Marketplace

EDI 834

Employee Navigator’s self-service EDI (Electronic Data Interchange) services automatically and securely sends enrollment data to insurance carriers in order to simplify enrollment management for companies. Employee Navigator supports the industry standard file format which is used by most health, dental and vision providers, the HIPPA ANSI 834 file format. We’ve designed our EDI services to be easily configured so you can get up and running faster. While some insurance carriers require companies to have at least 100 employees to use their EDI services; this requirement is not legal. HIPAA legally requires carriers to accept the standard data format for companies with 2 or more employees and cannot charge a fee to do so. Note: Sending data to a carrier will require users to set-up, manage and monitor the file transmissions. Below is a list of pre-configured carriers and we can set-up new carriers for a small 1-time fee.

What the EDI engine transmits:
• Full ANSI 834 files for medical, dental, vision and RX plans only, with Guardian as the exception.

What the EDI engine does not transmit:
• HSA enrollments
• Change only files

If you are looking for a list of our Data Exchange Partners (XML), which includes FSA, COBRA, Non-traditional TPAs, and Carriers, that list is available in our Marketplace.

1. 90 Degree Benefits
2. Acuity Group
3. Administrative Concepts Inc (ACI)
4. ADN Administrators (also Multi-tenant files)
5. Advantage Health Solutions
6. Advantica
7. Aetna
8. Aither Health Plan (also Multi-tenant files)
9. Allegiance
10. Allied Benefit Systems
11. AllWays Health Partners*
12. Always Care
13. Altus Dental
14. Amerihealth
15. Ameritas
16. AmeriBen
17. American Health Resources (AHR)
18. Anchor Benefits Advisors
19. Anthem BCBS - (also Multi-tenant files) if you are unsure if your local Anthem BCBS is the same configuration, review the specs attached to the article & compare

20. Anthem BCBS of Colorado
21. Anthem BCBS of Maine
22. Anthem BCBS of Missouri
23. Anthem BCBS of Nevada
24. Anthem BCBS of New Hampshire
25. Anthem BCBS of Ohio
26. Anthem BCBS of Kentucky
27. Anthem Dental Only
28. Anthem Life
29. Anthem of California
30. Anthem of Connecticut
31. Anthem of Virginia - BenefitFocus platform
32. Apostrophe Health
33. ARC Administrators
34. Argus Dental
35. ASI
36. ASR Health Benefits
37. Assured Benefit Administrators
38. Assurant - Dental & Vision only
39. AultCare
40. Automated Benefit Services
41. Auxiant
42. Avesis Vision
43. AvMed Health Plans
44. AXA Equitable
45. Baptist Health Plan
46. BAC / Benefits Administration Co)
47. BCBS (General 5010 format not tied to a specific state)
48. BCBS of Alabama
49. BCBS of Arizona
50. BCBS of Arkansas (also Multi-tenant files)
51. BCBS of Florida - aka Florida Blue
52. BCBS of Georgia - Anthem platform
53. BCBS of Illinois**
54. BCBS of Kansas
55. BCBS of KC
56. BCBS of LA (also Multi-tenant files)
57. BCBS of Massachusetts (also Multi-tenant files)
58. BCBS of Michigan** - (also Multi-tenant files)
59. BCBS of Minnesota
60. BCBS of Mississippi
61. BCBS of Montana
62. BCBS of Nebraska
63. BCBS of New Mexico
64. BCBS of North Carolina
65. BCBS of North Dakota
66. BCBS of Oklahoma
67. Highmark BCBS North East Pennsylvania
68. BCBS of Rhode Island
69. BCBS of South Carolina
70. BCBS of Tennessee (also Multi-tenant files)
71. BCBS of Texas**
72. BCBS of Vermont
73. BCBS of West Virginia (Highmark)
74. BCBS of Western NY
75. BeneCard
76. Benefit & Risk Management Services
77. Benefit Administration Services
78. Benefit Coordinators Corporation (BCC) (also Multi-tenant files)
79. Benefit Management Inc.
80. Benefit Plan Administrators
81. BeniComp Health Solutions
82. Beta Dental
83. Blue Benefit Administrators of MA
84. Blue Care Network
85. Blue Cross of Idaho
86. Blue Shield of California
87. Blue Shield of North Eastern New York
88. Boon Group
89. Boon-Chapman
90. Breckpoint
91. Brighter Dental
92. California Dental Network
93. Calvo's SelectCare
94. Capital Blue Cross - (also Multi-tenant files)
95. Capital Health Plan
96. Capital Rx
97. Capitol Administrators, Inc.
98. Caprock Health Plans
99. Carefirst
100. Carefirst Administrators**
101. CarePlus Dental
102. CBA Blue (also Multi-tenant files)
103. CDPHP

104. Century Healthcare
105. Centivo
106. CGS Health Care
107. CieloStar
108. Cigna (also Multi-tenant files)
109. Cigna Select
110. Coastal Administrative Services
111. Community Care
112. Companion Life
113. Compass Health
114. ConnectiCare*
115. Consociate Health
116. Continental Benefits (Well Systems)
117. CoreSource* (aka Trustmark)
118. Coventry
119. Cox Health Plans
120. CRX International aka CanaRx
121. CVS Caremark
122. CWI Benefits, LLC*
123. Cypress Ancillary Benefits
124. Cypress Benefit Administrators
125. Davis Vision
126. Dean Care
127. Delta Dental - Allied Administrators - 834 Platform is configured in EN. Connection will need to be established with the carrier. Reach out to your contact at the carrier for more information. (also Multi-tenant files)
128. Delta Dental of Alabama
129. Delta Dental of Arizona
130. Delta Dental of Arkansas
131. Delta Dental of California
132. Delta Dental of Colorado
133. Delta Dental of Georgia
134. Delta Dental of Idaho
135. Delta Dental of Illinois
136. Delta Dental of Indiana
137. Delta Dental of Iowa
138. Delta Dental of Kansas
139. Delta Dental of Kentucky
140. Delta Dental of Massachusetts
141. Delta Dental of Michigan - (also Multi-tenant files)
142. Delta Dental of Minnesota
143. Delta Dental of Missouri
144. Delta Dental of New Jersey
145. Delta Dental of New York
146. Delta Dental of North Carolina
147. Delta Dental of the Northeast
148. Delta Dental of Ohio
149. Delta Dental of Oklahoma
150. Delta Dental of Oregon
151. Delta Dental of Pennsylvania
152. Delta Dental of South Dakota
153. Delta Dental of Tennessee
154. Delta Dental of Utah
155. Delta Dental of Virginia
156. Delta Dental of Washington*
157. Delta Dental of Wisconsin
158. Delta Dental of Wyoming
159. Delta Health Systems
160. Dental Care Plus Group
161. Dental Select
162. Dentist Direct
163. Dentaquest
164. Dominion Dental Services
165. EBA&M
166. EBMS
167. EBPA (also Multi-tenant files)
168. EHIM
169. Elixir Solutions
170. Emblem Health
171. EMI Health
172. Empire Blue Cross Blue Shield (also Multi-tenant files)
173. Equipoint Partners
174. Everence Financial
175. Excellus Blue Cross Blue Shield
176. Express Scripts
177. Eyemed (also Multi-tenant files)
178. Fallon Health (4010 format)
179. First Choice Health
180. First Stop Health
181. FirstCare Health Plans
182. Flume Health
183. Fringe Benefit Group (FBG)
184. Geisinger Health Plan
185. GeniusAve
186. Gilsbar
187. GMR Health Care
188. Golden Dental
189. GPA
190. Gravie
191. Group Administrators Ltd
192. Group Benefit Services (GBS)
193. Group Health Plan of South Central Wisconsin (GHPSCW)
194. Group Vision Services
195. Guardian (also Multi-tenant files)
196. Harvard Pilgrim Health Care (HPHC)
197. Hawaii Dental Services aka Delta Dental of Hawaii
198. Hawaii Mainland Administrators
199. Health Alliance Plan (connected via Data Exchange)
200. Health Alliance Plan of Michigan
201. Health Design Plus
202. Health First Health Plan
203. Healthcare Highways
204. Healthcare Management Administrators
205. HealthEZ - (also Multi-tenant files)
206. Healthcare Highways
207. HealthComp
208. Healthgram
209. Healthiest You
210. HealthNet
211. HealthNow New York
212. HealthPartners
213. HealthScope
214. HealthSmart
215. Health Plans, Inc
216. Health Plan of Nevada
217. Health Net of California
218. Health New England
219. Health Resources Inc
220. Heritage Vision Plan
221. Highmark (also Multi-tenant files)
222. Horizon Blue Cross Blue Shield of NJ
223. Homestead
224. Hometown Health
225. Humana - (also Multi-tenant files)
226. Imagine360
227. Independence Administrators*
228. Independence Blue Cross
229. Independent Health
230. Indiana University Health aka IU Health
231. Innovative Health Services*
232. Insight Benefit Administrators
233. Insurance Management Services (IMS)*
234. Interactive Medical Systems (IMS)
235. Iowa Bankers Insurance & Services (IBIS)
236. Kaiser Permanente
237. Kaiser Permanente of WA
238. Kaiser Permanente of California
239. Kaiser Permanente Mid Atlantic Standard
240. Kansas City Life
241. Key Benefit Administrators
242. Leading Edge Administrators
243. Liberty Dental Plan (request support to pull in to your group)
244. LifeMap*
245. Lincoln Financial Group (LFG)
246. Maestro Health
247. Managed Care of America, Inc.
248. Maxor Administrative Services
249. Med-Pay
250. MedBen*
251. Medcost
252. Medica
253. Medical Associates Health Plans
254. Medical Mutual of Ohio
255. MedImpact
256. Medova Healthcare Financial Group
257. Medtipster (also Multi-tenant files)
258. MercyCare
259. Meritain Health
260. MESVision
261. MESSA
262. Metlife
263. MODA Health (merged w/Delta Dental of OR)
264. Morgan White Group
265. MotivHealth Insurance Company
266. Mountain Health CO-OP
267. Mutual of Omaha
268. MVP Health Care
269. Navitus
270. Network Health
271. New Benefits
272. North American Administrators*
273. Nova Healthcare
274. NVA-National Vision Administrators
275. OnDemand Healthcare
276. Opticare of Utah
277. Optim RX
278. Optima Health
279. Optimed
280. Oxford Health Plans (UHC subsidiary)
281. PacificSource Health Plans
282. Pan-American Life Insurance Group
283. Paramount Health
284. Patient Advocates
285. PharmAvail
286. PHP TPA Services
287. Physicians Eyecare Plan
288. Physicians Health Plans (PHP)
289. Planned Administrators Inc
290. Prairie States*
291. Premera Blue Cross
292. Premier Access
293. Presbyterian Health Plan (PHP)
294. Prevea360
295. Priority Health (also Multi-tenant files)
296. Principal Financial Group
297. ProAct, Inc.
298. ProBenefits
299. ProClaim*
300. Professional Benefits Administrators (PBA)
301. Prominence Health Plan
302. Providence Health Plans
303. Public Employees Health Plan (PEHP)
304. QualChoice
305. Quartz Benefits
306. Regence Blue Shield of Idaho
307. Regence BCBS of Utah - Benefitfocus platform
308. Regence BCBS of Oregon
309. Regional Care Inc. (RCI)
310. Reliance Matrix
311. Renaissance Dental
312. Rx 'n Go
313. S&S Healthcare
314. Samaritan Health Plans
315. SBMA Benefits
316. Scott & White Health Plans
317. Security Health Plan
318. SelectHealth** (also Multi-tenant files)
319. Selman Company
320. SISCO
321. SIHO
322. SIMNSA
323. Solstice (also Multi-tenant files)
324. Southern Scripts
325. Standard Insurance Company
326. Starmark
327. SummaCare
328. Sun Life Financial
329. Superior Dental (now Versant Health)
330. Superior Vision ( now Versant Health)
331. Surency
332. Surest
333. Sutter Health Plus
334. SVS Vision
335. Symetra
336. Tall Tree Administrators*
337. Teladoc
338. The Boon Group*
339. The Health Plan
340. The Kempton Group
341. The Loomis Company*
342. The Principal (5010 format) - not all lines of coverage or platforms are supported on the 834 file format, check with your Principal rep to confirm.
343. Total Dental Administrators
344. Tristar Benefit Administrator
345. TRS Medical Insurance
346. Trustmark Insurance Co.
347. Tufts Health Plan
348. UCHealth Plan Administrators
349. UHP Administrators
350. UltraBenefits
351. Unified Group Services
352. United Agriculture Benefit Trust
353. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only) (also Multi-tenant file)
354. United Heritage Insurance
355. United Concordia
356. Univera Healthcare
357. University Health Alliance (UHA)
358. University of Utah Health Plans
359. UNUM
360. UMR
361. UPMC Health Plan
362. Vantage Health Plan
363. Versant Health
364. Virtual Benefits Administrator (also Multi-Tenant file)
365. Vision Benefits of America*
366. Vision Care Direct
367. Viva Health (also Multi Tenant)
368. 366. VSP (also Multi-tenant files)
369. Web TPA
370. Western Growers Assurance Trust (WGA)
371. Western Health Advantage
372. Wellmark Blue Cross Blue Shield of Iowa
373. WellNet (also Multi-tenant files)
374. Willamette Dental
375. Wisconsin Physicians Service (WPS Health Insurance)

*Configurations marked with an asterisk are generally Third Party Administrators who accept an 834 file and transform it to meet their internal specifications (for example a .txt or .csv file). In many instances they will request additional values that Employee Navigator does not support. Please pay special attention to the specific configuration notes in our EDI forum as they will outline what is and is not supported and/or approved.

**Configurations marked with a double asterisk are generally Carriers who have requirements for additional options that may not be supported by Employee Navigator's EDI engine. Again, please pay special attention to the specific configuration notes in our EDI forum as they will outline what is/is not supported.