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. Captrue Benefits
122. Carefirst
123. Carefirst Administrators**
124. CarePlus Dental
125. CBA Blue (also Multi-tenant files)
126. CDPHP

127. Century Healthcare
128. CerpassRx
129. Centivo
130. CGS Health Care
131. Chinese Community Health Plans
132. Christian Brothers Services
133. CieloStar
134. Cigna (also Multi-tenant files)
135. Cigna Select
136. Claim Choice
137. Coastal Administrative Services
138. Coeur
139. CoeurSS and CoeurPAS
140. Collective Health
141. Community Eye Care
142. Community Health Options
143. Community Care
144. Companion Life
145. Compass Health
146. Compass Health
147. ConnectiCare*
148. Consociate Health
149. Core Management
150. CoreSource* (aka Trustmark)
151. Coventry
152. Cox Health Plans
153. CRX International aka CanaRx
154. CVS Caremark
155. CWI Benefits, LLC*
156. Cypress Ancillary Benefits
157. Cypress Benefit Administrators
158. Cypress Dental
159. Davis Vision
160. Dean Care
161. 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)
162. Delta Dental of Alabama
163. Delta Dental of Arizona
164. Delta Dental of Arkansas
165. Delta Dental of California
166. Delta Dental of Colorado
167. Delta Dental of Florida
168. Delta Dental of Georgia
169. Delta Dental of Idaho
170. Delta Dental of Illinois
171. Delta Dental of Indiana
172. Delta Dental of Iowa
173. Delta Dental of Kansas
174. Delta Dental of Kentucky
175. Delta Dental of Massachusetts
176. Delta Dental of Michigan - (also Multi-Tenant files)
177. Delta Dental of Minnesota
178. Delta Dental of Missouri
179. Delta Dental of New Jersey
180. Delta Dental of New Mexico
181. Delta Dental of New York
182. Delta Dental of North Carolina
183. Delta Dental of the Northeast
184. Delta Dental of Ohio (also Multi-Tenant files)
185. Delta Dental of Oklahoma
186. Delta Dental of Oregon
187. Delta Dental of Pennsylvania
188. Delta Dental of Rhode Island
189. Delta Dental of South Dakota
190. Delta Dental of Tennessee
191. Delta Dental of Utah
192. Delta Dental of Virginia
193. Delta Dental of Washington*
194. Delta Dental of West Virginia
195. Delta Dental of Wisconsin
196. Delta Dental of Wyoming
197. Delta Health Systems
198. Delta Vision
199. DENCAP
200. Dental Care Plus Group
201. Dental Health Services
202. Dental Select
203. Dental Services Organization
204. Dentist Direct
205. Dentaquest
206. Direct Dental Administrators
207. Dominion Dental Services
208. EBA&M
209. EBMS
210. EBPA (also Multi-tenant files)
211. EBSO
212. Edison Healthcare
213. EHIM
214. Elixir Solutions
215. Emblem Health
216. EMI Health
217. Empire Blue Cross Blue Shield (also Multi-tenant files)
218. Employer Driven Insurance Services (EDIS)
219. Enterprise Group Planning
220. Equipoint Partners
221. Equitable
222. Everence Financial
223. EVO First, Inc.
224. Excellus Blue Cross Blue Shield
225. Exemplar Health
226. Express Scripts
227. Eyemed (also Multi-tenant files)
228. Eyetopia
229. Fallon Health (4010 format)
230.Fidelio Dental
231. First Choice Health
232. First Continental
233. First Stop Health
234. FirstCare Health Plans
235. Fountain Health
236. Florida Combined Life
237. Flume Health
238. Fountain Health
239. Fox Everett
240. Freedom Claims Management Inc (FCMI)
241. Fringe Benefit Group (FBG)
242. Geaux Health (also Multi-tenant files)
243. Geisinger Health Plan
244. GeniusAve
245. Gilsbar
246. GISC
247. GMR Health Care
248. Golden Dental
249. GPA
250. Gravie
251. Group Administrators Ltd
252. Group Benefit Services (GBS)
253. Group Health Plan of South Central Wisconsin (GHPSCW)
254. Group Vision Services
255. Guardian (also Multi-tenant files)
256. Gulf Guaranty Life Insurance Co
257. Harbor Health
258. Harvard Pilgrim Health Care (HPHC)
259. Hawaii Dental Services aka Delta Dental of Hawaii
260. Hawaii Mainland Administrators
261. Hawaii Medical Assurance Association (HMAA)
262. Health Alliance Plan (connected via Data Exchange)
263. Health Alliance Plan of Michigan
264. Health Benefit Alliance
265. Health Design Plus
266. Health First Health Plan
267. Healthcare Highways
268. Healthcare Management Administrators
269. HealthEZ - (also Multi-tenant files)
270. Healthgram
271. Healthiest You
272. HealthNet
273. HealthNow New York
274. HealthPartners
275. HealthScope
276. HealthSmart
277. HealthyCT
278. Health Plans, Inc
279. Health Plan of Nevada
280. Health Net of California
281. Health New England
282. Health Resources Inc
283. Heritage Vision Plan
284. Highmark (also Multi-tenant files)
285. Horizon Blue Cross Blue Shield of NJ
286. Homestead
287. Hometown Health
288. Humana - (also Multi-tenant files)
289. IBA Flexible Benefit Solutions
290. Imagine360
291. Independence Administrators*
292. Independence Blue Cross
293. Independent Health
294. Innovative Health Services
295. Inshore Benefits
296. Indiana University Health aka IU Health
297. Innovative Health Services*
298. Insight Benefit Administrators
299. Insurance Management Services (IMS)*
300. Integrated Payor Solutions (IPS)
301. Interactive Medical Systems (IMS)
302. International Benefit Administrators TPA
303. Iowa Bankers Insurance & Services (IBIS)
304. Kaiser Permanente
305. Kaiser Permanente of WA
306. Kaiser Permanente of California
307. Kaiser Permanente Mid Atlantic Standard
308. Kaiser Foundation Health Plan of the Northwest
309. Kansas City Life
310. Kentucky Health Administrators
311. Key Benefit Administrators
312. Landmark Health
313. Leading Edge Administrators
314. Level
315. Liberty Dental Plan
316. LifeMap*
317. Lifetime Benefit Solutions
318. Lincoln Financial Group (LFG)
319. Lucent Health
320. Luminare Health
321. Lyra Health
322. Lyric
323. Maestro Health
324. Managed Care of America, Inc.
325. Marpai Health
326. Mass General Brigham (previously known as AllWays Health Partners)*
327. MBA Benefit Administrators
328. Med-Pay
329. MedBen*
330. Medcost
331. Medica
332. Medical Associates Health Plans
333. Medical Mutual of Ohio
334. MediExcel
335. MedImpact
336. MediOrbis
337. Medova Healthcare Financial Group
338. Medtipster (also Multi-tenant files)
339. MercyCare
340. Meritain Health (also Multi-tenant files)
341. MESVision
342. MESSA
343. Metlife
344. MODA Health (merged w/Delta Dental of OR)
345. Morgan White Group
346. MotivHealth Insurance Company
347. Mountain Health CO-OP
348. Mutual Health Services
349. Mutual of Omaha
350. MVP Health Care
351. Navitus
352. Neighborhood Health Plan
353. Network Health
354. New Benefits
355. Nippon Life Benefits
356. Northeast Delta Dental
357. Nova Healthcare
358. NVA-National Vision Administrators
359. OnDemand Healthcare
360. One to One Health
361. Opticare of Utah
362. Optilegra
363. Optim RX
364. Optimed
365. Optiplan
366. Oxford Health Plans (UHC subsidiary)
367. PACE
368. PacificSource Health Plans
369. Pan-American Life Insurance Group
370. Paramount Health
371. Patient Advocates
372. Pequot Plus Health Care
373. Personify Health (Formerly HealthComp)
374. PharmAvail
375. PHP TPA Services
376. Physicians Eyecare Plan
377. Physicians Health Plans (PHP)
378. Piedmont Community Health Plan
379. Pinnacle Claims Management (PCMI)
380. Planned Administrators Inc
381. Point C
382. PPi Benefit Solutions
383. Prairie States*
384. Precision Group Administrators
385. Premera Blue Cross
386. Premier Access
387. Presbyterian Health Plan (PHP)
388. Prescription Network
389. Prevea360
390. Priority Health (also Multi-tenant files)
391. Principal Financial Group
392. ProAct, Inc.
393. ProCare
394. ProClaim*
395. Professional Benefits Administrators (PBA)
396. Prominence Health Plan
397. Providence Health Plans
398. Public Employees Health Plan (PEHP)
399. QualChoice
400. Quartz Benefits
401. R&T Inc.
402. Regence Blue Shield of Idaho
403. Regence BCBS of Utah - Benefitfocus platform
404. Regence BCBS of Oregon
405. Regional Care Inc. (RCI)
406. Regence Group Administrators (RGA)
407. Reliance Standard
408. Renaissance Dental
409. Rightway Healthcare
410. Risk Program Administrators (RPA)
411. Rx 'n Go
412. RXBenefits
413. S&S Healthcare
414. Samaritan Health Plans
415. Sana Benefits
416. Sanford Health
417. Santeon
418. SBMA Benefits
419. Scott & White Health Plans
420. ScriptGuide Rx, Inc. (SGRX)
421. Script Care
422. Security Health Plan
423. SelectHealth** (also Multi-tenant files)
424. Selman Company
425. Sentara Health
426. Sharp Healthcare
427. Sidecar Health
428. SISC (Self-Insured Schools of California)
429. SISCO
430. SIHO
431. SIMNSA
432. Solstice (also Multi-tenant files)
433. SOTA Benefits
434. Southern Scripts
435. St. Luke’s Health Plan
436. Standard Insurance Company
437. Starmark
438. SummaCare
439. Sun Life Financial
440. Superior Dental (now Versant Health)
441. Superior Vision ( now Versant Health)
442. Surency
443. Surest
444. Sutter Health Plus
445. SVS Vision
446. Symetra
447. Tall Tree Administrators*
448. Teladoc
449. Ternian
450. The Boon Group*
451. The Health Plan
452. The Kempton Group
453. The Loomis Company*
454. The Standard
455. The Vitality Group
456. 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.
457. TLC Benefit Solutions, Inc.
458. Total Dental Administrators
459. Total Health Care
460. Transwestern Insurance Administrators
461. Tres Health
462. Trinity Marketing Services
463. Tristar Benefit Administrator
464. TRS Medical Insurance
465. TruAssure
466. True Rx Health Strategists
467. Trustmark Insurance Co.
468. Tufts Health Plan
469. TX Health Benefits Pool
470. UCHealth Plan Administrators
471. UHP Administrators
472. UltraBenefits
473. Unified Group Services
474. United Agriculture Benefit Trust
475. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only) (also Multi-tenant file)
476. United Heritage Insurance
477. United Concordia
478. Univera Healthcare (also Multi-Tenant file)
479. University Health Alliance (UHA)
480. University of Utah Health Plans
481. UNIVision & Dental Healthcare
482. UNUM
483. UMR
484. UPMC Health Plan
485. USA Vision
486. Vantage Health Plan
487. Vault Strategies
488. Versant Health
489. Vimly
490. Virtual Benefits Administrator (also Multi-Tenant file)
491. Vision Benefit Administrators
492. Vision Benefits of America*
493. Vision Care Direct
494. The Vitality Group
495. Vitori
496. Viva Health (also Multi Tenant)
497. VSP (also Multi-tenant files)
498. Vytlone
499. Web TPA
500. Western Dental
501. Western Growers Assurance Trust (WGA)
502. Western Health Advantage
503. Wellmark Blue Cross Blue Shield of Iowa
504. Wellmark Blue Cross Blue Shield of South Dakota
505. WellNet (also Multi-tenant files)
506. Willamette Dental
507. Wisconsin Physicians Service (WPS Health Insurance)
508. 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.