Form 1-C Comprehensive Premium Filing

Payment of Premiums (29 CFR part 4007)

2014 My PAA rev SCREENS to OMB.d1

Payment of Premiums (29 CFR part 4007)

OMB: 1212-0009

Document [pdf]
Download: pdf | pdf
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Figure 11: Text updates related to 2014 estimated filings on How to File screen

Comprehensive Single Employer- Enter Plan Information

Comprehensive Single Employer- Enter Filing Information screen

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OMB Screenshots – 2014 Changes
1. Single Employer - New P-Count Screen

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All plans except multiemployer plans, single-employer plans exempt from the VRP, and singleemployer plans reporting eligibility for the small employer cap.

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Single-employer plans reporting eligibility for the small employer cap choosing to report the data
in items 7c through 7g.

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Single-employer plans eligible for the small employer cap choosing not to report the data in
items 7c through 7g must omit items 7c-“Assumptions” through 7g-“Uncapped variable rate
premium”.

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Comprehensive Single Employer- Report Miscellaneous Screen

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Comprehensive Single Employer- Filing Manager Screen
Similar filing manager screen will be displayed for comprehensive single employer imported filing.

Comprehensive Single employer- Data summary screen.
The below data summary screen captures all the 2014 changes relating to plan size, new or newly
covered, adoption date, date coverage began, continuation plan, exemption reasons, participant count
breakdown and report miscellaneous section.

This Filing Has NOT Been Submitted.

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Comprehensive Multi Employer- Identify Filing to be made screen

Comprehensive Multi employer- Enter Plan Information Screen

Comprehensive Multi Employer- Enter Filing Information screen

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OMB Screenshots – 2014 Changes
2. Multi-Employer - New P-Count Screen

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Comprehensive Multi employer-Report Miscellaneous screen

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OMB Screenshots – 2014 Changes
3. Multi-Employer - New Data Summary Screen

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This Filing Has NOT Been Submitted.

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Imported Comp Single Employer Exempt Filing paid online via Electronic
Check

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Comprehensive Single Employer- Filing Manager Screen
Similar filing manager screen will be displayed for comprehensive single employer imported filing.

Comprehensive Single employer- Data summary screen.
The below data summary screen captures all the 2014 changes relating to plan size, new or newly
covered, adoption date, date coverage began, continuation plan, exemption reasons, participant count
breakdown and report miscellaneous section.

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This Filing Has NOT Been Submitted.

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Uploaded Filing paid using Other payment alternative

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File Typeapplication/pdf
Authordpcixa31
File Modified2013-05-08
File Created2012-09-11

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