Marketplace

EDI 834

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.

1. 90 Degree Benefits
2. Administrative Concepts Inc (ACI)
3. ADN Administrators
4. Advantage Health Solutions
5. Advantica
6. Aetna
7. Aither Health Plan (also Multi-tenant files)
8. Allegiance
9. Allied Benefit Systems
10. AllWays Health Partners
11. Always Care
12. Altus Dental
13. Amerihealth
14. Ameritas
15. AmeriBen
16. Anchor Benefits Advisors
17. 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

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

92. Century Healthcare
93. CGS Health Care
94. Christian Brothers Services
95. Cigna
96. Cigna Select
97. Community Care
98. Companion Life
99. ConnectiCare*
100. Consociate Health
101. Continental Benefits (Well Systems)
102. CoreSource* (aka Trustmark)
103. Coventry
104. Cox Health Plans
105. CRX International aka CanaRx
106. CVS Caremark
107. CWI Benefits, LLC*
108. Cypress Ancillary Benefits
109. Cypress Benefit Administrators
110. Davis Vision
111. Dean Care
112. 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.
113. Delta Dental of Alabama
114. Delta Dental of Arizona
115. Delta Dental of Arkansas
116. Delta Dental of Colorado
117. Delta Dental of Georgia
118. Delta Dental of Idaho
119. Delta Dental of Illinois
120. Delta Dental of Indiana
121. Delta Dental of Iowa
122. Delta Dental of Kansas
123. Delta Dental of Kentucky
124. Delta Dental of Massachusetts
125. Delta Dental of Michigan - (also Multi-tenant files)
126. Delta Dental of Minnesota
127. Delta Dental of Missouri
128. Delta Dental of New Jersey
129. Delta Dental of New York
130. Delta Dental of North Carolina
131. Delta Dental of the Northeast
132. Delta Dental of Oklahoma
133. Delta Dental of Oregon
134. Delta Dental of Pennsylvania
135. Delta Dental of South Dakota
136. Delta Dental of Tennessee
137. Delta Dental of Utah
138. Delta Dental of Virginia
139. Delta Dental of Washington
140. Delta Dental of Wisconsin
141. Delta Health Systems
142. Dental Care Plus Group
143. Dental Select
144. Dentist Direct
145. Dentaquest
146. Dominion Dental Services
147. EBA&M
148. EBMS
149. EBPA (also Multi-tenant files)
150. EHIM
151. Emblem Health
152. EMI Health
153. Empire Blue Cross Blue Shield (also Multi-tenant files)
154. Equipoint Partners
155. Everence Financial
156. Excellus Blue Cross Blue Shield
157. Express Scripts
158. Eyemed (also Multi-tenant files)
159. Fallon Health (4010 format)
160. First Choice Health
161. First Stop Health
162. FirstCare Health Plans
163. Flume Health
164. Geisinger Health Plan
165. Gilsbar
166. GMR Health Care
167. GPA
168. Group Administrators Ltd
169. Group Benefit Services (GBS)
170. Group Health Plan of South Central Wisconsin (GHPSCW)
171. Group Vision Services
172. Guardian
173. Harvard Pilgrim Health Care (HPHC)
174. Hawaii Dental Services aka Delta Dental of Hawaii
175. Hawaii Mainland Administrators
176. Health Alliance Plan (connected via Data Exchange)
177. Health Alliance Plan of Michigan
178. Health Design Plus
179. Health First Health Plan
180. Healthcare Management Administrators
181. HealthEZ - (also Multi-tenant files)
182. Healthgram
183. Healthiest You
184. HealthNet
185. HealthNow New York
186. HealthPartners
187. HealthScope
188. HealthSmart
189. Health Plans Inc
190. Health Plan of Nevada
191. Health Net of California
192. Health New England
193. Health Resources Inc
194. Heritage Vision Plan
195. Highmark (also Multi-tenant files)
196. Horizon Blue Cross Blue Shield of NJ
197. Homestead
198. Hometown Health
199. Humana - (also Multi-tenant files)
200. Independence Administrators*
201. Independence Blue Cross
202. Independent Health
203. Indiana University Health aka IU Health
204. Innovative Health Services*
205. Insight Benefit Administrators
206. Insurance Management Services (IMS)*
207. Interactive Medical Systems (IMS)
208. Kaiser Permanente
209. Kaiser Permanente of WA
210. Kaiser Permanente of California
211. Kaiser Permanente Mid Atlantic Standard
212. Kansas City Life
213. Key Benefit Administrators
214. Leading Edge Administrators
215. LifeMap*
216. Lincoln Financial Group (LFG)
217. Maestro Health
218. Managed Care of America, Inc.
219. Maxor Administrative Services
220. MedBen*
221. Medcost
222. Medica
223. Medical Mutual of Ohio
224. MedImpact
225. Medova Healthcare Financial Group
226. MercyCare
227. Meritain Health
228. MESVision
229. Metlife
230. MODA Health (merged w/Delta Dental of OR)
231. Morgan White Group
232. MotivHealth Insurance Company
233. Mountain Health CO-OP
234. Mutual of Omaha
235. MVP Health Care
236. Network Health
237. New Benefits
238. North American Administrators*
239. Nova Healthcare
240. NVA-National Vision Administrators
241. OnDemand Healthcare
242. Opticare of Utah
243. Optim RX
244. Optima Health
245. Optimed
246. Oxford Health Plans (UHC subsidiary)
247. PacificSource Health Plans
248. Pan-American Life Insurance Group
249. Patient Advocates
250. PharmAvail
251. Physicians Eyecare Plan
252. Planned Administrators Inc
253. Prairie States*
254. Premera Blue Cross
255. Premier Access
256. Presbyterian Health Plan (PHP)
257. Priority Health (also Multi-tenant files)
258. Principal Financial Group
259. ProClaim*
260. Prominence Health Plan
261. Providence Health Plans
262. Public Employees Health Plan (PEHP)
263. QualChoice
264. Quartz Benefits
265. Regence Blue Shield of Idaho
266. Regence BCBS of Utah - Benefitfocus platform
267. Regence BCBS of Oregon
268. Regional Care Inc. (RCI)
269. Reliance Standard
270. Renaissance Dental
271. Rx 'n Go
272. Samaritan Health Plans
273. SBMA Benefits
274. Scott & White Health Plans
275. Security Health Plan
276. SelectHealth**
277. Selman Company
278. SISCO
279. SIHO
280. SIMNSA
281. Solstice
282. Southern Scripts
283. Standard Insurance Company
284. Starmark
285. SummaCare
286. Sun Life Financial
287. Superior Dental (now Versant Health)
288. Superior Vision ( now Versant Health)
289. Surency
290. Sutter Health Plus
291. SVS Vision
292. Symetra
293. Tall Tree Administrators*
294. Teladoc
295. The Boon Group*
296. The Health Plan
297. The Kempton Group
298. The Loomis Company*
299. 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.
300. Total Dental Administrators
301. TRS Medical Insurance (In Development)
302. Tufts Health Plan
303. UltraBenefits
304. Unified Group Services
305. United Agriculture Benefit Trust
306. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only)
307. United Heritage Insurance
308. United Concordia
309. Univera Healthcare
310. University Health Alliance (UHA)
311. University of Utah Health Plans
312. UNUM
313. UMR
314. UPMC Health Plan
315. Vantage Health Plan
316. Versant Health
317. Virtual Benefits Administrator (also Multi-Tenant file)
318. Vision Benefits of America
319. Vision Care Direct
320. Viva Health (also Multi Tenant)
1. 321. VSP (also Multi-tenant files)
321. Web TPA
322. Western Health Advantage
323. Wellmark Blue Cross Blue Shield of Iowa
324. WellNet (also Multi-tenant files)
325. Willamette Dental
326. 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.

Participating EDI 834 Partners