a reissue of the initial form. |
522 |
Carrier Enrolled Person Without Payroll/Personnel Office Authorization |
The enrollee sent his/her information directly to the carrier (bypassing the personnel office). The carrier should never enroll an individual unless it receives the information from an authorized source, i.e., the payroll/personnel office or Employee Express. In the unlikely event it does happen, the payroll office should work with the personnel office, enrollee, and carrier to get proper enrollment paperwork that it can use to update the payroll office system. |
523 |
Carrier Changed Plan - Enrollee Out Of Service Area |
The enrollee requested a plan that is not allowed for the area in which he/she lives and the carrier automatically switched the enrollee to the correct plan. This should never happen as the carrier should never make enrollment changes unless it receives the information from an authorized source, i.e., the payroll/personnel office or Employee Express. In the unlikely event it does happen, the payroll office should work with the personnel office, enrollee, and carrier to get proper enrollment paperwork that it can use to update the payroll office system. |
524 |
Carrier Changed Option Without Payroll/Personnel Office Authorization |
The enrollee sent his/her information directly to the carrier (bypassing the personnel office) or the carrier automatically changed the option when the enrollee got married or when the last dependent turned 22 years of age. The carrier should never make enrollment changes unless it receives the information from an authorized source, i.e., the payroll/personnel office or Employee Express. In the unlikely event it does happen, the payroll office should work with the personnel office, enrollee, and carrier to get the proper enrollment paperwork that they can use to update the payroll office system. |
525 |
Carrier Rejected SF 2809 - Enrollee Out Of Service Area |
The enrollee requested a plan that is not allowed for the area in which he/she lives so the carrier rejected the enrollment or enrollment change. The payroll office should work with the personnel office and enrollee to get the proper paperwork so that it can update its system and send the enrollment or enrollment change to the carrier. |
526 |
Carrier Terminated Coverage Due To Death Of Enrollee |
This should never happen as the carrier should never make enrollment changes unless it receives the information from an authorized source, i.e., the payroll/personnel office or Employee Express. In the unlikely event it does happen, the payroll office should work with the personnel office, enrollee, and carrier to get proper enrollment paperwork that they can use to update the payroll office system. |
540 |
Enrollee In Unpaid Status - No Deductions For Pay Period |
Some payroll offices only send in records for those enrollees for whom premiums were paid (either by deductions from enrollee pay or by contribution from the enrollees Agency). If an enrollee did not pay that pay period but was truly enrolled, then use this code to indicate why the discrepancy occurred. For this situation, no change would be required to either the payroll office’s records or the carrier’s records. |
541 |
Enrollee Separation Not Submitted Timely |
Use this code if the enrollee’s separation paperwork is not received promptly by the payroll office and is therefore still reported by the payroll/personnel office (and possibly the carrier) as being enrolled. |
542 |
Enrollee Reported Under Two Payroll Offices - Transfer During Pay Period |
Use this code if two different payroll offices or Agencies report an enrollee because that enrollee was transferring-in during the reconciliation pay period. For this situation, no corrective action is required as both payroll offices/Agencies properly reported this enrollee to CLER . |
550 |
Transfer In Not Processed Timely By Gaining Payroll Office |
Use this code when the gaining payroll office has not processed the transfer in for the enrollee’s prior payroll office. Contact the other payroll office so that it can obtain the proper paperwork and update its records. |
551 |
Transfer In Not Processed Timely By OWCP |
Use this code if the carrier reports an enrollee as belonging to your payroll office even though that enrollee should be handled by the Office of Workers Compensation Program (OWCP). |
552 |
Transfer In Not Processed Timely By Gaining Payroll Office |
Use this code if the carrier reports a retiree as still belonging to the enrollee’s prior payroll office. A transfer in to correct both records needs to be processed. |
560 |
Retiree Transfer In Not Processed Timely |
This code should be used when the discrepancy is due solely to the difference in extraction date between the payroll office and carriers (refer to the Payroll Office Enrollment File Layout Specifications for more details). For example, the carriers extract their data on the first of the month and a payroll office that pays biweekly might extract data on the fifth. Between the first and fifth of the month, some enrollees may have dropped or changed coverage while others may have enrolled for the first time. |
570 |
Pseudo SSN Used |
Enrollees are not required to provide their SSN to the carrier so some enrollees provide a fake or pseudo SSN . This can result in a discrepancy unless the payroll office system also sends the pseudo SSN to CLER so that records can be properly matched. Use this code whenever the discrepancy is due to a pseudo SSN . |
580 |
Other - See Comments |
Use this code when no other code is suitable. Comments must be supplied to explain the reconciliation reason. |
590 |
OPM USE ONLY - Multiple Accounts with Shared CSA/CSF number |
Civil Service Retirement Claim (CSA/CSF) number shared by more than one annuitant/survivor. |
591 |
OPM USE ONLY - Enrollee Dropped Due to Death/Suspend Status - PO to investigate |
Enrollment is dropped due to death or because the case is in suspend status - Payroll office will investigate these and notify carrier of the termination effective date. |
See Also |