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
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. 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. EVO First, Inc.
219. Excellus Blue Cross Blue Shield
220. Exemplar Health
221. Express Scripts
222. Eyemed (also Multi-tenant files)
223. Eyetopia
224. Fallon Health (4010 format)
225. Fidelio Dental
226. First Choice Health
227. First Continental
228. First Stop Health
229. FirstCare Health Plans
230. Fountain Health
231. Florida Combined Life
232. Flume Health
233. Fountain Health
234. Fox Everett
235. Freedom Claims Management Inc (FCMI)
236. Fringe Benefit Group (FBG)
237. Geaux Health (also Multi-tenant files)
238. Geisinger Health Plan
239. GeniusAve
240. Gilsbar
241. GISC
242. GMR Health Care
243. Golden Dental
244. GPA
245. Gravie
246. Group Administrators Ltd
247. Group Benefit Services (GBS)
248. Group Health Plan of South Central Wisconsin (GHPSCW)
249. Group Vision Services
250. Guardian (also Multi-tenant files)
251. Gulf Guaranty Life Insurance Co
252. Harvard Pilgrim Health Care (HPHC)
253. Hawaii Dental Services aka Delta Dental of Hawaii
254. Hawaii Mainland Administrators
255. Hawaii Medical Assurance Association (HMAA)
256. Health Alliance Plan (connected via Data Exchange)
257. Health Alliance Plan of Michigan
258. Health Benefit Alliance
259. Health Design Plus
260. Health First Health Plan
261. Healthcare Highways
262. Healthcare Management Administrators
263. HealthEZ - (also Multi-tenant files)
264. HealthComp
265. Healthgram
266. Healthiest You
267. HealthNet
268. HealthNow New York
269. HealthPartners
270. HealthScope
271. HealthSmart
272. HealthyCT
273. Health Plans, Inc
274. Health Plan of Nevada
275. Health Net of California
276. Health New England
277. Health Resources Inc
278. Heritage Vision Plan
279. Highmark (also Multi-tenant files)
280. Horizon Blue Cross Blue Shield of NJ
281. Homestead
282. Hometown Health
283. Humana - (also Multi-tenant files)
284. IBA Flexible Benefit Solutions
285. Imagine360
286. Independence Administrators*
287. Independence Blue Cross
288. Independent Health
289. Innovative Health Services
290. Inshore Benefits
291. Indiana University Health aka IU Health
292. Innovative Health Services*
293. Insight Benefit Administrators
294. Insurance Management Services (IMS)*
295. Integrated Payor Solutions (IPS)
296. Interactive Medical Systems (IMS)
297. International Benefit Administrators TPA
298. Iowa Bankers Insurance & Services (IBIS)
299. Kaiser Permanente
300. Kaiser Permanente of WA
301. Kaiser Permanente of California
302. Kaiser Permanente Mid Atlantic Standard
303. Kansas City Life
304. Kentucky Health Administrators
305. Key Benefit Administrators
306. Leading Edge Administrators
307. Level
308. Liberty Dental Plan
309. LifeMap*
310. Lifetime Benefit Solutions
311. Lincoln Financial Group (LFG)
312. Lucent Health
313. Luminare Health
314. Lyra Health
315. Lyric
316. Maestro Health
317. Managed Care of America, Inc.
318. Marpai Health
319. Mass General Brigham (previously known as AllWays Health Partners)*
320. Maxor Administrative Services
321. MBA Benefit Administrators
322. Med-Pay
323. MedBen*
324. Medcost
325. Medica
326. Medical Associates Health Plans
327. Medical Mutual of Ohio
328. MediExcel
329. MedImpact
330. MediOrbis
331. Medova Healthcare Financial Group
332. Medtipster (also Multi-tenant files)
333. MercyCare
334. Meritain Health (also Multi-tenant files)
335. MESVision
336. MESSA
337. Metlife
338. MODA Health (merged w/Delta Dental of OR)
339. Morgan White Group
340. MotivHealth Insurance Company
341. Mountain Health CO-OP
342. Mutual Health Services
343. Mutual of Omaha
344. MVP Health Care
345. Navitus
346. Neighborhood Health Plan
347. Network Health
348. New Benefits
349. Nippon Life Benefits
350. Northeast Delta Dental
351. Nova Healthcare
352. NVA-National Vision Administrators
353. OnDemand Healthcare
354. Opticare of Utah
355. Optim RX
356. Optimed
357. Oxford Health Plans (UHC subsidiary)
358. PACE
359. PacificSource Health Plans
360. Pan-American Life Insurance Group
361. Paramount Health
362. Patient Advocates
363. Pequot Plus Health Care
364. PharmAvail
365. PHP TPA Services
366. Physicians Eyecare Plan
367. Physicians Health Plans (PHP)
368. Piedmont Community Health Plan
369. Pinnacle Claims Management (PCMI)
370. Planned Administrators Inc
371. PPi Benefit Solutions
372. Prairie States*
373. Precision Group Administrators
374. Premera Blue Cross
375. Premier Access
376. Presbyterian Health Plan (PHP)
377. Prescription Network
378. Prevea360
379. Priority Health (also Multi-tenant files)
380. Principal Financial Group
381. ProAct, Inc.
382. ProCare
383. ProClaim*
384. Professional Benefits Administrators (PBA)
385. Prominence Health Plan
386. Providence Health Plans
387. Public Employees Health Plan (PEHP)
388. QualChoice
389. Quartz Benefits
390. R&T Inc.
391. Regence Blue Shield of Idaho
392. Regence BCBS of Utah - Benefitfocus platform
393. Regence BCBS of Oregon
394. Regional Care Inc. (RCI)
395. Reliance Standard
396. Renaissance Dental
397. Rightway Healthcare
398. Risk Program Administrators (RPA)
399. Rx 'n Go
400. RXBenefits
401. S&S Healthcare
402. Samaritan Health Plans
403. Sana Benefits
404. Sanford Health
405. Santeon
406. SBMA Benefits
407. Scott & White Health Plans
408. Script Care
409. Security Health Plan
410. SelectHealth** (also Multi-tenant files)
411. Selman Company
412. Sentara Health
413. Sharp Healthcare
414. Sidecar Health
415. SISCO
416. SIHO
417. SIMNSA
418. Solstice (also Multi-tenant files)
419. Southern Scripts
420. St. Luke’s Health Plan
421. Standard Insurance Company
422. Starmark
423. SummaCare
424. Sun Life Financial
425. Superior Dental (now Versant Health)
426. Superior Vision ( now Versant Health)
427. Surency
428. Surest
429. Sutter Health Plus
430. SVS Vision
431. Symetra
432. Tall Tree Administrators*
433. Teladoc
434. Ternian
435. The Boon Group*
436. The Health Plan
437. The Kempton Group
438. The Loomis Company*
439. The Standard
440. The Vitality Group
441. 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.
442. TLC Benefit Solutions, Inc.
443. Total Dental Administrators
444. Total Health Care
445. Trinity Marketing Services
446. Tristar Benefit Administrator
447. TRS Medical Insurance
448. TruAssure
449. True Rx Health Strategists
450. Trustmark Insurance Co.
451. Tufts Health Plan
452. TX Health Benefits Pool
453. UCHealth Plan Administrators
454. UHP Administrators
455. UltraBenefits
456. Unified Group Services
457. United Agriculture Benefit Trust
458. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET
platform only) (also Multi-tenant file)
459. United Heritage Insurance
460. United Concordia
461. Univera Healthcare
462. University Health Alliance (UHA)
463. University of Utah Health Plans
464. UNUM
465. UMR
466. UPMC Health Plan
467. Vantage Health Plan
468. Versant Health
469. Vimly
470. Virtual Benefits Administrator (also Multi-Tenant file)
471. Vision Benefit Administrators
472. Vision Benefits of America*
473. Vision Care Direct
474. The Vitality Group
475. Vitori
476. Viva Health (also Multi Tenant)
477. VSP (also Multi-tenant files)
478. Web TPA
479. Western Dental
480. Western Growers Assurance Trust (WGA)
481. Western Health Advantage
482. Wellmark Blue Cross Blue Shield of Iowa
483. WellNet (also Multi-tenant files)
484. Willamette Dental
485. Wisconsin Physicians Service (WPS Health Insurance)
486. 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.