Client Level Configuration
- ISA06: Group Tax ID #
- GS02: Group Tax ID # (Must match ISA06)
- GS06: Group Control Number Unique Number assigned by sender
- REF_02: Master Policy Number (Please note this is s situational field, your carrier contact will advise if this is required in the file)
- DTP: Situational your spec from the carrier will advise if this segment should be housed in the file
- N102: Client Name
- N104: Client Federal Tax ID #
- Situational, can be excluded at client level unless advised by testing contact that it is a required field
- REF*1L: Carrier assigned Client ID (will be provided in the structure send for both employee and dependent)
- REF*DX: Deparment/Agency Codes (divsions) Situational, can be excluded at client level unless testing contact advises it is a requried field and provides value to be stored
- HD03: This is programmed at the plans link using the insurance line code drop down. You will assign on of the following values based on the plans you are sending
- MM, HMO, HLT, or PPO: Medical
- DEN: Dental
- VIS: Vision
- PDG: Prescription Drug
- REF*1L: Situational Carrier contact will advise if values should be sent in this field.
- Situational based upon presence of system data. If PCP information is not available exclude loop from file at client level.
- GE02: Group Control number, unique id assigned by client. This value must match the GS06 in the header
Password to File Specification: ADV2014
- Carrier will send file notifications receipts via email.
- All summary/error reports will be available to clients via Advantica's SFTP in the summary report folder
- Any questions on summary reports, file feed inquiries, etc.. should be emailed to EDI@advanticabenefits.com
- Open Enrollment files should include open and ended enrollments.
- Carrier expects new plan year enrollments only after open enrollment file is sent.
- Any changes that need to make for existing plan year plans after open enrollment file is sent should be sent to Advantica's manual eligibility team, email@example.com
- The carrier does not expect a different naming convention for the Open Enrollment file
- EDI@advanticabenefits.com should be notified when an Open Enrollment file is sent.