Anthem of VA Platforms
- Anthem of VA Benefit Focus
- Please note: this is a separate carrier configuration from the Anthem BCBS platform/configuration. If you are unsure which platform to use, please confirm with your carrier contact.
Last Updated 8/17/2016
Client Level Configuration: Anthem VA (Benefit Focus Platform)
- GS02: Tax ID of Sender
- GS06: Unique number assigned by client (same value must be populated in the GE02 in the footer)
- REF_02: Master policy number (Can be excluded at client level not required)
- N102: Client Name
- N104: Client Tax ID
- REF_1L: Group or Policy number
- If using the rules option in this loop please note there may be a requirement to enter the values on either the employee or dependent record or both
- The following segments are situational and can be excluded at the client level unless your EDI contact advises they need to be used
- HD03: PPO or HMO (can be set at Plans Tab under Insurance Line Code Drop down)
- HD04: Plan Coverage Description (Provided in group structure by testing contact)
Loops 2310 and 2320
- Situational loops that can be excluded at the client level.
- Note: The 2310 loop must be sent if the client offers an HMO plan. They carrier expects the PCP information to be passed at new hire enrollment only. As a result, it is recommended to make the PCP a required field on the HMO in the plan set up.
- GE02: Unique number assigned by the client (should be mirror the value populated in the Header, GS06)
- Terminations drop after 14 days.
- COBRA terms drop after 60 days
- Open Enrollment files should include ended and open enrollments. Carrier does not term by omission.
- When transmitting Open Enrollment file, carrier preference is to add OE in the file name; but it is not required.
- Notification should be sent to file contact when sending open enrollment file.