Civil Service Federal Employees Federal Employees Federal Employees

Retirement Group Life Health Benefits Retirement

System Insurance Program System

United States

Office of

Personnel Management

The Federal Government’s Human Resources Agency

Retirement and Insurance Service

 Payroll Office Letter

P-99-20 July 27, 1999

Subject: OPM Form 1523 – Supplemental Semiannual Headcount Report 

As we informed you in Payroll Office Letters P-99-07 dated February 17, 1999, the Federal

Employees Group Life Insurance Program (FEGLI), added two new FEGLI age bands (64-69

and 70+) to Optional life insurance that became effective April 24, 1999. The addition of these

age bands directly impacts Headcount reporting, specifically OPM Form 1523 as explained below.

We want to inform you that the format of the Supplemental Semiannual Headcount Report or

OPM Form 1523 as it is commonly known, has not been updated to reflect the two new age

bands of life insurance. We do not plan to revise the Form 1523 until the September 2001

Headcount. The current layout of the Form does not include the new bands, but will be

redesigned to expand the age categories, and then made available in time for that Headcount. 

However, prior to the release of the updated Form, we advise you to continue using the same

OPM Form 1523 that is routinely distributed in the Headcount payroll office letters (see

attached). Even though you may have collected individual data for these new bands, please

continue to report this information in the 60&up age category as you have done so in the past. 

If you have any questions concerning this information, please call us at (202) 606-0606, or send

an email to finance@opm.gov.

 

 Robert A. Yuran, Chief

Financial Policy Staff

Retirement and Insurance Service

Attachment
5. Pay Period

4. Date payroll paid

2. Payroll office number

From

3. Report number

To

6. To 7. Name of preparer (print) 8. Telephone number

Date

Number Enrolled

Dollar Amount

A. Life Insurance

1. Basic

2. Standard - Option A

Benefit Category Deductions Made No Deductions Made

3. Additional - Option B

a. To age 35

b. 35 - 39

c. 40 - 44

d. 45 - 49

e. 50 - 54

f. 55 - 59

g. 60 & up

4. Family - Option C

5. Post-Retirement - Basic

1. Regular

2. Payers of Full Premiums

3. Total Health Benefits* 

Office of Personnel Management

CSRS/FERS Handbook for Personnel and Payroll Offices

This form may be locally reproduced

Previous editions unusable

OPM Form 1523

Revised September 1996

1. Address of Payroll Office (including department, bureau,

location and zipcode)

Supplemental Semiannual Headcount Report

Office of Personnel Management

ATTN: Funds Control Branch

P.O. Box 582

Washington, D.C. 20044-0582

Signature of authorized official

9. I certify that the items listed herein are correct.

B. Health Benefits

6. Total Life Insurance*
Supplemental Semiannual Headcount Report

Payroll office number Report number Payroll paid date

Benefit Category Dollar Amount Aggregate Base

Salary Number Enrolled

C. Retirement

1. CSRS CPDF

Code Deductions Made No DeductionsMade

a. Regular Withholdings 1,R

Page 2

b. Regular Contributions 1,R

c. Special Withholdings 6,T

d. Special Contributions 6,T

e. Regular Withholdings

for Offset Employees

f. Regular Contributions

for Offset Employees

g. Special Withholdings

for Offset Employees

h. Special Contributions

for Offset Employees

i. Salary Offset

j. Military Deposits

k. Civilian Service Credit

2. FERS

a. Regular Withholdings

b. Regular Contributions

c. Reserve Technicians

Withholdings

d. Reserve Technicians

Contributions

e. A/T Controllers

Withholdings

f. A/T Controllers

Contributions

g. Law Enforcement/Firefighters Withholdings

h. Law Enforcement/Firefighters Contributions

i. Salary Offset

j.

k. Military Deposits

3. Total Retirement*

D. Grand Total (Dollars only)

E. Total Employees (and/or Annuitants) on Payroll

C

C

E

E

K

K

N

N

L

L

M

M

**

**

**

**

**

*Dollar amount must agree with SF 2812 for same reporting period.

**Memo entry only (do not include on line 3, Total Retirement).

Reverse of OPM 1523

Revised September 1996