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. 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 Benefit Consulting
22. Anchor Benefits Advisors
23. Angle Health
24. 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

25. Anthem Blue Cross (Blue Cross of CA)
26. Anthem BCBS of Colorado
27. Anthem BCBS of Maine
28. Anthem BCBS of Missouri
29. Anthem BCBS of Nevada
30. Anthem BCBS of New Hampshire
31. Anthem BCBS of Ohio
32. Anthem BCBS of Kentucky
33. Anthem Dental Only
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 Administrators, Inc.
91. Benefit Coordinators Corporation (BCC) (also Multi-tenant files)
92. Benefit Management Inc.
93. Benefit Plan Administrators
94. BeniComp Health Solutions
95. Beni Solutions
96. Bento Dental
97. Beta Dental
98. Beyond Med
99. Blackhawk TPA
100. Blue Benefit Administrators of MA
101. Blue Choice HealthPlan of South Carolina
102. Blue Care Network
103. Blue Cross of Idaho
104. Blue Shield of California
105. Blue Shield of North Eastern New York
106. Boon Group
107. Boon-Chapman
108. Breckpoint
109. Bright Benefits
110. Brighter Dental
111. Britton Benefits Services
112. Business Administrators & Consultants
113. Bywater
114. California Dental Network
115. Calvo's SelectCare
116. Capital Blue Cross - (also Multi-tenant files)
117. Capital Health Plan
118. Capital Rx
119. Capitol Administrators, Inc.
120. Caprock Health Plans
121. Carefirst
122. Carefirst Administrators**
123. CarePlus Dental
124. CBA Blue (also Multi-tenant files)
125. CDPHP

126. Century Healthcare
127. CerpassRx
128. Centivo
129. CGS Health Care
130. Christian Brothers Services
131. CieloStar
132. Cigna (also Multi-tenant files)
133. Cigna Select
134. Claim Choice
135. Coastal Administrative Services
136. Coeur
137. CoeurSS and CoeurPAS
138. Collective Health
139. Community Eye Care
140. Community Health Options
141. Community Care
142. Companion Life
143. Compass Health
144. Compass Health
145. ConnectiCare*
146. Consociate Health
147. Core Management
148. CoreSource* (aka Trustmark)
149. Coventry
150. Cox Health Plans
151. CRX International aka CanaRx
152. CVS Caremark
153. CWI Benefits, LLC*
154. Cypress Ancillary Benefits
155. Cypress Benefit Administrators
156. Cypress Dental
157. Davis Vision
158. Dean Care
159. 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)
160. Delta Dental of Alabama
161. Delta Dental of Arizona
162. Delta Dental of Arkansas
163. Delta Dental of California
164. Delta Dental of Colorado
165. Delta Dental of Florida
166. Delta Dental of Georgia
167. Delta Dental of Idaho
168. Delta Dental of Illinois
169. Delta Dental of Indiana
170. Delta Dental of Iowa
171. Delta Dental of Kansas
172. Delta Dental of Kentucky
173. Delta Dental of Massachusetts
174. Delta Dental of Michigan - (also Multi-Tenant files)
175. Delta Dental of Minnesota
176. Delta Dental of Missouri
177. Delta Dental of New Jersey
178. Delta Dental of New Mexico
179. Delta Dental of New York
180. Delta Dental of North Carolina
181. Delta Dental of the Northeast
182. Delta Dental of Ohio (also Multi-Tenant files)
183. Delta Dental of Oklahoma
184. Delta Dental of Oregon
185. Delta Dental of Pennsylvania
186. Delta Dental of Rhode Island
187. Delta Dental of South Dakota
188. Delta Dental of Tennessee
189. Delta Dental of Utah
190. Delta Dental of Virginia
191. Delta Dental of Washington*
192. Delta Dental of West Virginia
193. Delta Dental of Wisconsin
194. Delta Dental of Wyoming
195. Delta Health Systems
196. Delta Vision
197. DENCAP
198. Dental Care Plus Group
199. Dental Health Services
200. Dental Select
201. Dental Services Organization
202. Dentist Direct
203. Dentaquest
204. Direct Dental Administrators
205. Dominion Dental Services
206. EBA&M
207. EBMS
208. EBPA (also Multi-tenant files)
209. EBSO
210. Edison Healthcare
211. EHIM
212. Elixir Solutions
213. Emblem Health
214. EMI Health
215. Empire Blue Cross Blue Shield (also Multi-tenant files)
216. Employer Driven Insurance Services (EDIS)
217. Enterprise Group Planning
218. Equipoint Partners
219. Equitable
220. Everence Financial
221. EVO First, Inc.
222. Excellus Blue Cross Blue Shield
223. Exemplar Health
224. Express Scripts
225. Eyemed (also Multi-tenant files)
226. Eyetopia
227. Fallon Health (4010 format)
228. Fidelio Dental
229. First Choice Health
230. First Continental
231. First Stop Health
232. FirstCare Health Plans
233. Fountain Health
234. Florida Combined Life
235. Flume Health
236. Fountain Health
237. Fox Everett
238. Freedom Claims Management Inc (FCMI)
239. Fringe Benefit Group (FBG)
240. Geaux Health (also Multi-tenant files)
241. Geisinger Health Plan
242. GeniusAve
243. Gilsbar
244. GISC
245. GMR Health Care
246. Golden Dental
247. GPA
248. Gravie
249. Group Administrators Ltd
250. Group Benefit Services (GBS)
251. Group Health Plan of South Central Wisconsin (GHPSCW)
252. Group Vision Services
253. Guardian (also Multi-tenant files)
254. Gulf Guaranty Life Insurance Co
255. Harvard Pilgrim Health Care (HPHC)
256. Hawaii Dental Services aka Delta Dental of Hawaii
257. Hawaii Mainland Administrators
258. Hawaii Medical Assurance Association (HMAA)
259. Health Alliance Plan (connected via Data Exchange)
260. Health Alliance Plan of Michigan
261. Health Benefit Alliance
262. Health Design Plus
263. Health First Health Plan
264. Healthcare Highways
265. Healthcare Management Administrators
266. HealthEZ - (also Multi-tenant files)
267. Healthgram
268. Healthiest You
269. HealthNet
270. HealthNow New York
271. HealthPartners
272. HealthScope
273. HealthSmart
274. HealthyCT
275. Health Plans, Inc
276. Health Plan of Nevada
277. Health Net of California
278. Health New England
279. Health Resources Inc
280. Heritage Vision Plan
281. Highmark (also Multi-tenant files)
282. Horizon Blue Cross Blue Shield of NJ
283. Homestead
284. Hometown Health
285. Humana - (also Multi-tenant files)
286. IBA Flexible Benefit Solutions
287. Imagine360
288. Independence Administrators*
289. Independence Blue Cross
290. Independent Health
291. Innovative Health Services
292. Inshore Benefits
293. Indiana University Health aka IU Health
294. Innovative Health Services*
295. Insight Benefit Administrators
296. Insurance Management Services (IMS)*
297. Integrated Payor Solutions (IPS)
298. Interactive Medical Systems (IMS)
299. International Benefit Administrators TPA
300. Iowa Bankers Insurance & Services (IBIS)
301. Kaiser Permanente
302. Kaiser Permanente of WA
303. Kaiser Permanente of California
304. Kaiser Permanente Mid Atlantic Standard
305. Kaiser Foundation Health Plan of the Northwest
306. Kansas City Life
307. Kentucky Health Administrators
308. Key Benefit Administrators
309. Leading Edge Administrators
310. Level
311. Liberty Dental Plan
312. LifeMap*
313. Lifetime Benefit Solutions
314. Lincoln Financial Group (LFG)
315. Lucent Health
316. Luminare Health
317. Lyra Health
318. Lyric
319. Maestro Health
320. Managed Care of America, Inc.
321. Marpai Health
322. Mass General Brigham (previously known as AllWays Health Partners)*
323. Maxor Administrative Services
324. MBA Benefit Administrators
325. Med-Pay
326. MedBen*
327. Medcost
328. Medica
329. Medical Associates Health Plans
330. Medical Mutual of Ohio
331. MediExcel
332. MedImpact
333. MediOrbis
334. Medova Healthcare Financial Group
335. Medtipster (also Multi-tenant files)
336. MercyCare
337. Meritain Health (also Multi-tenant files)
338. MESVision
339. MESSA
340. Metlife
341. MODA Health (merged w/Delta Dental of OR)
342. Morgan White Group
343. MotivHealth Insurance Company
344. Mountain Health CO-OP
345. Mutual Health Services
346. Mutual of Omaha
347. MVP Health Care
348. Navitus
349. Neighborhood Health Plan
350. Network Health
351. New Benefits
352. Nippon Life Benefits
353. Northeast Delta Dental
354. Nova Healthcare
355. NVA-National Vision Administrators
356. OnDemand Healthcare
357. One to One Health
358. Opticare of Utah
359. Optilegra
360. Optim RX
361. Optimed
362. Oxford Health Plans (UHC subsidiary)
363. PACE
364. PacificSource Health Plans
365. Pan-American Life Insurance Group
366. Paramount Health
367. Patient Advocates
368. Pequot Plus Health Care
369. Personify Health (Formerly HealthComp)
370. PharmAvail
371. PHP TPA Services
372. Physicians Eyecare Plan
373. Physicians Health Plans (PHP)
374. Piedmont Community Health Plan
375. Pinnacle Claims Management (PCMI)
376. Planned Administrators Inc
377. PPi Benefit Solutions
378. Prairie States*
379. Precision Group Administrators
380. Premera Blue Cross
381. Premier Access
382. Presbyterian Health Plan (PHP)
383. Prescription Network
384. Prevea360
385. Priority Health (also Multi-tenant files)
386. Principal Financial Group
387. ProAct, Inc.
388. ProCare
389. ProClaim*
390. Professional Benefits Administrators (PBA)
391. Prominence Health Plan
392. Providence Health Plans
393. Public Employees Health Plan (PEHP)
394. QualChoice
395. Quartz Benefits
396. R&T Inc.
397. Regence Blue Shield of Idaho
398. Regence BCBS of Utah - Benefitfocus platform
399. Regence BCBS of Oregon
400. Regional Care Inc. (RCI)
401. Reliance Standard
402. Renaissance Dental
403. Rightway Healthcare
404. Risk Program Administrators (RPA)
405. Rx 'n Go
406. RXBenefits
407. S&S Healthcare
408. Samaritan Health Plans
409. Sana Benefits
410. Sanford Health
411. Santeon
412. SBMA Benefits
413. Scott & White Health Plans
414. ScriptGuide Rx, Inc. (SGRX)
415. Script Care
416. Security Health Plan
417. SelectHealth** (also Multi-tenant files)
418. Selman Company
419. Sentara Health
420. Sharp Healthcare
421. Sidecar Health
422. SISCO
423. SIHO
424. SIMNSA
425. Solstice (also Multi-tenant files)
426. SOTA Benefits
427. Southern Scripts
428. St. Luke’s Health Plan
429. Standard Insurance Company
430. Starmark
431. SummaCare
432. Sun Life Financial
433. Superior Dental (now Versant Health)
434. Superior Vision ( now Versant Health)
435. Surency
436. Surest
437. Sutter Health Plus
438. SVS Vision
439. Symetra
440. Tall Tree Administrators*
441. Teladoc
442. Ternian
443. The Boon Group*
444. The Health Plan
445. The Kempton Group
446. The Loomis Company*
447. The Standard
448. The Vitality Group
449. 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.
450. TLC Benefit Solutions, Inc.
451. Total Dental Administrators
452. Total Health Care
453. Tres Health
454. Trinity Marketing Services
455. Tristar Benefit Administrator
456. TRS Medical Insurance
457. TruAssure
458. True Rx Health Strategists
459. Trustmark Insurance Co.
460. Tufts Health Plan
461. TX Health Benefits Pool
462. UCHealth Plan Administrators
463. UHP Administrators
464. UltraBenefits
465. Unified Group Services
466. United Agriculture Benefit Trust
467. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only) (also Multi-tenant file)
468. United Heritage Insurance
469. United Concordia
470. Univera Healthcare (also Multi-Tenant file)
471. University Health Alliance (UHA)
472. University of Utah Health Plans
473. UNIVision & Dental Healthcare
474. UNUM
475. UMR
476. UPMC Health Plan
477. USA Vision
478. Vantage Health Plan
479. Vault Strategies
480. Versant Health
481. Vimly
482. Virtual Benefits Administrator (also Multi-Tenant file)
483. Vision Benefit Administrators
484. Vision Benefits of America*
485. Vision Care Direct
486. The Vitality Group
487. Vitori
488. Viva Health (also Multi Tenant)
489. VSP (also Multi-tenant files)
490. Web TPA
491. Western Dental
492. Western Growers Assurance Trust (WGA)
493. Western Health Advantage
494. Wellmark Blue Cross Blue Shield of Iowa
495. Wellmark Blue Cross Blue Shield of South Dakota
496. WellNet (also Multi-tenant files)
497. Willamette Dental
498. Wisconsin Physicians Service (WPS Health Insurance)
499. 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.