| Data Element Name |
Location |
Length |
| |
|
|
| Location Code 1 |
1 |
2 |
| Employee ID # |
3 |
9 |
| Social Security Number |
12 |
9 |
| Dependent ID # |
21 |
2 |
| Dependent Name |
23 |
26 |
| Dependent Birth Date |
49 |
6 |
| Dependent Sex Code |
55 |
1 |
| Dependent Social Security # |
56 |
9 |
| Dependent Relationship to Employee Code |
65 |
1 |
| Dependent Disabled Code |
66 |
1 |
| Dependent Medical Plan Coverage Eff Date |
67 |
6 |
| Dependent Dental Plan Coverage Eff Date |
73 |
6 |
| Dependent Vision Plan Coverage Eff Date |
79 |
6 |
| Dependent Legal Plan Coverage Eff Date |
85 |
6 |
| Employee Selection Code |
91 |
1 |