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, Nontraditional 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 Benefits Advisors
22. Angle Health
23. Anthem BCBS - (also Multi-tenant files) if you are unsure if your local Anthem BCBS is the
1. same configuration, review the specs attached to the article & compare

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

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