Report of Withholdings and Contributions for Health Benefits By Enrollment Code 2026

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Definition & Meaning

The "Report of Withholdings and Contributions for Health Benefits By Enrollment Code" is an official document that details the deductions and contributions made to health benefit plans, segmented by enrollment codes. The enrollment code categorizes different types of health benefit plans or tiers, which can be specified for various departments or employee groups. This report is crucial for maintaining transparency and accountability in managing health benefit contributions, ensuring that both employers and employees have a clear understanding of the funds withheld and their allocation.

How to Use the Report

Organizations use this report to track and manage financial and administrative aspects of health benefits. Here are the typical steps:

  1. Data Gathering: Compile all relevant payroll and benefit data, including department and payroll office numbers.

  2. Categorization by Code: Ensure contributions are accurately categorized by enrollment code.

  3. Verification: Review the report for accuracy, ensuring it aligns with payroll periods and contains actual contribution amounts.

  4. Distribution: Share the report with relevant stakeholders, such as HR departments, auditors, or employee representatives.

  5. Review Session: Conduct a session where the document can be reviewed jointly, ensuring clarity and addressing any discrepancies.

This report assists in ensuring regulatory compliance and provides insights into health benefit expenditures to optimize future benefit planning.

Steps to Complete the Report

Filling out this report involves several essential steps:

  1. Identify Enrollment Codes: Gather the list of applicable enrollment codes used by your organization.

  2. Compile Payroll Data: Use payroll numbers and reporting periods, ensuring alignment with the required periods in March and September.

  3. Calculate Withholdings: Determine the total withholdings for each enrollment code by consolidating payroll information.

  4. Contributions Mapping: Map contributions against each enrollment code to provide a clear picture of the benefit plan funding.

  5. Fill in Agency Details: Ensure agency contact information and related details are accurate for accountability.

  6. Review & Validate: Cross-check for any discrepancies or missed entries and validate with involved departments.

  7. Submit Report: Follow the defined submission method, whether online, mail, or in-person, to deliver the final report to the appropriate authority.

Key Elements of the Report

The document includes several critical elements:

  • Department and Payroll Office Number: Identifies the origin of the payroll data.
  • Report Number and Dates: Each report should have a unique identifier and reference dates for the payroll periods.
  • Agency Contact Details: Provides necessary contact information for follow-ups or clarifications.
  • Total Withholdings and Contributions: Aggregate financial data by enrollment code.
  • Enrollee Numbers: Specifies the number of employees enrolled under each code for reported periods.

These elements ensure that the report is comprehensive and aligns with organizational and regulatory needs.

Important Terms Related to the Report

  • Enrollment Code: Unique identifier categorizing specific health benefit plans.
  • Withholding: The portion of an employee’s paycheck withheld for insurance.
  • Contribution: The total amount paid towards an employee's health benefits.
  • Pay Periods: Designated time frames (e.g., bi-weekly) for processing payroll.

Having a grasp of these terms enhances comprehension and accuracy in handling the report.

Filing Deadlines / Important Dates

The report requires submission specific to designated payroll periods, particularly:

  • March and September Reporting: Data must reflect enrollees and contributions for these periods.
  • Annual Compliance Dates: Businesses may adhere to specific annual compliance deadlines to ensure regulatory obligations are met.

Adhering to these timelines is vital for regulatory compliance.

Who Issues the Form

Typically, the report is issued at an organizational level by the payroll or human resources department. They are responsible for gathering, compiling, and verifying all included data before submission to regulatory bodies or internal stakeholders.

Penalties for Non-Compliance

Failing to submit the report accurately or timely may result in:

  • Financial Penalties: Monetary fines for late or incorrect reporting.
  • Legal Repercussions: Legal actions if non-compliance results in regulatory infractions.
  • Operational Risks: Loss of transparency in financial management, leading to trust issues within the organization.

Understanding these penalties underscores the importance of meticulous and timely report preparation.

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The FEP FEHB membership cards are identified by coverage codes 104, 105, and 106 for the FEP Blue Standard Option and 111, 112, and 113 for the FEP Blue Basic Option. FEP Blue Focus enrollment codes are 131, 132, and 133.
Enrollment codes are found on the front cover of each plans brochure.
Insurance codes are used by your health plan to make decisions about your prior authorization requests and claims, and to determine how much to pay your healthcare providers. Typically, you will see these codes on your Explanation of Benefits and medical bills.
FEHB Coverage Code must be 4 (Eligible Pending) for employees who are eligible to enroll in health benefits. If IRIS 115 is not 4 (Eligible Pending), correct with an accession action or use a 915 Nature of Action (NOA) and select 4 (Eligible Pending).
The FEP FEHB membership cards are identified by coverage codes 104, 105, and 106 for the FEP Blue Standard Option and 111, 112, and 113 for the FEP Blue Basic Option.

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