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. Geisinger Health Plan
233. GeniusAve
234. Gilsbar
235. GISC
236. GMR Health Care
237. Golden Dental
238. GPA
239. Gravie
240. Group Administrators Ltd
241. Group Benefit Services (GBS)
242. Group Health Plan of South Central Wisconsin (GHPSCW)
243. Group Vision Services
244. Guardian (also Multi-tenant files)
245. Gulf Guaranty Life Insurance Co
246. Harvard Pilgrim Health Care (HPHC)
247. Hawaii Dental Services aka Delta Dental of Hawaii
248. Hawaii Mainland Administrators
249. Hawaii Medical Assurance Association (HMAA)
250. Health Alliance Plan (connected via Data Exchange)
251. Health Alliance Plan of Michigan
252. Health Design Plus
253. Health First Health Plan
254. Healthcare Highways
255. Healthcare Management Administrators
256. HealthEZ - (also Multi-tenant files)
257. HealthComp
258. Healthgram
259. Healthiest You
260. HealthNet
261. HealthNow New York
262. HealthPartners
263. HealthScope
264. HealthSmart
265. HealthyCT
266. Health Plans, Inc
267. Health Plan of Nevada
268. Health Net of California
269. Health New England
270. Health Resources Inc
271. Heritage Vision Plan
272. Highmark (also Multi-tenant files)
273. Horizon Blue Cross Blue Shield of NJ
274. Homestead
275. Hometown Health
276. Humana - (also Multi-tenant files)
277. IBA Flexible Benefit Solutions
278. Imagine360
279. Independence Administrators*
280. Independence Blue Cross
281. Independent Health
282. Innovative Health Services
283. Inshore Benefits
284. Indiana University Health aka IU Health
285. Innovative Health Services*
286. Insight Benefit Administrators
287. Insurance Management Services (IMS)*
288. Integrated Payor Solutions (IPS)
289. Interactive Medical Systems (IMS)
290. International Benefit Administrators TPA
291. Iowa Bankers Insurance & Services (IBIS)
292. Kaiser Permanente
293. Kaiser Permanente of WA
294. Kaiser Permanente of California
295. Kaiser Permanente Mid Atlantic Standard
296. Kansas City Life
297. Kentucky Health Administrators
298. Key Benefit Administrators
299. Leading Edge Administrators
300. Level
301. Liberty Dental Plan
302. LifeMap*
303. Lifetime Benefit Solutions
304. Lincoln Financial Group (LFG)
305. Lucent Health
306. Luminare Health
307. Lyra Health
308. Lyric
309. Maestro Health
310. Managed Care of America, Inc.
311. Marpai Health
312. Mass General Brigham (previously known as AllWays Health Partners)*
313. Maxor Administrative Services
314. MBA Benefit Administrators
315. Med-Pay
316. MedBen*
317. Medcost
318. Medica
319. Medical Associates Health Plans
320. Medical Mutual of Ohio
321. MediExcel
322. MedImpact
323. MediOrbis
324. Medova Healthcare Financial Group
325. Medtipster (also Multi-tenant files)
326. MercyCare
327. Meritain Health (also Multi-tenant files)
328. MESVision
329. MESSA
330. Metlife
331. MODA Health (merged w/Delta Dental of OR)
332. Morgan White Group
333. MotivHealth Insurance Company
334. Mountain Health CO-OP
335. Mutual of Omaha
336. MVP Health Care
337. Navitus
338. Neighborhood Health Plan
339. Network Health
340. New Benefits
341. Nippon Life Benefits
342. Northeast Delta Dental
343. Nova Healthcare
344. NVA-National Vision Administrators
345. OnDemand Healthcare
346. Opticare of Utah
347. Optim RX
348. Optimed
349. Oxford Health Plans (UHC subsidiary)
350. PACE
351. PacificSource Health Plans
352. Pan-American Life Insurance Group
353. Paramount Health
354. Patient Advocates
355. Pequot Plus Health Care
356. PharmAvail
357. PHP TPA Services
358. Physicians Eyecare Plan
359. Physicians Health Plans (PHP)
360. Piedmont Community Health Plan
361. Planned Administrators Inc
362. PPi Benefit Solutions
363. Prairie States*
364. Precision Group Administrators
365. Premera Blue Cross
366. Premier Access
367. Presbyterian Health Plan (PHP)
368. Prescription Network
369. Prevea360
370. Priority Health (also Multi-tenant files)
371. Principal Financial Group
372. ProAct, Inc.
373. ProCare
374. ProClaim*
375. Professional Benefits Administrators (PBA)
376. Prominence Health Plan
377. Providence Health Plans
378. Public Employees Health Plan (PEHP)
379. QualChoice
380. Quartz Benefits
381. R&T Inc.
382. Regence Blue Shield of Idaho
383. Regence BCBS of Utah - Benefitfocus platform
384. Regence BCBS of Oregon
385. Regional Care Inc. (RCI)
386. Reliance Standard
387. Renaissance Dental
388. Rightway Healthcare
389. Rx 'n Go
390. RXBenefits
391. S&S Healthcare
392. Samaritan Health Plans
393. Sana Benefits
394. Sanford Health
395. Santeon
396. SBMA Benefits
397. Scott & White Health Plans
398. Script Care
399. Security Health Plan
400. SelectHealth** (also Multi-tenant files)
401. Selman Company
402. Sentara Health
403. Sharp Healthcare
404. Sidecar Health
405. SISCO
406. SIHO
407. SIMNSA
408. Solstice (also Multi-tenant files)
409. Southern Scripts
410. Standard Insurance Company
411. Starmark
412. SummaCare
413. Sun Life Financial
414. Superior Dental (now Versant Health)
415. Superior Vision ( now Versant Health)
416. Surency
417. Surest
418. Sutter Health Plus
419. SVS Vision
420. Symetra
421. Tall Tree Administrators*
422. Teladoc
423. Ternian
424. The Boon Group*
425. The Health Plan
426. The Kempton Group
427. The Loomis Company*
428. The Standard
429. The Vitality Group
430. 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.
431. TLC Benefit Solutions, Inc.
432. Total Dental Administrators
433. Total Health Care
434. Trinity Marketing Services
435. Tristar Benefit Administrator
436. TRS Medical Insurance
437. True Rx Health Strategists
438. Trustmark Insurance Co.
439. Tufts Health Plan
440. TX Health Benefits Pool
441. UCHealth Plan Administrators
442. UHP Administrators
443. UltraBenefits
444. Unified Group Services
445. United Agriculture Benefit Trust
446. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only) (also Multi-tenant file)
447. United Heritage Insurance
448. United Concordia
449. Univera Healthcare
450. University Health Alliance (UHA)
451. University of Utah Health Plans
452. UNUM
453. UMR
454. UPMC Health Plan
455. Vantage Health Plan
456. Versant Health
457. Vimly
458. Virtual Benefits Administrator (also Multi-Tenant file)
459. Vision Benefit Administrators
460. Vision Benefits of America*
461. Vision Care Direct
462. The Vitality Group
463. Vitori
464. Viva Health (also Multi Tenant)
465. VSP (also Multi-tenant files)
466. Web TPA
467. Western Growers Assurance Trust (WGA)
468. Western Health Advantage
469. Wellmark Blue Cross Blue Shield of Iowa
470. WellNet (also Multi-tenant files)
471. Willamette Dental
472. Wisconsin Physicians Service (WPS Health Insurance)
473. 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.