
Schedule of Self-Administered Health Insurance Billing
Calendar Year 2002
Schedule A - Employees Continuing on Payroll
| (1) | (2) | (3) | (4) | (5) | ||||
|---|---|---|---|---|---|---|---|---|
| Pay Period Worked | Period in which Payroll Prepared | Applications & Forms to Vendors By* | Payroll Deduction Check Dates | For Coverage in Month of | ||||
| 11/16/2001 | - | 11/29/2001 | 11/30/2001 | - | 12/13/2001 | 12/11/2001 | 12/14/2001 | January, 2002 | 
| 11/30/2001 | - | 12/13/2001 | 12/14/2001 | - | 12/27/2001 | 12/28/2001 | ||
| 12/14/2001 | - | 12/27/2001 | 12/28/2001 | - | 01/10/2002 | 01/11/2002 | ||
| 12/28/2001 | - | 01/10/2002 | 01/11/2002 | - | 01/24/2002 | 01/22/2002 | 01/25/2002 | February, 2002 
 | 
| 01/11/2002 | - | 01/24/2002 | 01/25/2002 | - | 02/07/2002 | 02/08/2002 | ||
| 01/25/2002 | - | 02/07/2002 | 02/08/2002 | 02/21/2002 | 02/19/2002 | 02/22/2002 | March, 2002 | |
| 02/08/2002 | - | 02/21/2002 | 02/22/2002 | 03/07/2002 | 03/08/2002 | |||
| 02/22/2002 | - | 03/07/2002 | 03/08/2002 | 03/21/2002 | 03/19/2002 | 03/22/2002 | April, 2002 | |
| 03/08/2002 | - | 03/21/2002 | 03/22/2002 | 04/04/2002 | 04/05/2002 | |||
| 03/22/2002 | - | 04/04/2002 | 04/05/2002 | 04/18/2002 | 04/16/2002 | 04/19/2002 | May, 2002 | |
| 04/05/2002 | - | 04/18/2002 | 04/19/2002 | 05/02/2002 | 05/03/2002 | |||
| 04/19/2002 | - | 05/02/2002 | 05/03/2002 | 05/16/2002 | 05/14/2002 | 05/17/2002 | June, 2002 | |
| 05/03/2002 | - | 05/16/2002 | 05/17/2002 | 05/30/2002 | 05/31/2002 | |||
| 05/17/2002 | - | 05/30/2002 | 05/31/2002 | 06/13/2002 | 06/14/2002 | |||
| 05/31/2002 | - | 06/13/2002 | 06/14/2002 | 06/27/2002 | 06/25/2002 | 06/28/2002 | July, 2002 | |
| 06/14/2002 | - | 06/27/2002 | 06/28/2002 | 07/11/2002 | 07/12/2002 | |||
| 06/28/2002 | - | 07/11/2002 | 07/12/2002 | 07/25/2002 | 07/23/2002 | 07/26/2002 | August, 2002 | |
| 07/12/2002 | - | 07/25/2002 | 07/26/2002 | 08/08/2002 | 08/09/2002 | |||
| 07/26/2002 | - | 08/08/2002 | 08/09/2002 | - | 08/22/2002 | 08/20/2002 | 08/23/2002 | September, 2002 | 
| 08/09/2002 | - | 08/22/2002 | 08/23/2002 | - | 09/05/2002 | 09/06/2002 | ||
| 08/23/2002 | - | 09/05/2002 | 09/06/2002 | - | 09/19/2002 | 09/17/2002 | 09/20/2002 | October, 2002 | 
| 09/06/2002 | - | 09/19/2002 | 09/20/2002 | - | 10/03/2002 | 10/04/2002 | ||
| 09/20/2002 | - | 10/03/2002 | 10/04/2002 | - | 10/17/2002 | 10/15/2002 | 10/18/2002 | November, 2002 | 
| 10/04/2002 | - | 10/17/2002 | 10/18/2002 | - | 10/31/2002 | 11/01/2002 | ||
| 10/18/2002 | - | 10/31/2002 | 11/01/2002 | - | 11/14/2002 | 11/12/2002 | 11/15/2002 | December, 2002 | 
| 11/01/2002 | - | 11/14/2002 | 11/15/2002 | - | 11/28/2002 | 11/29/2002 | ||
| 11/15/2002 | - | 11/28/2002 | 11/29/2002 | - | 12/12/2002 | 12/10/2002 | 12/13/2002 | January, 2003 | 
| 11/29/2002 | - | 12/12/2002 | 12/13/2002 | - | 12/26/2002 | 12/27/2002 | ||
| 12/13/2002 | - | 12/26/2002 | 12/27/2002 | - | 01/09/2003 | 01/10/2003 | ||
*Change forms (to add dependents) that are completed by an employee during the shaded time frames should be submitted to the vendor as soon as possible, to assure coverage in a timely manner.
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