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 HIPPA 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 as the exception.
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. Acuity Group
3. Administrative Concepts Inc (ACI)
4. ADN Administrators (also Multi-tenant files)
5. Advantage Health Solutions
6. Advantica
7. Advisory Health Administrators (Transperra)
8. Aetna
9. Aither Health Plan (also Multi-tenant files)
10. Allegiance
11. Allied Benefit Systems
12. AllWays Health Partners*
13. Always Care
14. Altus Dental
15. Amerihealth
16. Ameritas
17. AmeriBen
18. American Health Resources (AHR)
19. Anchor Benefits Advisors
20. 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

21. Anthem BCBS of Colorado
22. Anthem BCBS of Maine
23. Anthem BCBS of Missouri
24. Anthem BCBS of Nevada
25. Anthem BCBS of New Hampshire
26. Anthem BCBS of Ohio
27. Anthem BCBS of Kentucky
28. Anthem Dental Only
29. Anthem Life
30. Anthem of California
31. Anthem of Connecticut
32. Anthem of Virginia - BenefitFocus platform
33. Apostrophe Health
34. ARC Administrators
35. Argus Dental
36. ASI
37. ASR Health Benefits
38. Assured Benefit Administrators
39. Assurant - Dental & Vision only
40. AultCare
41. Automated Benefit Services
42. Auxiant
43. Avesis Vision
44. AvMed Health Plans
45. AXA Equitable
46. Baptist Health Plan
47. BAC / Benefits Administration Co)
48. Bay Bridge Administrators
49. BCBS (General 5010 format not tied to a specific state)
50. BCBS of Alabama
51. BCBS of Arizona
52. BCBS of Arkansas (also Multi-tenant files)
53. BCBS of Florida - aka Florida Blue
54. BCBS of Georgia - Anthem platform
55. BCBS of Illinois**
56. BCBS of Kansas
57. BCBS of KC
58. BCBS of LA (also Multi-tenant files)
59. BCBS of Massachusetts (also Multi-tenant files)
60. BCBS of Michigan** - (also Multi-tenant files)
61. BCBS of Minnesota
62. BCBS of Mississippi
63. BCBS of Montana
64. BCBS of Nebraska
65. BCBS of New Mexico
66. BCBS of North Carolina
67. BCBS of North Dakota
68. BCBS of Oklahoma
69. Highmark BCBS North East Pennsylvania
70. BCBS of Rhode Island
71. BCBS of South Carolina
72. BCBS of Tennessee (also Multi-tenant files)
73. BCBS of Texas**
74. BCBS of Vermont
75. BCBS of West Virginia (Highmark)
76. BCBS of Western NY
77. BeneCard
78. Benefit & Risk Management Services
79. Benefit Administration Services
80. Benefit Coordinators Corporation (BCC) (also Multi-tenant files)
81. Benefit Management Inc.
82. Benefit Plan Administrators
83. BeniComp Health Solutions
84. Beta Dental
85. Blackhawk TPA
86. Blue Benefit Administrators of MA
87. Blue Care Network
88. Blue Cross of Idaho
89. Blue Shield of California
90. Blue Shield of North Eastern New York
91. Boon Group
92. Boon-Chapman
93. Breckpoint
94. Bright Benefits
95. Brighter Dental
96. California Dental Network
97. Calvo's SelectCare
98. Capital Blue Cross - (also Multi-tenant files)
99. Capital Health Plan
100. Capital Rx
101. Capitol Administrators, Inc.
102. Caprock Health Plans
103. Carefirst
104. Carefirst Administrators**
105. CarePlus Dental
106. CBA Blue (also Multi-tenant files)
107. CDPHP

108. Century Healthcare
109. Centivo
110. CGS Health Care
111. Christian Brothers Services
112. CieloStar
113. Cigna (also Multi-tenant files)
114. Cigna Select
115. Coastal Administrative Services
116. Collective Health
117. Community Care
118. Companion Life
119. Compass Health
120. ConnectiCare*
121. Consociate Health
122. Continental Benefits (Well Systems)
123. CoreSource* (aka Trustmark)
124. Coventry
125. Cox Health Plans
126. CRX International aka CanaRx
127. CVS Caremark
128. CWI Benefits, LLC*
129. Cypress Ancillary Benefits
130. Cypress Benefit Administrators
131. Davis Vision
132. Dean Care
133. 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)
134. Delta Dental of Alabama
135. Delta Dental of Arizona
136. Delta Dental of Arkansas
137. Delta Dental of California
138. Delta Dental of Colorado
139. Delta Dental of Georgia
140. Delta Dental of Idaho
141. Delta Dental of Illinois
142. Delta Dental of Indiana
143. Delta Dental of Iowa
144. Delta Dental of Kansas
145. Delta Dental of Kentucky
146. Delta Dental of Massachusetts
147. Delta Dental of Michigan - (also Multi-tenant files)
148. Delta Dental of Minnesota
149. Delta Dental of Missouri
150. Delta Dental of New Jersey
151. Delta Dental of New York
152. Delta Dental of North Carolina
153. Delta Dental of the Northeast
154. Delta Dental of Ohio
155. Delta Dental of Oklahoma
156. Delta Dental of Oregon
157. Delta Dental of Pennsylvania
158. Delta Dental of South Dakota
159. Delta Dental of Tennessee
160. Delta Dental of Utah
161. Delta Dental of Virginia
162. Delta Dental of Washington*
163. Delta Dental of Wisconsin
164. Delta Dental of Wyoming
165. Delta Health Systems
166. Delta Vision
167. DENCAP
168. Dental Care Plus Group
169. Dental Select
170. Dental Services Organization
171. Dentist Direct
172. Dentaquest
173. Dominion Dental Services
174. EBA&M
175. EBMS
176. EBPA (also Multi-tenant files)
177. EHIM
178. Elixir Solutions
179. Emblem Health
180. EMI Health
181. Empire Blue Cross Blue Shield (also Multi-tenant files)
182. Equipoint Partners
183. Everence Financial
184. Excellus Blue Cross Blue Shield
185. Express Scripts
186. Eyemed (also Multi-tenant files)
187. Fallon Health (4010 format)
188. First Choice Health
189. First Stop Health
190. FirstCare Health Plans
191. Fountain Health
192. Florida Combined Life
193. Flume Health
194. Fringe Benefit Group (FBG)
195. Geisinger Health Plan
196. GeniusAve
197. Gilsbar
198. GMR Health Care
199. Golden Dental
200. GPA
201. Gravie
202. Group Administrators Ltd
203. Group Benefit Services (GBS)
204. Group Health Plan of South Central Wisconsin (GHPSCW)
205. Group Vision Services
206. Guardian (also Multi-tenant files)
207. Harvard Pilgrim Health Care (HPHC)
208. Hawaii Dental Services aka Delta Dental of Hawaii
209. Hawaii Mainland Administrators
210. Health Alliance Plan (connected via Data Exchange)
211. Health Alliance Plan of Michigan
212. Health Design Plus
213. Health First Health Plan
214. Healthcare Highways
215. Healthcare Management Administrators
216. HealthEZ - (also Multi-tenant files)
217. HealthComp
218. Healthgram
219. Healthiest You
220. HealthNet
221. HealthNow New York
222. HealthPartners
223. HealthScope
224. HealthSmart
225. Health Plans, Inc
226. Health Plan of Nevada
227. Health Net of California
228. Health New England
229. Health Resources Inc
230. Heritage Vision Plan
231. Highmark (also Multi-tenant files)
232. Horizon Blue Cross Blue Shield of NJ
233. Homestead
234. Hometown Health
235. Humana - (also Multi-tenant files)
236. Imagine360
237. Independence Administrators*
238. Independence Blue Cross
239. Independent Health
240. Indiana University Health aka IU Health
241. Innovative Health Services*
242. Insight Benefit Administrators
243. Insurance Management Services (IMS)*
244. Integrated Payor Solutions (IPS)
245. Interactive Medical Systems (IMS)
246. Iowa Bankers Insurance & Services (IBIS)
247. Kaiser Permanente
248. Kaiser Permanente of WA
249. Kaiser Permanente of California
250. Kaiser Permanente Mid Atlantic Standard
251. Kansas City Life
252. Key Benefit Administrators
253. Leading Edge Administrators
254. Liberty Dental Plan (request support to pull in to your group)
255. LifeMap*
256. Lincoln Financial Group (LFG)
257. Lyra Health
258. Lyric
259. Maestro Health
260. Managed Care of America, Inc.
261. Maxor Administrative Services
262. Med-Pay
263. MedBen*
264. Medcost
265. Medica
266. Medical Associates Health Plans
267. Medical Mutual of Ohio
268. MedImpact
269. Medova Healthcare Financial Group
270. Medtipster (also Multi-tenant files)
271. MercyCare
272. Meritain Health
273. MESVision
274. MESSA
275. Metlife
276. MODA Health (merged w/Delta Dental of OR)
277. Morgan White Group
278. MotivHealth Insurance Company
279. Mountain Health CO-OP
280. Mutual of Omaha
281. MVP Health Care
282. Navitus
283. Network Health
284. New Benefits
285. Nova Healthcare
286. NVA-National Vision Administrators
287. OnDemand Healthcare
288. Opticare of Utah
289. Optim RX
290. Optima Health
291. Optimed
292. Oxford Health Plans (UHC subsidiary)
293. PacificSource Health Plans
294. Pan-American Life Insurance Group
295. Paramount Health
296. Patient Advocates
297. Pequot Plus Health Care
298. PharmAvail
299. PHP TPA Services
300. Physicians Eyecare Plan
301. Physicians Health Plans (PHP)
302. Planned Administrators Inc
303. Prairie States*
304. Premera Blue Cross
305. Premier Access
306. Presbyterian Health Plan (PHP)
307. Prevea360
308. Priority Health (also Multi-tenant files)
309. Principal Financial Group
310. ProAct, Inc.
311. ProClaim*
312. Professional Benefits Administrators (PBA)
313. Prominence Health Plan
314. Providence Health Plans
315. Public Employees Health Plan (PEHP)
316. QualChoice
317. Quartz Benefits
318. Regence Blue Shield of Idaho
319. Regence BCBS of Utah - Benefitfocus platform
320. Regence BCBS of Oregon
321. Regional Care Inc. (RCI)
322. Reliance Standard
323. Renaissance Dental
324. Rightway Healthcare
325. Rx 'n Go
326. S&S Healthcare
327. Samaritan Health Plans
328. Sana Benefits
329. SBMA Benefits
330. Scott & White Health Plans
331. Script Care
332. Security Health Plan
333. SelectHealth** (also Multi-tenant files)
334. Selman Company
335. Sidecar Health
336. SISCO
337. SIHO
338. SIMNSA
339. Solstice (also Multi-tenant files)
340. Southern Scripts
341. Standard Insurance Company
342. Starmark
343. SummaCare
344. Sun Life Financial
345. Superior Dental (now Versant Health)
346. Superior Vision ( now Versant Health)
347. Surency
348. Surest
349. Sutter Health Plus
350. SVS Vision
351. Symetra
352. Tall Tree Administrators*
353. Teladoc
354. The Boon Group*
355. The Health Plan
356. The Kempton Group
357. The Loomis Company*
358. 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.
359. TLC Benefit Solutions, Inc.
360. Total Dental Administrators
361. Tristar Benefit Administrator
362. TRS Medical Insurance
363. Trustmark Insurance Co.
364. Tufts Health Plan
365. TX Health Benefits Pool
366. UCHealth Plan Administrators
367. UHP Administrators
368. UltraBenefits
369. Unified Group Services
370. United Agriculture Benefit Trust
371. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET
platform only) (also Multi-tenant file)
372. United Heritage Insurance
373. United Concordia
374. Univera Healthcare
375. University Health Alliance (UHA)
376. University of Utah Health Plans
377. UNUM
378. UMR
379. UPMC Health Plan
380. Vantage Health Plan
381. Versant Health
382. Virtual Benefits Administrator (also Multi-Tenant file)
383. Vision Benefits of America*
384. Vision Care Direct
385. The Vitality Group
386. Viva Health (also Multi Tenant)
387. VSP (also Multi-tenant files)
388. Web TPA
389. Western Growers Assurance Trust (WGA)
390. Western Health Advantage
391. Wellmark Blue Cross Blue Shield of Iowa
392. WellNet (also Multi-tenant files)
393. Willamette Dental
394. Wisconsin Physicians Service (WPS Health Insurance)
*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.