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CLER for NFC

Part D-Reinstatement* Field Instructions

Part D-Reinstatement*

Conditional

Click the radio button if the enrollment is being reinstated, otherwise do not complete this field.

See Also

CLER Field Descriptions and Instructions

# (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 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