Client Level Configurations
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 and should be 1-9 digits (*Optional)
REF (Transaction Set Policy Number)-Optional segment. Do not include unless specifically asked by carrier
N102: Plan Sponsor Name
N104: Plan Sponsor EIN (Employer Identification Number)
N102: TPA or Broker Name
N104: TPA or Broker Tax ID
This loop is optional. Do not include unless specifically asked by carrier.
Carrier uses REF*1L to pass the HPHC Customer Account Number. The carrier will provide the expected values with the group structure.
Carrier uses REF*1L to pass the HPHC Customer Account Number. The carrier will provide the expected values with the group structure. The majority of REF segments are not used by the carrier. They will indicate if any of those will need to be included in the configuration.
- Carrier can accept both of these loops and the client level structure will list the carrier requirements for that individual case.
GE02: Group Control Number Assigned by Sender must be the same as GS06 (*Optional).
The carrier has not provided their Open Enrollment requirements. Once that is provided, this document will be updated. Please refer to the carrier if you have questions regarding their open enrollment/EDI process.
- HPHC uses an outside program to validate the test file. That program is called Ramp Management and the carrier will provide the instructions. This is not required by Employee Navigator but may be required by Harvard Pilgrim. During that process you may need to manually download the test file and load it to the required program. To download your test file from Employee Navigator, navigate to History>History>Under Revision#, select the link and the file download will begin.
- Terminated records are set to drop from this carrier’s file feeds at 14 days past the termination date.
- HPHC uses SFTP as their transmission protocol.