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1 Intrfac Nam: Dirction: Frquncy: Vnor/Agncy: BNO_021 Lif Enrollmnt fil Outboun Montly Minnsota Lif 1 Documnt Control: 1.1 Rvision History: Vrsion No. Dat Autor Cang Rfrnc 1.2 Layout an Spcifications Fil Format Har Rcor Fil Fil RECORD TYPE 1 X 1 Inicats rcor typ Harco vu of H FILE TYPE 4 X 2 Inicats wo t fil is for LIFE for lif insuranc fil FILLER 1 X 6 COUNT 8 N 7 Count of t # rcors on t nrollmnt fil FILLER 1 X 15 COVERAGE DATE 8 N 16 Covrag at tat t fil is for Formatt YYYYMMDD 1
2 FILLER 1 X 24 RUN DATE 8 N 25 Dat t fil was crat Formatt YYYYMMDD Dtail Rcor Fil Fil SSN 9 N 1 SSN of t subscribr NAME 28 X 10 Nam of t subscribr Formatt last nam, a,, first nam, a spac, mil initi Fil soul b forc to uppr cas. ADDRESS 44 X 38 Arss of t subscribr Fil soul b forc to uppr cas. CITY 30 X 82 City of t subscribr s arss STATE 2 X 112 Stat of t subscribr s arss ZIP CODE 9 X 114 Zip co of t subscribr s arss BIRTHDATE 8 N 123 Dat of birt of t subscribr Fil soul b forc to uppr cas. Fil soul b forc to uppr cas. Formatt YYYYMMDD SEX 1 X 131 Sx of t subscribr M for m, F for fm STATE HIRE DATE 8 N 132 Dat subscribr was ir Formatt YYYYMMDD wit t stat SAMAS ORG CODE 11 N 140 Samas org co of t subscribr If mploy status is Rtir an mploy is not a tacr, populat fil wit
3 Fil Fil COVERAGE CLASS 1 N 151 of covrag subscribr as wit t stat lif program Els if mploy status is Rtir an mploy is a tacr, populat fil wit Els if mploy status is COBRA, populat fil wit Els if mploy is a Univrsity mploy, fil soul b populat wit t agncy/subagncy combination follow by zros (i.. UWF mploy woul av in tis fil) Els if mploy is in a PSA of 002, 0003, 0004, 0005, 0006, 0010, 0022, populat fil wit Lgacy Agncy co (on ZBC_BTRTL tabl) an zro fill t rmaining fils Els if PSA vu is 0009, convrt to 0010 prior to rfrncing ZBC_BTRTL tabl Els slct first igt caractrs of FLAIR Organization Co on infotyp 9124 (NOT FLAIR ACCOUNT CODE). 0 for Unknown 1 for Carr Srvic mploy 2 for SES/SMS an otr spci cas mploy 3 for bing a Lgislator 4 for bing a Rtir 10K 5 for bing a Rtir 2.5K 6 for Vst Lg. Lif only 3
4 Fil Fil A for Carr Srvic w/vst Lg. Lif B for SES/SMS w/ Vst Lg. Lif C for Lgislator w/ Vst Lg. Lif D for Rtir 10K w/ Vst Lg. Lif E for Rtir 2.5K w/ Vst Lg. Lif SAP Nots: us function moul HR_BEN_GET_FROM_FEATURE_COV GR to trmin class co, tn cck covrag rturn ovrriing vus as follows BPLAN = = = = = 4 BPLAN = = 4 BPLAN & = A 0002 = B 0003 = C 4
5 Fil Fil BPLAN & = D 0002 = E BPLAN Only = 6 ANNUAL SALARY 8 N Annu sary of t subscribr LIFE IND 1 X 160 Inicats if t subscribr as lif insuranc LIFE EFF DATE 8 N 161 Effctiv at of t subscribr s lif insuranc LIFE TERM DATE 8 N 169 Trmination at of t subscribr s lif insuranc OPT LIFE CAP 1 X 177 Inicats t option lif insuranc lvl tat t subscribr as wic is capp at 500,000 Eliminat sning t sary information N for no, Y for ys Formatt YYYYMMDD Formatt YYYYMMDD Y for Ys /N for No SAP Nots: PA0168-PLTYP = 1100 If PA0168-COVOV <> 0 tn Y Els N OPT LIFE COVG LEVEL 1 X 178 Inicats t lvl tat t subscribr as for option lif insuranc Zro for not aving it 1-7 for t lvl tat ty o av it A F if ty o av it but ar capp at 500,000 pning unrwriting. Covrag Lvl - 0 = No Covrag 5
6 Fil Fil 1 = 1 x Bas Pay 2 = 2 x Bas Pay 3 = 3 x Bas Pay 4 = 4 x Bas Pay 5 = 5 x Bas Pay 6 = 6 x Bas Pay 7 = 7 x Bas Pay A = 1 x Bas Pay + 500K cap B = 2 x Bas Pay + 500K cap C = 3 x Bas Pay + 500K cap D = 4 x Bas Pay + 500K cap E = 5 x Bas Pay + 500K cap F = 6 x Bas Pay + 500K cap G = 7 x Bas Pay + 500K cap SAP Nots: PA0168-PLTYP = 1100 PA0168-BCOVR+3(1) will giv t covrag lvl OPT LIFE EFF DATE 8 N 179 Effctiv at of t subscribr s option lif insuranc OPT LIFE TERM DATE 8 N 187 Trmination at of t subscribr s option lif insuranc FILLER 6 X 195 Formatt YYYYMMDD, zros mans tat ty nvr a option lif insuranc Formatt YYYMMDD If trm at for plan 1100 in SAP is 12/31/9999, zro fill tis fil. 6
7 Mont En Covrag Mont Carrir Fils Dat fil snt to t vnors from PF Jan-15 12/29/2014 Fb-15 1/27/2015 Mar-15 2/25/2015 Apr-15 3/26/2015 May-15 4/28/2015 Jun-15 5/27/2015 Jul-15 6/26/2015 Aug-15 7/28/2015 Sp-15 8/26/2015 Oct-15 9/28/2015 Nov-15 10/28/2015 Dc-15 11/24/2015 Jan-16 12/28/2015 7
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