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. Harvard Pilgrim Health Care (HPHC)
258. Hawaii Dental Services aka Delta Dental of Hawaii
259. Hawaii Mainland Administrators
260. Hawaii Medical Assurance Association (HMAA)
261. Health Alliance Plan (connected via Data Exchange)
262. Health Alliance Plan of Michigan
263. Health Benefit Alliance
264. Health Design Plus
265. Health First Health Plan
266. Healthcare Highways
267. Healthcare Management Administrators
268. HealthEZ - (also Multi-tenant files)
269. Healthgram
270. Healthiest You
271. HealthNet
272. HealthNow New York
273. HealthPartners
274. HealthScope
275. HealthSmart
276. HealthyCT
277. Health Plans, Inc
278. Health Plan of Nevada
279. Health Net of California
280. Health New England
281. Health Resources Inc
282. Heritage Vision Plan
283. Highmark (also Multi-tenant files)
284. Horizon Blue Cross Blue Shield of NJ
285. Homestead
286. Hometown Health
287. Humana - (also Multi-tenant files)
288. IBA Flexible Benefit Solutions
289. Imagine360
290. Independence Administrators*
291. Independence Blue Cross
292. Independent Health
293. Innovative Health Services
294. Inshore Benefits
295. Indiana University Health aka IU Health
296. Innovative Health Services*
297. Insight Benefit Administrators
298. Insurance Management Services (IMS)*
299. Integrated Payor Solutions (IPS)
300. Interactive Medical Systems (IMS)
301. International Benefit Administrators TPA
302. Iowa Bankers Insurance & Services (IBIS)
303. Kaiser Permanente
304. Kaiser Permanente of WA
305. Kaiser Permanente of California
306. Kaiser Permanente Mid Atlantic Standard
307. Kaiser Foundation Health Plan of the Northwest
308. Kansas City Life
309. Kentucky Health Administrators
310. Key Benefit Administrators
311. Landmark Health
312. Leading Edge Administrators
313. Level
314. Liberty Dental Plan
315. LifeMap*
316. Lifetime Benefit Solutions
317. Lincoln Financial Group (LFG)
318. Lucent Health
319. Luminare Health
320. Lyra Health
321. Lyric
322. Maestro Health
323. Managed Care of America, Inc.
324. Marpai Health
325. Mass General Brigham (previously known as AllWays Health Partners)*
326. MBA Benefit Administrators
327. Med-Pay
328. MedBen*
329. Medcost
330. Medica
331. Medical Associates Health Plans
332. Medical Mutual of Ohio
333. MediExcel
334. MedImpact
335. MediOrbis
336. Medova Healthcare Financial Group
337. Medtipster (also Multi-tenant files)
338. MercyCare
339. Meritain Health (also Multi-tenant files)
340. MESVision
341. MESSA
342. Metlife
343. MODA Health (merged w/Delta Dental of OR)
344. Morgan White Group
345. MotivHealth Insurance Company
346. Mountain Health CO-OP
347. Mutual Health Services
348. Mutual of Omaha
349. MVP Health Care
350. Navitus
351. Neighborhood Health Plan
352. Network Health
353. New Benefits
354. Nippon Life Benefits
355. Northeast Delta Dental
356. Nova Healthcare
357. NVA-National Vision Administrators
358. OnDemand Healthcare
359. One to One Health
360. Opticare of Utah
361. Optilegra
362. Optim RX
363. Optimed
364. Optiplan
365. Oxford Health Plans (UHC subsidiary)
366. PACE
367. PacificSource Health Plans
368. Pan-American Life Insurance Group
369. Paramount Health
370. Patient Advocates
371. Pequot Plus Health Care
372. Personify Health (Formerly HealthComp)
373. PharmAvail
374. PHP TPA Services
375. Physicians Eyecare Plan
376. Physicians Health Plans (PHP)
377. Piedmont Community Health Plan
378. Pinnacle Claims Management (PCMI)
379. Planned Administrators Inc
380. Point C
381. PPi Benefit Solutions
382. Prairie States*
383. Precision Group Administrators
384. Premera Blue Cross
385. Premier Access
386. Presbyterian Health Plan (PHP)
387. Prescription Network
388. Prevea360
389. Priority Health (also Multi-tenant files)
390. Principal Financial Group
391. ProAct, Inc.
392. ProCare
393. ProClaim*
394. Professional Benefits Administrators (PBA)
395. Prominence Health Plan
396. Providence Health Plans
397. Public Employees Health Plan (PEHP)
398. QualChoice
399. Quartz Benefits
400. R&T Inc.
401. Regence Blue Shield of Idaho
402. Regence BCBS of Utah - Benefitfocus platform
403. Regence BCBS of Oregon
404. Regional Care Inc. (RCI)
405. Regence Group Administrators (RGA)
406. Reliance Standard
407. Renaissance Dental
408. Rightway Healthcare
409. Risk Program Administrators (RPA)
410. Rx 'n Go
411. RXBenefits
412. S&S Healthcare
413. Samaritan Health Plans
414. Sana Benefits
415. Sanford Health
416. Santeon
417. SBMA Benefits
418. Scott & White Health Plans
419. ScriptGuide Rx, Inc. (SGRX)
420. Script Care
421. Security Health Plan
422. SelectHealth** (also Multi-tenant files)
423. Selman Company
424. Sentara Health
425. Sharp Healthcare
426. Sidecar Health
427. SISC (Self-Insured Schools of California)
428. SISCO
429. SIHO
430. SIMNSA
431. Solstice (also Multi-tenant files)
432. SOTA Benefits
433. Southern Scripts
434. St. Luke’s Health Plan
435. Standard Insurance Company
436. Starmark
437. SummaCare
438. Sun Life Financial
439. Superior Dental (now Versant Health)
440. Superior Vision ( now Versant Health)
441. Surency
442. Surest
443. Sutter Health Plus
444. SVS Vision
445. Symetra
446. Tall Tree Administrators*
447. Teladoc
448. Ternian
449. The Boon Group*
450. The Health Plan
451. The Kempton Group
452. The Loomis Company*
453. The Standard
454. The Vitality Group
455. 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.
456. TLC Benefit Solutions, Inc.
457. Total Dental Administrators
458. Total Health Care
459. Transwestern Insurance Administrators
460. Tres Health
461. Trinity Marketing Services
462. Tristar Benefit Administrator
463. TRS Medical Insurance
464. TruAssure
465. True Rx Health Strategists
466. Trustmark Insurance Co.
467. Tufts Health Plan
468. TX Health Benefits Pool
469. UCHealth Plan Administrators
470. UHP Administrators
471. UltraBenefits
472. Unified Group Services
473. United Agriculture Benefit Trust
474. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only) (also Multi-tenant file)
475. United Heritage Insurance
476. United Concordia
477. Univera Healthcare (also Multi-Tenant file)
478. University Health Alliance (UHA)
479. University of Utah Health Plans
480. UNIVision & Dental Healthcare
481. UNUM
482. UMR
483. UPMC Health Plan
484. USA Vision
485. Vantage Health Plan
486. Vault Strategies
487. Versant Health
488. Vimly
489. Virtual Benefits Administrator (also Multi-Tenant file)
490. Vision Benefit Administrators
491. Vision Benefits of America*
492. Vision Care Direct
493. The Vitality Group
494. Vitori
495. Viva Health (also Multi Tenant)
496. VSP (also Multi-tenant files)
497. Vytlone
498. Web TPA
499. Western Dental
500. Western Growers Assurance Trust (WGA)
501. Western Health Advantage
502. Wellmark Blue Cross Blue Shield of Iowa
503. Wellmark Blue Cross Blue Shield of South Dakota
504. WellNet (also Multi-tenant files)
505. Willamette Dental
506. Wisconsin Physicians Service (WPS Health Insurance)
507. 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.