Blue Cross Blue Shield of North Carolina
HIPAA 834, 5010 - Benefitfocus
Client Level Configurations
- ISA06: Uses group’s Tax ID
- GS02: Uses group’s Tax ID
- GS06: Group Control Number must be 1-9 characters long and same value must also be populated in the GE02 in the footer. Cannot start with zero.
- REF Segment is not used and can be excluded at the Client level
- N102: Group Name
- N104: Group Tax ID #
Loop 1000C-Optional for this carrier
Loop 2000 - the carrier will indicate whether they want to receive the policy number in the 2000 or 2300 loop. Deselect the one not being used.
- REF_1L(Member Policy Number)- Input group/policy number for employees and dependents given by carrier and if different, the group structure or carrier will have the details
- REF_DX- (Department Agency Number)- Used by carrier but group structure will provide what values to enter
- REF_17( Member Identification Number)- Used by carrier but group structure will provide what values to enter
Loop 2300 - the carrier will indicate whether they want to receive the policy number in the 2000 or 2300 loop. Deselect the one not being used.
- HD04- If there is 1 policy number, enter in value. If there are multiple policy numbers, click "edit" under the "Rule" and map values.
- REF1L- (Member Policy Number) -Optional. Carrier will advise if this should be included in file here or in 2000 Loop
- GE02: Group Control Number must be 1-9 characters long and match GS06 value in the Header. Cannot start with zero.
- BCBS of North Carolina prefers to receive ended and and open enrollments on the open enrollment file.
- BCBS of North Carolina requires that the open enrollment file naming include OE.
- Notification should be sent to the clients assigned E-Exchange Account Manager when the open enrollment file is being sent.
- Eligibility maintenance files should cease after the open enrollment file is sent. Any updates to the current plan year plan eligibility must be sent to your BCBS NC dedicated processor to be manually processed.
- TIP: Employee Navigator has a limitation with Benefitfocus format when there is medical & dental included on the file. If you intend to send both, you must inform your implementation analyst that you are using the EN platform and ask for an exception to use the HD03 to identify the coverage. No additional coding is required by you for this exception.