Benefit Enrollment and Maintenance

Transfer Due to Interest and Servicing Sold

Termination of Additional Insured Interest

Addition of Additional Insured Endorsement

Abbreviated First Report on an Acquired Claim

Occupational Safety and Health Administration Injury and Illness Log (OSHA-300)

Office of Workers Compensation Program Injury Claim Report (OWCP CA-1)

Office of Workers Compensation Program Illness Claim Report (OWCP CA-2)

Occupational Safety and Health Administration Injury and Illness Record 
(OSHA-301)

Suspended Pending Appeal or Judicial Review

To place in force again, without the usual probationary or service period, a 
group contract or an individual's group insurance that for some reason has 
terminated

Certain situations such as military duty and CHAMPUS classify the subscriber 
ineligible for coverage or benefits. However, dependents of the subscriber are 
still eligible for coverage or benefits under the subscriber. Subscriber 
identifying elements are needed to accurately identify dependents

Suspension Medically Determined or Qualified to Return to Work

Non-compliance of Administrative Requirements

Consolidation Omnibus Budget Reconciliation Act (COBRA) Premium Paid

A physical or mental condition that makes an insured incapable of performing 
one or more duties of his or her own occupation

A change has been made to the primary elements that identify a specific person 
or relationship; such elements can include but are not limited to first name, 
last name, social security number, date of birth, and identification number.

A deferral-percentage test, defined by the Internal Revenue Code, to ensure a 
defined contribution retirement plan complies with limitations on contributions 
made by highly compensated employees as compared to all other employees covered 
by the plan

General information about the participant

Investment Elections and Contribution Rates

Percentage of contributions to be invested in specified funds and percentage of 
salary which the participant has elected to contribute to specified sources (or 
categories)

Financial information for repayment of the participant's loan

Financial information for contributions made to the plan

Current Customer Information File in Error

Revocation of Voluntary Market Acceptance

Primary Business Management includes corporate officer, partner or sole 
proprietor

Change Insured Federal Employer Identification Number (FEIN)

Change Employer Federal Employer Identification Number (FEIN)

Change Employer Unemployment Insurance (UI) Code

Modification without a Specific Operating Unit Location in Jurisdiction

Change Insurer Federal Employer Identification Number (FEIN)

Duplicate Entry on Customer Identification File

Removal of the Customer Identification File Merge ID

Removal of the Customer Identification File Buyout ID

Removal of the Customer Identification File in Error ID

Re-activation of an Out-of-Business Customer

Consolidation Omnibus Budget Reconciliation Act (COBRA)

A federal act that enables an insured, spouse, or dependent to continue 
benefits after a qualifying event which would otherwise cause them to lose 
their benefits

A section of the IRS regulations which allows a category of employees, such as 
teachers and educational staff, to contribute a portion of their salary 
(pretax) for the purchase of an annuity

A plan that provides a benefit payable upon death of the insured from any cause 
and is offered to all employees within a company

A plan that provides voluntary coverage to supplement a basic plan

Bundled alternative medicine services as defined between trading partners

Employee's contributions received by the employer to purchase insurance which 
continues in force until the death of the employee or until the case value of 
the insurance is returned to the employee

That form of short-term disability income that provides for the payment of a 
weekly benefit for disability due to an accident or illness

Lifestyle Life (Individualized Basic Life)

Any plan under which the employer and employees are not entitled to favorable 
tax benefits

A plan that offers life insurance at low-term rates with a death benefit that 
increases over time with the addition of growing cash values in an 
interest-earning cash accumulation account

A committee of professionals in the medical field who review cases involving 
extended duration of hospitalization and patterns of care in order to establish 
guidelines in terms of actual medical necessity; their review will also include 
the efficiency of institutional use, the appropriateness of admission, services 
ordered and provided, length of stay, and discharge practices

A form of health and accident insurance that provides payment to an insured's 
beneficiary or to the insured in the event of death or specific bodily losses 
resulting from an accident

403(C) Church Exempt Annuity Plans Covered by ERISA

A term used to describe a life insurance plan under which the insured shares in 
the cost of the plan with the policyholder

408(K) Employer Sponsored Qualified Defined Distribution Plans Funded with 
Individual IRA's

An amount specified by an employee to be allocated towards health, legal, 
dependent, or educational expenses in compliance with government regulations

A plan for employees of a State or Municipality which allows them to contribute 
a portion of their salary (pretax) to be invested and paid out at the time of 
their retirement or severance

An organization that provides a wide range of comprehensive health care 
services for a specified group at a fixed periodic payment

A defined benefits retirement plan established by organizations for their 
employees

408(B) Individual Retirement Account (IRA) Annuity Contract

A section of the IRS regulations which allows an individual to purchase an 
annuity and defer taxation on the principal and interest until distribution

A plan that provides a specified dollar benefit or more commonly a percent of 
expenses charged if a covered person suffers a loss of functional capacity due 
to an accidental injury or sickness

A plan that provides a source of monthly income for covered employees who are 
unable to work because of total disability; benefits are payable for a period 
of 5 to 10 years, or more commonly to the employee's normal age of retirement

457(F) Non-Government Deferred Compensation

A plan for employees of an organization, such as a religious, non-profit, or 
fraternal group, which allows them to contribute a portion of their salary 
(pretax) to be invested and paid out at the time of their retirement or 
severance

A plan established and maintained by an employer to provide for the 
participation in his profits by his employees or their beneficiaries

401(K) Qualified Cash or Deferred Arrangement

A section of the IRS regulations which allows an employee to contribute a 
portion of their salary (pretax) to be invested in a defined contribution plan; 
the taxation is deferred until the time of withdrawal

A section of the IRS regulations which allows an employee to contribute a 
portion of their salary (after-tax) to be invested in a defined contribution 
plan; the taxation on the earnings of these contributions will be deferred 
until the time of withdrawal

A plan that provides a source of income for covered employees who are unable to 
work because of disability; benefits are payable for a period of 13, 26, or 52 
weeks

A product with combined insurance lines other than dental and vision only; 
products that include mandated Essential Health Benefits are not a combined 
product.

The money applied to benefits before federal taxes have been incurred

The money applied to benefits after federal taxes have been incurred

Registered under the Income Tax Act of Canada

Non-Registered under the Income Tax Act of Canada

Registered under the Income Tax Act of Canada with contributions made by the 
owner's spouse

An amendment which modifies the terms of the life contract or certificate of 
insurance as they pertain to a dependent child. It may increase or decrease 
benefits, waive a condition or coverage, or in any other way amend the original 
contract

The individual employee has chosen to discontinue one-bill submission

Health benefits that continue to be paid after termination or death

The individual employee will submit only one bill

Salary that continues to be paid after a disability

The individual employee has chosen not to participate in one-bill submission

LC07 is the employee signature on file indicator. A "Y" value indicates the 
employee signature has been obtained and is on file; an "N" value indicates the 
employee signature has not been obtained.

LC Life Coverage

To provide information on life coverage