Post on 06-Feb-2018
IMPLEMENTATION GUIDE
Version: V3.13
Date: September 8, 2017
Copyright © 2017, National Association of State Workforce Agencies.
All Rights Reserved.
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Revision History
Date Version Description Author
5/6/2010 1.0 Initial Revision SIDES Team
6/3/2010 1.1 Corrected technical error in Section
4 under ‘Important Notes’. Changed
text FROM:
1. Any text codes (i.e. 'Y' for Yes)
can be accepted in upper or
lower case (or any combination
thereof).
TO:
a. Any text string not defined in
the XSD can be accepted in
upper or lower case (or any
combination thereof).
David Zemel
6/7/2010 1.2 Corrected flow diagram for states
posting requests to Central Broker.
Changed flow from notifying
employer/TPA to:
No acknowledgement within
established time frame
Resend up to 2 additional
times
Then Notify State
Administrator for manual
action
David Zemel
6/14/2010 1.3 Corrected X.509 definition in
glossary
David Zemel
7/2/2010 1.4 Corrected Part B. Employer or TPA
Response Form to include
previously missing columns
“Comments/Notes” and “Values”.
Colin Lennox
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7/27/2010 1. Updated all references to “wage
verification” to be “earnings
verification.”
SIDES Team
7/31/2010 1.6 Added comments to indicate that the
StateRequestRecordGUID is unique
within a state. Employers/TPAs
must ensure their Connector
software handles the possibility
where requests from different states
have the same
StateRequestRecordGUIDs.
Corrected error in validation rule for
StateRequestRecordGUID.
StateRequestRecordGUID cannot
have hyphens in it.
Corrected documentation error
associated with field
BrokerRecordTransactionNumber.
BrokerRecordTransactionNumber
cannot have dashes in it.
SIDES Team
9/29/2010 1.7 The Separation Information standard
format column, ‘Comments/Notes’,
associated with the
StateRequestRecordGUID was
enhanced to: clarify the definition of
a GUID, and guide developers to
generate GUIDs using utilities or
function calls available within the
development framework.
David Zemel
12/09/2010 1.8 Add clarification to the standard
format for numeric fields that
contain money (dollars and cents).
David Zemel
1/19/2010 1.9 Updated SIDES Infrastructure
Graphic in Executive Summary
David Zemel
5/9/2011 2.0 Incorporated Earnings Verification
SIDES Team
3/2/2012 2.1 Changed SIDES Web Services to
SIDES and SIDES Employer
Website to SIDES E-Response
SIDES Team
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(incorporating Chris Peretto edits)
Changed separation information
standard format to make
remuneration conditional and added
notes.
Added a note to claimant first name
and claimant last name fields for the
separation information and earnings
verification exchanges. The notes
specify "May contain a space
(decimal 32) if there is no last name
provided."
Added notes above the separation
information standard format and the
earnings verification standard
format. The notes indicating that a
character field containing only a
space(s) cannot be inserted into the
xml that is sent to the Broker
05/3/2012 3.0 Added Monetary Exchange
SIDES Team
09/27/2012 3.1 Added backfilled fields employer
name and claimant name to the
response portion of the Monetary
and Earnings Verification
Exchanges. This enables requests
and responses to be easily matched
up.
ER-15. Added the key word Code
to the end of the field
ClaimantEmployerWorkRelationshi
p
SIDES Team
11/27/2012 3.2 Changed MR-36 and MR-37
(ClaimantMiddleInitial and
ClaimantSuffix) from Optional to
Backfilled.
Changed ER-36 and ER-37
(ClaimantMiddleInitial and
ClaimantSuffix) from Optional to
Backfilled. Corrected business rule
SIDES Team
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on ER-18 to refer to ER-16
2/5/2013 3.3 Update standard format for Earnings
Verification and Monetary and
Potential Charges
SIDES Team
4/1/2013 3.4 Accepted changes and confirmed
changes to the Separation
Information, Earnings Verification,
Monetary and Potential Charges
standard format.
SIDES Team
4/5/2013 3.4.1 Minor correction to field B-26.6
Corrected bug in secondary business
rule. From: if A-21 is blank, must be more
recent than or equal to (B-2) Claim Effective
Date To: If A-21 is blank, must be more recent
than or equal to (B-2) Claim Effective Date
minus one year and not more than request date
plus one year
SIDES Team
4/16/2013 3.4.2 All changes to the Separation
Information format from April, 2013
Operations Committee meeting are
incorporated
SIDES Team
5/6/2013 3.4.3 Business rule corrections identify by
SIDES team.
M-27: Make business rule consistent with A-9.
ER-19: Add business rule Equal to or prior to
current date and not more than 6 years in the
past.
B-14: Modify business rule to add in must be
null if b-13 is null.
B-17: Move business rule 'not severance pay' to
comment field.
MR-21: Add business rule to restrict date ' must
be more recent than the request date minus 3
years.
SIDES Team
6/12/2013 3.4.4 Updated notes/comments field for
the Monetary and Potential Charges
standard format.
Field M-6: Corrected typo in the
SIDES Team
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notes/comments field so dates in the example use
the same year.
Field M-29: Clarified business rule by
enhancing the example in the notes/comments
field
8/9/2013 3.4.5 Approved by Operations Committee
8/6/2013:
Updated the business rule for the
separation information format, field
B26.5 (AllocationBeginDate).
From:
Changed “Must be more recent than or equal to
ClaimantReportedLastDayWork (A-21)
To:
“Must be more recent than or equal to
EmployerReportedClaimantLastDayofWork(B-
13)
SIDES Team
9/3/2013 3.4.6 Approved by Operations Committee
8/30/2013:
Updated the business rule for the
separation information format, field
B-13
(EmployerReportedClaimantLastDa
yofWork)
From:
Date is after or equal to
EmployerReportedClaimantFirstDayofWork (B-
12). Must be equal to or prior to the request date
To:
Date is after or equal to
EmployerReportedClaimantFirstDayofWork (B-
12). Must be less than or equal to the current
date
SIDES Team
2/20/14 3.4.7 Updated the Executive Summary to
reflect production operations of
Earnings Verification and Monetary
and Potential Charges.
SIDES Team
4/10/14 3.4.8 Updated to include the standard
format for the Determination and
Decision Standard format.
SIDES Team
12/20/14 3.4.9 Corrected Valid Values for Field A-
25, ClaimantSepReasonCode. Value
’20 = Never Employed Here’ is a
SIDES Team
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typo and was deleted from the valid
values.
1/21/2015 3.4.10 Corrected business rule for field ER-
18. Rule was: ‘Required if ER-15 is
‘1’ for Claimant Works/Worked for
Employer or ‘2’ for No Earnings’
Rule should be: ‘Required if ER-16
(EmployerEarningsCode) is ‘1’ or
‘2’
SIDES Team
1/22/2015 3.4.11 Corrected field size definitions for
EmpWorksiteState and
AgentAttorneyState in the
Determinations and Decision
standard format.
SIDES Team
10/16/2015 3.5 Moved text from SIDES
Participation Agreement into the
Implementation Guide. Updated the
SI standard format to reflect the
October 2015 changes approved by
the SIDES Operating System.
Updated the Separation Information
Screen Shots to reflect changes in
the standard format and to
streamline the user interface.
SIDES Team
1/26/2016 3.6 Updated Separation Information
Standard format for the 3/16/2016
cut over
SIDES Team
2/5/2016 3.7 Updated Separation Information
Standard format field B-20,
EmployerSepReasonCode value 99
changed to ‘Refuse To Provide’ and
B-33,
EmployerSepReasonComments
Business Rule “… or 99 for ‘Refuse
To Provide’
SIDES Team
7/1/2016 3.8 Updated to replace EV standard
format with new format for EV
SIDES Team
9/28/2016 3.9 Added Benefit Charges SIDES Team
10/26/2016 3.10 Added clarification note to EV
instructing UI agencies to assign an
unique identification number to out
of state employers, and provide
them the unique number to access E-
SIDES Team
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Response.
12/20/2016 3.11 Added additional text in the notes
column to field M-46 explaining that
if M-46 is set to N the employer, at
their option may or may not file a
protest.
SIDES Team
02/16/2017 3.12 SIDES Logo Updated SIDES Team
09/08/2017 3.13 Updated the field
“Required/Optional” for B-40,
PriorIncident
SIDES Team
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Table of Contents
1.0 INTRODUCTION ................................................................................................ 11
2.0 SIDES COMPONENTS AND OVERVIEW ......................................................... 13
3.0 SIDES FREQUENTLY USED TERMS ............................................................... 15
4.0 SIDES OPERATIONS ........................................................................................ 16
4.1 Operation of the SIDES Broker and E-Response Website ............................................................. 16
4.2 SIDES Participant System Requirements ........................................................................................ 19
4.3 SIDES Particpant Administrative, File Transfer and Other Requirements ................................. 20 4.3.1 Administrative Requirements .................................................................................................... 21 4.3.2 File Transmission Rules ............................................................................................................. 21 4.3.3 Other Requirements ................................................................................................................... 22
5.0 IMPLEMENTING SIDES: SCOPE OF THE PROJECT ...................................... 23
5.1 Connect to the SIDES Central Broker ............................................................................................. 23
5.2 Determine the Interface between the Connector and the Back-end System(s) ............................. 24
5.3 Modify Back-end Operational Procedures and Associated Software Processes:.......................... 24
5.4 Staff Training: .................................................................................................................................... 25
6.0 SIDES IMPLEMENTATION TEAM .................................................................... 26
6.1 Leadership Team ................................................................................................................................ 26
6.2 Project Team ....................................................................................................................................... 26
7.0 SUGGESTED CHECKLIST OF STEPS ............................................................. 27
8.0 IMPLEMENTING SIDES APPLICATIONS ..................................................... 29
8.1 The Separation Information Standard Format ............................................................................ 29
8.2 The Earnings Verification Standard Format ................................................................................... 61
8.3 The Monetary and Potential Charges Standard Format ............................................................ 87
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8.4 The Determination and Decision Standard Format ................................................................. 105
8.5 The Benefit Charges Standard Format ....................................................................................... 126
8.6 General Flow Overview ................................................................................................................ 156
8.7 General Step-by-Step Outline...................................................................................................... 156
8.8 Functional Details ............................................................................................................................. 158 8.8.1 State Posting a Request ............................................................................................................ 159 8.8.2 Pull a Request/Response .......................................................................................................... 160 8.8.3 Employer or TPA Posting Response ........................................................................................ 162 8.8.4 Push Request from Broker (optional) ...................................................................................... 164
8.9 SIDES E-Response ........................................................................................................................... 165 8.9.1 Overview of SIDES E-Response Operations ...................................................................... 165 8.9.2 Screen Captures of SIDES E-Response ............................................................................... 168
GLOSSARY OF TERMS ............................................................................................. 210
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1.0 INTRODUCTION
This document is intended to help state Unemployment Insurance (UI) agencies and employers/Third Party Administrators (TPA) successfully implement the State Information Data Exchange System (SIDES). SIDES is an Internet-based automated file transfer system through which states and employers/TPAs can exchange unemployment information using one or more applications to transmit established file formats.
The figure below shows the three components of the SIDES infrastructure and the data transfer applications that it currently supports. The applications in grey boxes may be added to SIDES in the future.
The Separation Information Application was put into production on February 2, 2010, and handles state job separation information requests and employer/TPA responses.
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The Earnings Verification Application was put into production on September 28, 2012, and handles state requests for verification of an individual's employment and earning and the employer/TPA responses.
The Monetary and Potential Charges Application was put into production at the end of February 2014 and advises employers that wages they have paid to a claimant are being used in the calculation of potential benefits payable to the claimant. The application advises employers of the potential charges that may impact their state unemployment taxes if benefits are paid. Additionally, the employer has an opportunity to submit corrected information and/or protest the information presented.
The Determination and Decision Application was put into production in April, 2014. It permits states to transmit a Non-Monetary Determination or an Appeals Decision to an employer/TPA electronically. The employer/TPA can electronically respond, if necessary, to file an appeal of a Non-Monetary Determination or of a Lower Level Appeal Decision using the standard national format.
The Benefit Charge Notices Application went into production September 2016. It permits states to transmit notices of benefits charges. The employer/TPA can electronicall respond, if necessary, to appeal/protest/question the charges.
This Implementation Guide includes first, a description of how SIDES operates and the requirements SIDES participants, both states and employers/TPAs, must meet. Second, it describes broadly the process for implementing SIDES, and third, it provides more detailed information about implementing each of the SIDES applications that are currently in production. Please note that this section is by no means exhaustive, and more detailed technical documentation is available in the SIDES Developers’ Guide.
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2.0 SIDES COMPONENTS AND OVERVIEW
The major components and relationships of the SIDES infrastructure are described
below and illustrated in the figure that follows.
SIDES Central Broker. The SIDES infrastructure consists primarily of the central
servers (Broker) and the software that runs on it. States and employers connect
with this system to send and receive their data. The Central Broker receives all
messages from participating states and employers/TPAs and routes them to
their intended targets. The SIDES infrastructure is capable of supporting all data
transfer applications that are developed to be compliant with it.
SIDES E-Response Website. The SIDES E-Response infrastructure allows states to
send their requests to the SIDES E-Response website via the Central Broker; non-
participating employers/TPAs can manually enter their data responses to the E-
Response website. Those responses are routed to the Central Broker and are
picked up by the state UI agencies.
SIDES Administrative Web Site. The SIDES Administrative Web site permits
states and employers/TPAs to:
- Generate reports of the transaction history contained in the Central Broker
database. (Note: administrators can only view and download information
to which they are a party);
- Record Connector scheduled and ad hoc downtimes (performed by the
Connector Administrator);
- Maintain Connector information; and
- Maintain user information.
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3.0 SIDES FREQUENTLY USED TERMS
The following terms are used frequently in this guide and are important in understanding how SIDES operates. Additional definitions are offered in the Glossary of Terms, and a more specific discussion of how your organization must negotiate these technologies in the development of your software is available in the Developer’s Guide.
Connectors are the applications and computer hardware operated by an individual participating state, employer or TPA that serve as the single secure point of contact for SIDES between the specific participant and the Central Broker.
XML: EXtensible Markup Language is the format of the application data that are exchanged between states and Employers/TPAs via SIDES.
XSD: The XML Schema Definition (XSD) is the template that provides the rules for validating the format of the data contained in XML files.
SOAP: The messaging protocol used by the Connectors and the Central Broker to exchange SIDES application data for transmission over the Internet. The messaging approach includes two items: the address to which the message is directed and the data itself.
X.509: the international security standard that SIDES uses to encrypt the state and employer/TPA data prior to transmitting sensitive data over the Internet.
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4.0 SIDES OPERATIONS
This section describes how the SIDES Central Broker operates and the requirements that
SIDES participants must meet in order to connect to the Broker and exchange
information with each other.
4.1 OPERATION OF THE SIDES BROKER AND E-RESPONSE
WEBSITE
CESER provides and oversees a data center for operation of the SIDES Broker and E-
Response website. The responsibilities, services, and security of the Broker, to which
each SIDES participant connects, are described below:
To ensure the integrity of the SIDES system and achieve the performance requirements consisting of 24x7 operations with a fixed maintenance window and Broker availability of not less than 99.9% in any 30-day period, a professional data center that is an ISO 20000 certified facility with mature standards, procedures, and processes is used to house the SIDES Broker and E-Response website.
The data center is fully equipped with fire, smoke, and moisture detection systems to protect against all environmental hazards. In case of power loss, emergency power will be provided for continuous operations of the SIDES Broker and E-Response website.
The data center operates and monitors the SIDES Broker and E-Response website with appropriate components such as network routers, switches, and firewalls. Upon detection of operational faults or a condition exceeding hardware usage thresholds, the data command center is immediately notified. The center will create, track, monitor, and close trouble tickets. When high priority trouble tickets are opened, the data center will follow an escalation procedure to notify the appropriate staff and the SIDES Broker administrator who will address the problem as appropriate.
The data center provides 24x7 onsite staffing to ensure hands-on management support for the SIDES Broker and E-Response website. The data center provides technical assistance, break/fix oversight, as well as operational monitoring of all devices and circuits. Additional operations and engineering personnel are on call during off hours in case of a SIDES Broker outage.
The data center monitors the SIDES Broker and E-Response network data communications infrastructure to ensure the network environment meets the Broker availability and performance requirements.
The data center network operations implement performance management and monitoring tools of the required capacity and scale to enable performance
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management for network devices with Simple Network Management Protocol (“SNMP”) capability.
To ensure data confidentiality and integrity, the data center protects SIDES resources and critical data assets from unauthorized access, destruction, modification, or disclosure. Security covering the electronic exchange of data was built into the requirements and design of the Central Broker and is implemented using industry standards in all aspects of SIDES. Security is addressed at three points:
o Protecting the data: The Connector and Central Broker secure the data, which are placed in a SOAP message and encrypted using the X.509 standard. This process can be thought of as putting the SIDES application data into an ‘envelope’ for which the recipient must have a special key to open. All data held on the Central Broker are encrypted and data backed up to off-site secured storage are encrypted.
o Protecting data during transfer to/from the Central Broker over the Internet: Next, when the ‘envelope’ is transported to the Central Broker, over the Internet, it places the original secured ‘envelope’ into a second secure ‘envelope.’ To create this second layer of security, SIDES uses encryption known as Secure Sockets Layer (SSL) which is communicated over Hypertext Transfer Protocol (HTTP). Most people will recognize this as the HTTPS which appears during online activities such as shopping or banking.
o Protecting the Central Broker: In addition to the two security measures just described, the Central Broker has its own security. These include:
Physical and Network Security. Physical security is provided 24x7 by onsite guards with card-key access through all external doors and critical production areas. Digital video surveillance of the facility perimeter, exits, entrances, and critical production areas are monitored 24x7. The data center campus is patrolled 24x7 by onsite security with a vehicle entrance controlled by gate access. The network is secured by a dedicated SIDES firewall and redundant connections to the Internet.
User Access. Authorized data center staff can login only through a secure VPN or console. Data center access is assigned on an ‘as needed’ basis only; default is ‘no access.’ User names and passwords are used according to data center standards and expire within 45 days.
Connector Access. Only the Broker Administrator can register a Connector with the appropriate security certificate. Only a registered Connector may send and receive messages to and from
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the SIDES Central Broker; all unauthorized or anonymous access is blocked.
Administrative Web Site Access. Only authorized users may access the Administrative Web Site and must provide user names and passwords.
Virus Protection. As part of data security, the data center is responsible for ensuring protection against computer viruses. Virus detection updates occur no less frequently than every 24 hours, and the data center will ensure that virus scans are up-to-date and active in the data center environment.
The data center maintains an established disaster recovery (“DR”) plan, including:
o Identification of persons responsible for disaster recovery activities;
o Development of team plans that encompass all the necessary functions for recovery;
o Utilization of plans during DR exercises for validation of procedures;
o Revision of plans to implement changes in recovery personnel, knowledge gained during a DR exercise, modifications in the computing environment noted in the change control process, and update of recovery methodologies.
o Performance of a post-exercise review with SIDES participants to ensure plan maintenance protocol is reviewed and expanded when necessary to reflect changing IT requirements.
The data center performs routine backup of the SIDES Broker and E-Response website. Automated backup procedures are used wherever appropriate. Broker backups are stored on a Virtual Tape Library (VTL), and the data center manages the library to ensure that the backups are rotated offsite. Sensitive information is encrypted and stored in the SIDES database. When backups of the database are taken, the backup itself is not encrypted; however, the database files (copied to tape) are already encrypted. If necessary, the data center will use the backups to perform recovery of the SIDES data and to support reconstruction of the environments.
The data center provides 24x7 service desk operations through toll-free, 800 phone service support to the SIDES participants. The service desk is a single point of contact (“SPOC”) for (a) all participant inquiries, and (b) problem reporting across the full spectrum of the SIDES Broker, including servers, data communications, credentials and SIDES administrator support. The service desk uses automated software to open, track, and monitor progress, and to close trouble tickets. Relationship management between participating states and
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nonparticipating employers and TPAs using the E-Response website is the participating state's responsibility.
The data center follows change management procedures prior to implementing any modifications to the production SIDES Broker and/or E-Response environment. Changes/enhancements to the SIDES custom application software are implemented in the development or test environment only with approval from the CESER after consultation with all SIDES participants and approval by CESER of a schedule for production. Migration of SIDES custom application software will successfully pass through change management prior to migration to the production environment.
The data center gives SIDES participants a minimum of six months’ notice of major commercial software upgrades planned for the SIDES Broker which could impact operation of the participants’ systems.
The data center provides performance and capacity management services to report on the health of the Broker and E-Response website environment. Implementing SIDES.
4.2 SIDES PARTICIPANT SYSTEM REQUIREMENTS
All SIDES participants must create and maintain at their own expense the systems necessary to interface with the SIDES Broker. The following is a list of high level requirements necessary for your system to successfully interface with the SIDES Broker to exchange information related to the specific data exchanges.
Obtain SIDES data from the Broker at least once every 24 hours to minimize prolonged storage of SIDES data on the Broker.
Back up SIDES data at least every 24 hours. This will minimize the number of “resends” of data from the Broker and avoid loss of data by a participant.
Size your production system to be capable of supporting the exchange of data flow during peak workload periods with other SIDES participants.
Support three environments for SIDES exchanges for which you have elected to participate: a Development System for the development of end-point SIDES interfaces and/or future upgrades and enhancements; a Test System for debugging and testing of the SIDES system or future upgrades or enhancement of the system, and a Production System for processing the exchange information for which you have elected to participate.
Perform certification testing of your interfaces to ensure proper operations prior to initiation of full production and connection to the SIDES production system, including providing test files to support this certification testing process. Certification testing entails successfully executing the following:
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o Verification that the participant and the Broker can securely communicate with each other using the Web Service Definition Language (WSDL)-defined exchange messages and associated XML Schema Document (XSD) type constructs; verification will be performed by the Broker administrator and the participant’s administrator.
o Verification that the participant can send data to the Broker.
o Verification that the participant can retrieve data from the Broker.
o Verification with the Broker administrator that the request or response data conform to the prescribed XSD data specification.
Conform to the SIDES Standards (based on World Wide Web Consortium (“W3C”) standards) established for the exchanges in which you have elected to participate:
o XML Request and Response file formats, including validation rules;
o WSDL (includes SOAP request/response messaging formats and attachment processing);
o Security Requirements and
o Request and Response Business Rule Requirements.
Meet the following security requirements:
o For the production system, initially obtain and change X.509 Security Certificates, at your expense, at least once every two years, from a commercial Certificate Authority (CA) (such as Symantec, Comodo, etc.), and to coordinate that update with the Broker System Administrator. For the development and test systems, generate and use self-signed certificates.
o Implement the SIDES security standards of Transport and Message Level Security.
o Comply with the Web Service Security and Web Service Trust as implemented in the SIDES system.
Be prepared to make necessary revisions to your software and complete testing by mutually agreed upon dates. (Multiple versions of the SIDES system are not supported).
4.3 SIDES PARTICPANT ADMINISTRATIVE, FILE TRANSFER AND
OTHER REQUIREMENTS
As you implement SIDES, keep in mind that the following list of operational steps are necessary for implementing and continuing SIDES operations.
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4.3.1 Administrative Requirements
a. Name an Administrator and at least one alternate administrator for your connector to handle operational issues that may arise.
b. Define and manage Users who access the Broker.
c. Maintain the currency and accuracy of your Administrator(s), User(s) and Entity information.
d. Keep your Uniform Resource Identifier (URI) addressing current and accurate.
e. Provide to the SIDES Broker Administrator your Connector data (e.g., Point(s) of Contact, email address, etc. two (2) weeks prior to your “go-live” date.
f. Maintain your Connector data after initial set-up by the SIDES Broker Administrator (see 4.3.1.e above). This includes all data and user roles.
4.3.2 File Transmission Rules
a. Files or records which fail the standards will be returned to the sender as a failed transmission and will NOT be sent to their destination.
b. Unencrypted but encoded files must be limited to not more than eight (8) Megabytes in size.
c. Request or Response files will be sent to one and only one destination.
d. Responses can only be sent by the party receiving a request for information.
e. The date an employer/TPA’s response is successfully submitted to the Broker is the Official Date of receipt by the State Agency.
f. Responses successfully submitted to the Broker by 11:59 PM Eastern Time on the Response Due Date are considered by the state to have been submitted timely.
g. The response due date for a Request for Information which fails validation, will be adjusted for the delay when the state corrects and successfully resends the request.
h. Following repeated file transmission failures (repeated file transmission failures is defined as after 2 re-sends, or 3 total consecutive transmission attempts, in which a file transmission fails) a SIDES participant must:
i. trouble shoot its own system, hardware, software, security certificates, etc.
ii. if the failure cause is not identified through internal trouble shooting, contact the Broker Administrator to describe fault and situation or conditions, and coordinate further trouble shooting with the Broker to establish the nature of the problem.
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iii. take agreed upon corrective action regarding internal faults.
iv. initiate re-transmission of all failed files.
i. If a participant cannot transmit and or pick up files for five (5) consecutive days, rollback to that entity’s legacy method shall occur within a total of seven (7) days. Rollback to the legacy method may be made earlier than five (5) days if necessary. The Connector will change the entity’s status in the SIDES Broker to “nonparticipant” until the party can become operational again, at which time the party will be updated to “participant” again.
k. Only the printable US American Standard Code for Information Interchange (US ACSII) characters will be used in all Broker communications. Individual field validations will be as given in the Baseline Requirements and Technical Design documentation.
4.3.3 Other Requirements
a. Each participant will create a disaster recovery and continuity of operations (“COOP”) plan that functions in conjunction with the mutually agreed upon Broker COOP plan.
b. The response due date for a request is contained in the A-30 field of the Separation Information Request record.
c. Employer/TPA participants understand that use of the "99 Code" for any response item for which it is permitted (see Baseline System Requirements) means that they do not have and/or cannot present the information requested, and the participating state should proceed based on information provided. The employer/TPA understands and agrees that the state should proceed with making a determination without this additional information and that the Employer/TPA may not be allowed to present the omitted information at a later time. The result of using the 99 Code may result in an adverse effect on the Employer account and its standing regarding the issue.
d. The Broker uses Eastern Time for date and time stamping all transactions.
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5.0 IMPLEMENTING SIDES: SCOPE OF THE PROJECT
In broad terms, implementing SIDES consists of four steps:
connecting to the Central Broker;
determining the interface between the Connector and your back-end system;
modifying your operational procedures and related software, and
training staff who will use information obtained through SIDES.
These steps are not necessarily sequential. For example, you might combine the effort to develop your Connector and its interface with your back-end system, and while doing that development keep in mind how that interface will impact your current business processes and procedures. Fully defining new business processes and training staff in advance of implementation is critical to the success of the project. We can’t stress enough the importance of staff training. Using information obtained through SIDES will be a new way of doing business for your staff, and in order to take full advantage of the efficiencies SIDES can give you, your staff must understand fully how to use it. Each of the steps outlined above is described in more detail below.
5.1 CONNECT TO THE SIDES CENTRAL BROKER
Identify hardware and software needed for communicating with the SIDES infrastructure.
Configure Connector components, and connect to the SIDES infrastructure to exchange files. Examples are available for download from the SIDES Website, and may be customized for use by states and employers/TPAs. Keep in mind that the Central Broker has three different environments: Development, Test, and Production. Your Connector software will also need to include and support your Development, Test and Production environments/systems.
Development Environment: may be small in scale as it does not need to handle significant workloads; may not need to be live at all times; may connect only to the Central Broker “test system.” A self-signed security certificate may be used.
Test Environment: should be equivalent functionally to the production environment, but it may be small in scale; it does not need to handle any significant workloads; may not need to be live at all times, and it may connect only to the Central Broker “test system.” A self-signed security certificate may be used.
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Production Environment: must be robust and scalable to handle the anticipated workload growth as new participants are added; must have security certificate from a certificate authority (i.e., Symantec); may access the Central Broker “production system” only after fulfilling all test and certification requirements.
5.2 DETERMINE THE INTERFACE BETWEEN THE CONNECTOR
AND THE BACK-END SYSTEM(S)
Implement the data format validation rules. Data format validation rules may be thought of as edit checks. The SIDES data, contained within the XML file, is compared to the associated XSD. For example, the XSD will validate that a Social Security Number is only nine characters long and is only composed of digits. If errors are detected during the validation process, an XSD error message is returned to the Connector.
Implement the SIDES business rules. Business rule validation consists of logic that cannot be defined in an XSD. Business rules define the parameters where certain data elements are required based upon the data supplied. For example, when considering a separation information response, a “Final Incident Reason” must be provided if the “Discharge Reason Code” is other than ‘Not Qualified’ or ‘No Data Supplied.’ To support the implementation of the SIDES business rules, Connectors must develop software to perform these checks.
5.3 MODIFY BACK-END OPERATIONAL PROCEDURES AND
ASSOCIATED SOFTWARE PROCESSES:
You will need to create and consume data in the exchange format from your back-end system. You should consider which of the following are applicable to the implementation of your design:
How will your business processes change, and
How will back-end systems need to be modified to support the interface with SIDES? A few examples are listed below:
o Particular applications, such as initial claims, adjudication, scheduling
o Imaging/Workflow
o Databases
o Other Web Services
o Printing and mailing processes
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5.4 STAFF TRAINING:
As with any new software application and processes, it is critical that all of the impacted staff have an opportunity to learn about the new system and how it affects their work. Some items to consider while developing your training plan are:
Coordinating training schedules to align with system development and plans to go live;
Defining changes to procedures for handling and processing information;
Explaining new terminology;
Defining codes used by SIDES;
Changing timelines for managing and processing returned information, and
Developing and explaining troubleshooting and issue resolution procedures.
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6.0 SIDES IMPLEMENTATION TEAM
As you can see from the scope of the project, implementing SIDES will require team members with both technical and business expertise. The following is a general description of the major members of an implementation team. Depending on the size and structure of your organization, your team may vary from this general outline.
6.1 LEADERSHIP TEAM
These team members are high ranking managers/executives who will ensure that the project gets the necessary resources and support. One member will likely be the individual who made or had final approval of the decision to implement SIDES. The other two members should be in high level positions on the business and technical sides of your organization and able to allocate resources from their respective area of responsibility to ensure the success of the project.
6.2 PROJECT TEAM
We suggest that the Project Team include the following:
Project Manager. The Project Manager should be someone who can mediate potential conflicts between the business/program and technical aspects of the project. He/she will make assignments to individual team members, make sure timeframes and budgets are met, and mitigate risks.
Program Lead. The program lead should be fully knowledgeable of your organizational structure, terminology, procedures, and reporting requirements. He/she will be responsible for the tasks associated with matching the business operations to the SIDES requirements.
Technical Lead. The technical lead should be fully knowledgeable of your organization’s information technology infrastructure, hardware, software, procedures, security, and administrative processes. He/she will be responsible for the tasks associated with matching the technical operations of the organization to the SIDES requirements.
Testing Lead. If possible, responsibility for testing should be assigned to a specific individual rather than leaving it to a general team effort.
Training Lead. It is critical that the person responsible for training staff to use SIDES is involved sufficiently in the development and implementation process that he/she is well prepared to develop training materials, and perhaps train other trainers, (depending on the size of your organization) before you go into production with SIDES.
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7.0 SUGGESTED CHECKLIST OF STEPS
The list below is a general guide to help you get started with your implementation planning. It is based, in part, on the experience of currently participating states and employers/TPAs as well as basic project management principles. Feel free to adapt it to your organization’s particular needs.
Initiate Project
Define the business case for the project and identify a Project Sponsor
Determine Project Scope
o Analyze current business and technical operations
o Determine required modifications to business processes
o Determine if vendor (contractor) support is required and procure suppliers
o Determine and, if necessary, procure commercial software and hardware
o Analyze and understand SIDES software requirements
Plan Project
Cost and schedule estimates
Create project management plan
Create test plan to document approach to testing and test data creation
Create operations roll out plan
Create operation management plan
Create training plan
Execute Project
Assign Resources
Convene Kick-Off Meeting
o Confirm Team Roles and Responsibilities
o Confirm Initial Project Plan and Timeline
Develop Software
o Define requirements and specifications
o Implement hardware and associated software
o Define and construct SIDES application software
Testing
o Project team testing
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Develop test data
Develop test cases
Test with Central Broker
Round-trip test with endpoints
Pass certification tests
o Business staff testing
Train business staff
Have business staff complete testing
o Acceptance testing
Operations Readiness Preparation/Go Live
o Develop operational plan and procedures
o Develop training plan
o Develop ongoing maintenance plan
o Implement revisions as required after testing
o Complete quality assurance
o Production Deployment
o Review and evaluate procedural steps after initial operations to improve your processes.
Close Project
Conduct any Desired Post-Mortem, document lesson learned
Begin Ongoing Maintenance Operations
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8.0 IMPLEMENTING SIDES APPLICATIONS
Prior to any other work, states and employers or TPAs must agree to and follow a standardized data format. These are known as the Separation Information Standard Format, the Earnings Verification Standard Format, the Monetary and Potential Charges Standard Format, and the Determination and Decision Standard Format. The next four sections address these standard formats.
8.1 THE SEPARATION INFORMATION STANDARD FORMAT
The two tables below detail what the Separation Information Standard Format requires for a state request for separation information and for the employer separation response. This standardized format is documented in much greater detail in the Developer’s Guide.
Important Notes:
1. Any text string not defined in the XSD can be accepted in upper or lower case (or any combination thereof).
2. For any character fields, if entry is via the Internet, do not allow entry of the characters for less than and greater than ('<', '>').
3. All field sizes are variable length unless marked with an Asterisk (*), which denotes the field size is fixed length.
4. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
For Employer Response Only:
1. An additional field, “Fact-Finding Question” is unique to the employer response table and provides a typical question that an employer might see.
2. For fields labeled as 'Backfilled', the data element is passed back from the Request for Separation Info and is not editable by the employer or TPA.
3. Fields B-1 through B-4 are key fields for matching response to request.
4. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
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State UI Agency Request for Separation Information [Version 22.7 - Requirements Baseline - 2-5-2016]
Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-32 StateRequestRecordGUID This is a unique ID given to this record by the State
Character 32* Required Contains only 32 hexadecimal digits
A GUID is a special identifier used in software applications to provide a unique reference number. The value is represented as a 32 character hexadecimal character string, such as {21EC2020-3AEA-1069-A2DD-08002B30309D}. Note: hyphens are
not permitted in GUIDs used in SIDES.
The SIDES team suggests GUIDs
be generated using utilities or function calls available within your development framework.
Each separation request record shall contain a unique StateRequestRecordGUID that cannot be reused for a period of 10 years. A StateRequestRecordGUID may be reused when the state does not receive a Broker acknowledgement to the Post, or when Broker the message code for the Post = 2 (total file failure), or when the Broker acknowledgement returns a message code = 3 and the record with the StateRequestRecordGUID is identified as a record in error.
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
Field contains a unique GUID within a state. Field cannot be guaranteed unique across states. Employers/TPAs must ensure their Connector software handles the possibility where requests from different states use the same StateRequestRecordGUIDs. In error processing situations or if a re-send is requested or required, the StateRequestRecordGUID may not be regenerated. Endpoints must be capable of handling a file that contains duplicate records, including control information (for example, the StateRequestRecordGUID field).
A-33 BrokerRecordTransactionNumber This is a unique ID given to this record by the broker.
Character 32 Required on Request to the Employer/TPA
Contains only digits Field must not be present in the request file from the State – will cause an XSD error if there.
A-1 SSN The claimant’s Social Security Number.
Character 9* Required Contains only numbers and there are no letters or special characters
Information on valid SSN from <http://www.ssa.gov/foia/stateweb.html>.
A-2 ClaimEffectiveDate The effective date of the claim is based on the date the claim is filed and other factors defined in each States' procedures. Can be an Initial or Additional claim.
Date yyyy-mm-dd
10* Required Must be equal to or more recent than the request date minus six years.
Contains only numbers and dashes. Must be a valid date.
A-3 ClaimNumber A unique identifier that can be used by the state to track a claim occurrence.
Character 18 Optional Contains the printable ASCII characters 32 – 126 decimal.
A-4 StateEmployerAccountNbr The State account number that identifies the employer on the separation information request form. It is a unique identifier for the employer.
Character 20 Required Contains the printable ASCII characters 32 – 126 decimal.
A-5 EmployerName The legal business name of the employer.
Character 100 Required Contains the printable ASCII characters 32 – 126 decimal.
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-6 FEIN The claimant's employer Federal Employer Identification Number (FEIN)
Character 9* Required Contains only numbers and there are no letters or special characters. Must be 9 digits.
A-7 TypeofEmployerCode The type of employer Character 1* Optional Value is either a digit or null. Can only be codes 1-7.
1 = Last, Base Period, and Lag Quarter Employer 2 = Last Employer 3 = Base Period Employer 4 = Lag Quarter Employer 5 = Last and Base Period Employer 6 = Last and Lag Quarter Employer 7 = Base Period and Lag Quarter Employer
A-8 TypeofClaimCode The type of claim Character 1* Required Value is a digit. Can only be codes 1-2.
1 = New Initial Claim 2 = Additional Claim
A-9 BenefitYearBeginDate The benefit year begin date is based on the date the claim is filed and other factors defined in each States' procedures.
Date yyyy-mm-dd
10* Required Must be equal to or more recent than the request date minus six years.
Contains only numbers and dashes. Must be a valid date.
A-10 RequestingStateAbbreviation US Postal (2 letter) state code
Character 2* Required Must be two alpha characters and no blanks allowed.
Information on valid 2-character state and territory abbreviations available from the FIPS website: <http://www.itl.nist.gov/fipspubs/fip5-2.htm>.
A-11 UIOfficeName The name or description of the appropriate UI office location to contact regarding this request.
Character 25 Optional Contains the printable ASCII characters 32 – 126 decimal.
A-12 UIOfficePhone Phone number for Employer to contact a person in the State regarding this request.
Character 15 Optional Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
A-13 UIOfficeFax Fax number for Employer to send Fax information pertaining to this request.
Character 10* Optional Contains only numbers. Must contain 10 digits.
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-14 ClaimantLastName The claimant’s last name. Character 30 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
A-15 OtherLastName The additional last name for a claimant who performed work using more than one SSN name. This covers SSN name changes, e.g., due to marriage or divorce.
Character 30 Optional Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
A-16 ClaimantFirstName The claimant’s first name. Character 25 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
A-17 ClaimantMiddleInitial The claimant’s middle initial. Character 1* Optional Contains a letter. Field cannot contain all spaces (there must be at least 1 non-space character)
A-18 ClaimantSuffix The claimant’s suffix, for example: Sr. Jr.
Character 8 Optional Contains letters, numbers, periods, and blanks. Field cannot contain all spaces (there must be at least 1 non-space character)
A-19 ClaimantJobTitle The claimant’s statement of his/her position/job title, or role at the time separation/reduction of hours from employment.
Character 30 Optional Contains the printable ASCII characters 32 – 126 decimal.
A-20 ClaimantReportedFirstDayofWork The claimants’ statement of his/her starting date of employment / first day of work
Date – yyyy-mm-dd
10* Optional Must be in the past and more recent than the request date minus one hundred years.
Contains only numbers and dashes. Must be a valid date.
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-21 ClaimantReportedLastDayofWork The claimant’s statement of his/her last day at work.
Date – yyyy-mm-dd
10* Optional Must be equal to or after Claimant Reported First Day of Work (A-20). Must be more recent than the request date minus 3 years and not more than the request date plus one year in the future.
Contains only numbers and dashes. Must be a valid date.
A-22 WagesWeeksNeededCode Indicates whether wages and/or weeks are needed.
Character 2* Required Value is 'WO', 'WW', or 'NA' WO = Wages Only WW = Weeks and Wages NA = Not Needed
A-23 WagesNeededBeginDate The beginning date for which wages are requested.
Date – yyyy-mm-dd
10* Conditional Required if WagesWeeksNeededCode (A-22) is 'WW' or 'WO' Must be in the past and more recent than the request date minus 18 months
Contains only numbers and dashes. Must be a valid date.
.
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-24 WagesNeededEndDate The ending date for which wages are requested.
Date – yyyy-mm-dd
10* Conditional Required if WagesNeededBeginDate (A-23) is completed
Must be in the past and more recent than the WagesNeededBeginDate.
If no value in (A-23) then (A-24) must be null
Contains only numbers and dashes. Must be a valid date.
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-25 ClaimantSepReasonCode The claimant's reason for separation.
Character 2 Required Value is all digits. Can only be codes 1 - 19 and 99.
1 = Temporary Layoff 2 = Laid Off/Lack of Work 3 = Fired/Discharged 4 = Vacation/ Holiday Shutdown 5 = Asked to Resign 6 = Voluntary Quit/Separation 7 = School Employee Between Semesters or Terms, Likely to Return 8 = School Employee Between Semesters or Terms, Not Likely to Return 9 = Still Employed, Full Time 10 = Still Employed, Part Time 11 = Still Employed, Hours Reduced by Employer 12 = On Call or Temporary Status 13 = Leave of Absence 14 = Retirement 15 = Disciplinary Suspension 16 = Labor Dispute 17 = Professional Athlete Between Sports Seasons 18 = Disaster Related Separation 19 = Not Listed Above 99 = Not provided
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-26
ClaimantSepReasonComments The claimant's statement on why he/she is no longer working for the employer. For example, the claimant may say that he or she quit because of disagreements with the employer.
Character 4000 Optional Contains the printable ASCII characters 32 – 126 decimal.
A-27 ReturntoWorkDate The date the claimant anticipates returning to work. Also known as the recall date.
Date – yyyy-mm-dd
10* Optional Must be after Claim Effective Date (A-2) and not more than the request date plus one year in the future.
Contains only numbers and dashes. Must be a valid date. .
A-28 Attachment Optional Occurs 0-10 times
A-28.1
DescriptionofAttachmentCode The description of the attachment format.
Character 1* Required for each Attachment (A-28)
Value is a digit.Can only be codes 1-5.
1 = RTF 2 = PDF 3 = TXT 4 = TIFF or TIF 5 = CSV
A-28.2
TypeofDocument Description of the type of document attached.
Character 40 Required for each Attachment (A-28)
Contains the printable ASCII characters 32 – 126 decimal.
A-28.3
UniqueAttachmentID A unique ID within the record given to this attachment, and when combined with the StateRecordGUID is unique within the universe
Character 2 Required for each Attachment (A-28)
Must be unique within a record.
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-28.4
ActionableAttachment Determines whether the Employer/TPA is required to perform an action with the attachment
Character 1* Required for each Attachment (A-28)
Value is a digit. Can only be codes 1-4.
1 - Informational only - No Action Needed (i.e a standard form that outlines how to follow an appeal that is not employer or claimant specific) 2 - Informational only - Claimant/Employer Specific - No Action Needed (ie. if a state is required to send an image of the claim form filed) 3 - Requires action - state standard question set (ie. states could identify the question set by file name (A-28.2) 4 - Requires action - adhoc question set added by the state
A-28.5
AttachmentSize The attachment size in bytes
Numeric Required for each Attachment (A-28)
Contains only numbers.
A-28.6
AttachmentData The actual attachment in Base64 encoding
Base64Binary Required for each Attachment (A-28)
Base64 encoded characters only
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Seq. No.
Data Element Name Data Element Description Type and/or
Format Field Size
Field Required /
Optional
Business Rules
Validation Comments/Notes Values:
A-29 RequestDate The date this Request for Separation Information is transmitted to the Employer/TPA.
Date – yyyy-mm-dd
10* Required Date must be greater than or equal to the current date minus one day and not more than the current date plus 6 months in the future.. State and Broker rule only.
Contains only numbers and dashes. Must be a valid date
Business rule component ‘and less than current date + 6 months’ permits retention of production readiness review data for 6 months before data must be regenerated.
A-30 ResponseDueDate The due date the response must be sent back to the state agency to be considered a timely response.
Date – yyyy-mm-dd
10* Required Must be at least XX days and cannot be more than 24 days after the RequestDate (A-29).
Contains only numbers and dashes. Must be a valid date.
A-31 FormNumber The form number this transaction applies to.
Character 12 Optional Contains the printable ASCII characters 32 – 126 decimal.
A-34 PIN This is the PIN that the employer uses to log into the E-Response website. This shall only be used for bundling E-Response records.
Character 20 Optional Can only be used if the file that the record s in is addressed to EResponse in the SOAP header, otherwise must be null
A-35 BrokerRecordEffectiveDate The date that the record was accepted from the State into the Central Broker.
DateTimeStamp
30 Broker generated field. Not put into the request by the State.
Contains a date and time stamp Format will be: 2010-01-27T16:03:08.000-04:00
Date and time the request was accepted by the Broker. Field must not be present in the request file from the State – will cause an XSD error if there.
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Part B. Employer or TPA Response Form [Version 22.7 - Requirements Baseline - 2-5-2016]
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-59* StateRequestRecordGUID NA This is a unique ID given to this record by the State
Character 32* Backfilled Contains only 32 hexadecimal digits
A GUID is a special identifier used in software applications to provide a unique reference number. The value is represented as a 32 character hexadecimal character string, such as {21EC2020-3AEA-1069-A2DD-08002B30309D}. Note: hyphens are not
permitted in GUIDs used in SIDES.
The SIDES team suggests
GUIDs be generated using utilities or function calls available within your development framework. Field contains a unique GUID within a state. Field cannot be guaranteed unique across states. Employers/TPAs must ensure their Connector software handles the possibility where requests from different states use the same StateRequestRecordGUIDs.
Endpoints must be capable of handling a file that contains duplicate records, especially the StateRequestRecordGUID field.
B-60* BrokerRecordTransactionNumber
NA This is a unique ID given to this record by the broker.
Character 32 Backfilled Contains only digits
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Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-70 RequestDate The date this Request for Separation Information is transmitted to the Employer/TPA.
Date – yyyy-mm-dd
10* Backfilled Contains only numbers and dashes. Must be a valid date
B-71 ResponseDueDate The due date the response must be sent back to the state agency to be considered a timely response.
Date – yyyy-mm-dd
10* Backfilled Contains only numbers and dashes. Must be a valid date.
B-1* SSN What is the claimant's Social Security Number (SSN)?
The claimant’s Social Security Number.
Character 9* Backfilled Must return SSN exactly as sent in A-1.
B-2* ClaimEffectiveDate What is the effective date of the claim?
The effective date of the claim is based on the date the claim is filed and other factors defined in each States' procedures.
Date – yyyy-mm-dd
10* Backfilled Must return ClaimEffectiveDate exactly as sent in A-2.
B-3* ClaimNumber What is the claim number?
A unique identifier that can be used by the state to track a claim occurrence.
Character 18 Backfilled If ClaimNumber sent in A-3, must return ClaimNumber exactly as sent in A-3.
B-4* StateEmployerAccountNbr What is the employer's state account number?
The employer's state account number.
Character 20 Backfilled Must return StateEmployerAcctNbr exactly as sent in A-4.
B-65 EmployerName What is the legal business name of the employer?
The legal business name of the employer.
Character 100
Backfilled Must return EmployerName exactly as sent in A-5
B-5 CorrectedEmployerName What is the employer's corrected legal business name?
The corrected legal business name of the employer,
Character 100 Optional Contains the printable ASCII characters 32 – 126 decimal.
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Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
according to the employer's records.
B-6 CorrectedStateEmployerAccountNbr
What is the employer's corrected state account number?
The corrected employer account number, according to the employer's records.
Character 20 Optional Contains the printable ASCII characters 32 – 126 decimal.
B-7 CorrectedFEIN What is the employer's corrected Federal Identification Number (FEIN)?
The corrected employer's FEIN, according to the employer's records.
Character 9* Optional Contains only numbers and there are no letters or special characters. Must be 9 digits.
B-8 OtherSSN What other Social Security Number (SSN) did the claimant use?
The additional SSN for a claimant who performed work under more than one Social Security Number.
Character 9* Optional Does not equal SSN (B-1) used for claim.
Contains only numbers and there are no letters or special characters
B-9 ClaimantNameWorkedAsForEmployer
If the claimant worked under another name, what was it?
The full name the claimant used while working for the employer, if different than the name sent in elements (A-14 through A-18).
Character 70 Optional Contains the printable ASCII characters 32 – 126 decimal.
B-66 ClaimantLastName What is the claimant’s last name?
The claimant’s last name.
Character 30 Backfilled Must return ClaimantLastName exactly as sent in A-14
B-67 ClaimantFirstName What is the claimant’s first name?
The claimant’s first name.
Character 25 Backfilled Must return ClaimantFirstName exactly as sent in A-16
B-68 ClaimantMiddleInitial What is the claimant’s middle initial?
The claimant’s middle initial.
Character 1* Backfilled If ClaimantMiddleInitial sent in A-17, must return
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Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
ClaimantMiddleInitial exactly as sent in A-17
B-69 ClaimantSuffix What is the claimant’s suffix, for example: Sr. Jr?
The claimant’s suffix, for example: Sr. Jr.
Character 8 Backfilled If ClaimantSuffix sent in A-18, must return ClaimantSuffix exactly as sent in A-18
B-10 ClaimantJobTitle What was the claimant's job title?
The claimant’s title, or role stated by the employer.
Character 30 Optional Contains the printable ASCII characters 32 – 126 decimal.
B-11 SeasonalEmploymentInd Was this seasonal employment?
A value indicating whether the employment is seasonal according to state law.
Character 1* Optional Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-12 EmployerReportedClaimantFirstDayof Work
What was the claimant's first day of work?
The date that the employer indicates was the claimant's first day of work.
Date – yyyy-mm-dd
10* Optional Date is before or equal to EmployerReportedClaimantLastDayofWork (B-13) Must be in the past and more recent than the request date minus one hundred years.
Contains only numbers and dashes. Must be a valid date.
B-13 EmployerReportedClaimantLastDayofWork
What was the claimant's last day of work?
The date the employer indicates was the claimant’s actual last day of work.
Date – yyyy-mm-dd
10* Conditional Required if EmployerSepReasonCode (B-20) does not equal 20, 21, or 99. Date is after or equal to EmployerReportedClaimantFirstDayofWork (B-12) and not more than the RequestDate
Contains only numbers and dashes. Must be a valid date.
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Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
(A-29) + 1 year. If EmployerReportedClaimantFirstDayofWork (B-12) is not provided, EmployerReportedClaimantLastDayofWork (B-13) must be equal to or more recent than RequestDate (A-29) minus six years and not more than RequestDate
+ 1 year. B-14 EffectiveSeparationDate What was the
date the claimant was separated from employment, if it was different from the last day of work?
The claimant's separation date if different from EmployerReportedClaimantLastDayofWork (B-13)
Date – yyyy-mm-dd
10* Optional Must be null if B-13 is null.
If B-13 is not null then B-14 is after or equal to EmployerReportedClaimantLastDayofWork (B-13) and not more than RequestDate + 1 year.
Contains only numbers and dashes. Must be a valid date.
B-61 TotalEarnedWagesNeededInd
Are Total Earned Wages Available for the dates requested in Section A A-23 and A-24?
Determines if TotalEarnedWages needs to be filled in.
Character 1* Conditional Required if WagesWeeksNeededCode (A-22) is 'WO' or 'WW' and EmployerSeparationReasonCode (B-20) does not equal 20 or 21
Value is a number or null. Value is 1-3.
1 - Wages are available 2 - Wages not currently available 3 - Wages not available, state should proceed without wages
B-15 TotalEarnedWages What were the total amount of wages earned by the claimant between the dates requested in Section A-23
Total wages earned by claimant between dates requested in Section A: WagesNeededBeginDate (A-23)
Numeric 15.2 Conditional Required if TotalEarnedWagesNeededInd = 1 for 'Wages are Available'
Only numbers and decimal point, or null No dollar sign ($) or commas allowed.
15.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 9999999999999.99. The maximum number of digits
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Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
and A-24? and WagesNeededEndDate (A-24).
that may be entered into the field are 13 before the decimal point with two after the decimal point.
B-62 TotalWeeksWorkedNeededInd
Are Total Weeks Worked Available for the dates requested in Section A A-23 and A-24?
Determines if TotalWeeksWorked needs to be filled in
Character 1* Conditional Required if WagesWeeksNeededCode (A-22) is 'WW' and EmployerSeparationReasonCode (B-20) does not equal 20 or 21
Value is a number or null. Value is 1-3.
1 - Weeks are available 2 - Weeks not currently available 3 - Weeks not available, state should proceed without weeks
B-16 TotalWeeksWorked What was the total number of weeks the claimant worked between the dates requested in Section A-23 and A-24?
Total number or weeks worked between dates requested in Section A: WagesNeededBeginDate (A-23) and WagesNeededEndDate (A-24).
Numeric 2 Conditional Required if TotalWeeksWorkedNeededInd = 1 for 'Weeks are Available'
Numbers only, or null.
B-17 WagesEarnedAfterClaimEffectiveDate
What were the total wages earned by the claimant after the effective date of the claim?
Total wages earned by claimant after the ClaimEffectiveDate (B-2).
Numeric 15.2 Optional Only numbers and decimal point. No dollar sign ($) or commas allowed.
Not severance pay.
15.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point.
B-18 NumberOfHoursWorkedAfterClaimEffectiveDate
What were the total hours worked by the claimant after the effective date of the claim?
Total hours worked by claimant after the ClaimEffectiveDate (B-2).
Numeric 2 Conditional Required if WagesEarnedAfterClaimEffectiveDate (B-17) is greater than 0.
Only numbers.
46
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-19 AverageWeeklyWage What was the claimant's average weekly wage?
The claimant's average weekly wage
Numeric 15.2 Conditional Required if any Remuneration (B-26) included in record.
Only numbers and decimal point. No dollar sign ($) or commas allowed.
15.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point.
B-20 EmployerSepReasonCode What is the reason for the claimant's separation from employment?
The employer's reason for separation.
Character 2 Required If PreparerTypeCode (B-52) is "E" for employer, then valid codes are 1-20 or 99. If PreparerTypeCode (B-52) is "T" for Third Party Administrator then valid codes are 1-21 or 99.
Value is 1-21 or 99. 1 = Temporary Layoff
2 = Laid Off/Lack of Work 3 = Fired/Discharged 4 = Vacation/ Holiday Shutdown 5 = Asked to Resign 6 = Voluntary Quit/Separation 7 = School Employee Between Semesters or Terms, Likely to Return 8 = School Employee Between Semesters or Terms, Not Likely to Return 9 = Still Employed, Full Time 10 = Still Employed, Part Time 11 = Still Employed, Hours Reduced by Employer 12 = On Call or Temporary Status 13 = Leave of Absence 14 = Retirement 15 = Disciplinary Suspension 16 = Labor Dispute 17 = Professional
47
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
Athlete Between Sports Seasons 18 = Disaster Related Separation 19 = Not Listed Above 20 = Never Employed Here 21 = TPA does not represent this employer 99 = Refuse To Provide
B-21 ReturnToWorkInd Does the claimant have reasonable assurance of returning to work?
A value indicating whether the claimant has reasonable assurance to return to work.
Character 1* Conditional Required if EmployerSepReasonCode (B-20) is 4 for 'Vacation/Holiday Shutdown' or is 7 for 'School Employee Between Semesters or Terms, Likely to Return' or is 17 for 'Professional Athlete Between Sports Seasons' or is 1 for 'Temporary Layoff' or is 15 for 'Disciplinary Suspension'
Value is 'Y' or 'N' for yes and no.
Y = Yes
N = No
B-22 ReturnToWorkDate What date do you expect the claimant to return to work?
The date the employer expects to have the claimant return to work.
Date – yyyy-mm-dd
10* Conditional Required if ReturnToWorkInd (B-21) = 'Y'. Date is after ClaimEffectiveDate (B-2). Must be after Effective Separation Date (B-14) and not more than request date plus one year in the future.
Contains only numbers and dashes. Must be a valid date.
48
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-73 ClaimantReportedReturnToWorkDate
What is the date the claimant anticipates returning to work. Also known as the recall date.
The date the claimant anticipates returning to work. Also known as the recall date.
Date – yyyy-mm-dd
10* Backfilled Must return ReturntoWorkDate exactly as sent in A-27.
B-23 WorkingAllAvailableHoursInd
Is the claimant working all available hours?
A value that indicates if the claimant is working all the available hours.
Character 2 Conditional Required if EmployerSepReasonCode (B-20) is 11 for 'Still Employed, Hours Reduced by Employer'
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-24 NotWorkingAvailableHoursReason
Why isn't the claimant working all available hours?
The employer's explanation of why the claimant is/was not working all the available hours.
Character 500 Conditional Required if WorkingAllAvailableHoursInd (B-23) is 'N'.
B-25 LaborDisputeTypeInd What is the type of labor dispute?
A value indicating the type of labor dispute.
Character 1* Conditional Required if EmployerSepReasonCode(B-20) is 16 for 'Labor Dispute'.
Value is 'S' for strike or 'L' for Lockout.
S = Strike L = Lockout
B-74 RemunerationInd Did/Will the claimant receive any compensation on or after the last day of work?
Indicator used to make B-26 required if claimant received compensation on or after the last day of work.
Character 1* Conditional Required if EmployerSepReasonCode (B-20) = 1 through 19; must be null if 20 or 21, or optional if 99
Value is “Y” or “N” for yes and no or null
For EmployerSepReasonCode = 1 through 19, RemuniationInd must be Y or N
For EmployerSepReasonCode = 20 or 21, RemuniationInd must be null
For EmployerSepReasonCode = 99, RemuniationInd must be Y, N, or Null
Y = Yes
N = No
Null
B-26 Remuneration Conditional Required if xxx-x
Occurs 0-unbounded times
Non-software business rule: Required if the claimant had
49
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
(RemunerationInd) = ‘Y” otherwise no entries in B-26
remuneration.
B-26.1
RemunerationTypeCode What kind of remuneration did or will the claimant receive on or after the last day of work?
Kind of remuneration the claimant received.
Character 2 Required for each Remuneration (B-26)
Values are all numbers. Value is 1-14.
1 = Severance
2 = Separation 3 = Vacation 4 = Holiday/Floating Holiday 5 = Pension 6 = Profit Sharing 7 = Bonus Pay 8 = Wages in Lieu of Notice 9 = Back Pay Award 10 = Residual Payments 11 = Commissions 12 = Sick 13 = Disability 14 = Not Listed Above
B-26.2
RemunerationAmountPerPeriod
What was the amount of the remuneration received per period?
The amount of the remuneration the claimant received each period.
Numeric 15.2 Required for each Remuneration (B-26)
Only numbers and decimal point. No dollar sign ($) or commas allowed. Value must be > 0.00
15.2 represents the precision and scale value of the dollars entered, with minimum value > 0.00 and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point.
50
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-26.3
RemunerationPeriodFrequencyCode
What was the frequency of the claimant's remuneration?
A value that indicates the frequency of the claimant’s remuneration.
Character 1* Required for each Remuneration (B-26)
Value is 'W' for 'Weekly' or is 'B' or 'Biweekly' or is 'M' for 'Monthly' or is 'Q' for 'Quarterly' or is 'L' for 'Lump Sum'.
D = Daily W = Weekly B = BiWeekly S = Semi-monthly M = Monthly Q = Quarterly L = Lump sum
B-26.4
DateRemunerationIssued What is the date the remuneration was or will be issued?
The date the remuneration was or will be issued
Date – yyyy-mm-dd
10* Required for each Remuneration (B-26)
Must be more recent than or equal to (B-2) Claim Effective Date minus two years and not more than request date plus five years
Contains only numbers and dashes. Must be a valid date.
B-26.5
EmployerAllocationInd Was the remuneration allocated?
A value to indicate whether the employer allocated the remuneration.
Character 1* Required for each Remuneration (B-26)
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-26.6
AllocationBeginDate What was the beginning date for the remuneration allocation?
The beginning date the remuneration was allocated.
Date – yyyy-mm-dd
10* Conditional Part A. Must be
null if EmployerAllocationCode (B-26.5) = ‘N’ otherwise required if EmployerAllocationCode (B-26.5) is 'Y'. Part B. If
EmployerAllocationCode (B-26.5) is 'Y', must be more recent than or equal to EmployerReportedClaimantLastDayofWork (B-13) and not more than request date plus one year in the
Contains only numbers and dashes. Must be a valid date.
51
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
future. Part C. Must be
more recent than or equal to (B-2) Claim Effective Date minus one year and not more than request date plus one year Part A and Part B
always are executed. Part C is
only executed if EmployerReportedClaimantLastDayWork in Part B is null.
B-26.7
AllocationEndDate What was the ending date for the remuneration allocation?
The ending date the remuneration was allocated.
Date – yyyy-mm-dd
10* Conditional Must be null if EmployerAllocationCode (B-26.5) = ‘N’ Required if EmployerAllocationCode (B-26.5) is 'Y'. Must be more recent than or equal to Allocation Begin Date (B-26.6) and not more than Allocation Begin Date (B-26.6) plus three years. If (B-26.6) AllocationBeginDate is null, then B-26.7 AllocationEndDate must be null
Contains only numbers and dashes. Must be a valid date.
B-27 AverageNumberofHoursWorkedperWeek
What was the average number of hours the
The average number of hours the claimant
Numeric 2 Conditional Required if any Remuneration (B-26) included in
Only numbers are entered. No decimal point allowed.
52
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
claimant worked per week?
worked per week. Used to allocate remuneration.
record.
B-28 MandatoryRetirementInd Was the retirement mandatory?
The answer to the question, “Was the retirement mandatory?”
Character 1* Conditional Required if EmployerSepReasonCode (B-20) is 14 for Retirement.
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-29 MandatoryPension Was the pension mandatory?
A value to indicate whether the pension was mandatory.
Character 1* Conditional Required if any entry for RemunerationTypeCode (B-26.1) is 5 for 'Pension'.
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-30 ContributoryorNotContributoryClaimantInd
Does/did the claimant contribute to the pension?
The answer to the question, “Does the claimant contribute to the pension?”
Character 1* Conditional Required if any entry for RemunerationTypeCode (B-26.1) is 5 for 'Pension'.
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-31 ClaimantPensionContributionPercent
What was the percentage of the pension that the claimant contributed?
The percentage of the pension contributed by the claimant.
Numeric 3 Conditional Required if ContributoryorNotContributoryClaimantInd (B-30) is 'Y'.
Only numbers are entered. No decimal point allowed. Valid values are 0 - 100.
B-32 PensionComments Provide any additional information about the claimant's pension.
The employers statement on the claimant's pension.
Character 1000 Optional Contains the printable ASCII characters 32 – 126 decimal.
B-33 EmployerSepReasonComments
Explain why the claimant is no longer employed; or indicate if and what additional information on the claim will be faxed or emailed to the state; or enter additional
The Employer or TPA can provide comments for the following: (1) Provide detailed information on why the claimant left his/her employment. (2) Indicate if and what additional
Character 2000 Conditional Required if EmployerSepReasonCode (B-20) is other than 3 for 'Discharged', 6 for 'Voluntary Quit, 1 for ‘Temporary Layoff’, 2 for ‘Laid Off/Lack of Work’, or 99 for ‘Refuse To Provide’.
Contains the printable ASCII characters 32 – 126 decimal.
53
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
information relevant to the claim.
information on the claim will be faxed or emailed to the state. (3) Enter additional information relevant to the claim.
B-34 DischargeReasonCode What is the reason the claimant was discharged from employment?
A description of the Discharge Reason selected by the employer/employer representative to explain why the claimant was discharged.
Character 2 Conditional Required if EmployerSepReasonCode (B-20) is 3 for 'Discharged' or 5 for 'Asked to Resign'. Required if B-44 (VoluntarySepReasonCode) = 5 (In Lieu of Discharge)
Value is 1-8. 1 = Not
Qualified/Inadequate Performance 2 = Absenteeism/Lateness 3 = Failed To Follow Instructions/Policy/Contract 4 = Drugs and Alcohol 5 = Dishonesty/Theft, Felony or Misdemeanor, Violation of Law, Criminal, Illegal Acts, Property Damage, Fighting 6 = Medical 7 = Failed Employment Requirements 8 = Not Listed Above
B-35 FinalIncidentReason What was the final incident that caused the discharge?
The employer’s statement of what was the final incident that caused the discharge. For example if a person violated an employer’s rule explain which rule was violated.
Character 1000 Conditional Required if DischargeReasonCode (B-34) is 2-8.
Contains the printable ASCII characters 32 – 126 decimal.
54
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-36 FinalIncidentDate What was the date of the final incident?
The date the claimant violated a rule, behaved unacceptably, was absent or late that caused the discharge.
Date – yyyy-mm-dd
10* Conditional Required if FinalIncidentReason (B-35) is completed. Date must be in the past. Prior or equal to the request date and after request date minus seven years.
Contains only numbers and dashes. Must be a valid date.
B-37 ViolateCompanyPolicyInd Did the claimant violate company policy?
The answer to the question, “Did the claimant violate company policy?”
Character 1* Conditional Required if DischargeReasonCode (B-34) is 2-8.
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-38 DischargePolicyAwareInd Was the claimant aware of the policy or unacceptable behavior that contributed to the discharge?
The answer to the question, “Was the claimant aware of the policy or unacceptable behavior that contributed to the discharge?
Character 1* Conditional Required if ViolateCompanyPolicyInd (B-37) = ‘Y’
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-39 DischargePolicyAwareExplanationCode
How was the claimant aware of the policy or unacceptable behavior that contributed to the discharge?
The answer to the question, “How was the claimant aware of the policy or unacceptable behavior that contributed to the discharge?
Character 1* Conditional Required if DischargePolicyAwareInd (B-37) = ‘Y’
Value is 'W' for Written or 'V' for Verbal or ‘B’ for both written and verbal.
W = Written V = Verbal B = Both
B-40 PriorIncident Conditional This field is not contingent upon any other data element. It is
Occurs 0-unbounded times.
55
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
conditioned only upon the employer having a prior incident to report. If there is a prior incident the employer has the option to enter it.
B-40.1
PriorIncidentDate What was the date the claimant violated a rule, behaved unacceptably, was absent or late prior to the final incident?
The date the claimant violated a rule, behaved unacceptably, was absent or late prior to the final incident.
Date – yyyy-mm-dd
10* Required Date must be in the past. Must be prior to Final Incident Date (B-36) Must be equal to or more recent than request date minus seven years.
Contains only numbers and dashes. Must be a valid date.
B-40.2
PriorIncidentReason What was the reason for the prior incident(s) of rule violation, unacceptable behavior, absenteeism or lateness?
The employer's explanation of an incident of rule violation, unacceptable behavior, absenteeism or lateness.
Character 1000 Required Contains the printable ASCII characters 32 – 126 decimal.
B-40.3
PriorIncidentWarningInd Was the claimant warned for the prior incident?
Indicates whether a warning was issued to the claimant based on this incident.
Character 1* Required Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-40.4
PriorIncidentWarningDate What was the date of the prior
The date the claimant was
Date – yyyy-mm-
10* Conditional Required if PriorIncidentWarnin
Contains only numbers and dashes.
56
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
incident warning?
issued a warning based on this incident.
dd gInd (B-40.3) = 'Y'. Must be more recent than or equal to Prior Incident Date (B-40.1) and prior to the request date.
Must be a valid date.
B-40.5
PriorIncidentWarningDescription
Describe what the prior incident warning said.
The employer's description of the warning issued to the claimant based upon this incident.
Character 1000 Conditional Required if PriorIncidentWarningInd (B-40.3) = 'Y'
Contains the printable ASCII characters 32 – 126 decimal.
B-41 WhoDischargedName What is the name of the person who discharged the claimant?
The name of the person who discharged the claimant.
Character 60 Conditional Required if DischargeReasonCode (B-34) is completed.
Contains the printable ASCII characters 32 – 126 decimal.
B-42 WhoDischargedTitle What is the title of the person who discharged the claimant?
The title of the person who discharged the claimant.
Character 60 Conditional Required if DischargeReasonCode (B-34) is completed.
Contains the printable ASCII characters 32 – 126 decimal.
B-43 DischargeReasonComments Provide any other comments regarding why the claimant was discharged.
Any other employer comments on the reason for discharge.
Character 1000 Conditional Required if DischargeReasonCode (B-34) is 8 for 'Other'.
Contains the printable ASCII characters 32 – 126 decimal.
B-44 VoluntarySepReasonCode What reason did the claimant give for voluntarily leaving employment?
State the reason selected by the employer/employer representative to indicate why the claimant quit the job even though continuing work was available.
Character 2 Conditional Required if EmployerSepReasonCode (B-20) is 6 for 'Voluntary Quit'.
Value ranges from 1-10. 1 = No Reason Given
2 = To Seek or Accept Other Employment 3 = Due to Health Reasons 4 = Due to Job Dissatisfaction 5 = In Lieu of Discharge 6 = Personal Reasons 7 = Failure to Report for Work/Abandonment 8 = Retirement 9 = Working Conditions 10 = Not Listed Above
57
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-45 HiringAgreementChangesCode
Were there changes in the claimant’s hiring agreement?
The answer to the question, “Were there changes in the claimant’s hiring agreement?” Used if reason for quit was working conditions.
Character 1* Conditional Required if VoluntarySepReasonCode (B-44) is 9 for 'Working Conditions'.
Valid values are 1-6.Only Numbers are entered.
1 = No Change 2 = Hours Changed 3 = Job Duties Changed 4 = Rate of Pay Changed 5 = Changed Job Location 6 = Not Listed Above
B-46 HiringAgreementChangesComments
What were the changes in the claimant's hiring agreement?
A brief description to explain the hiring agreement change.
Character 1000 Conditional Required if HiringAgreementChangesCode (B-45) is 2-6.
Contains the printable ASCII characters 32 – 126 decimal.
B-47 ClaimantActionstoAvoidQuitInd
Did the claimant take actions to avoid quitting?
The answer to the question, “Did the claimant take actions to avoid quitting?”
Character 1* Conditional Required if VoluntarySepReasonCode (B-44) is completed.
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-48 ActionTakenComments What action did the claimant take to avoid quitting?
The employer's comments on the action the claimant took to avoid quitting.
Character 1000 Conditional Required if VoluntarySepReasonCode (B-44) is completed, and if ClaimantActionstoAvoidQuitInd (B-47) = 'Y'.
Contains the printable ASCII characters 32 – 126 decimal.
B-49 ContinuingWorkAvailableInd Was continuing work available?
The answer to the question, “Was continuing work available?”
Character 1* Conditional Required if VoluntarySepReasonCode (B-44) is completed.
Value is 'Y' or 'N' for yes and no.
Y = Yes N = No
B-50 VoluntarySepReasonComments
Explain the reason the claimant gave for quitting even though continuing work was available.
A brief description of the reason the claimant gave for quitting the job on the last day even though continuing work was available.
Character 2000 Conditional Required if VoluntarySepReasonCode (B-44) is 10 for 'Other'.
Contains the printable ASCII characters 32 – 126 decimal.
B-51 Attachment Optional Occurs 0-10 times
58
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-51.1
DescriptionofAttachmentCode
What is the format of the attachment?
The description of the attachment format.
Character 1* Required for each Attachment (B-51)
Value is a digit. Can only be codes 1-5.
1 = RTF 2 = PDF 3 = TXT 4 = TIFF or TIF 5 = CSV
B-51.2
TypeofDocument What type of document is attached?
Description of the type of document attached.
Character 40 Required for each Attachment (B-51)
Contains the printable ASCII characters 32 – 126 decimal.
B-51.3
UniqueAttachmentID A unique ID within the record given to this attachment, and when combined with the StateRecordGUID is unique within the universe
Character 2 Required for each Attachment (B-51)
Must be unique within a record.
B-51.4
AttachmentSize The attachment size in bytes
Numeric Required for each Attachment (B-51)
Contains only numbers.
B-51.5
AttachmentData The actual attachment in Base64 encoding
Base64Binary
Required for each Attachment (B-51)
Base64 encoded characters only
B-52 PreparerTypeCode Who is providing the response?
Identifies if the employer or employer representative is providing a response to the request for the separation information.
Character 1* Required If EmployerSepReasonCode (B-20) = 21 for 'TPA does not represent this employer' then PreparerTypeCode must = 'T' for 'Third Party Administrator'
Value is 'E' for 'Employer' or 'T' for 'Third Party Administrator'.
E = Employer T = Third Party Administrator
B-53 PreparerCompanyName What is the name of the preparer's company?
The Third Party Administrator’s name.
Character 60 Conditional Required if PreparerTypeCode (B-52) = ‘T’ for 'Third Party Administrator'.
Contains the printable ASCII characters 32 – 126 decimal.
59
Seq. No.
Data Element Name Fact-Finding
Question Data Element Description
Type and/or Format
Field
Size
Field Required /
Optional Business Rules Validation Comments/Notes Values:
B-54 PreparerTelephoneNumberPlusExt
What is the preparer's telephone number with extension?
The preparer’s telephone number plus extension.
Character 15 Required Contains only numbers.. Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
B-55 PreparerContactName What is the name of the preparer?
The preparer’s name.
Character 60 Required Contains the printable ASCII characters 32 – 126 decimal.
B-56 PreparerTitle What is the title of the preparer?
The preparer’s title.
Character 30 Required Contains the printable ASCII characters 32 – 126 decimal.
B-57 PreparerFaxNbr What is the preparer's Fax number?
The preparer’s fax number.
Character 10* Optional Contains only numbers. Must contain 10 digits.
B-58 PreparerEmailAddress What is the preparer's e-mail address?
The preparer’s e-mail address.
Character 60 Optional Contains letters, dashes, @, periods, numbers, underscores.
B-63 AmendedResponse Is this an amended response to a previously submitted response? (new or additional information)
The amended response number.
Character 1* Optional Must contain 1 digit in the range 1 - 9.
Not provided=original response, 1=first change, 2=second change, etc.
B-64 AmendedResponseDescription
What is the description of the amended response?
The amended response description.
Character 2000 Optional Cannot be empty when B-63, AmendedResponse is not null.
Contains the printable ASCII characters 32 – 126 decimal.
B-72 BrokerRecordEffectiveDate The date that the record was accepted from the Empoyer/TPA into the Central Broker.
DateTimeStamp
30 Broker generated field. Not put in the Response from the Employer/TPA
Contains a date and time stamp Format will be: 2010-01-
27T16:03:08.000-04:00
Date and time the response was accepted by the Broker.
Field must not be present in the response file from the Employer/TPA – will cause an XSD error if there.
Note: Later additions to the format were added into the area it made most sense but to keep the numbering consistent and to reduce the possibility of errors the whole format was not renumbered.
60
Therefore:
B-59 and B-60 are the first two elements.
B-61 is after B-14.
B-62 is after B-15.
B-63 and B-64 are at the end of the exchange format
B-65 is after B-4.
B-66, 67, 68, 69 are after B-9.
B74 is the last elements in the format
61
8.2 THE EARNINGS VERIFICATION STANDARD FORMAT
The two tables below detail what the Earnings Verification Standard Format requires for a request
for earnings verification and for the employer earnings verification response. This standardized
format is documented in much greater detail in the Developer’s Guide.
Important Notes:
1. For out of state employers, the UI agency must provide an out of state identification
number in place of the SEIN for out of state employers. The UI agency must also
notify the employer with the state identification number. These requests may result
from Interstate Cross Match hits or National Directory of New Hires (NDNH)
matches.
2. Any text string not defined in the XSD can be accepted in upper or lower case (or any
combination thereof).
3. For any character fields, if entry is via the Internet, do not allow entry of the characters
for less than and greater than ('<', '>').
4. All field sizes are variable length unless marked with an Asterisk (*), which denotes the
field size is fixed length.
5. Unless noted in the standard format, any character field that has no value, but contains
spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be
present in the XML sent to the Broker). The Broker does not trap this situation because it
is not permitted to manipulate the data sent by states, employers, or TPAs.
For Employer Response Only:
1. For fields labeled as 'Backfilled', the data element is passed back from the Request for
Earnings Verification and is not editable by the employer or TPA.
2. Fields ER-1 and ER-2 are key fields for matching response to request.
Unless noted in the standard format, any character field that has no value, but contains spaces
(decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in
the XML sent to the Broker). The Broker does not trap this situation because it is not
permitted to manipulate the data sent by states, employers, or TPAs.
62
State UI Agency Request for Earnings Verification [Version 2.7 - Requirements Baseline - 05-12-2016]
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
E-1 StateEarningsVerificationRequestRecordGUID
This is a unique ID given to this record by the State for this earnings verification.
Character 32* Required Contains only 32 hexadecimal digits
Each request record shall contain a unique StateEarningsVerificationRequestRecordGUID that cannot be reused for a period of 10 years. A StateEarningsVerificationRequestRecordGUID may be reused when the state does not receive a Broker acknowledgement to the Post, or when Broker the message code for the Post = 2 (total file failure), or when the Broker acknowledgement returns a message code = 3 and the record with the StateEarningsVerificationRequestRecordGUID is identified as a record in error. Field contains a unique GUID within a state. Field cannot be guaranteed unique across states. Employers/TPAs must ensure their Connector software handles the possibility where requests from different states use the same StateEarningsVerificationRequestRecordGUIDs. In error processing situations or if a re-send is requested or required, the StateEarningsVerificationRequestRecordGUID may not be regenerated. Endpoints must be capable of handling a file that
63
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
contains duplicate records, including control information (for example, the StateEarningsVerificationRequestRecordGUID field).
E-3 RequestingStateAbbreviation
US Postal (2 letter) state code Character 2* Required Must be two alpha characters and no blanks allowed.
Information on valid 2-character state and territory abbreviations available from the FIPS website: <http://www.itl.nist.gov/fipspubs/fip5-2.htm>.
E-4 UIOfficeName The name or description of the appropriate UI office location to contact regarding this request.
Character 25 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
E-5 UIOfficePhone Phone number for Employer to contact a person in the State regarding this request.
Character 15 Optional Contains only numbers.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
E-6 UIOfficeFax Fax number for Employer to send Fax information pertaining to this request.
Character 10* Optional Contains only numbers. Must contain 10 digits.
E-32 UIOfficeEmailAddress Email Address for Employer to contact a person in the State regarding this request.
Character 60 Optional Contains letters, dashes, @, periods, numbers, underscores.
64
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
E-7 StateEmployerAccountNbr
If the employer's is a liable or reimbursable employer for the state enter the state employer identification number.
Character 20 Conditional
Required if E-30 (EarningsVerificationSourceCode) = 2 (State Directory of New Hire) or 3 (Quarterly Cross Match).
Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
Note to UI Agency:
Should be filled in if E-30 (EarningsVerificationSourceCode) = 1 or 4 or 5 or 6 if the earnings were earned in the requesting state and the employer is liable or reimbursing Note: Supports Single Sign On
(SSO) for SIDES Earnings Verification exchange via the UI agency’s employer portal. If a liable or reimbursable employer, State, FEIN, SEIN, and PIN are used for authentication. For out of state employers, no SEIN is provided, but the UI agency must provide an out of state identification number in place of the SEIN for out of state employers.
E-8 FEIN The claimant's employer Federal Employer Identification Number (FEIN)
Character 9* Required Contains only numbers and there are no letters or special characters. Must be 9 digits.
E-9 EmployerName The legal business name of the employer.
Character 100 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
E-10 SSN The claimant’s Social Security Number.
Character 9* Required
65
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
E-11 ClaimantLastName The claimant’s last name. Character 30 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
May contain a space (decimal 32) if there is no last name provided.
E-12 ClaimantFirstName The claimant’s first name. Character 25 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
May contain a space (decimal 32) if there is no last name provided.
E-13 ClaimantMiddleInitial The claimant’s middle initial. Character 1* Optional Contains only letters [a..z, A..Z] Field cannot contain all spaces (there must be at least 1 non-space character)
Blank characters and null characters are not permitted.
E-14 ClaimantSuffix The claimant’s suffix, for example: Sr. Jr.
Character 8 Optional Contains letters, numbers, periods, and blanks. Field cannot contain all spaces (there must be at least
66
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
1 non-space character)
E-16 EarningsVerificationWeekBeginDate
The start date for this particular earnings verification period.
Date – yyyy-mm-dd
10* Required Must be at least 7 days prior to request date and more recent than request date minus six years. Must be on a Sunday unless the state is NY where must be on a Monday.
Contains only numbers and dashes. Must be a valid date.
If request date is February 6, 2013 the EarningsVerificationWeekBeginDate must be between February 6, 2007 and January 30, 2013.
E-17 EarningsVerificationWeekEndDate
The end date for this particular earnings verification period.
Date – yyyy-mm-dd
10* Required Must be less than or equal to the request date and greater than or equal to EarningsVerification WeekBeginDate. Number of weeks must be less than or equal to 15 weeks (timeframe between E-16 and E-17) Number of Weeks must = the number of days included in E-16 thru E-17 divided by 7 days.
Contains only numbers and dashes. Must be a valid date.
If request date is February 6, 2013, the EarningsVerificationWeekEndDate must be between 6 days after the EarningsVerificationWeekBeginDate and February 12, 2013.
E-18 EarningsVerificationComments
Provide any additional information about the earnings Verification for this individual.
Character 1000 Optional Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
E-19 RequestDate The date this earnings Verification is transmitted to the Employer/TPA.
Date – yyyy-mm-dd
10* Required Date must be greater than or equal to the current date minus one day and
Contains only numbers and dashes.
If today’s date is February 6, 2013, the RequestDate must be February 5, 2013 or later.
67
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
less than current date + 6 months. State and Broker rule only.
Must be a valid date.
E-20 EarningsStatusCode Status Code that tells the Employer/TPA what is needed for earnings in this particular request
Numeric
1* Required Must be 2, 3, or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-21 TipsStatusCode Status Code that tells the Employer/TPA what is needed for tips in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-22 CommissionStatusCode Status Code that tells the Employer/TPA what is needed for commission in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-23 BonusStatusCode Status Code that tells the Employer/TPA what is needed for bonus in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-24 VacationStatusCode Status Code that tells the Employer/TPA what is needed for vacation in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
68
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
E-25 SickLeaveStatusCode Status Code that tells the Employer/TPA what is needed for sick leave in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-26 HolidayStatusCode Status Code that tells the Employer/TPA what is needed for holiday in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-27 SeveranceStatusCode Status Code that tells the Employer/TPA what is needed for severance in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-28 WagesInLieuStatusCode Status Code that tells the Employer/TPA what is needed for wages in lieu in this particular request
Numeric 1* Required
Must be 2, 3 or 4 2 – No Date 3 – Date Paid 4 – Date Allocated
E-29 ResponseDueDate
The date the response is due back to the state agency.
Date – yyyy-mm-dd
10* Required
Must be later than Date of the Request Date E-19 and must be at least XX days and cannot be more than 2 times XX days (see look-up table) after Request Date (E-19).
Contains only numbers and dashes. Must be a valid date.
If the State sending the request has a 10 day limit in the Broker for this exchange, and the RequestDate is February 6, 2015, then the ResponseDueDate must be February 16, 2015 and no later than February 26, 2015.
69
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
E-30 EarningsVerificationSourceCode
The internal state UI agency code used to identify the source (NDNH, SDNH, Crossmatch) that identified the need for this earnings verification
Numeric 1* Required Must be 1, 2, 3, 4, 5, or 6
1. National Directory of New Hire Match/Hit 2. State Directory of New Hire Match/Hit 3. Quarterly Cross Match of Benefits and Wages Records 4. Interstate Cross Match of Benefits and Wages Records 5. Tip or Lead 6. Other These values are internal State UI agencies numbers that correspond to the source (NDNH, SDNH, Crossmatch, etc) of the earnings verification. Source is NOT displayed on the E-Response web site
1 – 6
E-33 EarningsVerificationResponseCommentIndicator
Response Comment indicator that tells the employer/TPA whether or not they can fill in the EarningsVerificationResponseComment
Numeric 1* Required Must be 1 or 2. 1 = Yes 2 = No
E-34 PIN This is the PIN that the employer uses to log into the E-Response website. This shall only be used for bundling E-Response records.
Character 20 Optional Can only be used if the file that the records in is addressed to E-Response in the SOAP header, otherwise must be null
E-35 OriginatingStateHitFIPSCode
Enter the FIPS code for the state where the earnings hit originated.
Character 2 Conditional Should be filled in if the hit originated from state other than the requesting state
Must be numeric characters only
Inputs for case examination may come from the National Directory of New Hire (NDNH), the
70
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
and the source, E-30 = 1 (NDNH), E-30 = 4 (Interstate Crossmatch), E-30 = 5 (Tip or Lead) or E-30 = 6 (Other), Must be null if E-30 = 2 or 3.
Interstate Crossmatch, or other sources.
E-2 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 System Added to the Employer Request; Not put in the Request from the State; Added at the end of the XML record (according to XSD)
Contains only digits
Field must not be present in the request file from the State – will cause an XSD error if there.
E-31 BrokerRecordEffectiveDate
The date that the record was accepted from the State into the Central Broker.
DateTimeStamp
30 Broker generated field. Not put into the request by the State.
Contains a Date and Time stamp Format will be: 2010-04-27T16:03:08.000-04:00
Date and time the request was accepted by the Broker. Field must not be present in the request file from the State – will cause an XSD error if there.
71
Part B. Employer or TPA Response Form [Version 2.7 - Requirements Baseline - 05-12-2016]
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-1 StateEarningsVerificationRequestRecordGUID
This is a unique ID given to this record by the State for this earnings verification response
Character 32* Backfilled Contains only 32 hexadecimal digits
ER-2 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 Backfilled Contains only digits
ER-38
RequestDate The date this earnings Verification is transmitted to the Employer/TPA.
Date yyyy-mm-dd
10* Backfilled Must return exactly as sent in E-19
Contains only numbers and dashes. Must be a valid date.
ER-39
ResponseDueDate The date the response is due back to the state agency.
Date yyyy-mm-dd
10* Backfilled Must return exactly as sent in E-29
Contains only numbers and dashes. Must be a valid date.
ER-3 RequestingStateAbbreviation
US Postal (2 letter) state code Character 2* Backfilled Must return exactly as sent in E-3
Must be two alpha characters and no blanks allowed.
Information on valid 2-character state and territory abbreviations available from the FIPS website: <http://www.itl.nist.gov/fipspubs/fip5-2.htm>.
ER-4 UIOfficeName The name or description of the appropriate UI office location to contact regarding this request.
Character 25 Backfilled Must return UI Office Name exactly as sent in E-4
Contains the printable ASCII characters 32 – 126 decimal.
ER-5 StateEmployerAccountNbr
The employer's state account number.
Character 20 Backfilled Must return StateEmployerAcctNbr exactly as sent in E-7.
ER-6 FEIN The claimant's employer Federal Employer Identification Number (FEIN)
Character 9* Backfilled Must return FEIN exactly as sent in E-8.
Contains only numbers and there are no letters or special
72
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
characters. Must be 9 digits.
ER-7 CorrectedFEIN What is the employer's corrected Federal Identification Number (FEIN)?
Character 9* Optional Contains only numbers and there are no letters or special characters. Must be 9 digits.
ER-8 EmployerName The legal business name of the employer.
Character 100 Backfilled Must return company name exactly as E-9
Contains the printable ASCII characters 32 – 126 decimal.
ER-9 CorrectedEmployerName The corrected legal business name of the employer, according to the employer's records.
Character 100 Optional Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
ER-10
SSN The claimant’s Social Security Number.
Character 9* Backfilled Must return SSN exactly as sent in E-10
ER-34
ClaimantLastName The claimant’s last name. Character 30 Backfilled Contains the printable ASCII characters 32 – 126 decimal.
May contain a space (decimal 32) if there is no last name provided.
ER-35
ClaimantFirstName The claimant’s first name. Character 25 Backfilled Contains the printable ASCII characters 32 – 126 decimal.
May contain a space (decimal 32) if there is no last name provided.
ER-36
ClaimantMiddleInitial The claimant’s middle initial. Character 1* Backfilled Contains only letters [a..z, A..Z]
Blank characters and null characters are not permitted.
73
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-37
ClaimantSuffix The claimant’s suffix, for example: Sr. Jr.
Character 8 Backfilled Contains letters, numbers, periods, and blanks.
ER-11
ClaimantNameWorkedAsForEmployer
The full name the claimant used while working for the employer, if different than the name in Request elements (E-11 through E-14).
Character 70 Optional Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
ER-13
EarningsVerificationWeekBeginDate
The start date for this particular earnings verification period.
Date – yyyy-mm-dd
10* Backfilled Must return exactly as in E-16
Contains only numbers and dashes. Must be a valid date.
ER-14
EarningsVerificationWeekEndDate
The end date for this particular earnings verification period.
Date – yyyy-mm-dd
10* Backfilled Must return exactly as in E-17
Contains only numbers and dashes. Must be a valid date.
ER-15
ClaimantEmployerWorkRelationshipCode
Whether or not the Claimant and Employer had a work relationship.
Character 2 Required Values can be 1, 20 or 21
1 = The Claimant works/worked for the Employer 20 = Never Employed Here 21 = TPA does not represent this employer
74
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-16
EmployerEarningsCode Code indicating if the individual worked and earned any payments between the dates indicated on the request (E-16 thru E-17).
Character 1* Conditional
Required if ER-15 equals 1.
Values can be 1, 2, or 9.
Please Note: Report when earned NOT when Paid.
1 - Yes, this individual had earnings during the time frame requested. 2 - Claimant performs work and did not have earnings (100% sales person) 9 - Claimant did not work for employer during this time period
ER-17
FirstDayWorkedinPeriod The first day the individual performed actual work for the employer during the period of time requested.
Date – yyyy-mm-dd
10* Conditional Required if ER-16 equals '1' for YES or ‘2’ for No Earnings Must be between ER-13 and ER-14 if not null.
Contains only numbers and dashes. Must be a valid date.
ER-18
StillWorkingCode Is the individual still working for the employer?
Character 1* Conditional Required if ER-16 (EmployerEarningsCode) is ‘1’ or ‘2’.
Value is '1' for Yes or '2' for No
1= Yes 2= No
ER-19
LastDayWorked The Last Day Worked if the individual is no longer working for the employer
Date – yyyy-mm-dd
10* Conditional Required if ER-18 is '2' for No Must be equal to or prior to the current date and not more than six years in the past.
Contains only numbers and dashes. Must be a valid date. May be null if not required.
75
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-20
EmployerSepReasonCode
What is the reason for the claimant's separation from employment?
Character 2 Conditional
Required if ER-18 is '2' for No.
Value is 1, 2, 3, or 4
1 = Lack of Work 2 = Fired/Discharged 3 = Voluntary Quit/Separation 4 - Other
ER-57
EmployerSeparationReasonComments
Explain why the claimant is no longer employed; or indicate if and what additional information on the claim will be faxed or emailed to the state; or enter additional information relevant to the claim.
Character 1000 Conditional Required if ER-20 (EmployerSepReasonCode) is 2,3, or 4. Null if ER-20 (EmployerSepReasonCode) is 1.
Contains the printable ASCII characters 32 – 126 decimal.
ER-21
EarningsVerificationResponseComment
Employer Comments regarding this Earnings Verification Response
Character 1000 Conditional If E-33 (EarningsVerificationResponseCommentIndicator) is 2 for No then this field must be null. Otherwise, this field is optional.
Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
ER-40
RegularRateOfPay Employee’s regular rate of pay.
Numeric 7.2 Conditional Required only if EmployerEarnigsCode (ER-16) = 1 or 2.Must have one pay type, either ER-40 (RegularRateOfPay) or ER-44 (TrainingPay), or ER-46 (RatePerMile), or ER-47
Dollar amount. Example 15.00
76
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
(RatePerTripOrLoadOrUnit), or ER-48 (ContractWage)
ER-41
RegularRateOfPayPer Indicator specifying if the employee’s regular rate of pay is per hour, paid weekly, paid bi-weekly, or paid semi-monthly.
Character 1 Conditional Required only if EmployerEarnigsCode (ER-16) = 1 or 2. Required if ER-40 (RegularRateOfPay) is not null
Must be H, W, B, M, or S
H = Hourly W = Weekly B = Bi-Weekly M = Monthly S = Semi-Monthly
ER-42
OvertimeRateOfPay Employee’s overtime rate of pay.
Numeric 7.2 Optional Can only be populated if EmployerEarnigsCode (ER-16) = 1 or 2. ER-40 (RegularRateOfPay) must not be null.
Dollar amount. Example 18.00
ER-43
OvertimeRateOfPayPer Indicator specifying if the employee’s overtime rate of pay is per hour, paid weekly, paid bi-weekly, or paid semi-monthly.
Character 1 Conditional Required only if EmployerEarnigsCode (ER-16) = 1 or 2. Required if ER-42 (OvertimeRateOfPay) is not null.
Must be H, W, B, M, or S
H = Hourly W = Weekly B = Bi-Weekly M = Monthly S = Semi-Monthly
ER-44
TrainingPay Employee’s training pay. Numeric 7.2 Optional Can only be populated if EmployerEarnigsCode (ER-16) = 1 or 2. Must have one pay type, either ER-40 (RegularRateOfPay) or ER-44 (TrainingPay), or ER-46 (RatePerMile), or ER-47 (RatePerTripOrLoadOrUnit), or ER-48 (ContractWage)
Dollar amount. Example 18.00
77
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-45
TrainingPayPer Indicator specifying if the employee’s training rate of pay is per hour, paid weekly, paid bi-weekly, or paid semi-monthly.
Character 1 Conditional Required if ER-44 (TrainingPay) is not null.
Must be H, W, B, M, or S
H = Hourly W = Weekly B = Bi-Weekly M = Monthly S = Semi-Monthly
ER-46
RatePerMile Employee’s rate per mile pay. Numeric 7.2 Optional Can only be populated if EmployerEarnigsCode (ER-16) = 1 or 2. Must have one pay type, either ER-40 (RegularRateOfPay) or ER-44 (TrainingPay), or ER-46 (RatePerMile), or ER-47 (RatePerTripOrLoadOrUnit), or ER-48 (ContractWage)
Dollar amount. Example 0.95
ER-47
RatePerTripOrLoadOrUnit Employee’s pay for a trip, load, or unit.
Numeric 7.2 Optional Can only be populated if EmployerEarnigsCode (ER-16) = 1 or 2. Must have one pay type, either ER-40 (RegularRateOfPay) or ER-44 (TrainingPay), or ER-46 (RatePerMile), or ER-47 (RatePerTripOrLoadOrUnit), or ER-48 (ContractWage)
Only included if paid on a trip or load basis.
ER-48
Repeatable Contract ER-48.2 (ContractWageBeginDate) or ER-48.3 (ContractWageEndDate) must fall between E-16 (EarningsVerificationWeekBeginDate) and E-17 (EarningsVerificationWeekEndDate)
ER-48.1
ContractWage Employee’s contract pay. Numeric 7.2 Optional Can only be populated if EmployerEarnigsCode (ER-16) = 1 or 2. Must have one pay type, either ER-40
78
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
(RegularRateOfPay) or ER-44 (TrainingPay), or ER-46 (RatePerMile), or ER-47 (RatePerTripOrLoadOrUnit), or ER-48 (ContractWage)
ER-48.2
ContractWageBeginDate Employee contract begin date. Date – yyyy-mm-dd
10* Conditional Required if ER-48 (ContractWage) is not null. ER-48.2 and ER-48.3 must fall within E-16 (EarningsVerificationWeekBeginDate) and E-17 (EarningsVerificationWeekEndDate)
Contains only numbers and dashes. Must be a valid date.
ER-48.3
ContractWageEndDate Employee contract end date. Date – yyyy-mm-dd
10* Conditional Required if ER-49 (ContractWageBeginDate) is not null.
Contains only numbers and dashes. Must be a valid date.
ER-51
PayPeriod The pay period (daily, weekly, bi-weekly, monthly, or semi-monthly) that the employer pays the employee.
Character 1 Required Must be D, W, B, M, or S.
For E-Response, cannot navigate further into the site unless PayPeriod is defined.
D = Daily W = Weekly B = Bi-Weekly M = Monthly S = Semi-Monthly
ER-52
DayOfWeekPayPeriodEndDay
The day of the week that the pay period end date is on.
Numeric
1 Conditional Required if ER-51 (PayPeriod) = W
Must be 1, 2, 3, 4, 5, 6, or 7.
1 = Monday 2 = Tuesday 3 = Wednesday 4 = Thursday 5 = Friday 6 = Saturday 7 = Sunday
ER-56
BiWeeklyPayPeriodStartDate
The date of one bi-weekly pay period date.
Date yyyy-mm-dd
10* Conditional Required if ER-51 (PayPeriod) = B
Contains only numbers and dashes.
79
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
Must be a valid date.
ER-53
SemiMonthlyPayPeriod1StartDate
Day of the month that the semi-monthly pay period begins on.
Date – yyyy-mm-dd
10* Conditional Required if ER-51 (PayPeriod) = S
Must be a valid date..
ER-54
SemiMonthlyPayPeriod1EndDate
Day of the month that the semi-monthly pay period ends on.
Date – yyyy-mm-dd
10* Conditional Required if ER-51 (PayPeriod) = S. The number of days between ER-53 (SemiMonthlyPayPeriod1StartDate) and ER-54 (SemiMonthlyPayPeriod1EndDate) must be 14, 15 or 16 days.
Must be a valid date.
ER-55
MonthlyPayPeriodEndDay Day of the month that the monthly pay period ends on.
Character 2 Conditional Required if ER-51 (PayPeriod) = M
Must be 1 - 28 or L.
1 – 28 L = Last Day of Month
ER-22
Repeatable Earnings Verification
If ER-16 is '1' for YES or ‘2’ for No Earnings Then ER-22.1 thru ER-22.21 must be completed for each day that has a value other than all 0’s
ER-22.1
EVDay The day that this occurred on. Date – yyyy-mm-dd
10* Required for each Repeatable Daily Earnings Verification.
Earliest entry must be the start of the pay period that encapsulates the begin date (ER-13). Latest entry must be no later than the end of the pay period encapsulating the end date (ER-14). Cannot repeat.
Contains only numbers and dashes. Must be a valid date.
Display on E-Response for all paths
ER-22.3
HoursWorked Number of hours the individual actually worked and performed services during this day
Character 5 Required for each Repeatable Daily Earnings Verification.
Value is a number 0 – 24, followed by a ‘:’, followed by 00 – 59.
Display on E-Response for Responses requiring hours, do not display for responses requiring days. Must be 0:00 if no work performed during this period.
80
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-22.4
AmountEarnedForTheDay Amount earned by the individual for the day
Numeric 7.2 Required for each Repeatable Daily Earnings Verification.
Must be 0 if ER-22.3 = 0.
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
ER-22.5
EarningsPaidDate The date that the earnings were allocated or the individual was paid for hours worked during the day ER-22.1
Date – yyyy-mm-dd
10* Conditional Required if E-20 = 3 or 4 and ER-22.4 > 0. Must be null if E-20 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then EarningsPaidDate must be between February 6, 2013 and February 6, 2014.
ER-22.6
TipsAmountEarnedForDay
Amount of tips earned by the individual for the day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
ER-22.7
TipsPaidDate The date that the earnings were allocated or the individual was paid for tips during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-21 = 3 or 4 and ER-22.6 > 0. Must be null if E-21 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then TipsPaidDate must be between February 6, 2013 and February 6, 2014.
ER-22.8
CommissionAmountEarnedForDay
Amount of commission earned by the individual for the day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal
81
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
point.
ER-22.9
CommissionPaidDate The date that the earnings were allocated or the individual was paid for commissions during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-22 = 3 or 4 and ER-22.8 > 0. Must be null if E-22 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then CommisionPaidDate must be between February 6, 2013 and February 6, 2014.
ER-22.1
0
BonusAmountEarnedForDay
Amount of bonus earned by the individual for this day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
ER-22.1
1
BonusPaidDate The date that the earnings were allocated or the individual was paid for bonus during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-23 = 3 or 4 and ER-22.10 > 0. Must be null if E-23 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then BonusPaidDate must be between February 6, 2013 and February 6, 2014.
ER-22.1
2
VacationAmountPaidForDay
Amount of vacation pay paid to the individual for this day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
82
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-22.1
3
VacationPaidDate The date that the earnings were allocated or the individual was paid for vacation during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-24 = 3 or 4 and ER-22.12 > 0. Must be null if E-24 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then VacationPaidDate must be between February 6, 2013 and February 6, 2014.
ER-22.1
4
SickAmountPaidForDay Amount of sickpay paid to the individual for this day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
ER-22.1
5
SickPaidDate The date that the earnings were allocated or the individual was paid for sick leave during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-25 = 3 or 4 and ER-22.14 > 0. Must be null if E-25 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then SickPaidDate must be between February 6, 2013 and February 6, 2014.
ER-22.1
6
HolidayAmountPaidForDay
Amount of holiday pay paid to the individual for this day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
ER-22.1
7
HolidayPaidDate The date that the earnings were allocated or the individual was paid for holiday during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-26 = 3 or 4 and ER-22.16 > 0. Must be null if E-26 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then HolidayPaidDate must be between February 6, 2013 and February 6, 2014.
83
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-22.1
8
SeveranceAmountPaidForDay
Amount of severance pay paid to the individual for this day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
ER-22.1
9
SeverancePaidDate The date that the earnings were allocated or the individual was paid for severance during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-27 = 3 or 4 and ER-22.18 > 0. Must be null if E-27 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then SeverancePaidDate must be between February 6, 2013 and February 6, 2014.
ER-22.2
0
WagesInLieuAmountPaidForDay
Amount of wages in lieu pay paid to the individual for this day
Numeric 7.2 Optional
Only numbers and decimal point. No dollar sign ($) or commas allowed.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
ER-22.2
1
WagesInLieuPaidDate The date that the earnings were allocated or the individual was paid for wages in lieu during the day.
Date – yyyy-mm-dd
10* Conditional Required if E-28 = 3 or 4 and ER-22.20 > 0. Must be null if E-28 = 2. Must be more recent than or equal to the day (ER 22.1) and not more than the day (ER-22.1) plus one year.
Contains only numbers and dashes. Must be a valid date.
If the EVDay is February 6, 2013, then WagesInLieuPaidDate must be between February 6, 2013 and February 6, 2014.
ER-23
PreparerTypeCode Who is providing the response?
Character 1* Required Value is 'E' for 'Employer' or 'T' for 'Third Party Administrator'.
E = Employer T = Third Party Administrator
84
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
ER-24
PreparerCompanyName What is the name of the preparer's company?
Character 60 Conditional Required if PreparerTypeCode (ER-23) = ‘T’ for 'Third Party Administrator'.
Contains the printable ASCII characters 32 – 126 decimal.
ER-25
PreparerTelephoneNumberPlusExt
What is the preparer's telephone number with extension?
Character 15 Required Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
ER-26
PreparerContactName What is the name of the preparer?
Character 60 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
ER-27
PreparerTitle What is the title of the preparer?
Character 30 Required Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
ER-28
PreparerFaxNbr What is the preparer's Fax number?
Character 10* Optional Contains only numbers. Must contain 10 digits.
ER-29
PreparerEmailAddress What is the preparer's e-mail address?
Character 60 Required Contains letters, dashes, @, periods, numbers,
85
Seq. No.
Data Element Name Data Element Description Type and/or Format
Maximum Field Size
Field Required
Business Rules Validation* Comments/Notes Values:
underscores.
ER-30
AmendedResponse Is this an amended response to a previously submitted response? (new or additional information)
Character 1* Optional Value is either all numbers or null. Must contain 1 digit (null or 1 - 9).
ER-31
AmendedResponseDescription
What is the description of the amended response?
Character 2000 Optional Cannot be empty when ER-30, AmendedResponse is not null.
Contains the printable ASCII characters 32 – 126 decimal. Field cannot contain all spaces (there must be at least 1 non-space character)
ER-32
EarningsVerificationSourceCode
The internal state UI agency code used to identify the source (NDNH, SDNH, Crossmatch) that identified the need for earnings verification
Character 1 Backfilled Must return exactly as in E-30
Contains only whole numbers or is null
These values are internal State UI agencies numbers that correspond to the source (NDNH, SDNH, etc) of the earnings verification. Source is NOT displayed on the E-Response web site.
0 - 9
ER-33
BrokerRecordEffectiveDate
The date that the record was accepted from the Employer/TPA into the Central Broker.
DateTimeStamp
30 Broker generated field. Not put in the Response from the Employer/TPA
Contains a Date and Time stamp Format will be: 2010-04-27T16:03:08.000-04:00
Date and time the response was accepted by the Broker. Field must not be present in the response file from the Employer/TPA – will cause an XSD error if there.
Note: Later additions to the format were added into the area it made most sense but to keep the numbering consistent the whole format was not renumbered.
86
ER-57 is the last field in the standard format
87
8.3 THE MONETARY AND POTENTIAL CHARGES STANDARD FORMAT
The two tables below detail what the Monetary and Potential Charges Standard
Format requires for a request for monetary and potential charges and for the employer monetary and potential charges response.
Important Notes:
1. Any text string not defined in the XSD can be accepted in upper or lower case (or any combination thereof).
2. For any character fields, if entry is via the Internet, do not allow entry of the characters for less than and greater than ('<', '>').
3. All field sizes are variable length unless marked with an Asterisk (*), which denotes the field size is fixed length.
4. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
For Employer Response Only:
1. For fields labeled as 'Backfilled', the data element is passed back from the Request for Monetary and Potential Charges and is not editable by the employer or TPA.
2. Fields MR-1 and MR-2 are key fields for matching response to request.
3. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
88
State UI Agency Request for Monetary and Potential Charges [Version 2.1.1 - Requirements Baseline - 06-12-2013]
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-1 StateMonetaryChargeRequestRecordGUID
This is a unique ID given to this record by the State
Character 32* Required Contains only hexadecimal digits
State System Generated. Field contains a unique GUID within a state. Field cannot be guaranteed unique across states. Employers/TPAs must ensure their Connector software handles the possibility where requests from different states use the same StateMonteraryChargeRequestRecordGUIDs. In error processing situations or if a re-send is requested or required, the StateMonetaryChargeRequestRecordGUID may not be regenerated. Endpoints must be capable of handling a file that contains duplicate records, including control information (for example, the StateMonetaryChargeRequestRecordGUID field).
M-2 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 Required on Monetary Charge Notice from the Broker to the Employer/TPA
System Added to the Employer Request; Not put in the Request from the State; Added at the end of the XML record (according to XSD)
Contains only decimal digits
Field must not be present in the request file from the State – will cause an XSD error if there.
89
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-3 ClaimNumber A unique identifier that can be used by the state to track a claim occurrence
Character 18 Optional Contains the printable ASCII characters 32 – 126 decimal.
M-4 FormNumber The state form number this transaction applies to.
Character 12 Optional Contains letters, numbers, periods, dashes, and blanks. Can also be null
M-5 RequestDate The date the Monetary and Potential Charges Notice is transmitted to the Employer/TPA.
Date yyyy-mm-dd
10* Required Date must be greater than or equal to the current date minus one day. State and Broker rule only.
Contains only numbers and dashes. Must be a valid date.
If today’s date is February 6, 2013, the RequestDate must be February 5, 2013 or later.
M-6 ResponseDueDate The due date the response must be sent back to the state agency to be considered a timely response.
Date yyyy-mm-dd
10* Required
Must be at least XX days (see look-up table) after Request Date (M-5).
Contains only numbers and dashes. Must be a valid date.
If the State sending the request has a 10 day limit in the Broker for this exchange, and the RequestDate is February 6, 2012, then the ResponseDueDate must be February 16, 2012 or later.
M-7 RequestingStateAbbreviation
US Postal (2 letter) state code
Character 2* Required Must be two alpha characters and no blanks allowed.
Information on valid 2-character state and territory abbreviations available from the FIPS website: <http://www.itl.nist.gov/fipspubs/fip5-2.htm>.
M-8 UIOfficeName Name of the State Agency issuing the Monetary and Potential Charges Notice
Character 25 Required Contains the printable ASCII characters 32 – 126 decimal.
M-9 UIOfficePhone Phone number for Employer to contact the Agency regarding this request.
Character 15 Optional Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
M-10 UIOfficeFax Fax number for Employer to contact the state agency regarding this Charge Notice.
Character 10 Optional Contains only numbers or is null. Must contain 10 digits
Contain area code, 7-digit telephone number,
90
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-11 UIOfficeEmailAddress Email Address for Employer to contact a person in the State regarding this request.
Character 60 Optional Contains letters, dashes, @, periods, numbers, underscores.
M-12 FEIN The Employer Federal Employer Identification Number (FEIN)
Character 9* Required Contains only numbers and there are no letters or special characters. Must be 9 digits.
M-13 StateEmployerAccountNbr
The State account number to which the benefits will be charged. It is the State's unique identifier for the Employer.
Character 20 Required Contains the printable ASCII characters 32 – 126 decimal.
M-14 PredecessorEmployerAccountNbr
The State Employer Account Number for the Predecessor Account.
Character 20 Optional Contains the printable ASCII characters 32 – 126 decimal.
M-15 EmployerName The legal business name of the Employer.
Character 100 Required Contains the printable ASCII characters 32 – 126 decimal.
M-16 EmployerAccountType The type of Employer Account
Character 1* Optional Contains only numbers 1 or 2
1=taxable Employer 2=reimbusable Employer
M-17 TypeofEmployerCode The type of Employer Character 1* Optional Value is either a digit or null. Can only be codes 1-7.
1 = Last, Base Period, and Lag Quarter Employer 2 = Last Employer 3 = Base Period Employer 4 = Lag Quarter Employer 5 = Last and Base Period Employer 6 = Last and Lag Quarter Employer 7 = Base Period and Lag Quarter Employer
91
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-18 SSN The claimant’s Social Security Number.
Character 9* Required Contains only numbers and there are no letters or special characters
Information on valid SSN from <http://www.ssa.gov/foia/stateweb.html>.
M-19 ClaimantLastName The claimant’s last name. Character 30 Required Contains the printable ASCII characters 32 – 126 decimal.
M-20 OtherLastName The additional last name for a claimant who performed work using more than one name. This covers name changes, e.g., due to marriage or divorce.
Character 30 Optional Contains the printable ASCII characters 32 – 126 decimal.
M-21 ClaimantFirstName The claimant’s first name. Character 25 Required Contains the printable ASCII characters 32 – 126 decimal.
M-22 ClaimantMiddleInitial The claimant’s middle initial.
Character 1* Optional Contains the printable ASCII characters 32 – 126 decimal or null.
M-23 ClaimantSuffix The claimant’s suffix, for example: Sr. Jr.
Character 8 Optional Contains the printable ASCII characters 32 – 126 decimal or null.
M-24 Dependants Number of dependants claimant is reporting/claiming
Numeric 1* Optional Must be numeric and 0-5 Value is all digits.
92
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-25 ClaimantSepReasonCode
The claimant's reason for separation.
Character 2 Optional Must be numeric and 1-19 or 99
Contains the printable ASCII characters 32 – 126 decimal.
1 = Temporary Layoff 2 = Laid Off/Lack of Work 3 = Fired/Discharged 4 = Vacation/ Holiday Shutdown 5 = Asked to Resign 6 = Voluntary Quit/Separation 7 = School Employee Between Semesters or Terms, Likely to Return 8 = School Employee Between Semesters or Terms, Not Likely to Return 9 = Still Employed, Full Time 10 = Still Employed, Part Time 11 = Still Employed, Hours Reduced by Employer 12 = On Call or Temporary Status 13 = Leave of Absence 14 = Retirement 15 = Disciplinary Suspension 16 = Labor Dispute 17 = Professional Athlete Between Sports Seasons 18 = Disaster Related Separation 19 = Other 99 = Not provided
93
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-26 EmployerSepReasonNeededndicator
Whether the employer is required to enter the Separation Reason and Last Day worked questions (MR-13, MR-14, MR-11, MR-21) if they are filing a protest or M-46 = Y.
Character 1* Required Value is 'Y' or 'N' for yes or no
This indicator will determine whether the employer has to answer the Separation Information section on the response. F fields EmployerSeparationReasonCode; OtherSeparationReasonComments; LastDayWorked; and SeasonalEmploymentInd on the response. If set to Y, and the employer is required to file a protest or decides to file a protest, then these questions must be answered (they will be presented and required on EResponse). If it is set to N, the employer is prevented from answering the questions (they will not show up on EResponse).
Y = Yes N = No
M-27 BenefitYearBeginDate The benefit year begin date is based on the date the claim is filed and other factors defined in each States' procedures.
Date yyyy-mm-dd
10* Required Must be equal to or more recent than the request date minus six years.
Contains only numbers and dashes. Must be a valid date.
M-28 BasePeriodStartDate Base Period Beginning Date of Claim
Date yyyy-mm-dd
10* Required Must be equal to or more recent than Benefit Year Begin Date (M-27) minus 36 months
Contains only numbers and dashes. Must be a valid date.
If the BenefitYearBeginDate is August 6, 2011, the BasePeriodStartDate must be August 6, 2008 or later.
M-29 BasePeriodEndDate Base Period Ending Date of Claim
Date yyyy-mm-dd
10* Required Must equal Base Period Start Date (M-28) plus one year.
Contains only numbers and dashes. Must be a valid date.
This date is a true calendar year If the BasePeriodStartDate is August 6, 2008, the BasePeriodEndDate must equal August 5, 2009.
M-30 NumberEmployersInBasePeriod
The number of Base Period Employers.
Numeric 3 Optional Contains only numbers.
94
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-31 BasePeriodWagesAllEmployers
Base Period Wages from ALL Employers.
Numeric 16.2 Optional Contains only numbers.
M-32 BasePeriodWagesThisEmployer
Base Period Wages from this Employer
Numeric 16.2 Optional
Must be less than or equal to M-31 (if there is a value present). Must be equal to the sum of M-39 thru M-42 if any present.
Contains only numbers.
M-33 WeeklyBenefitAmount Weekly Benefit Amount Numeric 6.2 Optional
Contains only numbers.
M-34 MaximumBenefitAmount
Maximum Benefit Amount Numeric 8.2
Optional Contains only numbers.
M-35 TotalWeeksOfBenefits The number of weeks of benefits the claimant is eligible for
Numeric 2 Optional Must be larger than 0 if present
Contains only numbers.
M-36 PercentChargableEmployer
The Percentage of Payment to be Charged to this Employer
Numeric 7.4 Optional Must be zero or larger if present. Cannot be larger than 100.0000
Contains only numbers.
M-37 TotalEmployerCharge The total amount of the benefits that can be potentially charged to the employer
Numeric 8.2 Optional Must be less than or equal to M-34 if present.
Contains only numbers.
M-38 EmployerCharge
Optional Occurs 0-52 times
M-38.1
BeginWeekNumber The begin week number of this employer charge.
Numeric 2 Required for each Employer Charge (M-38)
Must be between 1 and 52. Must not overlap with any other week range.
Contains only numbers.
M-38.2
EndWeekNumber The end week number of this employer charge.
Numeric 2 Required for each Employer Charge (M-38)
Must be between 1 and 52 and must be greater than or equal to M-38.1. Must not overlap with any other week range.
Contains only numbers.
M-38.3
TotalWeeklyEmployerCharge
The amount of the benefits to be charged to the employer per week
Numeric 7.2 Required for each Employer Charge (M-38)
Must be 0 or larger and cannot be larger than M-34 if present.
Contains only numbers.
95
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-38.4
PotentialWeeksEmployerCharge
The total amount of the benefits that can be potentially charged to the employer over the course of all the weeks in this Employer Charge instance.
Numeric 7.2 Required for each Employer Charge (M-38)
Contains only numbers.
M-39 WagesInFirstQuarter Wages in first quarter from this Employer
Numeric 15.2 Optional Contains only numbers.
M-40 WagesInSecondQuarter
Wages in second quarter from this Employer
Numeric 15.2 Optional Contains only numbers.
M-41 WagesInThirdQuarter Wages in third quarter from this Employer
Numeric 15.2 Optional Contains only numbers.
M-42 WagesInFourthQuarter Wages in fourth quarter from this Employer
Numeric 15.2 Optional Contains only numbers.
M-43 InitialClaimDate The initial date of this claim.
Date 10* Optional Contains only numbers and dashes. Must be a valid date.
M-45 Attachment Optional Occurs 0-5 times
M-45.1
DescriptionofAttachmentCode
The description of the attachment format.
Character 1* Required for each Attachment (M-45)
Value is a digit. Can only be codes 1-5.
1 = RTF 2 = PDF 3 = TXT 4 = TIFF 5 = CSV
M-45.2
TypeofDocument Title or description of the document attached.
Character 40 Required for each Attachment (M-45)
Contains the printable ASCII characters 32 – 126 decimal.
M-45.3
UniqueAttachmentID A unique ID within the record given to this attachment, and when combined with the StateRecordGUID is unique within the universe
Character 2 Required for each Attachment (M-45)
Must be unique within a record.
96
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-45.4
ActionableAttachment Determines whether the Employer/TPA is required to perform an action with the attachment
Character 1* Required for each Attachment (M-45)
Value is a digit. Can only be codes 1 or 3.
1 - Informational only - No Action Needed 3 - Requires action
M-45.5
AttachmentSize The attachment size in bytes
Numeric Required for each Attachment (M-45)
Contains only numbers.
M-45.6
AttachmentData The actual attachment in Base64 encoding
Base64Binary
Required for each Attachment (M-45)
Base64 encoded characters only
M-46 ResponseRequiredIndicator
Indicator to instruct the employer a response is required
Character 1* Required
Value is 'Y' or 'N' for yes or no
If set to Y, then a response is required by the employer. On EResponse, this means that the option to file a protest/claim is not presented to the employer and the response flows through to submission to the state. If set to N, then an employer has the option of not responding to the request. On EResponse, this means that an explicit option is presented to the employer and if there are no changes to the request and they accept the request, then the employer is presented with a Thank You page and no response is filed with the State. Alternatively, if set to N, then the employer may still file a protest. On EResponse, a page will be presented to the employer asking if they want to protest the charges or wages used for this claim.
Y = Yes N = No
97
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field
Size
Field Required / Optional
Business Rules Validation* Comments/Notes Values:
M-47 ProtestCommentIndicator
Protest Response Comment indicator that tells the employer/TPA whether or not they can fill in the ProtestTotalEmployerCharge field.
Character 1* Required Value is 'Y' or 'N' for yes or no
This determines whether the State would like to get more information on the claim/protest through a Protest Comment in the ProtestTotalEmployerCharge response field. If set to Y, the employer is required to fill this in if applicable. If N, the ProtestTotalEmployerCharge must be left off of the response (this question is not displayed to employers on EResponse).
Y = Yes N = No
M-48 PIN This is the PIN that the employer uses to log into the E-Response website. This shall only be used for bundling E-Response records.
Character 20 Optional Can only be used if the file that the record s in is addressed to EResponse in the SOAP header, otherwise must be null
98
Part B. Employer or TPA Response Form [Version 2.1.1 - Requirements Baseline - 06-12-2013]
Seq. No.
Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
MR-1 StateMonetaryChargeRequestRecordGUID
This is a unique ID given to this record by the State
Character 32* Backfilled Must return exactly as sent in M-1
Contains only 32 hexadecimal digits
State System Generated
MR-2 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 Backfilled Contains only hexadecimal digits
Broker System Generated
MR-3 ClaimNumber A unique identifier that can be used by the State to track a claim occurrence
Character 18 Backfilled
If claim number sent in, must return ClaimNumber exactly as sent in M-3
MR-38 RequestDate The date the Monetary and Potential Charges Notice is transmitted to the Employer/TPA.
Date yyyy-mm-dd
10* Backfilled Must return exactly as sent in M-5
Contains only numbers and dashes. Must be a valid date.
MR-39 ResponseDueDate The due date the response must be sent back to the state agency to be considered a timely response.
Date yyyy-mm-dd
10* Backfilled Must return exactly as sent in M-6
Contains only numbers and dashes. Must be a valid date.
MR-4 CorrectedFEIN The corrected employer's FEIN according to the employer's records.
Character 9* Optional
Contains only numbers and there are no letters or special characters. Must be 9 digits.
MR-5 StateEmployerAccountNbr The State account number to which the benefits are charged. It is the State's unique identifier for the employer.
Character 20 Backfilled Must return exactly as sent in M-13
Contains the printable ASCII characters 32 – 126 decimal.
MR-6 CorrectedStateEmployerAccountNbr
The corrected employer account number according to the employer's records
Character 20 Optional Contains the printable ASCII characters 32 – 126 decimal.
MR-33 EmployerName The legal business name of the Employer.
Character 100 Backfilled Must return exactly as sent in Employer Name (M-15)
Contains the printable ASCII characters 32 – 126 decimal.
99
Seq. No.
Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
MR-7 CorrectedEmployerName The corrected legal business name of the employer, according to the employer's records
Character 100 Optional Contains the printable ASCII characters 32 – 126 decimal.
MR-8 SSN The claimant’s Social Security Number.
Character 9* Backfilled
Must return exactly as sent in M-18
Contains only numbers and there are no letters or special characters
Information on valid SSN from <http://www.ssa.gov/foia/stateweb.html>.
MR-9 OtherSSN The additional SSN for a claimant who performed work under more than one SSN
Character 9* Optional Does not equal MR-8 used for the claim
Contains only numbers and there are no letters or special characters
MR-34 ClaimantLastName The claimant’s last name. Character 30 Backfilled Must return exactly as sent in Claimant Last Name (M-19)
Contains the printable ASCII characters 32 – 126 decimal.
MR-35 ClaimantFirstName The claimant’s first name. Character 25 Backfilled Must return exactly as sent in Claimant First Name (M-21)
Contains the printable ASCII characters 32 – 126 decimal.
MR-36 ClaimantMiddleInitial The claimant’s middle initial. Character 1* Backfilled If Claimant Middle Initial (M-22) is not null, must return exactly as sent in Claimant Middle Initial (M-22)
Contains the printable ASCII characters 32 – 126 decimal or null.
MR-37 ClaimantSuffix The claimant’s suffix, for example: Sr. Jr.
Character 8 Backfilled If Claimant Suffix (M-23) is not null, must return exactly as sent in Claimant Suffix (M-23)
Contains the printable ASCII characters 32 – 126 decimal or null.
MR-10 ClaimantNameWorkedAsForEmployer
The full name the claimant used while working for the employer.
Character 70 Optional Contains the printable ASCII characters 32 – 126 decimal.
100
Seq. No.
Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
MR-11 SeasonalEmploymentInd A value indicating whether the employment is seasonal according to state law
Character 1* Optional Must be null if M-26 = N Optional if (MR-32 =Y and M-46 = N and M-26 = Y) or (M-26=Y and M-46=Y) otherwise must null.
Value is 'Y' or 'N' for yes or no
Y = Yes N = No
MR-12 EmployerReportedDependants
Number of dependants employer is reporting
Numeric 1* Optional Must be 0-5 can be null. Must be null if M-24 is null.
Contains numbers only.
MR-13 EmployerSeparationReasonCode
The employer's reason for separation
Character 2 Conditional
Must be null if M-26 = N and MR-13 does not equal 20 or 21 Required if (MR-32 =Y.and M-46 = N and M-26 = Y) or (M-26=Y and M-46=Y) otherwise must null unless MR-13 = 20 or 21. If PreparerTypeCode (MR-23 ) is 'E' for employer, then valid codes are 1-20 or 99. If PreparerTypeCode (MR-23) is 'T' for Third Party Administrator, then valid codes are 1-21 or 99
Valid is either all numbers or null. Value is 1-21 or 99
1 = Temporary Layoff 2 = Laid Off/Lack of Work 3 = Fired/Discharged 4 = Vacation/ Holiday Shutdown 5 = Asked to Resign 6 = Voluntary Quit/Separation 7 = School Employee Between Semesters or Terms, Likely to Return 8 = School Employee Between Semesters or Terms, Not Likely to Return 9 = Still Employed, Full Time 10 = Still Employed, Part Time 11 = Still Employed, Hours Reduced by Employer 12 = On Call or Temporary Status 13 = Leave of Absence 14 = Retirement 15 = Disciplinary
101
Seq. No.
Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
Suspension 16 = Labor Dispute 17 = Professional Athlete Between Sports Seasons 18 = Disaster Related Separation 19 = Other 20 = Never Employed Here 21 = TPA does not represent this employer 99 = Not provided
MR-14 OtherSeparationReasonComments
Comments to explain if the reason for separation is 19 - Other
Character 2000 Conditional Must be null if M-26 = N Required if (MR-32 =Y.and M-46 = N and M-26 = Y and MR-13 = “19-Other’) or (M-26=Y and M-46=Y and MR-13 = “19-Other). Optional if (MR-32 =Y.and M-46 = N and M-26 = Y and MR-13 <> “19-Other’) or (M-26=Y and M-46=Y and MR-13 <> “19-Other).
Contains the printable ASCII characters 32 – 126 decimal.
MR-32 ProtestInd Whether the employer is protesting the notice or not.
Character 1* Required Value is 'Y' or 'N' for yes or no
Y = Yes N = No
MR-16 ProtestTotalEmployerCharge
Reason for protesting the amount charged to the employer
Character 2000 Conditional Must be null if M-47 = N Required if M-47 = Y and MR-32 = Y and EmployerSeparationReasonCode does not equal 20 or 21 otherwise null.
Contains the printable ASCII characters 32 – 126 decimal.
MR-17 Employer Corrected Wage for First Quarter
Employer corrected wages for First Quarter
Numeric 15.2 Optional Contains only numbers.
102
Seq. No.
Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
MR-18 Employer Corrected Wage for Second Quarter
Employer corrected wages for Second Quarter
Numeric 15.2 Optional Contains only numbers.
MR-19 Employer Corrected Wage for Third Quarter
Employer corrected wages for Third Quarter
Numeric 15.2 Optional Contains only numbers.
MR-20 Employer Corrected Wage for Fourth Quarter
Employer corrected wages for Fourth Quarter
Numeric 15.2 Optional Contains only numbers.
MR-21 LastDayWorked
The last day worked for the employee.
Date 10* Conditional A. Must be null if Employer Separation Reason Needed Indicator(M-26) = N
B. If MR-13 is not null and
MR-13 is one of codes “9 = Still Employed, Full Time”, “10 = Still Employed, Part Time”, “11 = Still Employed, Hours Reduced by Employer”, “19 = Other”, “20 = Never Employed Here”, “21 = TPA does not represent this employer” or “99 = Not provided” then MR-21 is optional, otherwise if MR-13 is not null then MR-21 is required.
C. If B does not apply then, Required if (MR-32 =Y and M-46 = N and M-26 = Y) or (M-26=Y and M-46=Y) otherwise must null.
D. If not null, must be
more recent than the request date minus 3
Contains only numbers and dashes. Must be a valid date.
103
Seq. No.
Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
years.
MR-22 Attachment Optional Occurs 0-5 times
MR-22.1
DescriptionofAttachmentCode
The description of the attachment format.
Character 1* Required for each Attachment (MR-22)
Value is a digit. Can only be codes 1-5.
1 = RTF 2 = PDF 3 = TXT 4 = TIFF 5 = CSV
MR-22.2
TypeofDocument Title or description of the document attached.
Character 40 Required for each Attachment (MR-22)
Contains the printable ASCII characters 32 – 126 decimal.
MR-22.3
UniqueAttachmentID A unique ID within the record given to this attachment, and when combined with the StateRecordGUID is unique within the universe
Character 2 Required for each Attachment (MR-22)
Must be unique within a record.
MR-22.4
AttachmentSize The attachment size in bytes Numeric Required for each Attachment (MR-22)
Contains only numbers.
MR-22.5
AttachmentData The actual attachment in Base64 encoding
Base64Binary Required for each Attachment (MR-22)
Base64 encoded characters only
Preparer Information
MR-23 PreparerTypeCode Identifies if the employer or employer representative is providing a response to the request for the separation information.
Character 1* Required If EmployerSepReasonCode (MR-13) = 21 for 'TPA does not represent this employer' then PreparerTypeCode must = 'T' for 'Third Party Administrator'
Value is 'E' for 'Employer' or 'T' for 'Third Party Administrator'.
E = Employer T=Third Party Administrator
MR-24 PreparerCompanyName The Third Party Administrator’s company name.
Character 60 Conditional Required if PreparerTypeCode (MR-23) = ‘T’ for 'Third Party Administrator'.
Contains the printable ASCII characters 32 – 126 decimal.
104
Seq. No.
Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
MR-25 PreparerTelephoneNumberPlusExt
The preparer’s telephone number plus extension.
Character 15 Required Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
MR-26 PreparerContactName The preparer’s name. Character 60 Required Contains the printable ASCII characters 32 – 126 decimal.
MR-27 PreparerTitle The preparer’s title Character 30 Required Contains the printable ASCII characters 32 – 126 decimal.
MR-28 PreparerFaxNbr The preparer’s fax number Character 10* Optional Contains only numbers. Must contain 10 digits.
MR-29 PreparerEmailAddress The preparer’s e-mail address. Character 60 Required Contains letters, dashes, @, periods, numbers, underscores.
MR-30 AmendedResponse The amended response number.
Character 1* Optional Value is either all numbers or null. Must contain 1 digit (null or 1 - 9).
Null=original response, 1=first change, 2=second change, etc.
MR-31 AmendedResponseDescription
The amended response description.
Character 2000 Conditional Cannot be empty when MR-30, AmendedResponse is not null.
Contains the printable ASCII characters 32 – 126 decimal.
Note: Later additions to the format were added into the area it made most sense but to keep the numbering consistent the whole format was not renumbered.
Therefore:
MR-32 is after MR-14.
MR-33 is after MR-6.
MR-34, MR-35, MR-36 and MR-37 are after MR-9.
MR-38 and MR-39 are after MR-3.
105
8.4 THE DETERMINATION AND DECISION STANDARD FORMAT
The two tables below detail what the Determination and Decision Standard Format
requires for a determination and decision notification and for the employer determination and decision response.
Important Notes:
1. Any text string not defined in the XSD can be accepted in upper or lower case (or any combination thereof).
2. For any character fields, if entry is via the Internet, do not allow entry of the characters for less than and greater than ('<', '>').
3. All field sizes are variable length unless marked with an Asterisk (*), which denotes the field size is fixed length.
4. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
For Employer Response Only:
1. For fields labeled as 'Backfilled', the data element is passed back from the Request for Determination and Decision and is not editable by the employer or TPA.
2. Fields DR-1 through DR-16 , DR-32, DR-33, DR-53, and DR-54 are key fields for matching response to request.
3. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
106
State UI Agency Request for Determination and Decision [Version 1.0 - Requirements Baseline - 02-4-2014]
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
D-27 StateDeterminationDecisionRequestRecordGUID
This is a unique ID given to this record by the State
Character 32* Required Contains only hexadecimal digits
D-29 RequestDate The date this Non-Monetary Decision or Appeal Decision is transmitted to the Employer/TPA.
Date – yyyy-mm-dd
10* Required Date must be greater than or equal to the current date minus one day. State and Broker rule only.
Contains only numbers and dashes. Must be a valid date
D-1 RequestingStateAbbreviation US Postal (2 letter) state code Character 2* Required Must be two alpha characters and no blanks allowed.
Information on valid 2-character state and territory abbreviations available from the FIPS website: <http://www.itl.nist.gov/fipspubs/fip5-2.htm>.
D-2 SSN The claimant’s Social Security Number.
Character 9* Required Contains only numbers and there are no letters or special characters
Information on valid SSN from <http://www.ssa.gov/foia/stateweb.html>.
D-3 ClaimantLastName The claimant’s last name. Character 30 Required Contains the printable ASCII characters 32 – 126 decimal.
107
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
D-4 OtherLastName The additional last name for a claimant who performed work using more than one SSN name. This covers SSN name changes, e.g., due to marriage or divorce.
Character 30 Optional Contains the printable ASCII characters 32 – 126 decimal.
D-5 ClaimantFirstName The claimant’s first name. Character 25 Required Contains the printable ASCII characters 32 – 126 decimal.
D-6 ClaimantMiddleInitial The claimant’s middle initial. Character 1* Optional Contains a letter or null character.
D-7 ClaimantSuffix The claimant’s suffix, for example: Sr., Jr., III etc.
Character 8 Optional Contains the printable ASCII characters 32 – 126 decimal.
D-8 ClaimEffectiveDate The effective date of the claim is based on the date the claim is filed and other factors defined in each States' procedures. Can be an Initial or Additional claim.
Date yyyy-mm-dd
10* Required Must be before RequestDate (D-29) cannot be older than 2 years before the RequestDate
Contains only numbers and dashes. Must be a valid date.
D-9 ClaimNumber A unique identifier that can be used by the state to track a claim occurrence.
Character 18 Optional Contains the printable ASCII characters 32 – 126 decimal.
D-10 BenefitYearBeginDate The benefit year begin date is based on the date the claim is filed and other factors defined in each States' procedures.
Date yyyy-mm-dd
10* Required Must be before RequestDate (D-29) and cannot be older than 6 years before the RequestDate.
Contains only numbers and dashes. Must be a valid date.
D-11 StateEmployerAccountNbr The State account number that identifies the employer on the separation information request form. It is a unique identifier for
Character 20 Required Contains the printable ASCII characters 32 – 126 decimal.
108
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
the employer.
D-12 FEIN The claimant's employer Federal Employer Identification Number (FEIN).
Character 9* Required Contains only numbers and there are no letters or special characters. Must be 9 digits.
D-13 EmployerName The legal business name of the employer.
Character 100 Required Contains the printable ASCII characters 32 – 126 decimal.
D-14 UIOfficeName The name or description of the appropriate UI office location to contact regarding this nonmonetary determination.
Character 25 Required A combination of letters and numbers. Allows for slash, comma, period, dash and blanks.
D-15 UIOfficePhone Phone number for Employer to contact a person in the State regarding this nonmonetary determination.
Character 15 Optional Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
D-37 UIOfficeFax Fax number for Employer to contact a person in the State regarding this nonmonetary determination.
Character 10* Optional Contains only numbers or is null.
Contain area code, 7-digit telephone number
109
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
D-38 UIOfficeEmailAddress Email Address for Employer to contact a person in the State regarding this nonmonetary determination.
Character 60 Optional Contains letters, dashes, @, periods, numbers, underscores.
D-16 DeterminationOrDecisionInd The type of determination or decision being sent.
Character 2* Required Value is a digit. Can only be codes 10-90.
If value is 10, 11, 12, 13, 30, 31, 32, or 33 set type to Determination
If value is 60 or 90 set type to Decision
10=Non-Monetary Separation Determination 11=Non-Monetary Separation Re-Determination 12=Non-Monetary Separation Revision 13=Non-Monetary Separation Withdrawal 30=Non-Monetary Non-Separation Determination 31=Non-Monetary Non-Separation Re-Determination 32=Non-Monetary Non-Separation Revision 33=Non-Monetary Non-Separation Withdrawal 60=Lower Authority Appeal Decision 90=Higher Authority Appeal Decision
D-17 DecisionNumberOrDocketNumber
A Decision Number or Docket Number assigned by the state.
Character 20 Optional A combination of letters and numbers. Allows for slash, comma, period, dash and blanks.
D-18 DeterminationOrDecisionDate
The date the Determination or Decision was issued.
Date yyyy-mm-dd
10* Required Must be greater than Benefit Year Beginning Date D-10
Contains only numbers and dashes. Must be a valid date.
110
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
D-19 DeterminationOrDecisionResult
The outcome of the nonmonetary determination or appeal
Character 2* Required Value of 11 or 19 can only be used if D-16 DeterminationOrDecisionInd = 30, 31, 32 or 33
Value is a digit. Can only be codes 10-33.
10=Benefits Allowed/Claimant Eligible 11=Claimant Ineligible 20=Disqualification/Suspension Indefinite 31=Disqualification/Suspension Weeks 32=Disqualification/Suspension Earnings 33=Disqualification/Suspension Weeks/Earnings 19=Other (employment status/relationship, coverage, etc.)
D-20 EmployerChargableForBenefitsPaid.
Could employer's account be charged (for current benefit year or future benefit year) based on the results of this decision?
Character 1* Required Y=Yes N=No
D-31 AgentResponseIndicator Agent Response indicator that tells the employer/TPA whether or not they can select the AgentResponseType
Numeric 1* Required Must be 1 or 2. 1 = Yes 2 = No
D-32 EmpWorksiteIndicator Agent Response indicator that tells the employer/TPA whether or not they can provide the EmpWorksiteAddress
Numeric 1* Required Must be 1 or 2. 1 = Yes 2 = No
D-33 NotAvailableIndicator Agent Response indicator that tells the employer/TPA whether or not they can provide DatesTimesNotAvailable
Numeric 1* Required Must be 1 or 2. 1 = Yes 2 = No
111
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
D-34 InterpreterIndicator Agent Response indicator that tells the employer/TPA whether or not they can provide the InterpreterLanguage
Numeric 1* Required Must be 1 or 2. 1 = Yes 2 = No
D-35 SpecialNeedsIndicator Agent Response indicator that tells the employer/TPA whether or not they can provide SpecialNeeds
Numeric 1* Required Must be 1 or 2. 1 = Yes 2 = No
D-22 Attachment
Required (at least one attachment required) Occurs 1-5 times
D-22.1 DescriptionOfAttachmentCode
The description of the attachment format.
Character 1* Required for each Attachment (D-22)
Value is a digit. Can only be codes 1-4.
CSV option purposely omitted from this request
1 = RTF 2 = PDF 3 = TXT 4 = TIFF
D-22.2 TypeOfDocument Description of the type of document attached.
Character 40 Required for each Attachment (D-22)
Contains letters, numbers, punctuation, apostrophe, dash, and blanks.
D-22.3 UniqueAttachmentID A unique ID within the record given to this attachment, and when combined with the StateRecordGUID is unique within the universe.
Character 2 Required for each Attachment (D-22)
112
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
D-22.4 ActionableAttachment Determines whether the Employer/TPA is required to perform an action with the attachment
Character 2* Required for each Attachment (D-22)
Value is a digit. Can only be codes 11-15.
11=May require Employer/TPA Action - State Non-Monetary Determination attached 12=May require Employer/TPA Action - State Appeal Decision attached. 13=May require Employer/TPA Action - State Higher Authority Appeal Decision attached. 14=Other actionable attachment 15=Informational only - No action needed (i.e. instructional forms, determinations sent only as FYI, etc.)
D-22.5 AttachmentSize The attachment size in bytes Numeric Required for each Attachment (D-22)
Contains only numbers.
D-22.6 AttachmentData The actual attachment in Base64 encoding.
Base 64 Binary Required for each Attachment (D-22)
Base64 encoded characters only
113
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
D-23 Appealable DeterminationOrDecision
Is this determination/decision appealable via SIDES or E-Response?
Character 1* Required Must be digits 1, 2 or 3 1=Appealable via SIDES response 2=Appealable ONLY through method(s) described on determination/decision attachment 3=This determination/decision is not appealable
D-24 LastDateToAppeal The last date for a timely Appeal of this Determination/Decision to the state agency.
Date – yyyy-mm-dd
10* Required if D-23 is 1 or 2
Must be later than Date of the Request Date D-29 and must be equal to or greater than Request Date D-29 plus the number of days in look-up table.
Contains only numbers and dashes. Must be a valid date and at least XX days later than D-29 Request Date.
Use look-up table for number of days allowed for appeal of a Nonmonetary or Higher authority appeal.
D-25 FormNumber The state form number this transaction applies to.
Character 12 Optional Contains letters, numbers, periods, dashes, and blanks. Can also be null
D-36 PIN This is the PIN that the employer uses to log into the E-Response website. This shall only be used for bundling E-Response records.
Character 20 Optional Can only be used if the file that the record s in is addressed to EResponse in the SOAP header, otherwise must be null
D-28 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 Required on Request to the
Contains only hexadecimal digits
Field must not be present in the request
114
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
Employer/TPA
file from the State – will cause an XSD error if there.
D-30 BrokerRecordEffectiveDate The date that the record was accepted from the State into the Central Broker.
DateTimeStamp
30 System Added to the Employer; Not put in the Request from the State
Contains a Date and Time stamp Format will be: 2010-04-27T16:03:08.000-04:00
Field must not be present in the request file from the State – will cause an XSD error if there.
115
Part B. Employer or TPA Response Form [Version 1.0 - Requirements Baseline - 02-4-2014]
Seq. No. Data Element Name Data Element Description Type and/or Format
Field Size Field Required / Optional
Business Rules Validation* Comments/Notes
Values:
DR-32 StateDeterminationDecisionRequestRecordGUID
This is a unique ID given to this record by the State
Character 32* Backfilled Must return StateDeterminationDecisionRequestRecordGUID exactly as sent in D-27
Contains only hexadecimal digits
DR-33 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 Backfilled Must return BrokerRecordTransactionNumber exactly as sent in D-28
Contains only hexadecimal digits
DR-53 RequestDate The date this Non-Monetary Decision or Appeal Decision is transmitted to the Employer/TPA.
Date – yyyy-mm-dd
10* Backfilled Must return RequestDate exactly as sent in D-29
DR-54 LastDateToAppeal The last date for a timely Appeal of this Determination/Decision to the state agency.
Date – yyyy-mm-dd
10* Backfilled Must return LastDateToAppeal exactly as sent in D-24
DR-1 RequestingStateAbbreviation US Postal (2 letter) state code Character 2* Backfilled Must return RequestingStateAbbreviation exactly as sent in D-1
DR-2 SSN The claimant’s Social Security Number.
Character 9* Backfilled Must return SSN exactly as sent in D-2
116
DR-3 ClaimantLastName The claimant’s last name. Character 30 Backfilled Must return ClaimantLastName exactly in D-3
DR-4 OtherLastName The additional last name for a claimant who performed work using more than one SSN name. This covers SSN name changes, e.g., due to marriage or divorce.
Character 30 Backfilled Must return OtherLastName exactly as sent in D-4
DR-5 ClaimantFirstName The claimant’s first name. Character 25 Backfilled Must return ClaimantFirstName exactly as sent in D-5
DR-6 ClaimantMiddleInitial The claimant’s middle initial. Character 1* Backfilled Must return ClaimantMiddleInitial exactly as sent in D-6
DR-7 ClaimantSuffix The claimant’s suffix, for example: Sr., Jr., III etc.
Character 8 Backfilled Must return ClaimantSuffix exactly as sent in D-7
DR-8 ClaimEffectiveDate The effective date of the claim is based on the date the claim is filed and other factors defined in each States' procedures. Can be an Initial or Additional claim.
Date yyyy-mm-dd
10* Backfilled Must return ClaimEffectiveDate exactly as sent in D-8
DR-9 ClaimNumber A unique identifier that can be used by the state to track a claim occurrence.
Character 18 Backfilled Must return ClaimNumber exactly as sent in D-9
DR-10 BenefitYearBeginDate The benefit year begin date is based on the date the claim is filed and other factors defined in each States' procedures.
Date yyyy-mm-dd
10* Backfilled Must return BenefitYearBeginDate exactly as sent in D-10
DR-11 StateEmployerAccountNbr The State account number that identifies the employer on the separation information request form. It is a unique identifier for
Character 20 Backfilled Must return StateEmployerAccountNbr exactly as sent in D-11
117
the employer.
DR-12 FEIN The claimant's employer Federal Employer Identification Number (FEIN).
Character 9* Backfilled Must return FEIN exactly as sent in D-12
DR-13 EmployerName The legal business name of the employer.
Character 100 Backfilled Must return EmployerName exactly as sent in D-13
DR-14 DeterminationOrDecisionInd The type of determination or decision being responded to.
Character 2* Backfilled Must return Determination/DecisionInd exactly as sent in D-16
Value is a digit. Can only be codes 10-90.
If value is 10, 11, 12, 13, 30, 31, 32, or 33 set type to Determination
If value is 60 or 90 set type to Decision
10=Non-Monetary Separation Determination 11=Non-Monetary Separation Re-Determination 12=Non-Monetary Separation Revision 13=Non-Monetary Separation Withdrawal 30=Non-Monetary Non-Separation Determination 31=Non-Monetary Non-Separation Re-Determination 32=Non-Monetary Non-Separation Revision 33=Non-Monetary Non-Separation Withdrawal 60=Lower Authority Appeal Decision 90=Higher Authority Appeal Decision
DR-15 DecisionNumberOrDocketNumber
The Decision Number or Docket Number assigned by the state.
Character 20 Backfilled Must return DecisionNumber/DocNumber exactly as sent in D-17
118
DR-16 DeterminationOrDecisionDate
The date the Determination or Decision was issued.
Date yyyy-mm-dd
10* Backfilled Must return Determination/DecisionDate exactly as sent in D-18
DR-17 EmployerRequestingRedetOrAppealOfDeterminationOrDecision
The employer is requesting an appeal of this determination / decision.
Character 1* Conditional
Required if Appealable DeterminationOrDecision (D-23) is "1" and TPAToEmployerRelationship (DR-35) does not equal 21. If TPAToEmployerRelationship (DR-35) equals 21, then this field must be null.
Value is 'Y' A response can only be completed and sent if the decision sent out is appealable (See D-23) or if a TPA is informing the State of no longer having a relationship with the Employer.
Y=Yes Employer is requesting appeal (If no appeal is requested and the TPA is not informing the State of no relationship with the employer, no response should be sent)
DR-18 AppealReasonIndicator Appeal Reason Indicator Character 2* Conditional
Required if EmployerRequestingRedetOrAppealOfDeterminationOrDecision (DR17) is equal to "Y" otherwise must be null.
Value is a digit. Must be code 10, 20 or 30
10=Employer disagrees with findings 20=Employer has additional information that was not considered 30=Employer appeals account charges
DR-19 EmployerReasonRequestingRedetOrAppeal
Explain your reason for requesting an appeal/redetermination of this determination / decision?
Character 2000 Conditional
Required if EmployerRequestingRedetOrAppealOfDeterminationOrDecision (DR17) is equal to "Y" otherwise must be null.
Contains the printable ASCII characters 32 – 126 decimal.
DR-20 EmployerReasonLateAppeal Explain your reason for requesting an appeal/redetermination of this determination / decision after the
Character 2000 Conditional
Required if Current Date is greater than D-24 LastDayToAppeal (Employer/TPA and
Contains the printable ASCII characters 32 – 126 decimal.
119
due date Broker only rule)
DR-22 Attachment Optional Occurs 0-5 times
DR-22.1 DescriptionOfAttachmentCode
The description of the attachment format.
Character 1* Required for each Attachment (D-22)
Value is a digit. Can only be codes 1-5.
1 = RTF 2 = PDF 3 = TXT 4 = TIFF 5 = CSV
DR-22.2 TypeofDocument Description of the type of document attached.
Character 40 Required for each Attachment (D-22)
Contains letters, numbers, punctuation, apostrophe, dash, and blanks.
DR-22.3 UniqueAttachmentID A unique ID within the record given to this attachment, and when combined with the StateRecordGUID is unique within the universe.
Character 2 Required for each Attachment (D-22)
DR-22.4 AttachmentSize The attachment size in bytes Numeric Required for each Attachment (D-22)
Contains only numbers.
DR-22.5 AttachmentData The actual attachment in Base64 encoding.
Base 64 Binary
Required for each Attachment (D-22)
Base64 encoded characters only
DR-36 EmpWorksiteAddress1 Employer worksite address1. Flag set for display in D-32
Character 35 Optional Contains the printable ASCII characters 32 – 126 decimal.
120
DR-37 EmpWorksiteAddress2 Employer worksite address2. Flag set for display in D-32
Character 35 Optional Contains the printable ASCII characters 32 – 126 decimal.
DR-38 EmpWorksiteCity Employer worksite address city. Flag set for display in D-32
Character 19 Optional Contains the printable ASCII characters 32 – 126 decimal.
DR-39 EmpWorksiteState Employer worksite address state. Flag set for display in D-32
Character 3 Optional Only alpha characters May contain: US state abbreviation, Canadian Province abbreviation, or Mexican state abbreviation
DR-40 EmpWorksiteZip Employer worksite address zip. Flag set for display in D-32
Character 10 Optional If the State is in the U.S., the zip code must be 5 digits or 5 digits plus a dash plus 4 digits. If the State is in Mexico, it must be 5 digits. If the State is in Canada, the zip must be ADADAD or ADA DAD (A = letter, D = digit).
Contains one of 5 digits, 5 digits plus a dash plus 4 digits, or the Canadian Zip code of ADA DAD (A = letter, D = digit) with or without the middle space.
DR-41 EmpWorksiteTelephoneNumberPlusExt
The Employer’s worksite telephone number plus extension.
Character 15 Optional Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if
121
needed).
DR-42 AgentType Options are no, agent or attorney Character 1* Conditional
Required if D-31 = 1 and TPAToEmployerRelationship (DR-35) does not equal 21; otherwise must be null
Must be No, Agent, or Attorney (filled by selection of radio button on E-Response)
Selection other than "None" prompts display of DR-38 and DR-39 on E-Response
1= No 2 = Agent 3 = Attorney
DR-43 AgentAttorneyName Name of Agent or Attorney (based on D-42 response)
Character 50 Conditional
Required if DR-42 is not equal to "1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-42 is not equal to "No"
DR-44 AgentAttorneyAddress1 Agent/Attorney address1. Flag set for display in D-32
Character 35 Conditional
Required if DR-42 is not equal to 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-42 is not equal to "No"
DR-45 AgentAttorneyAddress2 Agent/Attorney address2. Flag set for display in D-32
Character 35 Conditional
Optional if DR-42 is not equal to 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-42 is not equal to "No"
DR-46 AgentAttorneyCity Agent/Attorney address city. Flag set for display in D-32
Character 19 Conditional
Required if DR-42 is not equal to 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-
122
42 is not equal to "No"
DR-47 AgentAttorneyState Agent/Attorney address state. Flag set for display in D-32
Character 3 Conditional
Required if DR-42 is not equal to 1, otherwise must be null
Only alpha characters Displayed on E-Response only if DR-42 is not equal to "No"
May contain: US state abbreviation, Canadian Province abbreviation, or Mexican state abbreviation
DR-48 AgentAttorneyZip Agent/Attorney address zip. Flag set for display in D-32
Character 10 Conditional
Required if DR-42 is not equal to 1, otherwise must be null. If the State is in the U.S., the zip code must be 5 digits or 5 digits plus a dash plus 4 digits. If the State is in Mexico, it must be 5 digits. If the State is in Canada, the zip must be ADADAD or ADA DAD (A = letter, D = digit).
Contains one of 5 digits, 5 digits plus a dash plus 4 digits, or the Canadian Zip code of ADA DAD (A = letter, D = digit) with or without the middle space.
Displayed on E-Response only if DR-42 is not equal to "No"
DR-49 AgentAttorneyTelephoneNumberPlusExt
The Agent/Attorney’s telephone number plus extension.
Character 15 Conditional
Required if DR-42 is not equal to 1, otherwise must be null
Contains only numbers or is null.
Contain area code, 7-digit telephone
123
number, and extension up to 5 digits (if needed).
DR-50 DateTimesUnavailable The dates and/or times that the employer is unavailable to participate in a hearing.
Character 500 Conditional
Optional if D-33 = 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if D-33 = 1
DR-51 InterpreterLanguage If an interpreter is requested, language(s) needed
Character 100 Conditional
Optional if D-34 = 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if D-34 = 1
DR-52 SpecialNeeds List of special needs requested by the employer/TPA
Character 500 Conditional
Optional if D-35=1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if D-35 = 1
Preparer Information
DR-23 PreparerTypeCode Identifies if the employer or employer representative is providing this response
Character 1* Required Value is 'E' for 'Employer' or 'T' for 'Third Party Administrator'.
E = Employer T=Third Party Administrator
DR-24 PreparerCompanyName The Third Party Administrator’s company name.
Character 60 Conditional
Required if PreparerTypeCode (DR-23) = ‘T’ for 'Third Party Administrator'.
Contains the printable ASCII characters 32 – 126 decimal.
DR-35 TPAToEmployerRelationship The relationship between the TPA and the Employer.
Numeric 2* Conditional
Can only be filled in if PreparerTypeCode (DR-23) = 'T' for 'Third Party Administrator'
Value is 21 or null. Must only be filled in when the TPA does not represent
21 = TPA no longer represents employer.
124
the Employer any longer.
DR-25 PreparerTelephoneNumberPlusExt
The preparer’s telephone number plus extension.
Character 15 Required Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
DR-26 PreparerContactName The preparer’s name. Character 60 Required Contains the printable ASCII characters 32 – 126 decimal.
DR-27 PreparerTitle The preparer’s title Character 30 Required Contains the printable ASCII characters 32 – 126 decimal.
DR-28 PreparerFaxNbr The preparer’s fax number Character 10* Optional Contains only numbers. Must contain 10 digits.
DR-29 PreparerEmailAddress The preparer’s e-mail address. Character 60 Required Contains letters, dashes, @, periods, numbers, underscores.
DR-30 AmendedResponse The amended response number. Character 1* Optional Value is either all numbers or null. Must contain 1 digit (null or 1 - 9).
Null=original response, 1=first change, 2=second change, etc.
DR-31 AmendedResponseDescription
Explanation of reason for amended response.
Character 2000 Conditional
Cannot be empty when DR-30, AmendedResponse is not null.
Contains the printable ASCII characters 32 – 126 decimal.
125
DR-34 BrokerRecordEffectiveDate The date that the record was accepted from the Employer/TPA into the Central Broker.
DateTimeStamp
30 System Added to the State; Not put in the Response from the Employer/TPA
Contains a Date and Time stamp Format will be: 2010-04-27T16:03:08.000-04:00
Field must not be present in the response file from the Employer/TPA – will cause an XSD error if there.
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8.5 THE BENEFIT CHARGES STANDARD FORMAT
The two tables below detail what the Benefit Charges Standard Format requires for a state and for the employer response.
Important Notes:
1. Any text string not defined in the XSD can be accepted in upper or lower case (or any combination thereof).
2. For any character fields, if entry is via the Internet, do not allow entry of the characters for less than and greater than ('<', '>').
3. All field sizes are variable length unless marked with an Asterisk (*), which denotes the field size is fixed length.
4. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
For Employer Response Only:
1. An additional field, “Fact-Finding Question” is unique to the employer response table and provides a typical question that an employer might see.
2. For fields labeled as 'Backfilled', the data element is passed back from the Request and is not editable by the employer or TPA.
3. Fields CR-1 through CR-9, and CR-32 and CR-33 are key fields for matching response to request.
4. Unless noted in the standard format, any character field that has no value, but contains spaces (decimal 32) must NOT be sent through SIDES (the field and space(s) cannot be present in the XML sent to the Broker). The Broker does not trap this situation because it is not permitted to manipulate the data sent by states, employers, or TPAs.
127
State UI Agency Notice of Benefit Charges [Version 1.0 - Requirements Baseline - 9-28-2016]
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
Part 1: Employer Summary
128
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C- 1 StateChargeRecordGUID
This is a unique ID given to this record by the State
Character 32* Required Contains only 32 hexadecimal digits
A GUID is a special identifier used in software applications to provide a unique reference number. The value is represented as a 32 character hexadecimal character string, such as {21EC2020-3AEA-1069-A2DD-08002B30309D}. Note: hyphens are not permitted in GUIDs used in SIDES. The SIDES team suggests GUIDs be generated using utilities or function calls available within your development framework. Each State Charge request record shall contain a unique StateChargeGUID that cannot be reused for a period of 10 years. A StateChargeGUID may be reused when the state does not receive a Broker acknowledgement to the Post, or when Broker the message code for the Post = 2 (total file failure), or when the Broker acknowledgement returns a message code = 3 and the record with the StateChargeGUID is identified as a record in error.
129
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-2 NoticeDate The date the Benefit Charge Notice is transmitted to the Employer/TPA.
Date yyyy-mm-dd
10* Required Date must be greater than or equal to the current date minus one day and less than CurrentDate plus 6 months State and Broker rule only.
Contains only numbers and dashes. Must be a valid date.
If today’s date is February 6, 2013, the NoticeDate must be February 5, 2013 or later.
Business rule component ‘and less than current date + 6 months’ permits retention of production readiness review data for 6 months before data must be regenerated.
C-33 DueDateRequiredInd
Indicates the state has a specific number of days the employer has to respond for either regular or reimbursable
Char 1 Required Y or N, cannot be null
Y=’Yes’
N=’No’
C-3 LastDayToRespond The last day an employer can provide a response to the charge notice.
Date yyyy-mm-dd
10* Conditional C-3 must be be null if C-33 is ‘N’
Required if DueDateRequiredInd (C-33) is ‘Y’
Date must be greater than or equal to NoticeDate (C-2) plus XX days and cannot be more than NoticeDate (C-2) + ZZ days
ZZ = Lookup table
Number of days to appeal, protest, question charges
- Reimbursable employer
- Taxable employer
Contains only numbers and dashes. Must be a valid date.
Must provide a date if the UI agency wants an employer or TPA to have the ability to appeal or protest the charges.
Number of days to provide a response is determined by employer type. Taxable or Reimbursable.
130
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-4 ChargingStateAbbreviation
US Postal (2 letter) state code
Character 2* Required Must be two alpha characters and no blanks allowed.
Information on valid 2-character state and territory abbreviations available from the FIPS website: <http://www.itl.nist.gov/fipspubs/fip5-2.htm>.
C-5 UIOfficeName Name of the State Agency issuing the Benefit Charge Notice
Character 25 Required Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-11 UIOfficeEmailAddress
Email Address for Employer to contact a person in the State regarding the Benefit Charge Notice
Character 60 Optional Contains letters, dashes, @, periods, numbers, underscores.
C-12 UIOfficePhone The UI Agency's telephone number plus extension for the Employer to contact regarding this Benefit Charge Notice.
Character 15 Optional Contains only numbers.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
C-13 UIOfficeFax Fax number for Employer to contact the state agency regarding this Benefit Charge Notice.
Character 10* Optional Contains only numbers.
Contain area code, 7-digit telephone number
C-14 ExperienceRatingMethod
The type of experience rating used by the state
Numeric 1* Required Contains only numbers
1=Reserve Ratio
2=Benefit Ratio (may also have a reserve ratio component)
3=Benefit Wage Ratio
4=Payroll Variation
131
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-15 StateEmployerAccountNbr
The State employer account number that identifies the employer to which the benefits are charged. It is a unique identifier for the employer.
Character 20 Required Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-16 PredecessorEmployerAccountNbr
The State account number that identifies the predecessor account number. It is a unique identifier for the predecessor employer.
Character 20 Optional Contains the printable ASCII characters 32 – 126 decimal.
Each state may define how far back in time to show predecessor account numbers.
C-17 EmployerName The legal business name of the Employer.
Character 100 Required Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-18 FEIN The Employer Federal Employer Identification Number (FEIN)
Character 9* Required Contains only numbers and there are no letters or special characters. Must be 9 digits.
132
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-19 ChargeStatementStartDate
Beginning Date for Benefit Charge Period included in this Notice.
Date yyyy-mm-dd
10* Required Must be less than or equal to NoticeDate (C-2) minus seven days and equal to or greater than the NoticeDate (C-2) minus 13 months and seven days.
Contains only numbers and dashes. Must be a valid date.
C-20 ChargeStatementEndDate
Ending Date for Benefit Charge Period included in this Notice.
Date yyyy-mm-dd
10* Required Must be equal to or greater than 7 days after ChargeStatementStartDate (C-19) and less than 93 days after ChargeStatementStartDate (C-19).
Contains only numbers and dashes. Must be a valid date.
C-21 EmployerAccountType
The type of Employer Account
Numeric 1* Required Contains only numbers 1 or 2
1=taxable Employer 2=reimbusable Employer
C-22 NumberOfIndividualSSNsWithCharges
Number of individual SSNs/benefit year / program code with charges to the employer for this notice.
Numeric 7 Required Must equal the number of records reporting SSNBYBChargeProgramCode C-28.0.
Contains only numbers = 1 or larger. No commas allowed.
C-23 TotalDollarAmountChargedToEmployer
Total dollar amount of benefits charged to the employers account in this notice
Numeric 15.2
Required Must equal the sum of charges listed in TotalAmountChargedToEmployer (C-28.13).
Only numbers, decimal point, and minus sign. No dollar sign($) or commas allowed. Can be a negative number.
15.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point.
133
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-24 ReserveBalance The Reserve Balance for the employers account
Numeric 15.2
Conditional Required if (C-14) ExperienceRatingMethod = 1 (Reserve Ratio) otherwise null
Only numbers, decimal point, and minus sign. No dollar sign($) or commas allowed. Can be a negative number. Can only be used by Reserve Ratio States.
15.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point.
C-25 InvoiceNumber The number assigned by the state to this individual invoice
Character 20 Optional InvoiceNumber (C-25) can only be filled in if C-29.4 (ActionableAttachment) equals 1 (invoice attached) and (C-21) EmployerAccountType = 2 (Reimbursable Employer)
Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-26 PaymentDueDate The last date that the Invoiced amount can be paid without penalty.
Date yyyy-mm-dd
10* Conditional Required if C-29.4 (ActionableAttachment) equals 1 and C-21 (EmployerAccountType = 2, reimbursable employer, otherwise null. Must be later than (C-2) NoticeDate and not more than YY days after (C-2) NoticeDate
YY = Number of days reimbursable employers have to send payment (lookup table)
Contains only numbers and dashes. Must be a valid date.
134
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-27 AmountDue Amount Due from Employer
Numeric 15.2
Conditional Required if C-29.4 (ActionableAttachment) equals 1 otherwise null.
Only numbers, decimal point, and minus sign. No dollar sign($) or commas allowed. Can be a negative number.
15.2 represents the precision and scale value of the dollars entered, with minimum value of -9999999999999.99and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point
.
Part 2: Total Charges for Each Unique Individual by SSN, BYB, and Program Code
C-28.0
SSNBYBChargeProgramCode - Repeatable 1 to n times. N=the number in data element C-22 above.
Required
C-28.1
SSN The claimant’s Social Security Number.
Character 9* Required Contains only numbers and there are no letters or special characters (no dashes).
Information on valid SSN from <http://www.ssa.gov/foia/stateweb.html>.
C-28.2
BenefitYearBeginDate
The benefit year begin date for the intial claim that these charges relate.
Date yyyy-mm-dd
10* Required Must be at least 7 days prior to NoticeDate (C-2) and cannot be more than 6 years before the (C-2) NoticeDate.
Contains only numbers and dashes. Must be a valid date.
135
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.16
ProgramCode Program Code Numeric 1*
Conditional Required if (C-28.0.0) is not null.
Contains only numbers 1 - 4
1=Regular State UI Benefits 2=Combined Wage Claim 3=Federal Extended Benefits
4= State Extended Benefits
5=Combined Wage Claim Extended Benefits
C-28.3
ClaimNumber A unique identifier that can be used by the state to track a claim occurrence.
Character 18 Optional Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-28.4
ClaimantLastName The claimant’s last name. Character 30 Required Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-28.5
OtherLastName The additional last name for a claimant who performed work using more than one SSN name. This covers SSN name changes, e.g., due to marriage or divorce.
Character 30 Optional Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1
136
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
non-space character)
C-28.6
ClaimantFirstName The claimant’s first name. Character 25 Required Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-28.7
ClaimantMiddleInitial
The claimant’s middle initial.
Character 1* Optional Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
C-28.8
ClaimantSuffix The claimant’s suffix, for example: Sr. Jr.
Character 8 Optional Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
137
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.9
TypeofEmployerCode
The type of employer Numeric 1* Optional Value is a digit.
Can only be codes 1-7.
1 = Last, Base Period, and Lag Quarter Employer 2 = Last Employer 3 = Base Period Employer 4 = Lag Quarter Employer 5 = Last and Base Period Employer 6 = Last and Lag Quarter Employer 7 = Base Period and Lag Quarter Employer
C-28.10
BasePeriodStartDate
Base Period Beginning Date of Claim
Date yyyy-mm-dd
10* Required Must be equal to or more recent than the BenefitYearBeginDate (C-28.2) minus 79 weeks and at least 52 weeks prior to the BenefitYearBeginDate (C28.2)
Contains only numbers and dashes. Must be a valid date.
C-28.11
BasePeriodEndDate Base Period Ending Date of Claim
Date yyyy-mm-dd
10* Required Must equal BasePeriodStartDate (C-28.10) plus 53 weeks.
Contains only numbers and dashes. Must be a valid date.
C-28.12
BasePeriodWages Base Period Wages Reported by Employer for this SSN, BYB, and Program Code.
Numeric 15.2
Optional Contains only numbers
15.2 represents the precision and scale value of the dollars entered, with minimum value of 0.01 and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point.
138
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.13
TotalAmountChargedToEmployer
Total amount of benefits charged by this notice to this employers account for this SSN, Benefit Year Beginning Date, and
Program Code
Numeric 15.2
Required If detail is provided in C28.0.0 (part-3), number must equal to the sum of dollars from C-28.0.8 for this SSN, Benefit Year Beginning Date, and Program Code.
Only numbers and decimal point. No dollar sign($) or commas allowed. Can be a negative number.
Must be 0, > 0, or < 0
Amounts < 0 are for credits and amounts > 0 are for charges
If detail is provided by the UI agency, then this entry should equal the total amount charged to the employer for the SSN, BYB, and Program Code.
Includes any dependency amount.
If no detail is provided in C28.0.0 (part 3). enter a number for the charges associated with the SSN, BYB, and Program Code.
15.2 represents the precision and scale value of the dollars entered, with minimum value of 0.01 and a maximum value of 9999999999999.99. The maximum number of digits that may be entered into the field are 13 before the decimal point with two after the decimal point.
C-28.14
TotalNumberOfWeeksChargedToEmployerAccount
Total number of weeks charged by this notice to this employer account for this SSN, Benefit Year Beginning Date, and Program Code.
Numeric 2
Required If detail is provided in C28.0.0 (part-3), number must equal the number of weeks reported in C28.0.1 is repeated for this SSN, Benefit Year Beginning Date, Program Code, and ChargeCode.
Must be equal or larger than 1 and less than 33.
Contains only numbers Must be greater than 0.
If detail is provided by the UI agency, then the UI agency should enter the total number of weeks charged to the employer for the SSN.
If no detail is provided in C28.0.0 (part 3). enter a number for the weeks associated with the SSN, BYB, and Program Code.
139
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.15
BenefitChargeComment
Benefit Charge Comments for this SSN, Benefit Year Beginning Date, and Program Code.
Character 2000 Optional Contains the printable ASCII characters 32 – 126 decimal.
PART – 3: Detail Charges for Each Unique SSN, BYB, Program Code, and Charge Code Combination for a Week Ending Date
Each Part – 3 detail entries matches with a single, unique charge specified in Part – 2: (total charges for each unique individual SSN, BYB, and Program Code). Developers must infer that Part - 3 detail charges are tied to their parent charge in Part – 2 (for the SSN, BYB, and Program Code)
C-28.0.0
WeeklyCharge - REPEATABLE 0 TO 30 TIMES for each unique SSN/BYB, Program Code, and (ChargeCode= debit series (>=10 and < 20) or ChargeCode = credit series (>=20 and < 30)) Combination for a Week Ending Date.
Optional - Used only if individual week detail on weeks and amount charged is provided to the employer.
May only have up to 15 credits and up to 15 debits
140
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.0.1
WeekEndingDate Week Ending Date of the payment or change of payment that resulted in this charge.
Date yyyy-mm-dd
10* Required for each weekly charge
If C-28.16 (ProgramCode) = 1 or 2, then WeekEndingDate must be greater than BenefitYearBeginDate (C-28.2) and less than BenefitYearBeginDate (C-28.2) plus 53 weeks.
If C-28.16 (ProgramCode) = 3, 4, 5, then WeekEndingDate must be greater than BenefitYearBeginDate (C-28.2) and less than BenefitYearBeginDate (C-28.2) plus 106 weeks.
Can not be repeated for the SSN, BYB, Program Code, and (ChargeCode is debit series (>=10 and < 20) or ChargeCode is credit series (>=20 and < 30)) combo.
Contains only numbers and dashes. Must be a valid date.
141
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.0.2
TotalAmountPaid Total Amount Charged for the Week Ending Date and charged to employers account.
Numeric 7.2 Required for each weekly charge
Can be a positive or negative amount, but not zero
If c-28.0.6 (ChargeCode) is 10 series, C-28.0.2 (TotalAmountPaid) must be positive, else C-28.0.2 (TotalAmountPaid) must be negative.
Required if (C-28.0.0) is not null.
Only numbers, decimal point, and minus sign. No dollar sign($) or commas allowed. Can be a negative number.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 4 before the decimal point with two after the decimal point.
C-28.0.3
DependencyAmountIncluded
Dependency Amount Paid included in C-28.0.2.
Numeric 7.2 Required for each weekly charge
Required if (C-28.0.0) is not null.
Only numbers, decimal point, and minus sign. No dollar sign($) or commas allowed. Can be a negative number.
7.2 represents the precision and scale value of the dollars entered, with minimum value of 0.00 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 4 before the decimal point with two after the decimal point.
Dependency amount can be zero.
Can be a positive or negative amount.
C-28.0.5
UIOfficeCode The code for the UI office for the charge.
Character 8 Optional Contains the printable ASCII characters 32 – 126 decimal.
Field cannot contain all spaces (there must be at least 1 non-space character)
142
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.0.6
ChargeCode The type of charge or credit.
Numeric 2 Required for each weekly charge
Required if (C-28.0.0) is not null.
Value is a digit. Can only be codes 11, 12, 15, 17, 22. 23, 24, 26, 27
10. Debit Series
11- Original Benefit Charge
12 – Adjust to Benefit Payment
15 - Benefits paid by another state
17 - Change to employer charge percentage
20 Credit Series
22 - Adjustment benefit payment
23 - Overpayment established (credit)
24 - Repayment of overpayment
26 - Change to employer charge status
27 - Change to employer charge percentage
C-28.0.7
PercentCharged The Percentage of Payment Charged to Employer
Numeric 7.4 Required for each weekly charge
Must be zero or larger. Can not be larger than 100.0000
Required if (C-28.0.0) is not null.
Only numbers and decimal point. No percentage (%) sign allowed.
143
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-28.0.8
DollarAmountChargedToEmployer
The amount of the payment charged to the employer's account for this week ending date.
Numeric 7.2 Required for each weekly charge
Must be less than or equal to C-28.0.2 (TotalAmountPaid).
Can NOT be equal to zero.
Required if (C-28.0.0) is not null.
Only numbers, decimal point, and minus sign (for credits). No dollar sign($) or commas allowed. Can be a positive or negative number.
7.2 represents the precision and scale value of the dollars entered, with minimum value of -99999.99 and a maximum value of 99999.99. The maximum number of digits that may be entered into the field are 5 before the decimal point with two after the decimal point.
C-29 Attachment - Repeatable up to 5 times
Optional Occurs 0-5 times
C-29.1
DescriptionofAttachmentCode
The description of the attachment's format Code.
Numeric 1* Required for each Attachment (C-29)
Value is a digit. Can only be codes 1-5.
1 = RTF 2 = PDF 3 = TXT 4 = TIFF, or TIF 5 = CSV
C-29.2
TypeofDocument Title of the document or form name or narrative description of the document attached.
Character 40 Required for each Attachment (C-29)
Contains the printable ASCII characters 32 – 126 decimal.
Contains letters, numbers, punctuation, apostrophe, dash, and blanks.
C-29.3
UniqueAttachmentID
A unique ID within the record given to this attachment, and when combined with the StateBenefitChargeGUID is unique within the universe
Character 2 Required for each Attachment (C-29)
Must be unique within a record
Field cannot contain all spaces (there must be at least 1 non-space character)
C-29.4
ActionableAttachment
Determines whether the Employer/TPA is required to perform an action with the attachment
Numeric 1* Required for each Attachment (C-29)
Only one attachment with Code 1 permitted
Code 1 permitted only if C-21 (EmployerAccountType) = 2, reimbursable employer.
Value is a digit. Can only be codes 1-3.
1 - Invoice, action required 2 - Requires action by Employer or Third Party Administrator. 3- Informational only - No Action Needed
144
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
C-29.5
AttachmentSize The attachment size in bytes
Numeric Required for each Attachment (C-29)
Contains only numbers.
C-29.6
AttachmentData The actual attachment in Base64 encoding.
Base 64 Binary
Required for each Attachment (C-29)
Base64 encoded characters only
C-29.7
FormNumber The state form number this attachment applies to.
Character 12 Optional Contains letters, numbers, periods, dashes, and blanks.
C-34 AgentResponseIndicator
Agent Response indicator that tells the employer/TPA whether or not they can select the AgentResponseType
Numeric 1* Required Must be 2 (No) if C-38(StateTerminologyUsed) = 3 (Question)
Must be 1 or 2. 1 = Yes 2 = No
C-35 NotAvailableIndicator
Not Available Response indicator that tells the employer/TPA whether or not they can select the Date and Times Not Avaliable.
Numeric 1* Required Must be 2 (No) if C-38(StateTerminologyUsed) = 3 (Question)
Must be 1 or 2. 1 = Yes 2 = No
C-36 InterpreterIndicator Interpreter Response indicator that tells the employer/TPA whether or not they can select the Interpreter
Numeric 1* Required Must be 2 (No) if C-38(StateTerminologyUsed) = 3 (Question)
Must be 1 or 2. 1 = Yes 2 = No
C-37 SpecialNeedsIndicator
Special Needs Response indicator that tells the employer/TPA whether or not they can select the Special Needs.
Numeric 1* Required Must be 2 (No) if C-38(StateTerminologyUsed) = 3 (Question)
Must be 1 or 2. 1 = Yes 2 = No
C-38 StateTerminologyUsed
State defined terminology to indicate if the notice is protestable, Appleable, Questionable,
Numeric 1* Required Must be 1, 2, 3, 4, 5 1 = Protest
2= Appeal
3 = Question
4 = Protest/Question
145
Seq. No.
Data Element Name Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation* Comments/Notes Values:
5 = Appeal / Question
C-39 PIN This is the PIN that the employer uses to log into the E-Response website. This shall only be used for bundling E-Response records.
Character 20 Optional Can only be used if the file that the record s in is addressed to EResponse in the SOAP header, otherwise must be null
C- 30 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 Required on Benefit Charge Notice from the Broker to the Employer/TPA
Contains only digits Field must not be present in the request file from the State – will cause an XSD error if there.
C-31 BrokerRecordEffectiveDate
The date that the record was accepted from the State into the Central Broker.
DateTimeStamp
30 System Added to the Employer/TPA; Not put in the Request from the State
Contains a Date and Time stamp
Format will be:
2010-04-27T16:03:08.000-04:00
Field must not be present in the response file from the State – will cause an XSD error if there.
146
Part B. Employer or TPA Response Form [Version 1.0 - Requirements Baseline - 9-28-2016]
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
CR-32 StateChargeRecordGUID This is a unique ID given to this record by the State
Character 32* Backfilled Must return StateChargeRecordGUID exactly as sent in C-1
Contains only hexadecimal digits
CR-33 BrokerRecordTransactionNumber
This is a unique ID given to this record by the broker.
Character 32 Backfilled Must return BrokerRecordTransactionNumber exactly as sent in C-30
Contains only hexadecimal digits
CR-1 NoticeDate The issue date of this charge notice.
Date yyyy-mm-dd
10* Backfilled Must return NoticeDate exactly as sent in C-2
CR-2 LastDayToRespond The last day an employer can file a timely protest or appeal the charges covered by this notice.
Date yyyy-mm-dd
10* Backfilled Must return LastDateToAppeal exactly as sent in C-3
CR-3 ChargingStateAbbreviation US Postal (2 letter) state code
Character 2* Backfilled Must return ChargingStateAbbreviation exactly as sent in C-4
CR-4 StateEmployerAccountNbr The State employer account number that identifies the employer to which the benefits are charged. It is a unique identifier for the employer.
Character 20 Backfilled Must return StateEmployerAccountNbr exactly as sent in C-15
CR-5 EmployerName The legal business name of the employer.
Character 100 Backfilled Must return EmployerName exactly as sent in C-17
CR-6 FEIN The claimant's employer Federal Employer Identification
Character 9* Backfilled Must return FEIN exactly as sent in C-18
147
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
Number (FEIN).
CR-7 ChargeStatementStartDate Beginning Date for Charge Period included in this Notice.
Date yyyy-mm-dd
10* Backfilled Must return Charge Period Start Date exactly as sent in C-19
Contains only numbers and dashes. Must be a valid date.
CR-8 ChargeStatementEndDate Ending Date for Charge Period included in this Notice.
Date yyyy-mm-dd
10* Backfilled Must return Charge Period Start Date exactly as sent in C-20
Contains only numbers and dashes. Must be a valid date.
CR-9 Repeatable 1 to n times. N=the number in data element C-22 above.
Required
CR-9.1 SSN The claimant’s Social Security Number.
Character 9* Backfilled Must return SSN exactly as sent in C-28.1
CR-9.2 ClaimNumber A unique identifier that can be used by the state to track a claim occurrence.
Character
18 Backfilled Must return ClaimNumber exactly as sent in C-28.3
CR-9.3 ClaimantLastName The claimant’s last name.
Character 30 Backfilled Must return ClaimantLastName exactly in C-28.4
CR-9.4 OtherLastName The additional last name for a claimant who performed work using more than one SSN name. This covers SSN name changes, e.g., due to marriage or divorce.
Character 30 Backfilled Must return OtherLastName exactly as sent in C-28.5
148
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
CR-9.5 ClaimantFirstName The claimant’s first name.
Character 25 Backfilled Must return ClaimantFirstName exactly as sent in C-28.6
CR-9.6 ClaimantMiddleInitial The claimant’s middle initial.
Character 1* Backfilled Must return ClaimantMiddleInitial exactly as sent in C-28.7
CR-9.7 ClaimantSuffix The claimant’s suffix, for example: Sr., Jr., III etc.
Character 8 Backfilled Must return ClaimantSuffix exactly as sent in C-28.8
CR-9.8
BenefitYearBeginDate The benefit year begin date is based on the date the claim is filed and other factors defined in each States' procedures.
Date yyyy-mm-dd
10* Backfilled Must return BenefitYearBeginDate exactly as sent in 28.2
CR-9.16
ProgramCode UI Program Code Numeric 1* Backfilled Must return Program Code exactly as sent in C-28.16
Contains only numbers 1 – 4 1=Regular State UI Benefits 2=Combined Wage Claim 3=Federal Extended Benefits 4= State Extended Benefits
CR-9.9 TypeofEmployerCode The type of employer
Character 1* Backfilled Must return Type of Employer Code exactly as sent in C-28.9
Value is either a digit or null. Can only be codes 1-7.
1 = Last, Base Period, and Lag Quarter Employer 2 = Last Employer 3 = Base Period Employer 4 = Lag Quarter Employer
149
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
5 = Last and Base Period Employer 6 = Last and Lag Quarter Employer 7 = Base Period and Lag Quarter Employer
CR-9.12
ProtestAppealQuestionReasonInd
Protest/Appeal/Question Reason Indicator
Character 3* Required for each CR-9 entry
Value is a digit.Must be codes 10, 11, 20, 30, 40, 41, 42, 43, 44, 46, 50, 51, 60, 70
10 - Claimant was working for this company during this period.
11 - Claimant was working for some other employer during this period.
20 - Claimant refused to return to work for the Employer when requested.
30 - Claimant is not able to or is not available for work.
40 - Claimant worked for employer less than the time period or earnings required to be a chargeable employer.
41 - Charges are for a period of claimant ineligibility based upon a previously issued determination/decision.
42 – A notice of claim was not received.
43 - Determination of
150
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
eligibility not received.
44 - Employer is exempt from charges due to circumstances of separation. 46 – Credit has been previously identified and approved, but not received. 50 - Wages reported are incorrect. 51 - Employer has no record of anyone ever having worked for them under this name or social security number. 60 - Charges are being questioned due to a pending protest/appeal of eligibility determination. 70 - Employer questions charges for statutory
151
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
reasons NOT listed above.
CR-9.13
EmployerReasonForProtestAppealQuestion
Explain your reason for protesting or appealing these charges?
Character 2000 Required Contains the printable ASCII characters 32 – 126 decimal.
2000 characters is same as largest field on Sep Info format
CR-9.14
EmployerReasonLateProtest/Appeal
Explain your reason for requesting an protest/appeal of this charge after the due date
Character 2000 Conditional
Required if LastDayToRespond (C-3) is in the request and current Date is greater than C-3 LastDayToRespond (Employer/TPA and Broker only rule)
Contains the printable ASCII characters 32 – 126 decimal.
2000 characters is same as largest field on Sep Info format
CR-9.15
Attachment Repeatable 1 to 5 times.
Optional Occurs 0-5 times
CR-9.15.1
DescriptionOfAttachmentCode
The description of the attachment format.
Character 1* Required for each Attachment (CR-9.15)
Value is a digit. 1 = RTF 2 = PDF 3 = TXT 4 = TIFF or TIF 5 = CSV
CR-9.15.2
TypeofDocument Description of the type of document attached.
Character 40 Required for each Attachment (CR-9.15)
Contains letters, numbers, punctuation, apostrophe, dash, and blanks.
CR-9.15.3
UniqueAttachmentID A unique ID within the record given to this attachment, and when combined with the StateRecordGUID is unique within the universe.
Character 2 Required for each Attachment (CR-9.15)
Must be unique within this sequence
152
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
CR-9.15.4
AttachmentSize The attachment size in bytes
Numeric Required for each Attachment (CR-9.15)
Contains only numbers.
CR-9.15.5
AttachmentData The actual attachment in Base64 encoding.
Base 64 Binary
Required for each Attachment (CR-9.15)
Base64 encoded characters only
CR-23 AgentType Options are no, agent or attorney
Character 1* Conditional
Required if C-34= 1 ; otherwise must be null
Must be No, Agent, or Attorney (filled by selection of radio button on E-Response)
Selection other than "None" prompts display of DR-38 and DR-39 on E-Response
1= No 2 = Agent 3 = Attorney
CR-24 AgentAttorneyName Name of Agent or Attorney (based on D-42 response)
Character 50 Conditional
Required if CR-23 is not equal to "1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-42 is not equal to "No"
CR-25 AgentAttorneyAddress1 Agent/Attorney address1. Flag set for display in D-32
Character 35 Conditional
Required if CR-23 is not equal to 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-42 is not equal to "No"
CR-26 AgentAttorneyAddress2 Agent/Attorney address2. Flag set for display in D-32
Character 35 Conditional
Optional if CR-23 is not equal to 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-42 is not equal to "No"
CR-27 AgentAttorneyCity Agent/Attorney address city. Flag set for display in D-32
Character 19 Conditional
Required if CR-23 is not equal to 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if DR-42 is not equal to "No"
CR-28 AgentAttorneyState Agent/Attorney address state. Flag set for display in D-32
Character 2* Conditional
Required if CR-23 is not equal to 1, otherwise must be null
Only alpha characters Displayed on E-Response only if DR-42 is not equal to "No"
CR-29 AgentAttorneyZip Agent/Attorney address zip. Flag set for display in D-32
Character 10 Conditional
Required if CR-23 is not equal to 1, otherwise must be null
Contains only numbers or is null.
Displayed on E-Response only if DR-42 is not equal to "No"
CR-30 AgentAttorneyTelephoneNumberPlusExt
The Agent/Attorney’s telephone number plus extension.
Character 15 Conditional
Required if CR-23 is not equal to 1, otherwise must be null
Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
153
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
CR-31 DatesTimesUnavailable The dates and/or times that the employer is unavailable to participate in a hearing.
Character 500 Conditional
Optional if C-35 = 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if D-33 = 1
CR-32 InterpreterLanguage If an interpreter is requested, language(s) needed
Character 100 Conditional
Optional if C-36 = 1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if D-34 = 1
CR-33 SpecialNeeds List of special needs requested by the employer/TPA
Character 500 Conditional
Optional if C-37 =1, otherwise must be null
Contains the printable ASCII characters 32 – 126 decimal.
Displayed on E-Response only if D-35 = 1
Preparer Information
CR-34 PreparerTypeCode Identifies if the
employer or employer representative is providing this response
Character 1* Required Value is 'E' for 'Employer' or 'T' for 'Third Party Administrator'.
E = Employer T=Third Party Administrator
CR-35 PreparerCompanyName The Third Party Administrator’s company name.
Character 60 Conditional
Required if PreparerTypeCode (CR-34) = ‘T’ for 'Third Party Administrator'.
Contains the printable ASCII characters 32 – 126 decimal.
CR-36 TPAToEmployerRelationship The relationship between the TPA and the Employer.
Numeric 2* Conditional
Can only be filled in if PreparerTypeCode (CR-34) = 'T' for 'Third Party Administrator'
Value is 21 or null. Must only be filled in when the TPA does not represent the Employer any longer.
21 = TPA no longer represents employer.
CR-37 PreparerTelephoneNumberPlusExt
The preparer’s telephone number plus extension.
Character 15 Required Contains only numbers or is null.
Contain area code, 7-digit telephone number, and extension up to 5 digits (if needed).
CR-38 PreparerContactName The preparer’s name.
Character 60 Required Contains the printable ASCII characters 32 – 126 decimal.
CR-39 PreparerTitle The preparer’s title Character 30 Required Contains the printable ASCII characters 32 – 126 decimal.
CR-40 PreparerFaxNbr The preparer’s fax number
Character 10* Optional Contains only numbers. Must contain 10 digits.
154
Seq. No. Data Element Name
Fact-Finding Question
Data Element Description
Type and/or Format
Field Size
Field Required / Optional Business Rules Validation Comments/Notes Values:
CR-41 PreparerEmailAddress The preparer’s e-mail address.
Character 60 Required Contains letters, dashes, @, periods, numbers, underscores.
CR-42 AmendedResponse The amended response number.
Character 1* Optional Value is either all numbers or null. Must contain 1 digit (null or 1 - 9).
Null=original response, 1=first change, 2=second change, etc.
CR-43 AmendedResponseDescription
Explanation of reason for amended response.
Character 2000 Conditional
Cannot be empty when CR-42 AmendedResponse is not null.
Contains the printable ASCII characters 32 – 126 decimal.
CR-44 BrokerRecordEffectiveDate The date that the record was accepted from the Employer/TPA into the Central Broker.
DateTimeStamp
30 System Added to the State; Not put in the Response from the Employer/TPA
Contains a Date and Time stamp Format will be: 2010-04-27T16:03:08.000-04:00
Field must not be present in the response file from the Employer/TPA – will cause an XSD error if there.
155
LOOKUP TABLE DEFINITION:
Benefit Charge Lookup Table:
- Number of days to appeal, protest, question charges
o Reimbursable Employer
o Taxable Employer
- Number Days Reimbursable Employers Have to Send Payment
Lookup table to be maintained on the SIDES admin site.
156
8.6 GENERAL FLOW OVERVIEW
States create and use their Connector to transmit (post) requests to employers and TPAs via the Central Broker. The employer or TPA uses its Connector to collect (pull) the state requests it finds at the Central Broker. After the employer or TPA back-end system processes the request, the employer or TPA Connector then transmits (posts) the response information back to the Central Broker where it can be collected (pulled) by the original requesting state. These flows are described in the graphic and table below:
8.7 GENERAL STEP-BY-STEP OUTLINE
Each of the states, employers, and TPAs are responsible for preparing their requests or response messages using standardized XML-based Web service calls to the Central Broker.
All XML request and response files are validated by the state, employer, and TPA Connectors (and also by the Central Broker) to ensure high integrity of the data being transmitted. Remember that the data contained in the XML request and response files are specified by the standardized Format (Separation Information, Earnings Verification, Monetary and Potential Charges, Determination and Decision, and future formats).
The transmission “handshake” of request and response files for a typical (error-free) state
request- employer or TPA response “round trip” is as follows:
STATE EMPLOYERS or
THIRD PARTY ADMINISTRATORS
1. State Connector posts a Request to Central Broker
CENTRAL BROKER
2. Employer Connector pulls a Request from the Central Broker
4. State Connector pulls a Response from Central Broker
3. Employer Connector posts a Response to Central Broker
1. Post Requests
Connector Connector
State UI Agency Back-end System
Employer / TPA Back-
end System
2. Pull Requests
4. Pull Responses
3. Post Responses
CENTRAL BROKER
157
STATE CENTRAL BROKER EMPLOYERS/TPA CENTRAL BROKER STATE
The state extracts the
request information from
their UI Benefit system.
The state generates an
XML request file.
The state Connector
constructs a SOAP
message with the request
file and applies security.
The state Connector sends
the SOAP message to the
employer/TPA via
Central Broker.
The Central Broker
authenticates the sending
state.
The Central Broker
applies security rules and
parses the SOAP
message, including the
request file; performs
business rule validations
to ensure quality data;
and stages the request file
for employer/TPA
collection.
The employer/TPA
Connector (after being
authenticated by the
Central Broker and
ensuring message
integrity) collects the
encrypted request file.
The employer/TPA
applies security and
sends the request
information to the back-
end systems for
processing.
The back-end system
prepares response
information.
The employer/TPA
generates an XML
response file and
constructs a SOAP
message with the
response file and applies
security.
The employer/TPA
sends the SOAP message
to the state via the
Central Broker.
The Central Broker
authenticates the sending
employer/TPA.
The Central Broker
applies security and
parses the SOAP
message, including the
response file, performs
business rule validations
to ensure quality data,
and stages the response
file for State collection.
The state Connector (after
being authenticated by the
Central Broker and
ensuring message
integrity) collects the
encrypted response file.
The state applies security
and provides the response
information to the back-
end systems for
processing.
158
8.8 FUNCTIONAL DETAILS
This section provides more functional details and technical discussion on the Post, Pull, and Push methods that states, employers, and TPAs must understand in order to create a Connector client that successfully integrates with SIDES. Overview diagrams of each flow are provided. Please note that these diagrams provide only a high-level overview of the functionality that a Connector must implement to successfully integrate and communicate with the Central Broker. None of the error paths or alternate flows is detailed in this overview. See the Developer Guide for the detailed error paths or alternate flows. The diagrams are as follows:
State Posting a Request (p. 74)
Pull a Request/Response (p. 75)
Employer or TPA Posting Response (p. 76)
Push Request from Central Broker - optional (p. 77)
DIAGRAMS BEGIN ON NEXT PAGE
159
8.8.1 State Posting a Request
The chart below depicts the process for a state preparing and sending a Request message to the
Central Broker.
CENTRAL BROKERSTATE CLIENT
Build File with Requests
for one Employer/TPA
Run Edits and Validations on
records and file
Encrypt file with keys
Send SOAP message with
File Request to SIDES
Broker
Pass
Record/File Fails Edits
and/or Validation
Initiate Request Record
Establish Post
Request Transaction
Exception Flow – State can NOT
connect to Broker
Create State File and
Record GUIDs
Process to track & stamp
records being sent
Check file sizeFile size over 8 MB
Pass
Received
Acknowledgement
Record metrics
(File size, Sender, Failed
Records etc.)
Document
file/record transfer
acknowledgement
End Post Request Transaction
No acknowledgement within
established time frame
- Resend up to 2 additional
times
- Then Notify State
Administrator for manual
action
Receive
acknowledgement /
error code from Broker
Send acknowledgement or
Error Code to State
Exception Flow -
Unable to transmit to State
Break File up into
records
- Date/time stamp
receipt of message/
file/record
(Official Broker Date of
Record Receipt)
Start Post Request Transaction
Error handling / Alternative Flows
See:
– Detailed Flow Charts
- SIDES Requirements
Documentation
- Developer’s Guide
Errors
No Errors
Errors
No Errors
State Request Post to Broker
Broker
Security
Processing
- Check
Certificate
- Decrypt
Acknowledgement / Error Code
Errors- Duplicate Checking
- Active participant
Checking
- Validation and Edit
Checking
Stage records for collection
by Employer
The state client steps are on the left-hand side (red text in header).
The corresponding steps of the Central Broker are on the right-hand side (black text in header).
Blue boxes depict main flow while white boxes show error handling and other secondary information.
The flow starts in the top left hand corner – ‘Start Post Request Transaction.’
160
8.8.2 Pull a Request/Response
This chart shows the process for an employer or TPA to pull a state Request file or for a state to
pull an employer or TPA Response file from the Central Broker.
The steps that must be implemented by the employer, TPA, or state client are on the left-hand side (blue/red text
in header).
The corresponding steps provided by the Central Broker are on the right-hand side (black text in header).
Blue boxes depict main flow while white boxes show error handling and other secondary information.
The flow starts in the top left hand corner – ‘Start Pull Transaction.’
161
EMPLOYER / TPA CLIENT CENTRAL BROKER
Pull Request or Response from Broker
(OR STATE CLIENT)
Initiate pull of request
or response file from
Broker
Can Not
Connect
to Broker
Error handling / Alternative Flows
See:
– Detailed Flow Charts
- SIDES Requirements
Documentation
- Developer’s Guide
Start Pull Transaction
Establish Pull Transaction
Broker Processing:
- Set Receive Start Date for
new transaction
- Determine if Connector is
active
- Prepare File with Staged
Records for the Conector
Send SOAP messages
- 8MB max file size per
message
- include File Level
Transaction Number
- or “No files to transmit” (if
applicable)
Records date and file metrics
No Errors
Errors
Errors
Error handling / Alternative Flows
See:
– Detailed Flow Charts
- SIDES Requirements
Documentation
- Developer’s Guide
Security Processing
- Check Certificate
- Receive Full Message
- Decrypt Message
No Errors
Receive SOAP message
Perform
Security
CheckingErrors
No Errors
No file recevied within
established time frame
- Re-Pull up to 2 additional times
- Then Notify Connector
Administrator for manual action
Connector Client Processing:
- Data Validation
- Date Time Stamp receipt of
message/record/file
Errors
No Errors
Send acknowledgement to
Broker with Message Code 1
End Pull Transaction
Log file transfer results
Receive acknowledgement
from Connector of successful
file transfer
Request Files
Acknowledgement
File Received
162
8.8.3 Employer or TPA Posting Response
The next flow chart describes the process for an employer or TPA preparing and sending a
Response message to the Central Broker.
As a state must do when posting its request fields, the employer or TPA client must also perform
all validations, edits, and encryption prior to sending the response to avoid rejection and an error
message.
CENTRAL BROKEREMPLOYER/TPA CLIENT
Received
Acknowledgement
Document
file/record transfer
acknowledgement
End Post Response Transaction
No acknowledgement within
established time frame
- Resend up to 2 additional
times
- Then Notify Employer/TPA
Administrator for manual
action
Receive
acknowledgement /
error code from Broker
Send acknowledgement or
Error Code to Employer/TPA
Start Post Response Transaction
Error handling / Alternative Flows
See:
– Detailed Flow Charts
- SIDES Requirements
Documentation
- Developer’s Guide
Errors
No Errors
No Errors
Employer/TPA Response Post to Broker
Create Employer/TPA File
GUIDs
Exception Flow – Employer/TPA can
NOT connect to Broker
Encrypt file with keys
Send SOAP message with
File Response to SIDES
Broker
Initiate Response Record
Check file size
Pass
Process to track & stamp
records being sent
Run Edits and Validations on
records and file
File size over 8 Meg
Failed to Connect to Broker (Broker is down)
Build File with Responses
for one State
Pass
Record/File Fails Edits
and/or Validation
Broker Security
Processing
- Check Certificate
- Decrypt
- Duplicate Checking
- Active participant
Checking
- Validation and Edit
Checking
Break File up into records
- Date/time stamp receipt
of message/file/record
(Official Broker Date of
Record Receipt)
Errors
Record metrics
(File size, Sender, Failed
Records etc.)
Stage records for collection
by State
Establish Post Response
Transaction
Acknowledgement / Error Code
The steps implemented by the employer or TPA client are on the left-hand side (blue text in header).
The corresponding steps provided by the Central Broker are on the right-hand side (black text in header).
Blue boxes depict main flow while white boxes show error handling and other secondary information.
The flow starts in the top left hand corner – ‘Start Post Response Transaction’.
163
164
8.8.4 Push Request from Broker (optional)
The final chart describes the process for the Central Broker to Push a Request file for an
employer or TPA that is configured to accept “automatic delivery” of request files without using
the pull process.
EMPLOYER / TPA CLIENT CENTRAL BROKER
Push Request from Broker
Start Push Transaction
Error handling / Alternative Flows
See:
– Detailed Flow Charts
- SIDES Requirements
Documentation
- Developer’s Guide
End Push Transaction
Broker processing
- Look up Employer
- Ensure Valid Address
- Prepare Request File for
PushErrors
Broker records file metrics
Broker builds and
transmits SOAP messageEmployer/TPA
validates security
on SOAP file
Employer/TPA
sends
acknowledgement
to Broker with
Message Code 1
Employer/TPA
validates file
Employer/TPA
receives file
No Errors
Establish Push Request
Transaction
No
Alternate Flow -
Request XML File Error
Mark current file
as next file to Push
Broker receives
acknowledgement from
Employer/TPA
End Task
YesFailure Message
Code?
Acknowledement /
Error Messages
Errors
No Errors
Error handling / Alternative Flows
See:
– Detailed Flow Charts
- SIDES Requirements
Documentation
- Developer’s Guide
Errors
No Errors
No Errors
Errors
Errors
No Errors
The Central Broker steps are on the right-hand side (black text in header).
The corresponding employer/TPA steps (blue text in header) are on the left.
Blue boxes depict main flow while white boxes show error handling and other secondary information.
The flow starts in the top right hand corner – ‘Start Push Transaction’.
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8.9 SIDES E-RESPONSE
Once a state has decided to implement SIDES, they may also elect to use the SIDES E-
Response web site for non SIDES participating employers. If a state elects to use SIDES E-
Response, a non-participating employer may use SIDES E-Response to manually enter and
submit their responses instead of creating a SIDES client Connector.
Some employers do not have the workload or the resources necessary to implement an automated
SIDES connection to exchange information with the state UI agencies via the Central Broker.
SIDES E-Response may be a perfect alternative for those employers. The rest of this section
details how an employer would use SIDES E-Response for their reporting needs.
8.9.1 Overview of SIDES E-Response Operations
Connector Employer
Employer logs into
account and manually
enters Responses.
2. 4. State Pulls Responses.
State must inform (via mail or some other
mechanism) an employer that a request for
information is available via SIDES E-Response.
State Posts
Requests.
1B.
CENTRAL BROKER
1C. The Central Broker directs request
to SIDES E-RESPONSE
1A.
State UI
Agency
Back-end
System
SIDES E-
Response
SIDES E-Response routes
response to the Central Broker. 3.
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Request from State to Employer/TPA
STATE EMPLOYERS / TPAs
1A. States notify employers and
TPAs by mail (or other form of
communication) that a request
for information is available via
SIDES E-Response, providing
login and PIN/access code
information.
1B. States send their requests to
the Central Broker using the
same Web service methods for
routing directly to the employer
or TPA that have their own
connectors.
2. Employers/TPAs log in to
SIDES E-Response, using a user
ID and password made up of a
combination of State, FEIN, SEIN,
and PIN numbers provided by the
state.
Employers then manually enter
their information for each request
routed to them by the Central
Broker.
Please note: requests remain
available on SIDES E-
Response for 30 days at which
point, requests and any responses
are purged from the system.
Transaction logs are retained on
the Central Broker.
1A.
1B.
2.
SIDESINFRASTRUCTURE
CENTRALBROKER
SIDES E-Response
1B.
1C. The Central Broker
examines the request
message routing
information and directs
requests to SIDES E-
Response.
CENTRAL BROKER
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Response from Employer/TPA to State
STATE EMPLOYERS / TPAs
4. State connector pulls
Response from Central Broker
2. Employers/TPAs submits their
response, the Web site performs edit
checks and validations. If the
response fails edit checks or
validations, the user is prompted to
correct the entry. If the response
passes all edit checks and validations,
the SIDES E-Response provides
the employers/TPA a confirmation
number for their records.
2.
SIDESINFRASTRUCTURE
3.
CENTRALBROKER
SIDES E-Response
4.
CENTRAL BROKER
3. SIDES E-Response
routes the response to the
Central Broker in an
identical fashion to those
received from SIDES
employer or TPA
connectors. The Central
Broker stages the response
for the state.
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8.9.2 Screen Captures of SIDES E-Response
The following screen shots show a few examples of what the SIDES E-Response user will see
when they login and commence using the Web site. The relevant response data is entered page
by page, and then transmitted directly to the Central Broker when the user clicks ‘submit’ upon
the completion of their data entry. SIDES E-Response performs all validation and applies all
business rule checks before allowing the user to submit.
Important Note on SIDES E-Response and FEIN/SEIN/PIN Numbers
A state uses the Central Broker Web services to post requests to SIDES E-Response. The
state must also notify the employer/TPA that a request for information is pending on SIDES E-
Response and provide the employer/TPA with the web site address and a PIN number to use as
part of the login process. SIDES E-Response uses the combination of the State ID, FEIN, SEIN
(depending on SIDES E-Response), and PIN to authenticate the user and grant access to the
specific request information for that employer.
States may choose how they will manage the use of PIN numbers. A state may use:
A new PIN or one-time-use PIN for each request.
A single PIN for all requests sent for a specific employer.
Regardless of the method used, when an employer logs in to fulfill their request, they can see all
requests as long as that particular PIN remains active.
When the employer logs into SIDES E-Response, the first screen they will see is the SIDES E-
Response Dashboard. The SIDES E-Response Dashboard allows the employer to pick an
application to log into. Currently, SIDES E-Response dashboard has the Separation
Information SIDES E-Response and the Earnings Verification SIDES E-Response to choose
from.
Scenario One Scenario Two
State creates requests for Employer or TPA:
Employer receives multiple requests for
information with just one PIN, which works for
all requests.
Employer receives multiple requests for
information with a different PIN for each
request.
Employer logs in and sees all requests for the FEIN and SEIN (depending on SIDES E-Response).
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SIDES E-Response DASHBOARD
8.9.2.1 Screen Captures of the Separation Information Application
When the user chooses the Separation Information application from the SIDES E-Response
Dashboard, they are brought to the Separation Information login screen.
LOGIN
The first action the user
takes is to login to SIDES E-Response.
The user selects the state
the Request is from, enters
the Federal Employer
Identification Number,
State Employer
Identification Number and
the Identification
number/Access Code (‘the
PIN’).
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LIST OF REQUESTS
Upon successful login to SIDES E-Response the user is presented with the Request screen.
This screen is SIDES E-Response’s home page. From here, the user responds to requests from
participating states.
The four requests shown have a
‘Not Started’ status, each
awaiting employer response.
171
The figure below shows the same requests in each of the four available processing states: ‘Not
Started’, ‘In Progress’, ‘Submitted’ and ‘Amendment in Progress’.
The four available processing states are
shown: ‘Not Started’, ‘In Progress’,
‘Submitted’ and ‘Amendment in
Progress’.
172
CLAIMANT AND EMPLOYER IDENTIFICATION
The employer or TPA verifies their employer information and enters their preparer information.
173
PREPARER INFORMATION
The employer or TPA enters their preparer information.
174
EMPLOYMENT INFORMATION
This screen permits the employer or TPA to enter job information and to select the reason for the
claimant’s separation.
175
Each screen in each path collects response data using the same question / answer format as
illustrated above.
Depending upon the separation reason selected, the SIDES E-Response will guide the user through
one of five different paths to collect response data
required for that separation code.
176
ADDITIONAL SEPARATION INFORMATION SCREEN
The Additional Separation Information screen permits the employer to indicate compensation
after separation received by the employee.
177
ATTACHMENTS SCREEN
The attachments screen permits the employer to include for submission any relevant supporting
documents.
178
SUBMISSION SCREEN
After the employer or TPA completes entry of required response data, and any attachments, the
submission screen is presented. Upon entry to the submission screen, all data is validated and
business rules are applied. When the Submit to State button is pressed, the response is delivered
to the Central Broker.
179
CONFIRMATION SCREEN
Upon successful delivery to the Central Broker, the employer or TPA is provided a confirmation
number.
180
SCREEN CAPTURES OF THE EARNINGS VERIFICATION APPLICATION
When the user chooses the Earnings Verification application from the SIDES E-Response
Dashboard, they are brought to the Earnings Verification login screen.
LOGIN
The first action the user
takes is to login to SIDES E-Response.
The user selects the state
the Request is from, enters
the Federal Employer
Identification Number,
State Employer
Identification Number and
the Identification
number/Access Code (‘the
PIN’).
181
LIST OF REQUESTS
Upon successful login to SIDES E-Response, the user is presented with the Request screen.
This screen is SIDES E-Response’s home page. From here, the user responds to requests from
participating states.
The two requests shown have a
‘Not Started’ status, each
awaiting employer response.
182
CLAIMANT AND EMPLOYER IDENTIFICATION
The employer or TPA verifies their employer information and enters their preparer information.
183
EARNINGS INFORMATION
This screen permits the employer or TPA to select the relationship they had with this employee
between the required dates.
Depending upon the answer selected, the SIDES E-Response will guide the user through different paths to
collect response data required for the earnings verification.
184
PAY PERIOD
The Earnings Verification exchange is designed so employers my select their pay period (daily,
weekly, monthly, or semi-monthly) and enter earnings information in the format that matches
their pay period.
185
PAY PERIOD AND WORKING INFORMATION - DAILY
The employer specifies the first day worked during the time period that the request for earnings
covers. The Earnings Verification exchange also requests that the employer fill out working
information (still working or not).
186
EARNINGS SELECTION – DAILY
The Earnings Verification exchange is designed so employers may specify if the employee was
working and performed services, and if the individual was payed tips, commission, bonus,
severance, wages in lieu of work, vacation, holiday, or sick pay. Selection of these earnings types
is used in subsequent screens to determine the applicable data entry fields that are presented to
the employer for data entry. The state sets indicators in each wage request record, which instruct
E-Response to optionally display the data entry fields for date paid or date allocated that are
associated with each particular earnings information data entry field(s). Below is a screen shot
illustrating the case where an employer checks the boxes associated with the earnings they will
report for the employee.
187
EARNINGS BY PAY PERIOD - DAILY
The Earnings Verification exchange displays the Earnings by Pay Period screen that has data
entry fields for the work week that the employer specified the employee had earnings.
188
OTHER EARNINGS AND PAYMENTS – DAILY
The Earnings Verification exchange displays the Other Earnings and Payments screen that has
data entry fields for the work week that the employer specified the employee had other earnings.
189
EARNINGS AND PAYMENTS SUMMARY – DAILY
190
SUBMISSION
SUBMISSION CONFIRMATION
191
CONFIRMATION
192
SCREEN CAPTURES OF THE MONETARY AND POTENTIAL CHARGES
APPLICATION
When the user chooses the Monetary and Potential Charges application (Notice of UI Claim,
Wages Reported and Possible Charges) from the SIDES E-Response Dashboard, they are
brought to the Notice of UI Claim, Wages Reported and Possible Charges login screen.
LOGIN
The first action the user
takes is to login to SIDES E-Response.
The user selects the state
the Request is from, enters
the Federal Employer
Identification Number,
State Employer
Identification Number and
the Identification
number/Access Code (‘the
PIN’).
193
LIST OF REQUESTS
Upon successful login to SIDES E-Response, the user is presented with the Request screen.
This screen is SIDES E-Response’s home page. From here, the user responds to requests from
participating states.
The five requests shown have a
‘Not Started’ status, each
awaiting employer response.
194
The figure below shows the same requests in each of the five available processing states: ‘Not
Started’, ‘In Progress’, ‘Submitted’, ‘Amendment in Progress’, and ‘Completed’.
The five available processing states are
shown: ‘Not Started’, ‘In Progress’,
‘Submitted’, ‘Amendment in Progress’
and ‘Completed’.
195
CLAIMANT AND EMPLOYER IDENTIFICATION
The employer or TPA verifies their employer information and reviews the Claimant Information.
196
ELIGIBILITY AND CHARGE INFORMATION
This screen permits the employer or TPA to review and correct any wages or dependent
information.
197
SUBMISSION SCREEN
After the employer or TPA completes entry of required monetary and potential charges response
data, the submission screen is presented. Upon entry to the submission screen, all data is
validated and business rules are applied. When the Submit to State button is pressed, the
response is delivered to the Central Broker.
198
CONFIRMATION SCREEN
Upon successful delivery to the Central Broker, the employer or TPA is provided a confirmation
number.
199
SCREEN CAPTURES OF THE BENEFIT CHARGES APPLICATION
When the user chooses the Benefit Charges application from the SIDES E-Response
Dashboard, they are brought to the Benefit Charges login screen.
LOGIN
The first action the user
takes is to login to SIDES E-Response.
The user selects the state
the Request is from, enters
the Federal Employer
Identification Number,
State Employer
Identification Number and
the Identification
number/Access Code (‘the
PIN’).
200
LIST OF REQUESTS
Upon successful login to SIDES E-Response, the user is presented with the Request screen.
This screen is SIDES E-Response’s home page. From here, the user responds to requests from
participating states.
The request shown has a ‘Not
Started’ status awaiting
employer response.
201
STATE AND EMPLOYER IDENTIFICATION
The employer or TPA reviews their employer information and Claimant Information.
202
BENEFIT CHARGES
This screen permits the employer or TPA to review the Benefit Charges included in this notice.
203
BENEFIT CHARGES WEEKLY CHARGE
This screen permits the employer or TPA to review the weekly charges for a given Benefit
Charge.
204
PROTEST INDIVIDUAL BENEFIT CHARGE
This screen permits the employer or TPA to review and protest any benefit charge.
205
PROTEST BENEFIT CHARGES SUMMARY
This screen permits the employer or TPA to review all protested benefit charges.
206
SUPPLEMENTAL PROTEST INFORMATION
This screen permits the employer or TPA to supply supplemental information.
207
SUBMISSION SCREEN
After the employer or TPA completes entry of required benefit charges response data, the
submission screen is presented. Upon entry to the submission screen, all data is validated and
business rules are applied. When the Submit to State button is pressed, the response is delivered
to the Central Broker.
208
CONFIRMATION SCREEN
Upon successful delivery to the Central Broker, the employer or TPA is provided a confirmation
number.
209
THANK YOU SCREEN
After the employer or TPA completes viewing the benefit charges request data and decides there
is no reason to send in response data, the Thank You screen is presented thanking the employer
for viewing their benefit charges. Nothing is delivered to the Central Broker.
210
GLOSSARY OF TERMS
Broker Administrator
This title refers to the SIDES operational staff responsible for monitoring and maintaining the
Central Broker. Their tasks also include setting up new SIDES participants in the Central
Broker as well as troubleshooting operational issues with existing states, employers, and
TPA participants.
SIDES Broker / Central Broker / Broker
The Central Broker (or Broker) serves as the “hub” for SIDES, providing a secure single
point of communication for participating states, employers, and TPAs.
It consists of all the software and computer hardware that make up the centralized operations
and controls for SIDES. The Central Broker controls participant access, ensures data
quality (via edits and validation), collects transaction logs, and ensures the secure transfer of
data to participating states, employers and/or TPAs.
It is also the participating states’ point of access to SIDES E-Response.
Certificate (See ‘X.509’)
Connector Administrator
This title refers to the state, employer, or TPA staff person who administers their respective
organization’s Connector. Managing access to the SIDES Administrative Web Site is one of
the primary duties of the Connector Administrator. Other duties include reporting and setting
active dates (availability), although the Connector Administrator has the discretion to
determine who exactly will perform these different roles within his/her organization.
Connector / End Point
These terms refer to the applications and computer hardware operated by an individual
participating state, employer or TPA and serves as single secure point of contact between the
specific participant and the Central Broker.
Participating states, employers, and TPAs must create client “connector” software in order to
transmit their request and response messages to each other via the Central Broker.
Command Center
This is the group of technical staff who support and monitor the hour to hour operations of
the Central Broker and SIDES E-Response. This group of technical staff possesses a
variety of technical skill sets necessary to monitor the systems operation, carry out
maintenance and correct problems that may arise with the proper operation and
communication for the Central Broker and/or SIDES E-Response.
Employer
This term refers to any employing unit that agrees to participate in the operation of the
SIDES system, including but not limited to those employers who participate in testing the
SIDES system.
Federal Employer Identification Number / FEIN
211
An employer specific number the Internal Revenue Service (IRS) assigns to identify an
employer for tax purposes.
HTTPS (Transport-Layer Security)
HTTPS is the method of securely exchanging data over the Internet using SIDES. HTTPS
stands for Hyper Text Transfer Protocol over SSL (Secure Socket Layer). It is a transport
protocol used by Web servers to transfer and display Web content securely over networks.
The data transferred is encrypted so that it cannot be read by anyone except the recipient.
SIDES requires a security certificate issued by a Certificate Authority to encrypt the
application data during transport.
Non participating employers or TPAs
This is an employer or TPA that does not interface with the Central Broker via Web
services.
Non-participating employers may be able to use SIDES E-Response if a participating state
invites the employer to exchange the data through SIDES E-Response.
These non-participating employers and TPAs manually enter data and information into
SIDES E-Response. SIDES E-Response validates the data and electronically transmits the
response data to the requesting state UI agency via the Central Broker. Making SIDES E-
Response available allows employers to participate in the system via the Web site without
the need for implementing the SIDES Web Service Infrastructure.
Participating Employers and TPAs
This term refers to those employers or TPAs who developed their Connector software for the
exchange of data using the SIDES Web Service Infrastructure.
Participating States
This term refers to those State Unemployment Insurance (UI) agencies that have agreed to
exchange data using the SIDES infrastructure. State UI agencies may also elect to participate
in the exchange of data through the SIDES E-Response infrastructure.
Security Certificate (See ‘X.509’)
SOAP
SOAP is the term used to specify a set of rules that describe how to exchange information
with Web services in computer networks. It relies on eXtensible Markup Language (XML)
and uses mechanisms such as HTTPS, as its message format to transport data to the
destination or recipient computer.
SSL Certificate (Secure Socket Layer Certificate)
This term refers to the https security certificate used on secure Web sites. It is also referred to
as a ‘security certificate,’ a ‘digital certificate,’ or simply a ‘certificate’.
SIDES E-Response
212
SIDES E-Response refers to the applications and computer hardware that comprise the
public Web site operated together with the Central Broker for use by participating states to
exchange information to non-participating employers and TPAs.
SIDES / SIDES System
The various related computer hardware and applications that facilitates participating states,
employers, and TPAs to electronically exchange information through a standardized
transmission process via the Central Broker and SIDES E-Response.
State Employer Identification Number / SEIN
An employer specific number assigned by a state UI agency to identify an employer.
Third-party administrator / TPA
Entities that provide UI administrative services on behalf of employers in one or more states,
and that are the addressee of record for an employer.
WSDL
The Web Services Description Language is an XML-based language that provides a model
for describing Web services – it defines the Broker’s Web services function calls. WSDL
defines an XML grammar for describing network services as collections of communication
endpoints capable of exchanging messages. WSDL service definitions provide
documentation for distributed systems and serve as a recipe for automating the details
involved in applications communication.
The WSDL for SIDES is broken into two sets of files: a StateBroker.wsdl (Separation
Information) and EarningsVerificationStateBroker.wsdl (Earnings Verification) that describe
the interfaces exposed to the states from the Broker, and an EmployerTPABroker.wsdl
(Separation Information) and EarningsVerificationEmployerTPABroker.wsdl (Earnings
Verification) that describe the interfaces exposed to the employer and TPAs from the
Central Broker.
XML
The eXtensible Markup Language (XML) a standardized textual format used to create data
files where the specific data values are associated with their particular data element name,
known as tags. The goal of XML is to provide a standardized data format that emphasizes
simplicity, generality, and is usable over the Internet.
XSD
The XML Schema Definition (XSD) is the template that provides the rules for validating the
format of the data contained in XML files.
X.509
SIDES adheres to the X.509 standard which is the Telecommunications Standardization
Sector (ITU-T) standard for a public key infrastructure (PKI) for single sign-on (SSO)
and Privilege Management Infrastructure (PMI). The X.509 standard is used for information
encryption.
213
The Central Broker uses the X.509 standard which applies the Connector’s public key to
encrypt the data being sent to the state, employer, or TPA.
The entity pulling the data from the Central Broker uses its private key to decrypt the data.
Similarly, states, employers, or TPAs use the Central Broker’s public key to encrypt data to
be sent to the Central Broker. The Central Broker uses its private key to decrypt received
data.