CHB Chargeback Information

To define elements associated with a charge to unemployment insurance tax account

Position
Element
Name
Type
Requirement
Min
Max
Repeat
CHB01
Location Qualifier
Identifier (ID)
Conditional
1
2
1
Code identifying type of location
P0102: If either CHB-01 or CHB-02 is present, then the other is required
CHB02
Location Identifier
String (AN)
Conditional
1
30
1
Code which identifies a specific location
CHB03
Reason Stopped Work Code
Identifier (ID)
Optional
2
2
1
Code identifying reason claimant stopped working
CHB04
Claim Type Code
Identifier (ID)
Optional
1
2
1
Code identifying the basis and type of a legal claim
CHB05
Claim Status Code
Identifier (ID)
Optional
1
2
1
Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization
CHB06
Entity Identifier Code
Identifier (ID)
Optional
2
3
1
Code identifying an organizational entity, a physical location, property or an individual
CHB06 may be used to identify the type of employer.
CHB07
Credit/Debit Flag Code
Identifier (ID)
Optional
1
1
1
Code indicating whether amount is a credit or debit
CHB08
Industry Code
String (AN)
Optional
1
30
1
Code indicating a code from a specific industry code list
CHB08 is a code assigned by an employment security agency.
CHB09
Allowance or Charge Indicator
Identifier (ID)
Optional
1
1
1
Code which indicates an allowance or charge for the service specified

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