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# (Online Entry) Field Instructions # (System Generated) Field Instructions % (System Generated) Percentage of Discrepancies/Reconciliation Field Instructions % (System Generated) Percentage of Reconciled Discrepancies Field Instructions % (System Generated) Percentage of Matching Records Field Instructions Accepted (System Generated) Field Instructions Action (System Generated) Field Instructions Address (System Generated) Carrier Field Instructions Address (System Generated) Payroll Office Field Instructions Address 1 (System Generated) Personnel Office Contact Field Instructions Address Line 1 (2810) Field Instructions Address Line 1 (Carrier Plan Contact) Field Instructions Address Line 1 (Carrier) Field Instructions Address Line 1 (Enrollee) Field Instructions Address Line 1 (New) Field Instructions Address Line 1 (Payroll Contact) Field Instructions Address Line 1 (Payroll Office) Field Instructions Address Line 1 (Personnel Office Contact) Field Instructions Address Line 1 (System Generated) Carrier Contact Field Instructions Address Line 1 (System Generated) Carrier Field Instructions Address Line 1 (System Generated) Carrier Plan Contact Field Instructions Address Line 1 (System Generated) Enrollee Field Instructions Address Line 1 (System Generated) Field Instructions Address Line 1 (System Generated) Payroll Contact Field Instructions Address Line 1 (System Generated) Payroll Office Field Instructions Address Line 1 Field Instructions Address Line 1* (Enrollee) Field Instructions Address Line 1* Field Instructions Address Line 2 (2810) Field Instructions Address Line 2 (Carrier Plan Contact) Field Instructions Address Line 2 (Carrier) Field Instructions Address Line 2 (Enrollee) Field Instructions Address Line 2 (New) Field Instructions Address Line 2 (Payroll Contact) Field Instructions Address Line 2 (Payroll Office) Field Instructions Address Line 2 (Personnel Office Contact) Field Instructions Address Line 2 (System Generated) Carrier Contact Field Instructions Address Line 2 (System Generated) Carrier Field Instructions Address Line 2 (System Generated) Carrier Plan Contact Field Instructions Address Line 2 (System Generated) Enrollee Field Instructions Address Line 2 (System Generated) Field Instructions Address Line 2 (System Generated) Payroll Contact Field Instructions Address Line 2 (System Generated) Payroll Office Field Instructions Address Line 2 (System Generated) Personnel Office Contact Field instructions Address Line 2 Field Instructions Address Line 2* (Enrollee) Field Instructions Address Line 2* Field Instructions Address Line 3 (2810) Field Instructions Address Line 3 (Carrier Plan Contact) Field Instructions Address Line 3 (Carrier) Field Instructions Address Line 3 (Enrollee) Field Instructions Address Line 3 (New) Field Instructions Address Line 3 (Payroll Contact) Field Instructions Address Line 3 (Payroll Office) Field Instructions Address Line 3 (Personnel Office Contact) Field instructions Address Line 3 (System Generated) Carrier Contact Field Instructions Address Line 3 (System Generated) Carrier Field Instructions Address Line 3 (System Generated) Carrier Plan Contact Field Instructions Address Line 3 (System Generated) Enrollee Field Instructions Address Line 3 (System Generated) Field Instructions Address Line 3 (System Generated) Payroll Contact Field Instructions Address Line 3 (System Generated) Payroll Office Field Instructions Address Line 3 (System Generated) Personnel Office Contact Field Instructions Address Line 3 Field Instructions Address Line 3* (Enrollee) Field Instructions Address Line 3* Field Instructions Affects (System Generated) Field Instructions Affects Carrier (System Generated) Field Instructions Affects Carrier Field Instructions Affects Payroll (System Generated) Field Instructions Affects Payroll Field Instructions Affects* Field Instructions Agcy (System Generated) Field Instructions Agency (System Generated) Field Instructions Agency (System Generated) Reports Field Instructions Agency Field Instructions Agency ID (System Generated) Field Instructions Agency ID Field Instructions Agency Name (System Generated) Field Instructions Agency Name* Field Instructions Agency Use (System Generated) Field Instructions Agency Use Field Instructions Agency* Field Instructions Amount (System Generated) Field Instructions Amount Field Instructions Amount Received (System Generated) Field Instructions Amt Received Field Instructions Amount Sent (System Generated) Field Instructions Amt Sent Field Instructions Annuity Claim # (System Generated) Field Instructions Annuity Claim # Field Instructions As of Date (System Generated) Field Instructions As of Date (System Generated) Payroll Office Field Instructions As of Date for Pay Period Transmission: From Field Instructions As of Date for Pay Period Transmission: To Field Instructions As of Date From Field Instructions As of Date To Field Instructions As of Date* (Drop-Down) Field Instructions As of Date* (PP Schedule) Field Instructions As of Date* (Transmission) Field Instructions Authorized Official Date (System Generated) Field Instructions Authorized Official Date Field Instructions Authorized Official First Name (2810) Field Instructions Authorized Official First Name (System Generated) 2809 Field Instructions Authorized Official First Name (System Generated) 2810 Field Instructions Authorized Official First Name Field Instructions Authorized Official Initial (2810) Field Instructions Authorized Official Initial (System Generated) 2809 Field Instructions Authorized Official Initial (System Generated) 2810 Field Instructions Authorized Official Initial Field Instructions Authorized Official Last Name (2810) Field Instructions Authorized Official Last Name (System Generated) 2809 Field Instructions Authorized Official Last Name (System Generated) 2810 Field Instructions Authorized Official Last Name* Field Instructions Authorized Official Phone (System Generated) Field Instructions Authorized Official Phone Field Instructions Banner Message Field Instructions Cancel Enrollment For Reasons Other Than Above (System Generated) Field Instructions Cancel Enrollment For Reasons Other Than Above Field Instructions Carrier (Drop-Down) Field Instructions Carrier (Enrollee) Field Instructions Carrier (Identification Code) Field Instructions Carrier (Organization Carrier Drop-Down) Field Instructions Carrier (System Generated) Field Instructions Carrier (System Generated) Identification Code Field Instructions Carrier Comments (System Generated) Field Instructions Carrier Errors (System Generated) Field Instructions Carrier Field Instructions Carrier ID (Contact Record) Field Instructions Carrier ID (Drop-Down) Field Instructions Carrier ID (System Generated) Field Instructions Carrier ID Field Instructions Carrier ID* (Carrier Discrepancy) Field Instructions Carrier ID* (Carrier Validation) Field Instructions Carrier Total Field Instructions Carrier* (Drop-Down) Field Instructions Carrier* Field Instructions Change (#) (System Generated) Field Instructions Change (%) (System Generated) Field Instructions Change Actual (System Generated) Field Instructions Change Percentage (System Generated) Field Instructions Check Box To Create Report Without Totals Field Instructions City (2810) Field Instructions City (Carrier Contact) Field Instructions City (Carrier Plan Contact) Field Instructions City (Carrier) Field Instructions City (New) Field Instructions City (Payroll Contact) Field Instructions City (Payroll Office) Field Instructions City (Personnel Office Contact) Field Instructions City (System Generated) Payroll Office Field Instructions City (System Generated) Carrier Contact Field Instructions City (System Generated) Carrier Field Instructions City (System Generated) Carrier Plan Field Instructions City (System Generated) Employing Contact Field Instructions City (System Generated) Enrollee Field Instructions City (System Generated) Personnel Contact Office Field Instructions City* (Employing Contact) Field Instructions City* (Enrollee) Field Instructions Claim # (System Generated) Field Instructions Claim # Field Instructions Code (System Code) Field Instructions Code (System Generated) Carrier Field Instructions Code (System Generated) Field Instructions Code (System Generated) Reports Field Instructions Code (System Generated) Search Results Field Instructions Code (System Generated) System Codes Field Instructions Code (System Generated) Transmissions Field Instructions Code Line 1 (System Generated) Field Instructions Code Line 1 Field Instructions Code Line 10 (System Generated) Field Instructions Code Line 10 Field Instructions Code Line 2 (System Generated) Field Instructions Code Line 2 Field Instructions Code Line 3 (System Generated) Field Instructions Code Line 3 Field Instructions Code Line 4 (System Generated) Field Instructions Code Line 4 Field Instructions Code Line 5 (System Generated) Field Instructions Code Line 5 Field Instructions Code Line 6 (System Generated) Field Instructions Code Line 6 Field Instructions Code Line 7 (System Generated) Field Instructions Code Line 7 Field Instructions Code Line 8 (System Generated) Field Instructions Code Line 8 Field Instructions Code Line 9 (System Generated) Field Instructions Code Line 9 Field Instructions Code* Field Instructions Code-Total Field Instructions Confirmed Errors (System Generated) Field Instructions Contact (Payroll) First Name (System Generated) Field Instructions Contact (Payroll) First Name Field Instructions Contact (Payroll) Initial (System Generated) Field Instructions Contact (Payroll) Initial Field Instructions Contact (Payroll) Last Name (System Generated) Field Instructions Contact (Payroll) Last Name* Field Instructions Contact (Payroll) Phone (System Generated) Field Instructions Contact (Payroll) Phone Field Instructions Contact (Personnel) First Name (System Generated) Field Instructions Contact (Personnel) First Name Field Instructions Contact (Personnel) Initial (System Generated) Field instructions Contact (Personnel) Initial Field Instructions Contact (Personnel) Last Name (System Generated) Field Instructions Contact (Personnel) Last Name* Field Instructions Contact (Personnel) Phone (System Generated) Field Instructions Contact (Personnel) Phone Field Instructions Corrective Action (System Generated) Carrier Validation Field Instructions Corrective Action (System Generated) Field Instructions Country (2810) Field Instructions Country (Carrier) Field Instructions Country (Employing Contact) Field Instructions Country (Enrollee) Field Instructions Country (New) Field Instructions Country (Payroll Contact) Field Instructions Country (Payroll Office) Field Instructions Country (Personnel Contact) Field Instructions Country (System Generated) Employing Contact Field Instructions Country (System Generated) Enrollee Field Instructions Cut Off Date (System Generated) Field Instructions Cut Off Date* Field Instructions Date (System Generated) Field Instructions Date Due (System Generated) Field Instructions Date Field Instructions Date of Action (System Generated) Field Instructions Date of Action* Field Instructions Date of Birth (2810) Field Instructions Date of Birth (Annuitant) Field Instructions Date of Birth (Enrollee) Field Instructions Date of Birth (System Generated) Field Instructions Date of Birth Line 1 (System Generated) Field Instructions Date of Birth Line 1 Field Instructions Date of Birth Line 10 (System Generated) Field Instructions Date of Birth Line 10 Field Instructions Date of Birth Line 2 (System Generated) Field Instructions Date of Birth Line 2 Field Instructions Date of Birth Line 3 (System Generated) Field Instructions Date of Birth Line 3 Field Instructions Date of Birth Line 4 (System Generated) Field Instructions Date of Birth Line 4 Field Instructions Date of Birth Line 5 (System Generated) Field Instructions Date of Birth Line 5 Field Instructions Date of Birth Line 6 (System Generated) Field Instructions Date of Birth Line 6 Field Instructions Date of Birth Line 7 (System Generated) Field Instructions Date of Birth Line 7 Field Instructions Date of Birth Line 8 (System Generated) Field Instructions Date of Birth Line 8 Field Instructions Date of Birth Line 9 (System Generated) Field Instructions Date of Birth Line 9 Field Instructions Date of Birth* (Enrollee) Field Instructions Date of Death (System Generated) Field Instructions Date of Death Field Instructions Date Processed (System Generated) Field Instructions Date Processed (System Generated) Transmissions Field Instructions Date Received (System Generated) Field Instructions Date Received* Field Instructions Date Signed (System Generated) Field Instructions Date Signed Field Instructions Deceased Annuitant SSN (System Generated) Field Instructions Deceased Annuitant SSN Field Instructions Description (System Generated) Enrollment Record Field Instructions Description (System Generated) Field Instructions Description* Field Instructions Discrepancies (System Generated) Search Field Instructions Discrepancy (System Generated) Discrepancy Listing Field Instructions Discrepancy (System Generated) View Field Instructions Display (Carrier Enrollees) Field Instructions Display (Forms) Field Instructions Display (Payroll Discrepancy Listing) Field Instructions Display (System Codes) Field Instructions Display Field Instructions Disputed Errors (System Generated) Field Instructions Eff. Date (System Generated) Reports Field Instructions Effective Date ( System Generated) 2809 Field Instructions Effective Date (System Generated) Field Instructions Effective Date Field Instructions Effective Date of Coverage Field Instructions Effective Date* Field Instructions Email (System Generated) Carrier Contact Field Instructions Email (System Generated) Carrier Plan Contact Field Instructions Email Address (Carrier Contact) Field Instructions Email Address (Carrier Plan Contact) Field Instructions Email Address (Payroll Contact) Field Instructions Email Address (Personnel Contact) Field Instructions Email Address (System Generated) Carrier Contact Field Instructions Email Address (System Generated) Carrier Plan Contact Field Instructions Email Address (System Generated) Payroll Contact Field Instructions Email Address (System Generated) Personnel Office Field Instructions Email Date (System Generated) Transmissions Field Instructions Email Time (System Generated) Transmissions Field Instructions Employee/Annuitant Indicator Field instructions Employee/Annuitant Indicator (System Generated) Field Instructions End Date (Drop-Down Carrier Enrollment) Field Instructions End Date (Drop-Down Carrier Plan) Field Instructions End Date (Payroll Office) Field Instructions End Date (System Generated) Carrier Enrollment Code Field Instructions End Date (System Generated) Carrier Field Instructions End Date (System Generated) Field Instructions End Date* (Carrier) Field Instructions End Date* Field Instructions Enrolled in a Medicare Managed Care Plan (System Generated) Field Instructions Enrolled In a Medicare Managed Care Plan Field Instructions Enrollee (System Generated) Field Instructions Enrollee SSN (System Generated) Field Instructions Enrollees (Left/Drop) (System Generated) Field Instructions Enrollees (New/Add) (System Generated) Field Instructions Enrollees (System Generated) Reconciliation Summary Field Instructions Enrollment Changes % Added (System Generated) Field Instructions Enrollment Changes % Dropped (System Generated) Field Instructions Enrollment Changes Added (System Generated) Field Instructions Enrollment Changes Dropped (System Generated) Field Instructions Enrollment Code (Drop-Down) Field Instructions Enrollment Code (Forms) Field Instructions Enrollment Code (System Generated) Field Instructions Enrollment Code (System Generated) Forms Field Instructions Enrollment Code Field Instructions Enrollment Code* (2810) Field Instructions Enrollment Code* Field Instructions Enrollment ID (System Generated) Field Instructions Enrollment ID Field Instructions Error Code (Drop-Down) Field Instructions Error Code Field Instructions Error Threshold (System Generated) Field Instructions Error Threshold Field Instructions Errors (System Generated) Field Instructions Errors Reconciled (System Generated) Field Instructions Event That Permits Change (System Generated) Field Instructions Event That Permits Change Field Instructions Explanation (System Generated) Field Instructions Explanation Field Instructions Fail Count (Discrepancy and Reconciliation Reports) Field Instructions Fail Count (System Generated) Field Instructions Fail Count From Field Instructions Fail Count To Field Instructions Fax Number (Carrier Contact) Field Instructions Fax Number (Carrier Plan Contact) Field Instructions Fax Number (Payroll Contact) Field Instructions Fax Number (Personnel Contact) Field Instructions Fax Number (Personnel Office Contact) Field Instructions Fax Number (System Generated) Carrier Contact Field Instructions Fax Number (System Generated) Carrier Plan Contact Field Instructions Fax Number (System Generated) Payroll Office Contact Field Instructions First Name (2809) Field Instructions First Name (2810) Field Instructions First Name (Forms) Field Instructions First Name (New) Field Instructions First Name (System Generated) 2809 Field Instructions First Name (System Generated) Field Instructions First Name Field Instructions First Name Line 1 (System Generated) Field Instructions First Name Line 1 Field Instructions First Name Line 10 (System Generated) Field Instructions First Name Line 10 Field Instructions First Name Line 2 (System Generated) Field Instructions First Name Line 2 Field Instructions First Name Line 3 (System Generated) Field Instructions First Name Line 3 Field Instructions First Name Line 4 (System Generated) Field Instructions First Name Line 4 Field Instructions First Name Line 5 (System Generated) Field Instructions First Name Line 5 Field instructions First Name Line 6 (System Generated) Field Instructions First Name Line 6 Field Instructions First Name Line 7 (System Generated) Field Instructions First Name Line 7 Field Instructions First Name Line 8 (System Generated) Field Instructions First Name Line 8 Field Instructions First Name Line 9 (System Generated) Field Instructions First Name Line 9 Field Instructions First Name* Field Instructions Foreign Country (Carrier Contact Drop-Down) Field Instructions Foreign Country (Carrier Plan Contact Drop-Down) Field Instructions Foreign Country (Employing Contact) Field Instructions Foreign Country (New) Field Instructions Foreign Country (Payroll Office Contact) Field Instructions Foreign Country (Personnel Office Contact) Field Instructions Foreign Country (System Generated) Carrier Contact Field Instructions Foreign Country (System Generated) Carrier Field Instructions Foreign Country (System Generated) Carrier Plan Contact Field Instructions Foreign Country (System Generated) Employing Contact Field Instructions Foreign Country (System Generated) Payroll Office Field Instructions Foreign Country (System Generated) Personnel Office Contact Field Instructions Foreign Country Field Instructions Foreign Country(System Generated) Payroll Office Contact Field Instructions From (System Generated) Quarter/Year Field Instructions Grand-Total (System Generated) Field Instructions HB ID# (System Generated) Field Instructions HB ID# Field Instructions ID (System Generated) Field Instructions Indicator (System Generated) Field Instructions Initial (2810) Field Instructions Initial (Forms) Field Instructions Initial (New) Field Instructions Initial (System Generated) 2809 Field Instructions Initial (System Generated) Field Instructions Initial Field Instructions Initial Line 1 (System Generated) Field Instructions Initial Line 1 Field Instructions Initial Line 10 (System Generated) Field Instructions Initial Line 10 Field Instructions Initial Line 2 (System Generated) Field Instructions Initial Line 2 Field instructions Initial Line 3 (System Generated) Field Instructions Initial Line 3 Field Instructions Initial Line 4 (System Generated) Field Instructions Initial Line 4 Field Instructions Initial Line 5 (System Generated) Field Instructions Initial Line 5 Field Instructions Initial Line 6 (System Generated) Field Instructions Initial Line 6 Field Instructions Initial Line 7 (System Generated) Field Instructions Initial Line 7 Field Instructions Initial Line 8 (System Generated) Field Instructions Initial Line 8 Field Instructions Initial Line 9 (System Generated) Field Instructions Initial Line 9 Field Instructions Last Carrier Update Date (System Generated) Field Instructions Last Carrier Update ID (System Generated) Field Instructions Last Carrier Update Time (System Generated) Field Instructions Last Changed Date (System Generated) Field Instructions Last Changed ID (System Generated) Field Instructions Last Changed Time (System Generated) Field Instructions Last CL10 Date (System Generated) Field Instructions Last CL10 Time (System Generated) Field Instructions Last CL20 Date (System Generated) Field Instructions Last CL20 Time (System Generated) Field Instructions Last CL30 Date (System Generated) Field Instructions Last CL30 Time (System Generated) Field Instructions Last CL40 Date (System Generated) Field Instructions Last CL40 Time (System Generated) Field Instructions Last CL50 Date Field Instructions Last CL50 Time Field Instructions Last CL60 Date (System Generated) Field Instructions Last CL60 Time (System Generated) Field Instructions Last CL70 Date Field Instructions Last CL70 Time Field Instructions Last CL80 Date (System Generated) Field Instructions Last CL80 Time (System Generated) Field Instructions Last CL90 Date (System Generated) Field Instructions Last CL90 Time (System Generated) Field Instructions Last Name (2810) Field Instructions Last Name (Forms) Field Instructions Last Name (New) Field Instructions Last Name (System Generated) 2809 Field Instructions Last Name (System Generated) Field Instructions Last Name Field Instructions Last Name Line 1 (System Generated) Field Instructions Last Name Line 1 Field Instructions Last Name Line 10 (System Generated) Field Instructions Last Name Line 10 Field Instructions Last Name Line 2 (System Generated) Field Instructions Last Name Line 2 Field Instructions Last Name Line 3 (System Generated) Field Instructions Last Name Line 3 Field Instructions Last Name Line 4 (System Generated) Field Instructions Last Name Line 4 Field Instructions Last Name Line 5 (System Generated) Field Instructions Last Name Line 5 Field Instructions Last Name Line 6 (System Generated) Field Instructions Last Name Line 6 Field Instructions Last Name Line 7 (System Generated) Field Instructions Last Name Line 7 Field Instructions Last Name Line 8 (System Generated) Field Instructions Last Name Line 8 Field Instructions Last Name Line 9 (System Generated) Field Instructions Last Name Line 9 Field Instructions Last Name* (Forms) Field Instructions Last Name* Field Instructions Last Payroll Update Date (System Generated) Field Instructions Last Payroll Update ID (System Generated) Field Instructions Last Payroll Update Time (System Generated) Field Instructions Last Validate Date (System Generated) Field Instructions Last Validate ID (System Generated) Field Instructions Last Validate Time (System Generated) Field Instructions Married (System Generated) Field Instructions Married Field Instructions Married* (Enrollee) Field Instructions Match (System Generated) Field Instructions Medicare Spouse (System Generated) Field Instructions Medicare Spouse Field Instructions Medicare You (System Generated) Field Instructions Medicare You Field Instructions Middle Name (System Generated) Field Instructions Middle Name Field Instructions Name (Carrier Contact) Field Instructions Name (Carrier Plan Contact) Field Instructions Name (Carrier) Field Instructions Name (Other) (System Generated) Field Instructions Name (Other) Field Instructions Name (Payroll Office Contact) Field Instructions Name (Payroll Office) Field Instructions Name (Personnel Office) Field Instructions Name (System Generated) Carrier Contact Field Instructions Name (System Generated) Carrier Field Instructions Name (System Generated) Carrier Plan Contact Field Instructions Name (System Generated) Payroll Office Contact Field Instructions Name (System Generated) Payroll Office Field Instructions Name (System Generated) Personnel Office Field Instructions Name (System Generated) Reports Field Instructions Nature of Action (System Generated) Field Instructions Nature of Action* (Forms) Field Instructions New Enrollment Code (System Generated) Field Instructions New Enrollment Code Field Instructions New Enrollment Code Number (System Generated) Field Instructions New Enrollment Code Number Field Instructions New Plan Name (System Generated) Field Instructions New Plan Name Field Instructions Not Received (System Generated) Field Instructions Order By (Agency) Field Instructions Order By (Carrier Code) Field Instructions Order By (Carrier Contacts) Field Instructions Order By (Carrier Error Page) Field Instructions Order By (Carrier Plan Contacts) Field Instructions Order By (Carrier) Field Instructions Order By (Contacts Page) Field Instructions Order By (Pay Cycle) Field Instructions Order By (Payroll Office Errors) Field Instructions Order By (Payroll Office Information Page) Field Instructions Order By (Payroll Office Transmission) Field Instructions Order By (Personnel Office Contacts Page) Field Instructions Order By (View) Field Instructions Order By 1st (Carrier Discrepancy) Field Instructions Order By 1st (Carrier Enrollees) Field Instructions Order By 1st (Carrier Enrollment Transmission) Field Instructions Order By 1st (Carrier Validation) Field Instructions Order By 1st (Pay Period Transmissions Payment Amounts Reports) Field Instructions Order By 1st (Payroll Discrepancy Listing) Field Instructions Order By 1st (Payroll Office Enrollee) Field Instructions Order By 1st (Reconciliation Action) Field Instructions Order By 1st (Reconciliation Reason) Field Instructions Order By 1st (Reconciliation Report) Field Instructions Order By 1st (Reconciliation Summary) Field Instructions Order By 1st (Transmissions) Field Instructions Order By 2nd (Carrier Discrepancy) Field Instructions Order By 2nd (Carrier Enrollees) Field Instructions Order By 2nd (Carrier Validation) Field Instructions Order By 2nd (Pay Period Transmissions Payment Amounts Report) Field Instructions Order By 2nd (Payroll Discrepancy Listing) Field Instructions Order By 2nd (Payroll Office Enrollee) Field Instructions Order By 2nd (Reconciliation Action) Field Instructions Order By 2nd (Reconciliation Reason) Field Instructions Order By 2nd (Reconciliation Report) Field Instructions Order By 2nd (Reconciliation Summary) Field Instructions Order By 2nd (Transmissions) Field Instructions Order By 2nd Carrier Enrollment Transmission) Field Instructions Order By 3rd (Carrier Discrepancy) Field Instructions Order By 3rd (Carrier Enrollees) Field Instructions Order By 3rd (Carrier Enrollment Transmission) Field Instructions Order By 3rd (Carrier Validation) Field Instructions Order By 3rd (Pay Period Transmissions Payment Amounts Reports) Field Instructions Order By 3rd (Payroll Discrepancy Listing) Field Instructions Order By 3rd (Payroll Office Enrollee) Field Instructions Order By 3rd (Reconciliation Action) Field Instructions Order By 3rd (Reconciliation Reason) Field Instructions Order By 3rd (Reconciliation Report) Field Instructions Order By 3rd (Reconciliation Summary) Field Instructions Order By 3rd (Transmissions) Field Instructions Order By 4th (Carrier Discrepancy) Field Instructions Order By 4th (Carrier Enrollees) Field Instructions Order By 4th (Carrier Validation) Field Instructions Order By 4th (Pay Period Transmissions Payment Amounts) Field Instructions Order By 4th (Payroll Discrepancy Listing) Field Instructions Order By 4th (Payroll Office Enrollee) Field Instructions Order By 4th (Reconciliation Action) Field Instructions Order By 4th (Reconciliation Reason) Field Instructions Order By 4th (Reconciliation Report) Field Instructions Order By 4th (Reconciliation Summary) Field Instructions Order By 5th (Carrier Discrepancy) Field Instructions Order By 5th (Carrier Enrollees) Field Instructions Order By 5th (Carrier Validation) Field Instructions Order By 5th (Pay Period Transmissions Payment Amounts) Field instructions Order By 5th (Payroll Discrepancy Listing) Field Instructions Order By 5th (Payroll Office Enrollee) Field Instructions Order By 5th (Reconciliation Action) Field Instructions Order By 5th (Reconciliation Reason) Field Instructions Order By 5th (Reconciliation Report) Field Instructions Order By 6th (Carrier Discrepancy) Field Instructions Order By 6th (Carrier Validation) Field Instructions Order By 6th (Payroll Discrepancy Listing) Field Instructions Order By 6th (Payroll Office Enrollee) Field Instructions Order By 6th (Reconciliation Action) Field Instructions Order By 6th (Reconciliation Reason) Field Instructions Order By 6th (Reconciliation Report) Field Instructions Order By 7th (Payroll Office Enrollee) Field Instructions Order By 8th (Payroll Office Enrollee) Field Instructions Order By 9th (Payroll Office Enrollee) Field Instructions Other (System Generated) Field Instructions Other Carrier ID (System Generated) Field Instructions Other Carrier ID Field instructions Other Field Instructions Other ID (System Generated) Field Instructions Other ID - From Field Instructions Other ID - To Field Instructions Other Insurance (System Generated) Field Instructions Other Insurance Field Instructions Other Insurance* (Enrollee) Field Instructions Other Payroll ID (System Generated) Field Instructions Other Payroll ID Field Instructions Part B-Termination (System Generated) Field Instructions Part B-Termination* Field Instructions Part C-Transfer In (System Generated) Field Instructions Part C-Transfer* In Field Instructions Part D-Reinstatement (System Generated) Field Instructions Part D-Reinstatement* Field Instructions Part E-Change of Enrollee Information (System Generated) Field Instructions Part E-Change of Enrollee Information* Field Instructions Part F-Change in Enrollment/Survivor Annuitant (System Generated) Field Instructions Part F-Change in Enrollment/Survivor Annuitant* Field Instructions Password Field Instructions Pay Cycle (Drop-Down) Field Instructions Pay Cycle (System Generated) Field Instructions Pay Cycle Field Instructions Pay Cycle* Field Instructions Pay Period* Field Instructions Payroll Office (System Generated) Field Instructions Payroll Office Comments (System Generated) Field Instructions Payroll Office Comments Field Instructions Payroll Office Due Date Field Instructions Payroll Office Field Instructions Payroll Office ID (Drop-Down) Field Instructions Payroll Office ID (System Generated) Field Instructions Payroll Office ID (System Generated) Field Instructions Payroll Office ID Field Instructions Payroll Office ID* (2809) Field Instructions Payroll Office ID* (2810) Field Instructions Payroll Office ID* (Drop-Down) Field Instructions Payroll Office ID* Field Instructions Payroll Office Name Field Instructions Payroll Office Number (System Generated) Field Instructions Payroll Office Quarter Field Instructions Payroll Office Status Field Instructions Payroll Office Submission Date Field Instructions Payroll Office Year Field Instructions Payroll Office* Field Instructions Percent Discrepancies Reconciled (System Generated) Field Instructions Personnel Office ID (2809) Field Instructions Personnel Office ID (Forms) Field Instructions Personnel Office ID (System Generated) 2809 Field Instructions Personnel Office ID (System Generated) Field Instructions Personnel Office ID Field Instructions Personnel Office ID* Field Instructions Phone (Enrollee) Field Instructions Phone (System Generated) Carrier Contact Field Instructions Phone (System Generated) Carrier Plan Contact Field Instructions Phone (System Generated) Field Instructions Phone Number (Carrier Contact) Field Instructions Phone Number (Carrier Plan Contact Record) Field Instructions Phone Number (Payroll Contact) Field Instructions Phone Number (Personnel Contact) Field Instructions Phone Number (System Generated) Carrier Contact Field Instructions Phone Number (System Generated) Payroll Office Contact Field Instructions Phone Number (System Generated) Personnel Office Contact Field Instructions Phone/Phone Number (System Generated) Carrier Plan Contact Field Instructions Plan (System Generated) Field Instructions Plan Field Instructions Plan Name Field Instructions Plan* Field Instructions POI (Maintained Records) Field Instructions POI (System Generated) Field Instructions POI (System Generated) Maintained Records Field Instructions POI (System Generated) Personnel Field Instructions POI (System Generated) Reports Field Instructions POI* Field instructions Policyholder First Name (System Generated) Field Instructions Policyholder First Name Field Instructions Policyholder Initial (System Generated) Field Instructions Policyholder Initial Field Instructions Policyholder Last Name (System Generated) Field Instructions Policyholder Last Name Field Instructions Present Enrollment Code (Add) Field Instructions Present Enrollment Code (System Generated) Field Instructions Present Plan Name (System Generated) Field Instructions Present Plan Name Field Instructions Processed Date Field Instructions Processed Time Field Instructions Processing Code (Online Entry) Field Instructions Processing Code* Field Instructions Pseudo SSN (System Generated) Field Instructions Pseudo SSN Field Instructions Qtr Field Instructions Quarter (Error Statistics) Field Instructions Quarter (Online Entry) Field Instructions Quarter (System Generated) Error Statistics Field Instructions Quarter (System Generated) Field Instructions Quarter (System Generated) Transmission Field Instructions Quarter (Transmission Record) Field Instructions Quarter* (2809) Field Instructions Quarter* (2810) Field Instructions Quarter* (Drop-Down) Field Instructions Quarter* (Schedule) Field Instructions Quarter* From (Drop-Down) Field Instructions Quarter* To (Drop-Down) Field Instructions Reason (System Generated) Field Instructions Reason Code (Drop-Down) Field Instructions Reason Code (System Generated) Field Instructions Recon Field Instructions Reconciliation Action (System Generated) Field Instructions Reconciliation Action (System Generated) Reconciliation Report Field Instructions Reconciliation Action* Field Instructions Reconciliation Date (System Generated) Reconciliation Report Field Instructions Reconciliation Date From Field Instructions Reconciliation Date To Field Instructions Reconciliation Fail Count (System Generated) Reconciliation Report Field Instructions Reconciliation Reason (System Generated) Field Instructions Reconciliation Reason (System Generated) Reconciliation Report Field Instructions Reconciliation Reason* Field Instructions Reconciliation User ID (System Generated) Reconciliation Report Field Instructions Records Field Instructions Records Processed (System Generated) Field Instructions Records Received (System Generated) Field Instructions Records Reconciled (System Generated) Field Instructions Records Sent (System Generated) Field Instructions Records With Errors (System Generated) Field Instructions Records With Errors (System Generated) Payroll Office Field Instructions Records With Warnings (System Generated) Field Instructions Records With Warnings (System Generated) Payroll Office Field Instructions Region (System Generated) Carrier Enrollment Field Instructions Region* Field Instructions Rejected (System Generated) Field Instructions Release Date Field Instructions Released By Field Instructions Released Date Field Instructions Released ID Field Instructions Released Time Field Instructions Remarks (Contact Record) Field Instructions Remarks (System Generated) Field Instructions Remarks Field Instructions Report # (System Generated) Field Instructions Report # Field Instructions Report (Drop-Down) Field Instructions Response Reminder Date (System Generated) Field Instructions Response Reminder Date* Field Instructions Role (Payroll Office) Field Instructions Role (Personnel Office) Field Instructions Role (System Generated) Field Instructions Role Field Instructions Select Another Discrepancy Field Instructions Select Field Instructions Sex (2810) Field Instructions Sex (System Generated) Field Instructions Sex Field Instructions Sex Line 1 (System Generated) Field Instructions Sex Line 1 Field Instructions Sex Line 10 (System Generated) Field Instructions Sex Line 10 Field Instructions Sex Line 2 (System Generated) Field Instructions Sex Line 2 Field Instructions Sex Line 3 (System Generated) Field Instructions Sex Line 3 Field Instructions Sex Line 4 (System Generated) Field Instructions Sex Line 4 Field Instructions Sex Line 5 (System Generated) Field Instructions Sex Line 5 Field Instructions Sex Line 6 (System Generated) Field Instructions Sex Line 6 Field Instructions Sex Line 7 (System Generated) Field Instructions Sex Line 7 Field Instructions Sex Line 8 (System Generated) Field Instructions Sex Line 8 Field Instructions Sex Line 9 (System Generated) Field Instructions Sex Line 9 Field Instructions Sex* (Enrollee) Field Instructions Source (System Generated) Field Instructions SSN (2810) Field Instructions SSN (Annuitant) Field Instructions SSN (Enrollee) Field Instructions SSN (Forms) Field Instructions SSN (System Generated) 2809 Field Instructions SSN (System Generated) Enrollee Field Instructions SSN (System Generated) Reports Field Instructions SSN - From Field Instructions SSN - To Field Instructions SSN Line 1 (System Generated) Field Instructions SSN Line 1 Field Instructions SSN Line 10 (System Generated) Field Instructions SSN Line 10 Field Instructions SSN Line 2 (System Generated) Field Instructions SSN Line 2 Field Instructions SSN Line 3 (System Generated) Field Instructions SSN Line 3 Field Instructions SSN Line 4 (System Generated) Field Instructions SSN Line 4 Field Instructions SSN Line 5 (System Generated) Field Instructions SSN Line 5 Field Instructions SSN Line 6 (System Generated) Field Instructions SSN Line 6 Field Instructions SSN Line 7 (System Generated) Field Instructions SSN Line 7 Field Instructions SSN Line 8 (System Generated) Field Instructions SSN Line 8 Field Instructions SSN Line 9 (System Generated) Field Instructions SSN Line 9 Field Instructions SSN* (Enrollee) Field Instructions Start Date (Drop-Down Carrier Enrollment) Field Instructions Start Date (Drop-Down Carrier Plan) Field Instructions Start Date (Payroll Office) Field Instructions Start Date (System Generated) Carrier Enrollment Code Field Instructions Start Date (System Generated) Carrier Field Instructions Start Date (System Generated) Field Instructions Start Date (System Generated) Schedule Field Instructions Start Date* (Carrier) Field Instructions Start Date* (PP Schedule) Field Instructions Start Date* (Schedule) Field Instructions State (2810) Field Instructions State (Employing Contact) Field Instructions State (Enrollee) Field Instructions State (New) Field Instructions State (Payroll Contact) Field Instructions State (Payroll Office) Field Instructions State (Personnel Office Contact) Field Instructions State (System Generated) Carrier Contact Field Instructions State (System Generated) Carrier Field Instructions State (System Generated) Employing Field Instructions State (System Generated) Enrollee Field Instructions State (System Generated) Payroll Office Field Instructions State (System Generated) Personnel Office Contact Field instructions State Field Instructions Status (Online Entry) Field Instructions Status (System Generated) 2809 Field Instructions Status (System Generated) Carrier Enrollment Transmission Field Instructions Status (System Generated) Field Instructions Status (System Generated) Payroll Office Transmissions Field Instructions Status (System Generated) Transmissions Field Instructions Submission (Online Entry) Field Instructions Submission (System Generated) Field Instructions Submission (System Generated) Transmission Date Field Instructions Submission Date (System Generated) Carrier Enrollment Transmission Field Instructions Submission Date (System Generated) Field Instructions Submission Reminder Date (System Generated) Field Instructions Submission Reminder Date* Field Instructions Submitter Use #1 (System Generated) Field Instructions Submitter Use #1 Field Instructions Submitter Use #2 (System Generated) Field Instructions Submitter Use #2 Field Instructions Submitter Use #3 (System Generated) Field Instructions Submitter Use #3 Field Instructions Survivor Annuity Claim # (System Generated) Field Instructions Survivor Annuity Claim # Field Instructions Threshold Type (System Generated) Field Instructions Threshold Type Field Instructions Time Processed (System Generated) Field Instructions Time Processed (System Generated) Transmissions Field Instructions To (System Generated) Quarter/Year Field Instructions Total (System Generated) Field Instructions Total (System Generated) Reconciliation Action Field Instructions Total (System Generated) Reconciliation Reason Field Instructions Total Discrepancies Found (System Generated) Field Instructions Total Discrepancies Reconciled (System Generated) Field Instructions Total Enrollee Records (System Generated) Field Instructions Total Errors (System Generated) Field Instructions Total Errors (System Generated) Reconciliation Field Instructions Total Errors (System Generated) Transmission File Field Instructions Total Matches Found (System Generated) Field Instructions Total Records (System Generated) Field Instructions Total Records (System Generated) Reconciliation Field Instructions Total Records (System Generated) Reconciliation Report Field Instructions Total Warnings (System Generated) Field Instructions Total Warnings (System Generated) Transmissions File Field Instructions Transmission File Name (System Generated) Field Instructions Transmission File Name Field Instructions Transmission Type Field Instructions Transmission Type (System Generated) Field Instructions Transmission Type*Field Instructions Transmissions Field Instructions TRICARE/CHAMPUS (System Generated) Field Instructions TRICARE/CHAMPUS Field Instructions Type (System Generated) Field Instructions Type Field Instructions Type* Field Instructions Unrecon (System Generated) Field Instructions Unvalidated (System Generated) Field Instructions User ID (Enter) Field Instructions User ID (Forms) Field Instructions User ID (System Generated) Field Instructions User ID Field Instructions Validated (System Generated) Field Instructions Validation (System Generated) Field Instructions Validation Date (System Generated) Field Instructions Validation Date From Field Instructions Validation Date To Field Instructions Warning (System Generated) Field Instructions Warning Code (Drop-Down) Field Instructions Warning Code Field Instructions Warnings (System Generated) Field Instructions Whld Amt (System Generated) Reports Field Instructions Will Be Covered Under The Enrollment Of (System Generated) Field Instructions Will Be Covered Under The Enrollment Of Field Instructions With Errors (System Generated) Reconciliation Report Field Instructions Without Errors (System Generated) Reconciliation Report Field Instructions Year (Error Statistics) Field Instructions Year (Online Entry) Field Instructions Year (System Generated) Carrier Error Field Instructions Year (System Generated) Errors Statistics Field Instructions Year (System Generated) Field Instructions Year (System Generated) Transmission Field Instructions Year (Transmission Record) Field Instructions Year Field Instructions Year* (2809) Field Instructions Year* (2810) Field Instructions Year* (Drop-Down) Field Instructions Year* (Schedule) Field Instructions Year* From (Drop-Down) Field Instructions Year* To (Drop-Down) Field Instructions Year/Quarter From (System Generated) Field Instructions Year/Quarter To (System Generated) Field Instructions Zip (2810) Field Instructions Zip (Carrier Plan Contact) Field Instructions ZIP (Carrier) Field Instructions Zip (Employing Contact) Field Instructions Zip (Enrollee) Field Instructions Zip (New) Field Instructions Zip (Payroll Contact) Field Instructions Zip (Payroll Office) Field Instructions Zip (Personnel Office Contact) Field Instructions Zip (System Generated) Carrier Contact Field Instructions ZIP (System Generated) Carrier Field Instructions Zip (System Generated) Carrier Plan Contact Field Instructions Zip (System Generated) Employing Contact Field Instructions Zip (System Generated) Enrollee Field Instructions Zip (System Generated) Payroll Office Contact Field Instructions Zip (System Generated) Payroll Office Field Instructions Zip (System Generated) Personnel Office Contact Field Instructions Zip Line 1 (System Generated) Field Instructions Zip Line 1 Field Instructions Zip Line 10 (System Generated) Field Instructions Zip Line 10 Field Instructions Zip Line 2 (System Generated) Field Instructions Zip Line 2 Field Instructions Zip Line 3 (System Generated) Field Instructions Zip Line 3 Field Instructions Zip Line 4 (System Generated) Field Instructions Zip Line 4 Field Instructions Zip Line 5 (System Generated) Field Instructions Zip Line 5 Field Instructions Zip Line 6 (System Generated) Field Instructions Zip Line 6 Field Instructions Zip Line 7 (System Generated) Field Instructions Zip Line 7 Field Instructions Zip Line 8 (System Generated) Field Instructions Zip Line 8 Field Instructions Zip Line 9 (System Generated) Field Instructions Zip Line 9 Field Instructions |
