
Notice to Employer of Monetary Determination and Request for Separation Information - Form BC-3E
Purpose
To notify an employer of potential benefits payable to a former employee who has filed a claim for unemployment insurance. This form also allows you to notify us of any information that could potentially disqualify the named employee. (See Form)
Use
We will send this form to the employer for each claim filed against that employer's identification number. The form shows the total potential unemployment benefits payable (maximum benefit amount) based on all employment in the base year, the amount of potential unemployment benefits (maximum chargeable amount) payable based on employment with the individual employer, and the percent of the potential weekly benefit amount that may be charged to that employer's experience rating. The form also asks the employer to supply us with any information that could potentially disqualify the individual employee who has filed a claim for benefits.
Use by Employer
The top half of this form explains your right of appeal. Keep this portion of the form for your records. Complete the bottom half of the BC-3E and return it to the address indicated on the form if:
1. The claimant was separated for reasons other than lack of work. If the claimant was separated for reasons other than lack of work, he/she may not be eligible for unemployment benefits. You should be as specific as possible about the reason for separation.
2. The claimant is receiving a company pension. Receipt of a pension may effect the amount of benefits a claimant is entitled to receive.
3. The claimant received wages for a period after his/her last day of work (for example, vacation pay, severance pay, payment in lieu of notice, etc.). Receipt of monies for a period after the last day of work may affect a claimant's eligibility.
4. The claimant's separation is temporary and the claimant has a definite date to return to work.

