| Plan |
The name of the disability insurance plan. Click the
Lookup using list icon and select
the plan for the employee. |
| Plan type |
The type of health benefit plan. Fills in when the plan
is selected. |
| Plan ID |
The identification number of the health plan. |
| Start date |
Date when the benefit is active for the employee and
beneficiaries. |
| End date |
Date when the benefit is no longer active for the
employee and beneficiaries. |
| Employee |
The user who requested enrollment. Click the
Lookup using list icon and select
the user. |
| Employee Contribution (per paycheck) |
Dollar amount employee contributes to plan per
paycheck. |
| Employee Contribution (per year) |
Dollar amount employee contributes to plan per
year. |
| Employer Contribution (per paycheck) |
Dollar amount employer contributes to plan per
paycheck. |
| Employer Contribution (per year) |
Dollar amount employer contributes to plan per
year. |