EDI 100 Insurance Plan Description

EDI 100 Format

ISA*01*0000000000*01*0000000000*ZZ*ABCDEFGHIJKLMNO*ZZ*123456789012345*101127*1719*U*00400*000003438*0*P*> GS*PG*1234567890 *999999999 *20120125*1325*1*T*004010 ST*100*0001 BGN*00*Reference Identification*20120125*1325*01*Reference Identification*01*1*00 C3*CUR*433283*CUR*CUR DTP*001*CC*Date Time Period NM1*01*1*Name Last or Organization Name*Name First*Name Middle*Name Prefi*Name Suffi*1*Identification Code*01*01 N3*Address Information*Address Information N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier REF*01*Reference Identification*Description*01Reference Identification1Reference Identification1Reference Identification PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe N1*01*Name*1*Identification Code*01*01 N2*Name*Name N3*Address Information*Address Information N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier COM*AA*Communication Number III*0*Industry Code*01*Free-Form Message Text*21485498*0143158130293911918169715624141982212425988541872985312067915267222*1S*1S*1S MSG*Free-Form Message Text*AA*6187232 PER*1A*Name*AA*Communication Number*AA*Communication Number*AA*Communication Number*Contact Inquiry Refe N3*Address Information*Address Information N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier PID*F*01*10*Product Desc*Description*1S*Source Subquali*N*LAN LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID DTP*001*CC*Date Time Period NM1*01*1*Name Last or Organization Name*Name First*Name Middle*Name Prefi*Name Suffi*1*Identification Code*01*01 BLI*A1*Product/Service ID*27920257061*01*ACT*2798913313178101*01*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*1*1*1*1*1 DTP*001*CC*Date Time Period III*0*Industry Code*01*Free-Form Message Text*19*0158091304630633213771918124539111132422858125946145732373313952921068123138305008690271483*1S*1S*1S AMT*1*514476602*C QTY*01*65*01260941387304321657129381113216166161122374312562423501312173117812251210525412 SI*10*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID*Se*Product/Service ID AMT*1*538813688*C QTY*01*1479*0117481153916378851350323529221217132569151696826112921831412578217197320381 AM1*01*A1*Product/Service ID*124402331*245*29956146 MSG*Free-Form Message Text*AA*258 PO1*Assigned Identificat*4841*01*75619743286555608*AA*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID LIN*Assigned Identificat*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID SPA*01*CC*Date Time Period*1*15*001*001*001*10*Product Desc*Source Subquali III*0*Industry Code*01*Free-Form Message Text*171194058841141*012332510731215352550524166115530103620041214122795*1S*1S*1S N4*City Name*ST*POSTAL CODE*COU*A*Location Identifier SPA*01*CC*Date Time Period*1*1495*001*001*001*10*Product Desc*Source Subquali AM1*01*A1*Product/Service ID*3056328601*26957647*1439 MSG*Free-Form Message Text*AA*20147 PO1*Assigned Identificat*3065*01*12461199*AA*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID*A1*Product/Service ID SPA*01*CC*Date Time Period*1*2596930853611*001*001*001*10*Product Desc*Source Subquali SPA*01*CC*Date Time Period*1*136662354327753*001*001*001*10*Product Desc*Source Subquali III*0*Industry Code*01*Free-Form Message Text*169834*01238371552311009134127549226686227451124211211276146576116*1S*1S*1S SE*48*0001 GE*1*1 IEA*1*000000001

EDI 100 Specification

This X12 Transaction Set contains the format and establishes the data contents of the Insurance Plan Description Transaction Set (100) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set is used to transmit life insurance, annuity, and disability insurance product availability and features, historical performance, investment options, distributions channels, and offering company information.

Sources

Accredited Standards Committee X12. ASC X12 Standard [Table Data]. Data Interchange Standards Association, Inc., Falls Church, VA. http://www.x12.org