MVP Health Care
HIPAA 834 file, 5010 format
Member Enrollment for the Benefit Enrollment and Maintenance (834) 005010X220A1
Client Level Configuration
ISA06/GS02: Senders Tax ID
GS06: Group Control Number Assigned by Sender must match GE02 in footer (required to be 1-9 digits)
REF*38 is required. Refer to group structure to see if required for your setup
N102: Plan Sponsor Name
N104: Plan Sponsor Tax ID
Loop 1000C- Situational
N102: TPA or Broker Name
N104: TPA or Broker Tax ID
Loop 1100C – Situational
This is optional. Carrier client level structure will indicate if this is needed.
REF1L 02: Group or Policy # populate for Employee and Dependents
REF1L: Group or Policy # (Per spec, you can exclude the REF1L from the 2300 loop if you send it in the 2000 loop, you may want to ask your contact the preference 2000 vs. 2300)
Loops 2310/2320 – Situational
Both loops are optional and if required for your setup the carrier will advise.
GE02: Group Control Number Assigned by Sender must be the same as GS06
Accepted Transmission Protocol:
- SFTP with Password Authentication
- FTP with PGP Key Encryption – The PGP Key is stored on the system level.
- Host or URL Address: ecomftp.mvphealthcare.com
- Directory Structure: 834/ - For inbound enrollment files
** For User Name and Password, please call the EAS Coordinator for name of EDI Analyst to provide password to for setup.
Additional Carrier Notes:
During your group’s “Open Enrollment period” MVP requires full files with terms to be submitted. The group must notify the EAS EDI Coordinator, one month prior to, the submission of the group’s Open Enrollment file to ensure appropriate benefit and/or ID card changes are in place. If a full file, with terms, is not submitted there is a risk that some members may receive incorrect benefits for the following calendar year or receive benefits they should not have because they chose to no longer elect MVP health care.
MVP will not term by absence on a file. The termination record is required to be sent on 2 consecutive files and then the termination record needs to be dropped from the file. ** The carrier template is set to stop sending terminations once they are 14 days past the termination date.