Adding a 2810 Record

The Add function allows users to add 2810 records.

To Add a 2810 Record:

Select the Forms tab at the top of the CLER Main Menu. The Forms Main Page is displayed with the options 2809 and 2810.
Select the 2810 option. The 2810 Form is displayed.
Click Add. The Form 2810 Add (Part A) page is displayed.

Complete the fields as follows:

Field	Instruction
Payroll Office ID*	Required Select the payroll office identification number for the 2810 record being created from the drop-down menu.
Year*	Optional, default Select the reconciliation year for the 2810 record being created from the drop-down menu. If no year is selected, this field automatically defaults to the current reconciliation year.
Quarter*	Optional, default Select the reconciliation quarter for the 2810 record being created from the drop-down menu. If no quarter is selected, this field automatically defaults to the current reconciliation quarter.
Personnel Office ID	Optional, alphanumeric, 4 positions If access is limited to a specific personnel office identifier code enter that code. Note: Although the system allows for a blank field, please complete this field if the condition applies.
Last Name*	Required, alphanumeric, 25 positions maximum Enter the enrollee’s last name. If the enrollee has a title (e.g., Jr, Sr, I, II, or III), it should be entered after the last name without punctuation (e.g., Smith Jr or Smith III).
First Name*	Required, alphanumeric, 17 positions maximum Enter the enrollee’s first name.
Initial	Optional, alphanumeric, 1 position Enter the enrollee’s middle initial.
Address Line 1*	Required, alphanumeric, 35 positions maximum Enter the first line of the enrollee’s domestic or foreign street, apartment number, or post office box, rural route, etc., if applicable.
Address Line 2*	Required, alphanumeric, 35 positions maximum Enter the second line of the enrollee’s domestic or foreign street, apartment number, or post office box, rural route, etc., if applicable.
Address Line 3*	Required, alphanumeric, 35 positions maximum Enter the third line of the enrollee’s domestic or foreign street, apartment number, or post office box, rural route, etc., if applicable.
City*	Required, alphanumeric, 25 positions maximum Enter the name of the enrollee’s domestic or foreign city. Note: If the address is an overseas military address, type FPO for fleet post office or APO for army post office in lieu of the city.
State	Conditional Select the enrollee's State, U.S. territory, or overseas military abbreviation from the drop-down menu. For a list and descriptions of State, U.S. territory, and overseas military abbreviations, see State, U.S. Territory, and Overseas Military Abbreviations Table.
Zip	Conditional, alphanumeric, 11 positions maximum Enter the enrollee's domestic or foreign ZIP Code or foreign postal code.
Foreign Country	Optional Select the enrollee’s country code from the drop-down menu. For a list and descriptions of country codes, see Country Codes Table.
SSN Social Security number*	Required, alphanumeric, 9 positions Enter the enrollee’s Social Security number (SSN). If the enrollee does not want his/her SSN provided to the carrier, a pseudo SSN may be used if the pseudo SSN is also reported to CLER.
Date of Birth*	Required, alphanumeric, 8 positions Enter the enrollee’s date of birth (MMDDYYYY).
Enrollment Code*	Optional, alphanumeric, 3 positions Enter the enrollment code, which consists of the plan and option codes.
Enrollment ID	Conditional, alphanumeric, 9 positions If the annuitant is deceased, and the FEHB coverage is being transferred to a survivor, enter the deceased annuitant's SSN; otherwise, do not complete this field. Note: Although the system allows for a blank field, please complete this field if the condition applies and the data is available.
Effective Date*	Required, alphanumeric, 8 positions Enter the date (MMDDYYYY) the requested action goes into effect.
Annuity Claim #	Optional, alphanumeric, 9 positions Enter the civil service annuitant (CSA) number assigned to the enrollee by OPM.
Survivor Annuity Claim #	Optional, alphanumeric, 9 positions Enter the civil service final (CSF) number assigned to the enrollee by OPM.
Report #	Optional, alphanumeric, 7 positions maximum Enter the number of the original report (e.g., notification to carrier, transmittal number).

Click Save Form. If no errors occur, a pop up message is displayed to confirm the record has been added.
Click OK to close the pop up.
Select Part B thru F at the top of the Form 2810 Add (Part A) page. The Form 2810 Add (Part B thru F) page is displayed.

Complete the fields as follows:

Field	Instruction
Part B-Termination*	Conditional Click the radio button if the enrollment is terminated, otherwise do not complete this field.
Part C-Transfer In*	Conditional Click the radio button if the enrollment is being transferred from one payroll office to another, otherwise do not complete this field.
Part D-Reinstatement*	Conditional Click the radio button if the enrollment is being reinstated, otherwise do not complete this field.
Part E-Change of Enrollee Information*	Conditional If (1) an enrollee's name has changed, (2) the enrollment has changed from the enrollee's name to the name of the survivor annuitant, or (3) the enrollment has changed from the survivor annuitant's name to the name of another survivor annuitant, click the radio button; otherwise do not complete this field.
Last Name	Optional, alphanumeric, 25 positions maximum If the Change in Name of Enrollee radio button is selected enter the enrollee’s new last name or the new last name of the survivor annuitant, as applicable. If the individual has a title (e.g., Jr, Sr, I, II, or III), it should be entered after the last name without punctuation (e.g., Smith Jr or Smith III).
First Name	Optional, alphanumeric, 25 positions maximum If the Change in Name of Enrollee radio button is selected, enter the enrollee’s new first name or the new first name of the survivor annuitant, as applicable.
Initial	Conditional, alphanumeric, 1 position If the Change in Name of Enrollee radio button is selected, enter the enrollee’s new middle initial or the middle initial of the new survivor annuitant, as applicable.
Address Line 1	Conditional, alphanumeric, 35 positions maximum If the Change in Name of Enrollee radio button is selected, and the first line of the street address for the enrollee or survivor annuitant is different than the address listed in Part A-Address Line 1, enter the first line of the enrollee or survivor annuitant's new domestic or foreign street, apartment number, or post office box, rural route, etc., as applicable.
Address Line 2	Conditional, alphanumeric, 35 positions maximum If the Change in Name of Enrollee radio button is selected, and the second line of the street address for the enrollee or survivor annuitant is different than the address listed in Part A-Address Line 2, enter the second line of the enrollee or survivor annuitant's new domestic or foreign street, apartment number, or post office box, rural route, etc., as applicable.
Address Line 3	Conditional, alphanumeric, 35 positions maximum If the Change in Name of Enrollee radio button is selected, and the third line of the street address for the enrollee or survivor annuitant is different than the address listed in Part A-Address Line 3, enter the third line of the enrollee or survivor annuitant's new domestic or foreign street, apartment number, or post office box, rural route, etc., as applicable.
City	Conditional, alphanumeric, 23 positions maximum If the Change in Name of Enrollee radio button is selected, and the domestic or foreign city for the enrollee or survivor annuitant's address is different than the city listed in Part A-City, enter the name of the new city of the enrollee or survivor annuitant's address. If the address is an overseas military address, enter FPO for fleet post office or APO for army post office in lieu of city.
State	Conditional If the Change in Name of Enrollee radio button is selected, and the state, U.S. territory, or overseas military abbreviation for the enrollee or survivor annuitant's address is different than the state, U.S. territory, or overseas military abbreviation listed in Part A-State, click the drop-down menu and select the new State, U.S. territory, or overseas military abbreviation for the enrollee or survivor annuitant's address. For a list and descriptions of State, U.S. territory, and overseas military abbreviations, see State, U.S. Territory, and Overseas Military Abbreviations Table.
Zip	Conditional, alphanumeric, 11 positions maximum If (1) the Change in Name of Enrollee radio button is selected, and (2) the Zip Code or foreign postal code for the enrollee or survivor annuitant's address is different than the Zip Code or foreign postal code listed in Part A-Zip, enter the name of the new Zip Code or foreign postal code for the enrollee or survivor annuitant's address.
Country	Conditional If (1) the Change in Name of Enrollee radio button is selected, (2) the address is foreign, and (3) the country code for the enrollee or survivor annuitant's address is different than the country code listed in Part A-Country Code, click the drop-down menu and select the new country code for the enrollee or survivor annuitant's address. For a list and descriptions of country codes, see Country Codes Table.
Date of Birth	Conditional, alphanumeric, 8 positions If the Change in Name of Enrollee radio button is selected,enter the enrollee or survivor annuitant’s date of birth (MMDDYYYY); otherwise, do not complete this field.
SSN Social Security number	Conditional, alphanumeric, 9 positions If the Change in Name of Enrollee radio button is selected, enter the enrollee or survivor annuitant’s Social Security number (SSN). If the individual does not want his/her SSN provided to the carrier, a pseudo SSN may be used if the pseudo SSN is also reported to CLER. If the Change in Name of Enrollee radio button is not selected, do not complete this field.
Sex	Conditional If the Change in Name of Enrollee radio button is selected, select the radio button next to one of the following values: M - Indicates the enrollee is male. F - Indicates the enrollee is female.
Part F-Change in Enrollment/Survivor Annuitant*	Conditional If the survivor annuitant's code has changed, click the radio button; otherwise, do not complete this field.
New Enrollment Code Number	Conditional, alphanumeric, 3 positions If the Change in Enrollment/Survivor Annuitant radio button is selected, enter the new enrollment code for the survivor annuitant; otherwise, do not complete this field. The enrollment code consists of the plan and option codes for the survivor annuitant.

Click Save Form. If no errors occur, a pop up message is displayed to confirm the record has been added.
Click OK to close the pop up.
Select Part G thru H at the top of the Form 2810 Add (Part B thru F) page. The Form 2810 Add (Part G thru H) page is displayed.

Complete the fields as follows:

Field	Instruction
Remarks	Optional, alphanumeric, 400 positions maximum Enter remarks about this record.
Date of Death	Conditional, alphanumeric, 8 positions If the enrollee is deceased, enter the date of death (MMDDYYYY); otherwise, do not complete this field.
Agency Name*	Required, alphanumeric, 35 positions maximum Enter the name of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.
Address Line 1*	Required, alphanumeric, 35 positions maximum Enter the first line of the domestic or foreign street, PO Box, rural route, etc., of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.
Address Line 2*	Required, alphanumeric, 35 positions maximum Enter the second line of the domestic or foreign street, PO box, rural route, etc., of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.
Address Line 3*	Conditional, alphanumeric, 35 positions maximum Enter the third line of the domestic or foreign street, PO box, rural route, etc., if applicable, of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.
City*	Required, alphanumeric, 23 positions maximum Enter the name of the domestic or foreign city for the enrollee's employing, personnel, or point of contact office. Note: If the address is an overseas military address, type FPO for fleet post office or APO for army post office in lieu of the city.
State	Conditional Select the State, U.S. territory, or overseas military abbreviation from the drop-down menu for the enrollee's employing, personnel or point of contact office. For a list and descriptions of State, U.S. territory, and overseas military abbreviations, see State, U.S. Territory, and Overseas Military Abbreviations Table.
Zip	Conditional, alphanumeric, 11 positions maximum Enter the enrollee's domestic ZIP Code or foreign postal code for the enrollee's employing, personnel, or point of contact office.
Foreign Country	Select the country code from the drop-down menu for the enrollee's employing, personnel, or point of contact office. For a list and description of country codes, see Country Codes Table.
Agency ID	Optional, alphanumeric, 4 positions Enter the Agency identification code for the enrollee's employing, personnel, or point of contact office (example: AG90 for U.S. Department of Agriculture, Office of the Chief Financial Officer).
Personnel Office ID	Required, alphanumeric, 4 positions Enter the personnel office number for the enrollee's employing, personnel, or point of contact office.
Agency Use	Optional, alphanumeric, 15 positions maximum Enter information regarding this record.
Authorized Official Last Name*	Required, alphanumeric, 25 positions maximum Enter the last name of the Agency official who is authorized to sign the Form 2809. If the Agency official has a title (e.g., Jr, Sr, I, II, or III), it should be entered after the last name without punctuation (e.g., Smith Jr or Smith III).
Authorized Official First Name	Optional, alphanumeric, 17 positions maximum Enter the first name of the Agency official who is authorized to sign the Form 2810.
Authorized Official Initial	Optional, alphanumeric, 1 position Enter the middle initial of the Agency official who is authorized to sign the Form 2810.
Authorized Official Date	Required, alphanumeric, 8 positions Enter the date the authorized Agency official signed the document.
Contact (Personnel) Last Name*	Conditional, alphanumeric, 25 positions maximum Enter the last name of the personnel office contact. If the contact has a title (e.g., Jr, Sr, I, II, or III), it should be entered after the last name without punctuation (e.g., Smith Jr or Smith III). Note: If the Last Name field under Contact (Payroll) is not completed, this field is required; otherwise, this field is optional.
Contact (Personnel) First Name	Conditional, alphanumeric, 17 positions maximum Enter the first name of the personnel office contact, if the Last Name field of Contact (Personnel) is completed.
Contact (Personnel) Initial	Conditional, alphanumeric, 1 position Enter the middle initial of the personnel office contact, if the Last Name field of Contact (Personnel) is completed.
Contact (Personnel) Phone	Conditional, numeric, 17 positions maximum Enter the personnel office contact's daytime area code and telephone number, if the Last Name field of Contact (Payroll) is completed. Do not type alpha characters, spaces, dashes, parentheses, periods, etc.
Contact (Payroll) Last Name*	Conditional, alphanumeric, 25 positions maximum Enter the last name of the payroll office contact. If the contact has a title (e.g., Jr, Sr, I, II, or III), it should be entered after the last name without punctuation (e.g., Smith Jr or Smith III). Note: If the Last Name field under Contact (Personnel) is not completed, this field is required; otherwise, this field is optional.
Contact (Payroll) First Name	Conditional, alphanumeric, 17 positions maximum Enter the first name of the payroll office contact, if the Last Name field of Contact (Payroll) is completed.
Contact (Payroll) Initial	Conditional, alphanumeric, 1 position Enter the middle initial of the payroll office contact, if the Last Name field of Contact (Payroll) is completed.
Contact (Payroll) Phone	Conditional, numeric, 17 positions maximum Enter the payroll office contact's daytime area code and telephone number, if the Last Name field of Contact (Payroll) is completed. Do not type alpha characters, spaces, dashes, parentheses, periods, etc.

Click Save Form. If no errors occur, a pop up message is displayed to confirm the record has been added.
Click OK to close the pop up.

CLER for NFC

Adding a 2810 Record

To Add a 2810 Record:

See Also