Kaiser 5010 Platform
**Kaiser Permanente has 3 distinct platforms -- Mid-Atlantic, California, and WA. The companion guide is client-specific and will be provided by your rep at Kaiser Permanente.**
Client Level Configurations
- ISA06: Sender ID-Usually Client Tax ID
- GS02: Interchange Sender ID-Carrier assigned values
- GS03: Receiver ID-Carrier assigned value. Kaiser will provide this value
- GS06: Group Control Number Assigned by Sender must match GE02 in footer (required to be 1-9 digits)
- REF: Transaction Set Policy Number-This is optional and can be deselected unless the carrier specifically asks to include it
- N102: Plan Sponsor Name
- N104: Plan Sponsor Tax ID
- N102: TPA or Broker Name
- N104: TPA or Broker Tax ID
- This loop is optional
- This loop is optional. The carrier will indicate if they require this loop on the file and if not this should be deselected
Multiple REF segments are used by this carrier. They are optional and the group structure from the carrier will indicate which REF segment to include.
- REF*1L: Carrier uses this segment to report Policy Number and will provide the expected values
- REF*DX: Carrier uses this segment to report subgroup ID and will provide the expected values
- REF*ZZ: Carrier uses this to report Class ID and will provide the expected values
- These loops are all optional. The carrier will advise if any of these loops are required for a specific setup.
- REF*1L-Optional segment. Carrier will indicate if it is required for your setup
Loop 2310 and 2320
- These are optional loops. The carrier will inform if these are required via the group structure document
- GE02: Group Control Number Assigned by Sender must be the same as GS06
The carrier will notify you of their Open Enrollment requirements.
- Carrier template is set to stop sending terminated records 14 days after the termination date has passed.
- PGP encryption is used but not always required. When not required to use PGP encryption, the carrier still uses a secure transmission protocol (SFTP).
- Kaiser provides a generic 5010 companion guide when requested initially. Once they are ready for testing, they will then provide a detailed companion guide with the required client specific values. They will also provide a spreadsheet of the expected sub-group codes if applicable.