Marketplace

EDI 834

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 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. 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. Angle Health
21. 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

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

110. Century Healthcare
111. Centivo
112. CGS Health Care
113. Christian Brothers Services
114. CieloStar
115. Cigna (also Multi-tenant files)
116. Cigna Select
117. Coastal Administrative Services
118. Collective Health
119. Community Care
120. Companion Life
121. Compass Health
122. ConnectiCare*
123. Consociate Health
124. Continental Benefits (Well Systems)
125. CoreSource* (aka Trustmark)
126. Coventry
127. Cox Health Plans
128. CRX International aka CanaRx
129. CVS Caremark
130. CWI Benefits, LLC*
131. Cypress Ancillary Benefits
132. Cypress Benefit Administrators
133. Davis Vision
134. Dean Care
135. 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)
136. Delta Dental of Alabama
137. Delta Dental of Arizona
138. Delta Dental of Arkansas
139. Delta Dental of California
140. Delta Dental of Colorado
141. Delta Dental of Georgia
142. Delta Dental of Idaho
143. Delta Dental of Illinois
144. Delta Dental of Indiana
145. Delta Dental of Iowa
146. Delta Dental of Kansas
147. Delta Dental of Kentucky
148. Delta Dental of Massachusetts
149. Delta Dental of Michigan - (also Multi-tenant files)
150. Delta Dental of Minnesota
151. Delta Dental of Missouri
152. Delta Dental of New Jersey
153. Delta Dental of New York
154. Delta Dental of North Carolina
155. Delta Dental of the Northeast
156. Delta Dental of Ohio
157. Delta Dental of Oklahoma
158. Delta Dental of Oregon
159. Delta Dental of Pennsylvania
160. Delta Dental of South Dakota
161. Delta Dental of Tennessee
162. Delta Dental of Utah
163. Delta Dental of Virginia
164. Delta Dental of Washington*
165. Delta Dental of Wisconsin
166. Delta Dental of Wyoming
167. Delta Health Systems
168. Delta Vision
169. DENCAP
170. Dental Care Plus Group
171. Dental Select
172. Dental Services Organization
173. Dentist Direct
174. Dentaquest
175. Dominion Dental Services
176. EBA&M
177. EBMS
178. EBPA (also Multi-tenant files)
179. EHIM
180. Elixir Solutions
181. Emblem Health
182. EMI Health
183. Empire Blue Cross Blue Shield (also Multi-tenant files)
184. Employer Driven Insurance Services (EDIS)
185. Equipoint Partners
186. Everence Financial
187. Excellus Blue Cross Blue Shield
188. Express Scripts
189. Eyemed (also Multi-tenant files)
190. Fallon Health (4010 format)
191. First Choice Health
192. First Stop Health
193. FirstCare Health Plans
194. Fountain Health
195. Florida Combined Life
196. Flume Health
197. Fringe Benefit Group (FBG)
198. Geisinger Health Plan
199. GeniusAve
200. Gilsbar
201. GMR Health Care
202. Golden Dental
203. GPA
204. Gravie
205. Group Administrators Ltd
206. Group Benefit Services (GBS)
207. Group Health Plan of South Central Wisconsin (GHPSCW)
208. Group Vision Services
209. Guardian (also Multi-tenant files)
210. Harvard Pilgrim Health Care (HPHC)
211. Hawaii Dental Services aka Delta Dental of Hawaii
212. Hawaii Mainland Administrators
213. Health Alliance Plan (connected via Data Exchange)
214. Health Alliance Plan of Michigan
215. Health Design Plus
216. Health First Health Plan
217. Healthcare Highways
218. Healthcare Management Administrators
219. HealthEZ - (also Multi-tenant files)
220. HealthComp
221. Healthgram
222. Healthiest You
223. HealthNet
224. HealthNow New York
225. HealthPartners
226. HealthScope
227. HealthSmart
228. Health Plans, Inc
229. Health Plan of Nevada
230. Health Net of California
231. Health New England
232. Health Resources Inc
233. Heritage Vision Plan
234. Highmark (also Multi-tenant files)
235. Horizon Blue Cross Blue Shield of NJ
236. Homestead
237. Hometown Health
238. Humana - (also Multi-tenant files)
239. Imagine360
240. Independence Administrators*
241. Independence Blue Cross
242. Independent Health
243. Indiana University Health aka IU Health
244. Innovative Health Services*
245. Insight Benefit Administrators
246. Insurance Management Services (IMS)*
247. Integrated Payor Solutions (IPS)
248. Interactive Medical Systems (IMS)
249. International Benefit Administrators TPA
250. Iowa Bankers Insurance & Services (IBIS)
251. Kaiser Permanente
252. Kaiser Permanente of WA
253. Kaiser Permanente of California
254. Kaiser Permanente Mid Atlantic Standard
255. Kansas City Life
256. Key Benefit Administrators
257. Leading Edge Administrators
258. Level
259. Liberty Dental Plan
260. LifeMap*
261. Lincoln Financial Group (LFG)
262. Luminare Health
263. Lyra Health
264. Lyric
265. Maestro Health
266. Managed Care of America, Inc.
267. Maxor Administrative Services
268. Med-Pay
269. MedBen*
270. Medcost
271. Medica
272. Medical Associates Health Plans
273. Medical Mutual of Ohio
274. MediExcel
275. MedImpact
276. Medova Healthcare Financial Group
277. Medtipster (also Multi-tenant files)
278. MercyCare
279. Meritain Health
280. MESVision
281. MESSA
282. Metlife
283. MODA Health (merged w/Delta Dental of OR)
284. Morgan White Group
285. MotivHealth Insurance Company
286. Mountain Health CO-OP
287. Mutual of Omaha
288. MVP Health Care
289. Navitus
290. Network Health
291. New Benefits
292. Nova Healthcare
293. NVA-National Vision Administrators
294. OnDemand Healthcare
295. Opticare of Utah
296. Optim RX
297. Optimed
298. Oxford Health Plans (UHC subsidiary)
299. PACE
300. PacificSource Health Plans
301. Pan-American Life Insurance Group
302. Paramount Health
303. Patient Advocates
304. Pequot Plus Health Care
305. PharmAvail
306. PHP TPA Services
307. Physicians Eyecare Plan
308. Physicians Health Plans (PHP)
309. Planned Administrators Inc
310. Prairie States*
311. Premera Blue Cross
312. Premier Access
313. Presbyterian Health Plan (PHP)
314. Prevea360
315. Priority Health (also Multi-tenant files)
316. Principal Financial Group
317. ProAct, Inc.
318. ProClaim*
319. Professional Benefits Administrators (PBA)
320. Prominence Health Plan
321. Providence Health Plans
322. Public Employees Health Plan (PEHP)
323. QualChoice
324. Quartz Benefits
325. Regence Blue Shield of Idaho
326. Regence BCBS of Utah - Benefitfocus platform
327. Regence BCBS of Oregon
328. Regional Care Inc. (RCI)
329. Reliance Standard
330. Renaissance Dental
331. Rightway Healthcare
332. Rx 'n Go
333. S&S Healthcare
334. Samaritan Health Plans
335. Sana Benefits
336. Sanford Health
337. SBMA Benefits
338. Scott & White Health Plans
339. Script Care
340. Security Health Plan
341. SelectHealth** (also Multi-tenant files)
342. Selman Company
343. Sentara Health
344. Sidecar Health
345. SISCO
346. SIHO
347. SIMNSA
348. Solstice (also Multi-tenant files)
349. Southern Scripts
350. Standard Insurance Company
351. Starmark
352. SummaCare
353. Sun Life Financial
354. Superior Dental (now Versant Health)
355. Superior Vision ( now Versant Health)
356. Surency
357. Surest
358. Sutter Health Plus
359. SVS Vision
360. Symetra
361. Tall Tree Administrators*
362. Teladoc
363. The Boon Group*
364. The Health Plan
365. The Kempton Group
366. The Loomis Company*
367. 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.
368. TLC Benefit Solutions, Inc.
369. Total Dental Administrators
370. Tristar Benefit Administrator
371. TRS Medical Insurance
372. Trustmark Insurance Co.
373. Tufts Health Plan
374. TX Health Benefits Pool
375. UCHealth Plan Administrators
376. UHP Administrators
377. UltraBenefits
378. Unified Group Services
379. United Agriculture Benefit Trust
380. United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET
platform only) (also Multi-tenant file)
381. United Heritage Insurance
382. United Concordia
383. Univera Healthcare
384. University Health Alliance (UHA)
385. University of Utah Health Plans
386. UNUM
387. UMR
388. UPMC Health Plan
389. Vantage Health Plan
390. Versant Health
391. Virtual Benefits Administrator (also Multi-Tenant file)
392. Vision Benefits of America*
393. Vision Care Direct
394. The Vitality Group
395. Viva Health (also Multi Tenant)
396. VSP (also Multi-tenant files)
397. Web TPA
398. Western Growers Assurance Trust (WGA)
399. Western Health Advantage
400. Wellmark Blue Cross Blue Shield of Iowa
401. WellNet (also Multi-tenant files)
402. Willamette Dental
403. 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.

Participating EDI 834 Partners