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 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, 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. Advisory Health Administrators (Transperra)
8. Aetna
9. Aither Health Plan (also Multi-tenant files)
10. Allegeant
11. Allegiance
12. Allied Benefit Systems
13. Altus Dental
14. Always Care
15. Amerihealth
16. Ameritas
17. AmeriBen
18. American Health Resources (AHR)
19. American Plan Administrators
20. Anchor Benefits Advisors
21. Angle Health
22. 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

23. Anthem Blue Cross (Blue Cross of CA)
24. Anthem BCBS of Colorado
25. Anthem BCBS of Maine
26. Anthem BCBS of Missouri
27. Anthem BCBS of Nevada
28. Anthem BCBS of New Hampshire
29. Anthem BCBS of Ohio
30. Anthem BCBS of Kentucky
31. Anthem Dental Only
32. Anthem Life
33. Anthem of California
34. Anthem of Connecticut
35. Anthem of Virginia - BenefitFocus platform
36. Apostrophe Health
37. ARC Administrators
38. Argus Dental
39. ASI
40. Aspirus Health Plan
41. ASR Health Benefits
42. Associated Employers
43. Assured Benefit Administrators
44. Assurant - Dental & Vision only
45. Asuris Northwest Health
46. AudioNET
47. AultCare
48. Automated Benefit Services
49. Auxiant
50. Avesis Vision
51. Avera
52. AvMed Health Plans
53. AXA Equitable
54. Baptist Health Plan
55. BAC / Benefits Administration Co)
56. Bay Bridge Administrators

57. BCBS (General 5010 format not tied to a specific state)
58. BCBS of Alabama
59. BCBS of Arizona
60. BCBS of Arkansas (also Multi-tenant files)
61. BCBS of Florida - aka Florida Blue
62. BCBS of Georgia - Anthem platform
63. BCBS of Illinois**
64. BCBS of Kansas
65. BCBS of KC
66. BCBS of LA (also Multi-tenant files)
67. BCBS of Massachusetts (also Multi-tenant files)
68. BCBS of Michigan** - (also Multi-tenant files)
69. BCBS of Minnesota
70. BCBS of Mississippi
71. BCBS of Montana
72. BCBS of Nebraska
73. BCBS of New Mexico
74. BCBS of North Carolina
75. BCBS of North Dakota
76. BCBS of Oklahoma
77. Highmark BCBS North East Pennsylvania
78. BCBS of Rhode Island
79. BCBS of South Carolina
80. BCBS of Tennessee (also Multi-tenant files)
81. BCBS of Texas**
82. BCBS of Vermont
83. BCBS of West Virginia (Highmark)
84. BCBS of Western NY
85. Beazley
86. BeneCard
87. Benefit & Risk Management Services
88. Benefit Administration Services
89. Benefit Coordinators Corporation (BCC) (also Multi-tenant files)
90. Benefit Management Inc.
91. Benefit Plan Administrators
92. BeniComp Health Solutions
93. Bento Dental
94. Beta Dental
95. Beyond Med
96. Blackhawk TPA
97. Blue Benefit Administrators of MA
98. Blue Choice HealthPlan of South Carolina
99. Blue Care Network
100. Blue Cross of Idaho
101. Blue Shield of California
102. Blue Shield of North Eastern New York
103. Boon Group
104. Boon-Chapman
105. Breckpoint
106. Bright Benefits
107. Brighter Dental
108. Britton Benefits Services
109. Business Administrators & Consultants
110. Bywater
111. California Dental Network
112. Calvo's SelectCare
113. Capital Blue Cross - (also Multi-tenant files)
114. Capital Health Plan
115. Capital Rx
116. Capitol Administrators, Inc.
117. Caprock Health Plans
118. Carefirst
119. Carefirst Administrators**
120. CarePlus Dental
121. CBA Blue (also Multi-tenant files)
122. CDPHP

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

Participating EDI 834 Partners