Page 28 - Employer Admin Guide

Billing Procedures

The Premium Invoice

Summary

Premium payment address.
1
The same address appears on the
payment coupon.

2 Your company’s name and address.
You know us by .
3
3 Your company’s account number, the 1
billing period covered by the invoice, the
premium due date, invoice number and
date the invoice was produced (also 4
located on page three of your invoice). 2
Premium billing department phone
4
number. 5 6
7
8
Message box containing important
5 9
billing information. 10
11
The amount of premium owed for the 12
6
current billing period. 13
14
An adjustment code is assigned to any
7
adjustment made to the previous or
current billing period. The code appears
here and is explained in the itemized
15
portion of the invoice.
The current premium due after
8
adjustments.
The monthly administration fee,
9
if applicable.
Any outstanding balance carried over 16
10
from a previous billing period
appears here.
The amount of payment received since
11
the last bill posting.
12 The total amount due for the current
billing period.

13 Date premium payment is due.
Premium payment procedures.
14
All correspondences (other than
15
premium payments) should be mailed
to the address listed.
16 Premium due date and total amount due.

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