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 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. AultCare
45. Automated Benefit Services
46. Auxiant
47. Avesis Vision
48. Avera
49. AvMed Health Plans
50. AXA Equitable
51. Baptist Health Plan
52. BAC / Benefits Administration Co)
53. Bay Bridge Administrators
54. BCBS (General 5010 format not tied to a specific state)
55. BCBS of Alabama
56. BCBS of Arizona
57. BCBS of Arkansas (also Multi-tenant files)
58. BCBS of Florida - aka Florida Blue
59. BCBS of Georgia - Anthem platform
60. BCBS of Illinois**
61. BCBS of Kansas
62. BCBS of KC
63. BCBS of LA (also Multi-tenant files)
64. BCBS of Massachusetts (also Multi-tenant files)
65. BCBS of Michigan** - (also Multi-tenant files)
66. BCBS of Minnesota
67. BCBS of Mississippi
68. BCBS of Montana
69. BCBS of Nebraska
70. BCBS of New Mexico
71. BCBS of North Carolina
72. BCBS of North Dakota
73. BCBS of Oklahoma
74. Highmark BCBS North East Pennsylvania
75. BCBS of Rhode Island
76. BCBS of South Carolina
77. BCBS of Tennessee (also Multi-tenant files)
78. BCBS of Texas**
79. BCBS of Vermont
80. BCBS of West Virginia (Highmark)
81. BCBS of Western NY
82. BeneCard
83. Benefit & Risk Management Services
84. Benefit Administration Services
85. Benefit Coordinators Corporation (BCC) (also Multi-tenant files)
86. Benefit Management Inc.
87. Benefit Plan Administrators
88. BeniComp Health Solutions
89. Beta Dental
90. Blackhawk TPA
91. Blue Benefit Administrators of MA
92. Blue Care Network
93. Blue Cross of Idaho
94. Blue Shield of California
95. Blue Shield of North Eastern New York
96. Boon Group
97. Boon-Chapman
98. Breckpoint
99. Bright Benefits
100. Brighter Dental
101. Britton Benefits Services
102. California Dental Network
103. Calvo's SelectCare
104. Capital Blue Cross - (also Multi-tenant files)
105. Capital Health Plan
106. Capital Rx
107. Capitol Administrators, Inc.
108. Caprock Health Plans
109. Carefirst
110. Carefirst Administrators**
111. CarePlus Dental
112. CBA Blue (also Multi-tenant files)
113. CDPHP

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