Y-Yes to HSA/HRA Indicate Employer HSA/HRA whether the Contribution. Employer employer Varchar 1 No N-No to Contribution contributes to HSA/HRA HSA/HRA Employer Contribution Indicate Indicate HSA/HRA employer employer Employer contribution contribution Varchar 15 No Contribution amount to amount to Amount HSA/HRA if HSA/HRA if applicable applicable Indicator of whether a specific plan Y-Yes to will also be Child–Only Child–Only offered at a Offering. Varchar 1 No Offering child–only rate N-No to or have a Child–Only corresponding Offering. child–only plan Y-Yes to number Child–Only assigned to a Plan ID. Plan ID Varchar 1 No child–only N-No to offering that Child–Only corresponds to Plan ID. this plan
HSA/HRA Employer Contribution Indicate whether the employer contributes to HSA/HRA Varchar 1 No Y-Yes to HSA/HRA Employer Contribution. N-No to HSA/HRA Employer Contribution HSA/HRA Employer Contribution Amount Indicate employer contribution amount to HSA/HRA if applicable Varchar 15 No Indicate employer contribution amount to HSA/HRA if applicable Child–Only Offering Indicator of whether a specific plan will also be offered at a child–only rate or have a corresponding child–only plan Varchar 1 No Y-Yes to Child–Only Offering. N-No to Child–Only Offering. Plan ID number assigned to a child–only offering that corresponds to this plan Varchar 1 No Y-Yes to Child–Only Plan ID. N-No to Child–Only Plan ID.
TPA-Integration-Package07242013.docx