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, 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. Always Care
14. Altus Dental
15. Amerihealth
16. Ameritas
17. AmeriBen
18. American Health Resources (AHR)
19. Anchor Benefits Advisors
20. Angle Health
21. 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

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

115. Century Healthcare
116. Centivo
117. CGS Health Care
118. Christian Brothers Services
119. CieloStar
120. Cigna (also Multi-tenant files)
121. Cigna Select
122. Coastal Administrative Services
123. CoeurSS and CoeurPAS
124. Collective Health
125. Community Care
126. Companion Life
127. Compass Health
128. ConnectiCare*
129. Consociate Health
130. Continental Benefits (Well Systems)
131. CoreSource* (aka Trustmark)
132. Coventry
133. Cox Health Plans
134. CRX International aka CanaRx
135. CVS Caremark
136. CWI Benefits, LLC*
137. Cypress Ancillary Benefits
138. Cypress Benefit Administrators
139. Davis Vision
140. Dean Care
141. 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)
142. Delta Dental of Alabama
143. Delta Dental of Arizona
144. Delta Dental of Arkansas
145. Delta Dental of California
146. Delta Dental of Colorado
147. Delta Dental of Georgia
148. Delta Dental of Idaho
149. Delta Dental of Illinois
150. Delta Dental of Indiana
151. Delta Dental of Iowa
152. Delta Dental of Kansas
153. Delta Dental of Kentucky
154. Delta Dental of Massachusetts
155. Delta Dental of Michigan - (also Multi-tenant files)
156. Delta Dental of Minnesota
157. Delta Dental of Missouri
158. Delta Dental of New Jersey
159. Delta Dental of New York
160. Delta Dental of North Carolina
161. Delta Dental of the Northeast
162. Delta Dental of Ohio
163. Delta Dental of Oklahoma
164. Delta Dental of Oregon
165. Delta Dental of Pennsylvania
166. Delta Dental of South Dakota
167. Delta Dental of Tennessee
168. Delta Dental of Utah
169. Delta Dental of Virginia
170. Delta Dental of Washington*
171. Delta Dental of Wisconsin
172. Delta Dental of Wyoming
173. Delta Health Systems
174. Delta Vision
175. DENCAP
176. Dental Care Plus Group
177. Dental Select
178. Dental Services Organization
179. Dentist Direct
180. Dentaquest
181. Dominion Dental Services
182. EBA&M
183. EBMS
184. EBPA (also Multi-tenant files)
185. EHIM
186. Elixir Solutions
187. Emblem Health
188. EMI Health
189. Empire Blue Cross Blue Shield (also Multi-tenant files)
190. Employer Driven Insurance Services (EDIS)
191. Equipoint Partners
192. Everence Financial
193. Excellus Blue Cross Blue Shield
194. Express Scripts
195. Eyemed (also Multi-tenant files)
196. Fallon Health (4010 format)
197. Fidelio Dental
198. First Choice Health
199. First Stop Health
200. FirstCare Health Plans
201. Fountain Health
202. Florida Combined Life
203. Flume Health
204. Fringe Benefit Group (FBG)
205. Geisinger Health Plan
206. GeniusAve
207. Gilsbar
208. GMR Health Care
209. Golden Dental
210. GPA
211. Gravie
212. Group Administrators Ltd
213. Group Benefit Services (GBS)
214. Group Health Plan of South Central Wisconsin (GHPSCW)
215. Group Vision Services
216. Guardian (also Multi-tenant files)
217. Harvard Pilgrim Health Care (HPHC)
218. Hawaii Dental Services aka Delta Dental of Hawaii
219. Hawaii Mainland Administrators
220. Health Alliance Plan (connected via Data Exchange)
221. Health Alliance Plan of Michigan
222. Health Design Plus
223. Health First Health Plan
224. Healthcare Highways
225. Healthcare Management Administrators
226. HealthEZ - (also Multi-tenant files)
227. HealthComp
228. Healthgram
229. Healthiest You
230. HealthNet
231. HealthNow New York
232. HealthPartners
233. HealthScope
234. HealthSmart
235. Health Plans, Inc
236. Health Plan of Nevada
237. Health Net of California
238. Health New England
239. Health Resources Inc
240. Heritage Vision Plan
241. Highmark (also Multi-tenant files)
242. Horizon Blue Cross Blue Shield of NJ
243. Homestead
244. Hometown Health
245. Humana - (also Multi-tenant files)
246. Imagine360
247. Independence Administrators*
248. Independence Blue Cross
249. Independent Health
250. Indiana University Health aka IU Health
251. Innovative Health Services*
252. Insight Benefit Administrators
253. Insurance Management Services (IMS)*
254. Integrated Payor Solutions (IPS)
255. Interactive Medical Systems (IMS)
256. International Benefit Administrators TPA
257. Iowa Bankers Insurance & Services (IBIS)
258. Kaiser Permanente
259. Kaiser Permanente of WA
260. Kaiser Permanente of California
261. Kaiser Permanente Mid Atlantic Standard
262. Kansas City Life
263. Key Benefit Administrators
264. Leading Edge Administrators
265. Level
266. Liberty Dental Plan
267. LifeMap*
268. Lincoln Financial Group (LFG)
269. Luminare Health
270. Lyra Health
271. Lyric
272. Maestro Health
273. Managed Care of America, Inc.
274. Mass General Brigham (previously known as AllWays Health Partners)*
275. Maxor Administrative Services
276. Med-Pay
277. MedBen*
278. Medcost
279. Medica
280. Medical Associates Health Plans
281. Medical Mutual of Ohio
282. MediExcel
283. MedImpact
284. Medova Healthcare Financial Group
285. Medtipster (also Multi-tenant files)
286. MercyCare
287. Meritain Health (also Multi-tenant files)
288. MESVision
289. MESSA
290. Metlife
291. MODA Health (merged w/Delta Dental of OR)
292. Morgan White Group
293. MotivHealth Insurance Company
294. Mountain Health CO-OP
295. Mutual of Omaha
296. MVP Health Care
297. Navitus
298. Network Health
299. New Benefits
300. Nova Healthcare
301. NVA-National Vision Administrators
302. OnDemand Healthcare
303. Opticare of Utah
304. Optim RX
305. Optimed
306. Oxford Health Plans (UHC subsidiary)
307. PACE
308. PacificSource Health Plans
309. Pan-American Life Insurance Group
310. Paramount Health
311. Patient Advocates
312. Pequot Plus Health Care
313. PharmAvail
314. PHP TPA Services
315. Physicians Eyecare Plan
316. Physicians Health Plans (PHP)
317. Planned Administrators Inc
318. Prairie States*
319. Premera Blue Cross
320. Premier Access
321. Presbyterian Health Plan (PHP)
322. Prevea360
323. Priority Health (also Multi-tenant files)
324. Principal Financial Group
325. ProAct, Inc.
326. ProClaim*
327. Professional Benefits Administrators (PBA)
328. Prominence Health Plan
329. Providence Health Plans
330. Public Employees Health Plan (PEHP)
331. QualChoice
332. Quartz Benefits
333. Regence Blue Shield of Idaho
334. Regence BCBS of Utah - Benefitfocus platform
335. Regence BCBS of Oregon
336. Regional Care Inc. (RCI)
337. Reliance Standard
338. Renaissance Dental
339. Rightway Healthcare
340. Rx 'n Go
341. S&S Healthcare
342. Samaritan Health Plans
343. Sana Benefits
344. Sanford Health
345. SBMA Benefits
346. Scott & White Health Plans
347. Script Care
348. Security Health Plan
349. SelectHealth** (also Multi-tenant files)
350. Selman Company
351. Sentara Health
352. Sidecar Health
353. SISCO
354. SIHO
355. SIMNSA
356. Solstice (also Multi-tenant files)
357. Southern Scripts
358. Standard Insurance Company
359. Starmark
360. SummaCare
361. Sun Life Financial
362. Superior Dental (now Versant Health)
363. Superior Vision ( now Versant Health)
364. Surency
365. Surest
366. Sutter Health Plus
367. SVS Vision
368. Symetra
369. Tall Tree Administrators*
370. Teladoc
371. The Boon Group*
372. The Health Plan
373. The Kempton Group
374. The Loomis Company*
375. 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.
376. TLC Benefit Solutions, Inc.
377. Total Dental Administrators
378. Tristar Benefit Administrator
379. TRS Medical Insurance
380. Trustmark Insurance Co.
381. Tufts Health Plan
382. TX Health Benefits Pool
383. UCHealth Plan Administrators
384. UHP Administrators
385. UltraBenefits
386. Unified Group Services
387. United Agriculture Benefit Trust
388. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only) (also Multi-tenant file)
389. United Heritage Insurance
390. United Concordia
391. Univera Healthcare
392. University Health Alliance (UHA)
393. University of Utah Health Plans
394. UNUM
395. UMR
396. UPMC Health Plan
397. Vantage Health Plan
398. Versant Health
399. Virtual Benefits Administrator (also Multi-Tenant file)
400. Vision Benefits of America*
401. Vision Care Direct
402. The Vitality Group
403. Vitori
404. Viva Health (also Multi Tenant)
405. VSP (also Multi-tenant files)
406. Web TPA
407. Western Growers Assurance Trust (WGA)
408. Western Health Advantage
409. Wellmark Blue Cross Blue Shield of Iowa
410. WellNet (also Multi-tenant files)
411. Willamette Dental
412. 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.