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❖ The first row of the file must contain the column headers in the order specified below, <br /> even if some fields are left blank. Removal of the column headers or changes to the <br /> column headers prevent the file from processing successfully. <br /> FIELD-LEVEL SPECIFICATIONS <br /> ❖ Required fields are indicated in red in the table below. The required fields need to be <br /> populated with a value in order for the enrollment file to upload. <br /> Column # Field Name Notes <br /> 1 Client Name This is an Abbreviated form of the Client's <br /> Name that will be provided to the Client by <br /> Vera. Example: WCC for"Wood Chip <br /> Corporation, Inc." <br /> 2 Employer Name The full name of the Employer as used in <br /> official documents. Sometimes the Client is <br /> the same as the Employer, and sometimes the <br /> Employer is different from the Client. <br /> Example: The Employer"The Milling <br /> Company"operating under the"Wood Chip <br /> Corporation, Inc."would be written as"The <br /> Milling Company". <br /> 3 Social Security Number SSN of the member(employee, <br /> spouse/domestic partner or child) <br /> Example: 123-45-6789 <br /> 4 Last Name Last name of the member(employee, <br /> spouse/domestic partner or child) <br /> 5 First Name First name of the member(employee, <br /> spouse/domestic partner or child) <br /> 6 Street Address Resident street address of the member. <br /> 7 City Resident city of the member <br /> 8 State Resident state of the member(two letter <br /> abbreviation) <br /> Example: WA <br /> 9 Zip Code Zip code of residence of member <br /> Example: 67854 <br /> 10 Home Phone Number Home phone number for member <br /> Do not add Country Code <br /> Exhibit 1, Page 2 <br />