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 HIPAA 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 and Anthem Life as the exceptions.

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, Nontraditional TPAs, and Carriers, that list is available in our Marketplace.

1. 90 Degree Benefits
2. Access Health Services, LLC
3. Acuity Group
4. Administrative Concepts Inc (ACI)
5. ADN Administrators (also Multi-tenant files)
6. Advantage Health Solutions
7. Advantica
8. Advisory Health Administrators (Transperra)
9. Aetna
10. Aither Health Plan (also Multi-tenant files)
11. Allegeant
12. Allegiance
13. Allied Benefit Systems
14. Altus Dental
15. Always Care
16. Amerihealth
17. Ameritas
18. AmeriBen
19. American Health Resources (AHR)
20. American Plan Administrators
21. Anchor Benefits Advisors
22. Angle Health
23. 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

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

124. Century Healthcare
125. CerpassRx
126. Centivo
127. CGS Health Care
128. Christian Brothers Services
129. CieloStar
130. Cigna (also Multi-tenant files)
131. Cigna Select
132. Coastal Administrative Services
133. Coeur
134. CoeurSS and CoeurPAS
135. Collective Health
136. Community Eye Care
137. Community Health Options
138. Community Care
139. Companion Life
140. Compass Health
141. Compass Health
142. ConnectiCare*
143. Consociate Health
144. Core Management
145. CoreSource* (aka Trustmark)
146. Coventry
147. Cox Health Plans
148. CRX International aka CanaRx
149. CVS Caremark
150. CWI Benefits, LLC*
151. Cypress Ancillary Benefits
152. Cypress Benefit Administrators
153. Cypress Dental
154. Davis Vision
155. Dean Care
156. 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)
157. Delta Dental of Alabama
158. Delta Dental of Arizona
159. Delta Dental of Arkansas
160. Delta Dental of California
161. Delta Dental of Colorado
162. Delta Dental of Florida
163. Delta Dental of Georgia
164. Delta Dental of Idaho
165. Delta Dental of Illinois
166. Delta Dental of Indiana
167. Delta Dental of Iowa
168. Delta Dental of Kansas
169. Delta Dental of Kentucky
170. Delta Dental of Massachusetts
171. Delta Dental of Michigan - (also Multi-tenant files)
172. Delta Dental of Minnesota
173. Delta Dental of Missouri
174. Delta Dental of New Jersey
175. Delta Dental of New Mexico
176. Delta Dental of New York
177. Delta Dental of North Carolina
178. Delta Dental of the Northeast
179. Delta Dental of Ohio
180. Delta Dental of Oklahoma
181. Delta Dental of Oregon
182. Delta Dental of Pennsylvania
183. Delta Dental of Rhode Island
184. Delta Dental of South Dakota
185. Delta Dental of Tennessee
186. Delta Dental of Utah
187. Delta Dental of Virginia
188. Delta Dental of Washington*
189. Delta Dental of West Virginia
190. Delta Dental of Wisconsin
191. Delta Dental of Wyoming
192. Delta Health Systems
193. Delta Vision
194. DENCAP
195. Dental Care Plus Group
196. Dental Health Services
197. Dental Select
198. Dental Services Organization
199. Dentist Direct
200. Dentaquest
201. Direct Dental Administrators
202. Dominion Dental Services
203. EBA&M
204. EBMS
205. EBPA (also Multi-tenant files)
206. EBSO
207. EHIM
208. Elixir Solutions
209. Emblem Health
210. EMI Health
211. Empire Blue Cross Blue Shield (also Multi-tenant files)
212. Employer Driven Insurance Services (EDIS)
213. Enterprise Group Planning
214. Equipoint Partners
215. Equitable
216. Everence Financial
217. EVO First, Inc.
218. Excellus Blue Cross Blue Shield
219. Exemplar Health
220. Express Scripts
221. Eyemed (also Multi-tenant files)
222. Eyetopia
223. Fallon Health (4010 format)
224. Fidelio Dental
225. First Choice Health
226. First Continental
227. First Stop Health
228. FirstCare Health Plans
229. Fountain Health
230. Florida Combined Life
231. Flume Health
232. Fountain Health
233. Fox Everett
234. Freedom Claims Management Inc (FCMI)
235. Fringe Benefit Group (FBG)
236. Geaux Health (also Multi-tenant files)
237. Geisinger Health Plan
238. GeniusAve
239. Gilsbar
240. GISC
241. GMR Health Care
242. Golden Dental
243. GPA
244. Gravie
245. Group Administrators Ltd
246. Group Benefit Services (GBS)
247. Group Health Plan of South Central Wisconsin (GHPSCW)
248. Group Vision Services
249. Guardian (also Multi-tenant files)
250. Gulf Guaranty Life Insurance Co
251. Harvard Pilgrim Health Care (HPHC)
252. Hawaii Dental Services aka Delta Dental of Hawaii
253. Hawaii Mainland Administrators
254. Hawaii Medical Assurance Association (HMAA)
255. Health Alliance Plan (connected via Data Exchange)
256. Health Alliance Plan of Michigan
257. Health Benefit Alliance
258. Health Design Plus
259. Health First Health Plan
260. Healthcare Highways
261. Healthcare Management Administrators
262. HealthEZ - (also Multi-tenant files)
263. HealthComp
264. Healthgram
265. Healthiest You
266. HealthNet
267. HealthNow New York
268. HealthPartners
269. HealthScope
270. HealthSmart
271. HealthyCT
272. Health Plans, Inc
273. Health Plan of Nevada
274. Health Net of California
275. Health New England
276. Health Resources Inc
277. Heritage Vision Plan
278. Highmark (also Multi-tenant files)
279. Horizon Blue Cross Blue Shield of NJ
280. Homestead
281. Hometown Health
282. Humana - (also Multi-tenant files)
283. IBA Flexible Benefit Solutions
284. Imagine360
285. Independence Administrators*
286. Independence Blue Cross
287. Independent Health
288. Innovative Health Services
289. Inshore Benefits
290. Indiana University Health aka IU Health
291. Innovative Health Services*
292. Insight Benefit Administrators
293. Insurance Management Services (IMS)*
294. Integrated Payor Solutions (IPS)
295. Interactive Medical Systems (IMS)
296. International Benefit Administrators TPA
297. Iowa Bankers Insurance & Services (IBIS)
298. Kaiser Permanente
299. Kaiser Permanente of WA
300. Kaiser Permanente of California
301. Kaiser Permanente Mid Atlantic Standard
302. Kansas City Life
303. Kentucky Health Administrators
304. Key Benefit Administrators
305. Leading Edge Administrators
306. Level
307. Liberty Dental Plan
308. LifeMap*
309. Lifetime Benefit Solutions
310. Lincoln Financial Group (LFG)
311. Lucent Health
312. Luminare Health
313. Lyra Health
314. Lyric
315. Maestro Health
316. Managed Care of America, Inc.
317. Marpai Health
318. Mass General Brigham (previously known as AllWays Health Partners)*
319. Maxor Administrative Services
320. MBA Benefit Administrators
321. Med-Pay
322. MedBen*
323. Medcost
324. Medica
325. Medical Associates Health Plans
326. Medical Mutual of Ohio
327. MediExcel
328. MedImpact
329. MediOrbis
330. Medova Healthcare Financial Group
331. Medtipster (also Multi-tenant files)
332. MercyCare
333. Meritain Health (also Multi-tenant files)
334. MESVision
335. MESSA
336. Metlife
337. MODA Health (merged w/Delta Dental of OR)
338. Morgan White Group
339. MotivHealth Insurance Company
340. Mountain Health CO-OP
341. Mutual Health Services
342. Mutual of Omaha
343. MVP Health Care
344. Navitus
345. Neighborhood Health Plan
346. Network Health
347. New Benefits
348. Nippon Life Benefits
349. Northeast Delta Dental
350. Nova Healthcare
351. NVA-National Vision Administrators
352. OnDemand Healthcare
353. Opticare of Utah
354. Optim RX
355. Optimed
356. Oxford Health Plans (UHC subsidiary)
357. PACE
358. PacificSource Health Plans
359. Pan-American Life Insurance Group
360. Paramount Health
361. Patient Advocates
362. Pequot Plus Health Care
363. PharmAvail
364. PHP TPA Services
365. Physicians Eyecare Plan
366. Physicians Health Plans (PHP)
367. Piedmont Community Health Plan
368. Pinnacle Claims Management (PCMI)
369. Planned Administrators Inc
370. PPi Benefit Solutions
371. Prairie States*
372. Precision Group Administrators
373. Premera Blue Cross
374. Premier Access
375. Presbyterian Health Plan (PHP)
376. Prescription Network
377. Prevea360
378. Priority Health (also Multi-tenant files)
379. Principal Financial Group
380. ProAct, Inc.
381. ProCare
382. ProClaim*
383. Professional Benefits Administrators (PBA)
384. Prominence Health Plan
385. Providence Health Plans
386. Public Employees Health Plan (PEHP)
387. QualChoice
388. Quartz Benefits
389. R&T Inc.
390. Regence Blue Shield of Idaho
391. Regence BCBS of Utah - Benefitfocus platform
392. Regence BCBS of Oregon
393. Regional Care Inc. (RCI)
394. Reliance Standard
395. Renaissance Dental
396. Rightway Healthcare
397. Risk Program Administrators (RPA)
398. Rx 'n Go
399. RXBenefits
400. S&S Healthcare
401. Samaritan Health Plans
402. Sana Benefits
403. Sanford Health
404. Santeon
405. SBMA Benefits
406. Scott & White Health Plans
407. Script Care
408. Security Health Plan
409. SelectHealth** (also Multi-tenant files)
410. Selman Company
411. Sentara Health
412. Sharp Healthcare
413. Sidecar Health
414. SISCO
415. SIHO
416. SIMNSA
417. Solstice (also Multi-tenant files)
418. Southern Scripts
419. St. Luke’s Health Plan
420. Standard Insurance Company
421. Starmark
422. SummaCare
423. Sun Life Financial
424. Superior Dental (now Versant Health)
425. Superior Vision ( now Versant Health)
426. Surency
427. Surest
428. Sutter Health Plus
429. SVS Vision
430. Symetra
431. Tall Tree Administrators*
432. Teladoc
433. Ternian
434. The Boon Group*
435. The Health Plan
436. The Kempton Group
437. The Loomis Company*
438. The Standard
439. The Vitality Group
440. 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.
441. TLC Benefit Solutions, Inc.
442. Total Dental Administrators
443. Total Health Care
444. Trinity Marketing Services
445. Tristar Benefit Administrator
446. TRS Medical Insurance
447. True Rx Health Strategists
448. Trustmark Insurance Co.
449. Tufts Health Plan
450. TX Health Benefits Pool
451. UCHealth Plan Administrators
452. UHP Administrators
453. UltraBenefits
454. Unified Group Services
455. United Agriculture Benefit Trust
456. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET
platform only) (also Multi-tenant file)
457. United Heritage Insurance
458. United Concordia
459. Univera Healthcare
460. University Health Alliance (UHA)
461. University of Utah Health Plans
462. UNUM
463. UMR
464. UPMC Health Plan
465. Vantage Health Plan
466. Versant Health
467. Vimly
468. Virtual Benefits Administrator (also Multi-Tenant file)
469. Vision Benefit Administrators
470. Vision Benefits of America*
471. Vision Care Direct
472. The Vitality Group
473. Vitori
474. Viva Health (also Multi Tenant)
475. VSP (also Multi-tenant files)
476. Web TPA
477. Western Dental
478. Western Growers Assurance Trust (WGA)
479. Western Health Advantage
480. Wellmark Blue Cross Blue Shield of Iowa
481. WellNet (also Multi-tenant files)
482. Willamette Dental
483. Wisconsin Physicians Service (WPS Health Insurance)
484. Yuzu Health

*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.