Everence Financial 5010 Platform
Client Level Configurations
Header
- ISA06: Interchange Sender ID-Use sender's identification, usually the TAX ID
- GS02: Senders Tax ID
- GS06: Group Control Number Assigned by Sender must match GE02 in footer (required to be 1-9 digits)
Loop 1000A
- N102: Plan Sponsor Name
- N104: Plan Sponsor Tax ID
Loop 1000B
- N102: Plan Sponsor Name
- N104: Plan Sponsor Tax ID
Loop 1000C
- N102: TPA or Broker Name
- N104: TPA or Broker Tax ID
- This loop is optional
Loop 1100C
- This loop is optional. The carrier will indicate if they require this loop on the file.
Loop 2000
- Exclude all REF segments except REF*OF and REF*1L unless specifically asked to include by carrier
- REF*1L will populate Group/Policy# and will be assigned by carrier
Loops 2100B-2100G
- These loops are all optional. The carrier will advise if any of these loops are required for a specific setup
Loop 2300
- HD03-Insurance Line Code will be based on the benefit offered. Carrier has the following options:
Vision=VIS
Medical=HLT
Dental=DEN
- REF*1L will populate Group/Policy# and will be assigned by carrier
Loop 2310 and 2320
- Exclude from client level configuration unless carrier specifically asks to include as these are optional
Footer
- GE02: Group Control Number Assigned by Sender must be the same as GS06
OPEN ENROLLMENT
- Carrier will provide open enrollment requirements and preferences
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