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 Benefits Advisors
22. Angle Health
23. 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

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