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