EDI 273 Insurance/Annuity Application Status

Functional Group ID

X12N Insurance Subcommittee

This Draft Standard for Trial Use contains the format and establishes the data contents of the Insurance/Annuity Application Status Transaction Set (273) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used by insurance providers to inform their trading partners of the current status of a life insurance or annuity application during the underwriting process.

Heading

1. 010 · ST · Transaction Set Header · Max 1 · Mandatory

   To indicate the start of a transaction set and to assign a control number

2. 020 · BGN · Beginning Segment · Max 1 · Mandatory

   To indicate the beginning of a transaction set

3. 030 · CUR · Currency · Max 1 · Optional

   To specify the currency (dollars, pounds, francs, etc.) used in a transaction

4. 035 · UD · Underwriting Status · Max 1 · Optional

   To identify and describe underwriting status of submitted applications

5. NM1 Loop Optional Repeat 2

   1. 040 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

      To supply the full name of an individual or organizational entity

   2. 050 · N3 · Address Information · Max 3 · Optional

      To specify the location of the named party

   3. 060 · N4 · Geographic Location · Max 1 · Optional

      To specify the geographic place of the named party

   4. 070 · REF · Reference Identification · Max 9 · Optional

      To specify identifying information

   5. 080 · PER · Administrative Communications Contact · Max 3 · Optional

      To identify a person or office to whom administrative communications should be directed

Detail

1. ACT Loop Mandatory Repeat >1

   1. 010 · ACT · Account Identification · Max 1 · Mandatory

      To specify account information

      The ACT loop repeats for each individual case.

   2. 020 · PER · Administrative Communications Contact · Max 3 · Optional

      To identify a person or office to whom administrative communications should be directed

   3. 030 · UD · Underwriting Status · Max 1 · Optional

      To identify and describe underwriting status of submitted applications

   4. 040 · DTP · Date or Time or Period · Max 19 · Optional

      To specify any or all of a date, a time, or a time period

   5. 050 · BLI · Baseline Item Data · Max 1 · Optional

      To specify basic item data: item identification, quantity, and price

   6. 060 · AMT · Monetary Amount · Max 9 · Optional

      To indicate the total monetary amount

   7. 070 · LIN · Item Identification · Max 1 · Optional

      To specify basic item identification data

   8. 080 · REF · Reference Identification · Max 9 · Optional

      To specify identifying information

   9. 090 · K3 · File Information · Max 3 · Optional

      To transmit a fixed-format record or matrix contents

   10. LX Loop Mandatory Repeat >1

       1. 100 · LX · Assigned Number · Max 1 · Mandatory

          To reference a line number in a transaction set

          The LX loop is required to avoid collision with the BLI loop.

       2. 110 · BLI · Baseline Item Data · Max 1 · Optional

          To specify basic item data: item identification, quantity, and price

          The BLI segment is used to transmit coverage which relates to the entire application.

       3. 120 · INV · Investment Vehicle Selection · Max 9 · Optional

          To specify type of investment vehicle or account and other basic data about the investment

       4. 130 · UD · Underwriting Status · Max 1 · Optional

          To identify and describe underwriting status of submitted applications

       5. 135 · M1 · Insurance · Max 1 · Optional

          To specify details related to insurance

       6. 140 · DTP · Date or Time or Period · Max 9 · Optional

          To specify any or all of a date, a time, or a time period

       7. 150 · RPA · Rate Amounts or Percents · Max 1 · Optional

          To identify rate amounts or percents for a specific cost or other line item

       8. 160 · K3 · File Information · Max 3 · Optional

          To transmit a fixed-format record or matrix contents

       9. BEN Loop Optional Repeat >1

          1. 170 · BEN · Beneficiary or Owner Information · Max 1 · Mandatory

             To supply beneficiary, co-participant, and owner information

             The BEN loop is used to transmit beneficiary information that relates only to the coverage information in 2/100 - 2/160.

          2. 180 · NM1 · Individual or Organizational Name · Max 1 · Optional

             To supply the full name of an individual or organizational entity

          3. 190 · N2 · Additional Name Information · Max 1 · Optional

             To specify additional names or those longer than 35 characters in length

          4. 192 · N3 · Address Information · Max 1 · Optional

             To specify the location of the named party

          5. 195 · N4 · Geographic Location · Max 1 · Optional

             To specify the geographic place of the named party

          6. 197 · DTP · Date or Time or Period · Max 1 · Optional

             To specify any or all of a date, a time, or a time period

       10. ENT Loop Optional Repeat >1

           1. 200 · ENT · Entity · Max 1 · Mandatory

              To designate the entities which are parties to a transaction and specify a reference meaningful to those entities

           2. 210 · NM1 · Individual or Organizational Name · Max 1 · Optional

              To supply the full name of an individual or organizational entity

           3. 220 · N2 · Additional Name Information · Max 2 · Optional

              To specify additional names or those longer than 35 characters in length

           4. 230 · REF · Reference Identification · Max 9 · Optional

              To specify identifying information

           5. 240 · N3 · Address Information · Max 3 · Optional

              To specify the location of the named party

           6. 250 · N4 · Geographic Location · Max 1 · Optional

              To specify the geographic place of the named party

           7. 260 · PER · Administrative Communications Contact · Max 3 · Optional

              To identify a person or office to whom administrative communications should be directed

           8. 270 · DMG · Demographic Information · Max 1 · Optional

              To supply demographic information

           9. 275 · DMA · Additional Demographic Information · Max 1 · Optional

              To supply additional demographic identification

           10. 280 · REL · Relationship · Max 1 · Optional

               To specify relationship and birth order of entity

           11. 290 · UD · Underwriting Status · Max 1 · Optional

               To identify and describe underwriting status of submitted applications

           12. 300 · DTP · Date or Time or Period · Max 9 · Optional

               To specify any or all of a date, a time, or a time period

           13. 310 · QTY · Quantity · Max 9 · Optional

               To specify quantity information

           14. 320 · K3 · File Information · Max 3 · Optional

               To transmit a fixed-format record or matrix contents

           15. LQ Loop Optional Repeat >1

               1. 330 · LQ · Industry Code · Max 1 · Mandatory

                  Code to transmit standard industry codes

                  The LQ loop contains the underwriting requirements.

               2. 340 · V9 · Event Detail · Max 1 · Optional

                  To specify information about a specific event

               3. 350 · DTP · Date or Time or Period · Max 9 · Optional

                  To specify any or all of a date, a time, or a time period

               4. 360 · K3 · File Information · Max 3 · Optional

                  To transmit a fixed-format record or matrix contents

               5. NM1 Loop Optional Repeat >1

                  1. 370 · NM1 · Individual or Organizational Name · Max 1 · Mandatory

                     To supply the full name of an individual or organizational entity

                  2. 380 · N3 · Address Information · Max 3 · Optional

                     To specify the location of the named party

                  3. 390 · N4 · Geographic Location · Max 1 · Optional

                     To specify the geographic place of the named party

                  4. 400 · G61 · Contact · Max 9 · Optional

                     To identify a person or office to whom communications should be directed

           16. BEN Loop Optional Repeat >1

               1. 410 · BEN · Beneficiary or Owner Information · Max 1 · Mandatory

                  To supply beneficiary, co-participant, and owner information

                  The BEN loop is used to transmit beneficiary information that relates only to the entity information in 2/200 - 2/320.

               2. 420 · NM1 · Individual or Organizational Name · Max 1 · Optional

                  To supply the full name of an individual or organizational entity

               3. 430 · N2 · Additional Name Information · Max 1 · Optional

                  To specify additional names or those longer than 35 characters in length

               4. 432 · N3 · Address Information · Max 1 · Optional

                  To specify the location of the named party

               5. 435 · N4 · Geographic Location · Max 1 · Optional

                  To specify the geographic place of the named party

               6. 437 · DTP · Date or Time or Period · Max 1 · Optional

                  To specify any or all of a date, a time, or a time period

           17. BLI Loop Optional Repeat >1

               1. 440 · BLI · Baseline Item Data · Max 1 · Mandatory

                  To specify basic item data: item identification, quantity, and price

                  The BLI loop is used to transmit coverage information that relates only to the entity information in 2/200 - 2/320.

               2. 450 · INV · Investment Vehicle Selection · Max 9 · Optional

                  To specify type of investment vehicle or account and other basic data about the investment

               3. 460 · UD · Underwriting Status · Max 1 · Optional

                  To identify and describe underwriting status of submitted applications

               4. 462 · UDA · Underwriting Condition · Max >1 · Optional

                  To specify the condition under which insurance coverage is offered

               5. 465 · M1 · Insurance · Max 1 · Optional

                  To specify details related to insurance

               6. 470 · DTP · Date or Time or Period · Max 9 · Optional

                  To specify any or all of a date, a time, or a time period

               7. 475 · QTY · Quantity · Max >1 · Optional

                  To specify quantity information

               8. 480 · RPA · Rate Amounts or Percents · Max >1 · Optional

                  To identify rate amounts or percents for a specific cost or other line item

               9. 490 · K3 · File Information · Max 3 · Optional

                  To transmit a fixed-format record or matrix contents

               10. BEN Loop Optional Repeat >1

                   1. 500 · BEN · Beneficiary or Owner Information · Max 1 · Mandatory

                      To supply beneficiary, co-participant, and owner information

                      The BEN loop is used to transmit beneficiary information that relates only to the coverage information in 2/440 - 2/490.

                   2. 510 · NM1 · Individual or Organizational Name · Max 1 · Optional

                      To supply the full name of an individual or organizational entity

                   3. 520 · N2 · Additional Name Information · Max 1 · Optional

                      To specify additional names or those longer than 35 characters in length

                   4. 522 · N3 · Address Information · Max 1 · Optional

                      To specify the location of the named party

                   5. 525 · N4 · Geographic Location · Max 1 · Optional

                      To specify the geographic place of the named party

                   6. 527 · DTP · Date or Time or Period · Max 1 · Optional

                      To specify any or all of a date, a time, or a time period

   11. MSG Loop Optional Repeat >1

       1. 530 · MSG · Message Text · Max 1 · Mandatory

          To provide a free-form format that allows the transmission of text information

       2. 540 · DTP · Date or Time or Period · Max 1 · Optional

          To specify any or all of a date, a time, or a time period

       3. 550 · NM1 · Individual or Organizational Name · Max 1 · Optional

          To supply the full name of an individual or organizational entity

2. 560 · SE · Transaction Set Trailer · Max 1 · Mandatory

   To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)