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.
90 Degree Benefits
Access Health Services, LLC
Acuity Group
Administrative Concepts Inc (ACI)
ADN Administrators (also Multi-tenant files)
Advantage Health Solutions
Advantica
Advisory Health Administrators (Transperra)
Aetna
Aither Health Plan (also Multi-tenant files)
Allegeant
Allegiance
Allied Benefit Systems
Altus Dental
Always Care
Amerihealth
Ameritas
AmeriBen
American Health Resources (AHR)
American Plan Administrators
Anchor Benefit Consulting
Anchor Benefits Advisors
Angle Health
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
Anthem Blue Cross (Blue Cross of CA)
Anthem BCBS of Colorado
Anthem BCBS of Maine
Anthem BCBS of Missouri
Anthem BCBS of Nevada
Anthem BCBS of New Hampshire
Anthem BCBS of Ohio
Anthem BCBS of Kentucky
Anthem Dental Only
Anthem of California
Anthem of Connecticut
Anthem of Virginia - BenefitFocus platform
Apostrophe Health
ARC Administrators
Argus Dental
ASI
Aspirus Health Plan
ASR Health Benefits
Associated Employers
Assured Benefit Administrators
Assurant - Dental & Vision only
Asuris Northwest Health
AudioNET
AultCare
Automated Benefit Services
Auxiant
Avesis Vision
Avera
AvMed Health Plans
AXA Equitable
Baptist Health Plan
BAC / Benefits Administration Co)
Bay Bridge Administrators
BCBS (General 5010 format not tied to a specific state)
BCBS of Alabama
BCBS of Arizona
BCBS of Arkansas (also Multi-tenant files)
BCBS of Florida - aka Florida Blue
BCBS of Georgia - Anthem platform
BCBS of Illinois**
BCBS of Kansas
BCBS of KC
BCBS of LA (also Multi-tenant files)
BCBS of Massachusetts (also Multi-tenant files)
BCBS of Michigan** - (also Multi-tenant files)
BCBS of Minnesota
BCBS of Mississippi
BCBS of Montana
BCBS of Nebraska
BCBS of New Mexico
BCBS of North Carolina
BCBS of North Dakota
BCBS of Oklahoma
Highmark BCBS North East Pennsylvania
BCBS of Rhode Island
BCBS of South Carolina
BCBS of Tennessee (also Multi-tenant files)
BCBS of Texas**
BCBS of Vermont
BCBS of West Virginia (Highmark)
BCBS of Western NY
Beazley
BeneCard
Benefit & Risk Management Services
Benefit Administration Services
Benefit Administrators, Inc.
Benefit Coordinators Corporation (BCC) (also Multi-tenant files)
Benefit Management Inc.
Benefit Plan Administrators
BeniComp Health Solutions
Beni Solutions
Bento Dental
Beta Dental
Beyond Med
Blackhawk TPA
Blue Benefit Administrators of MA
Blue Choice HealthPlan of South Carolina
Blue Care Network
Blue Cross of Idaho
Blue Shield of California
Blue Shield of North Eastern New York
Boon Group
Boon-Chapman
Breckpoint
Bright Benefits
Brighter Dental
Britton Benefits Services
Business Administrators & Consultants
Bywater
California Dental Network
Calvo's SelectCare
Capital Blue Cross - (also Multi-tenant files)
Capital Health Plan
Capital Rx
Capitol Administrators, Inc.
Caprock Health Plans
Carefirst
Carefirst Administrators**
CarePlus Dental
CBA Blue (also Multi-tenant files)
CDPHP
Century Healthcare
CerpassRx
Centivo
CGS Health Care
Christian Brothers Services
CieloStar
Cigna (also Multi-tenant files)
Cigna Select
Claim Choice
Coastal Administrative Services
Coeur
CoeurSS and CoeurPAS
Collective Health
Community Eye Care
Community Health Options
Community Care
Companion Life
Compass Health
Compass Health
ConnectiCare*
Consociate Health
Core Management
CoreSource* (aka Trustmark)
Coventry
Cox Health Plans
CRX International aka CanaRx
CVS Caremark
CWI Benefits, LLC*
Cypress Ancillary Benefits
Cypress Benefit Administrators
Cypress Dental
Davis Vision
Dean Care
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)
Delta Dental of Alabama
Delta Dental of Arizona
Delta Dental of Arkansas
Delta Dental of California
Delta Dental of Colorado
Delta Dental of Florida
Delta Dental of Georgia
Delta Dental of Idaho
Delta Dental of Illinois
Delta Dental of Indiana
Delta Dental of Iowa
Delta Dental of Kansas
Delta Dental of Kentucky
Delta Dental of Massachusetts
Delta Dental of Michigan - (also Multi-Tenant files)
Delta Dental of Minnesota
Delta Dental of Missouri
Delta Dental of New Jersey
Delta Dental of New Mexico
Delta Dental of New York
Delta Dental of North Carolina
Delta Dental of the Northeast
Delta Dental of Ohio (also Multi-Tenant files)
Delta Dental of Oklahoma
Delta Dental of Oregon
Delta Dental of Pennsylvania
Delta Dental of Rhode Island
Delta Dental of South Dakota
Delta Dental of Tennessee
Delta Dental of Utah
Delta Dental of Virginia
Delta Dental of Washington*
Delta Dental of West Virginia
Delta Dental of Wisconsin
Delta Dental of Wyoming
Delta Health Systems
Delta Vision
DENCAP
Dental Care Plus Group
Dental Health Services
Dental Select
Dental Services Organization
Dentist Direct
Dentaquest
Direct Dental Administrators
Dominion Dental Services
EBA&M
EBMS
EBPA (also Multi-tenant files)
EBSO
Edison Healthcare
EHIM
Elixir Solutions
Emblem Health
EMI Health
Empire Blue Cross Blue Shield (also Multi-tenant files)
Employer Driven Insurance Services (EDIS)
Enterprise Group Planning
Equipoint Partners
Equitable
Everence Financial
EVO First, Inc.
Excellus Blue Cross Blue Shield
Exemplar Health
Express Scripts
Eyemed (also Multi-tenant files)
Eyetopia
Fallon Health (4010 format)
Fidelio Dental
First Choice Health
First Continental
First Stop Health
FirstCare Health Plans
Fountain Health
Florida Combined Life
Flume Health
Fountain Health
Fox Everett
Freedom Claims Management Inc (FCMI)
Fringe Benefit Group (FBG)
Geaux Health (also Multi-tenant files)
Geisinger Health Plan
GeniusAve
Gilsbar
GISC
GMR Health Care
Golden Dental
GPA
Gravie
Group Administrators Ltd
Group Benefit Services (GBS)
Group Health Plan of South Central Wisconsin (GHPSCW)
Group Vision Services
Guardian (also Multi-tenant files)
Gulf Guaranty Life Insurance Co
Harvard Pilgrim Health Care (HPHC)
Hawaii Dental Services aka Delta Dental of Hawaii
Hawaii Mainland Administrators
Hawaii Medical Assurance Association (HMAA)
Health Alliance Plan (connected via Data Exchange)
Health Alliance Plan of Michigan
Health Benefit Alliance
Health Design Plus
Health First Health Plan
Healthcare Highways
Healthcare Management Administrators
HealthEZ - (also Multi-tenant files)
Healthgram
Healthiest You
HealthNet
HealthNow New York
HealthPartners
HealthScope
HealthSmart
HealthyCT
Health Plans, Inc
Health Plan of Nevada
Health Net of California
Health New England
Health Resources Inc
Heritage Vision Plan
Highmark (also Multi-tenant files)
Horizon Blue Cross Blue Shield of NJ
Homestead
Hometown Health
Humana - (also Multi-tenant files)
IBA Flexible Benefit Solutions
Imagine360
Independence Administrators*
Independence Blue Cross
Independent Health
Innovative Health Services
Inshore Benefits
Indiana University Health aka IU Health
Innovative Health Services*
Insight Benefit Administrators
Insurance Management Services (IMS)*
Integrated Payor Solutions (IPS)
Interactive Medical Systems (IMS)
International Benefit Administrators TPA
Iowa Bankers Insurance & Services (IBIS)
Kaiser Permanente
Kaiser Permanente of WA
Kaiser Permanente of California
Kaiser Permanente Mid Atlantic Standard
Kaiser Foundation Health Plan of the Northwest
Kansas City Life
Kentucky Health Administrators
Key Benefit Administrators
Leading Edge Administrators
Level
Liberty Dental Plan
LifeMap*
Lifetime Benefit Solutions
Lincoln Financial Group (LFG)
Lucent Health
Luminare Health
Lyra Health
Lyric
Maestro Health
Managed Care of America, Inc.
Marpai Health
Mass General Brigham (previously known as AllWays Health Partners)*
Maxor Administrative Services
MBA Benefit Administrators
Med-Pay
MedBen*
Medcost
Medica
Medical Associates Health Plans
Medical Mutual of Ohio
MediExcel
MedImpact
MediOrbis
Medova Healthcare Financial Group
Medtipster (also Multi-tenant files)
MercyCare
Meritain Health (also Multi-tenant files)
MESVision
MESSA
Metlife
MODA Health (merged w/Delta Dental of OR)
Morgan White Group
MotivHealth Insurance Company
Mountain Health CO-OP
Mutual Health Services
Mutual of Omaha
MVP Health Care
Navitus
Neighborhood Health Plan
Network Health
New Benefits
Nippon Life Benefits
Northeast Delta Dental
Nova Healthcare
NVA-National Vision Administrators
OnDemand Healthcare
One to One Health
Opticare of Utah
Optilegra
Optim RX
Optimed
Oxford Health Plans (UHC subsidiary)
PACE
PacificSource Health Plans
Pan-American Life Insurance Group
Paramount Health
Patient Advocates
Pequot Plus Health Care
Personify Health (Formerly HealthComp)
PharmAvail
PHP TPA Services
Physicians Eyecare Plan
Physicians Health Plans (PHP)
Piedmont Community Health Plan
Pinnacle Claims Management (PCMI)
Planned Administrators Inc
PPi Benefit Solutions
Prairie States*
Precision Group Administrators
Premera Blue Cross
Premier Access
Presbyterian Health Plan (PHP)
Prescription Network
Prevea360
Priority Health (also Multi-tenant files)
Principal Financial Group
ProAct, Inc.
ProCare
ProClaim*
Professional Benefits Administrators (PBA)
Prominence Health Plan
Providence Health Plans
Public Employees Health Plan (PEHP)
QualChoice
Quartz Benefits
R&T Inc.
Regence Blue Shield of Idaho
Regence BCBS of Utah - Benefitfocus platform
Regence BCBS of Oregon
Regional Care Inc. (RCI)
Reliance Standard
Renaissance Dental
Rightway Healthcare
Risk Program Administrators (RPA)
Rx 'n Go
RXBenefits
S&S Healthcare
Samaritan Health Plans
Sana Benefits
Sanford Health
Santeon
SBMA Benefits
Scott & White Health Plans
ScriptGuide Rx, Inc. (SGRX)
Script Care
Security Health Plan
SelectHealth** (also Multi-tenant files)
Selman Company
Sentara Health
Sharp Healthcare
Sidecar Health
SISCO
SIHO
SIMNSA
Solstice (also Multi-tenant files)
Southern Scripts
St. Luke’s Health Plan
Standard Insurance Company
Starmark
SummaCare
Sun Life Financial
Superior Dental (now Versant Health)
Superior Vision ( now Versant Health)
Surency
Surest
Sutter Health Plus
SVS Vision
Symetra
Tall Tree Administrators*
Teladoc
Ternian
The Boon Group*
The Health Plan
The Kempton Group
The Loomis Company*
The Standard
The Vitality Group
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.
TLC Benefit Solutions, Inc.
Total Dental Administrators
Total Health Care
Tres Health
Trinity Marketing Services
Tristar Benefit Administrator
TRS Medical Insurance
TruAssure
True Rx Health Strategists
Trustmark Insurance Co.
Tufts Health Plan
TX Health Benefits Pool
UCHealth Plan Administrators
UHP Administrators
UltraBenefits
Unified Group Services
United Agriculture Benefit Trust
United Health Group (United Healthcare) -including AllSavers Plans(Multi-tenant for UNET platform only) (also Multi-tenant file)
United Heritage Insurance
United Concordia
Univera Healthcare (also Multi-Tenant file)
University Health Alliance (UHA)
University of Utah Health Plans
UNIVision & Dental Healthcare
UNUM
UMR
UPMC Health Plan
USA Vision
Vantage Health Plan
Vault Strategies
Versant Health
Vimly
Virtual Benefits Administrator (also Multi-Tenant file)
Vision Benefit Administrators
Vision Benefits of America*
Vision Care Direct
The Vitality Group
Vitori
Viva Health (also Multi Tenant)
VSP (also Multi-tenant files)
Web TPA
Western Dental
Western Growers Assurance Trust (WGA)
Western Health Advantage
Wellmark Blue Cross Blue Shield of Iowa
Wellmark Blue Cross Blue Shield of South Dakota
WellNet (also Multi-tenant files)
Willamette Dental
Wisconsin Physicians Service (WPS Health Insurance)
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.