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ANSI 834 Enrollment Implementation Format

The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.

Layout
An example layout of an X12 834 Version 005010 file is shown below. Each line starts with a code to identify the type of data that follows, with individual pieces of data separated by an asterisk. The tilde indicates the end of that section. INS*Y*18*030*XN*A*E**FT~ REF*0F*881019999~ REF*1L*Blue~ DTP*336*D8*20070101~ NM1*IL*1*BLUTH*LUCILLE****34*881019999~ N3*224 N DES PLAINES*6TH FLOOR~ N4*CHICAGO*IL*60661*USA~ DMG*D8*19720121*F*M~ HD*030**VIS**EMP~ DTP*348*D8*20111016~ INS*N*19*030*XN*A*E***N*N~ REF*0F*881019999~ REF*1L*Blue~ DTP*357*D8*20111015~ NM1*IL*1*BLUTH*BUSTER~ N3*224 N DES PLAINES*6TH FLOOR~ N4*CHICAGO*IL*60661*USA~ DMG*D8*19911015*M~ HD*030**VIS~ DTP*348*D8*20110101~ DTP*349*D8*20111015~ ==See also==
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