EDI 111 Individual Insurance Policy and Client Information
Functional Group IF
X12N Insurance Subcommittee
This X12 Transaction Set contains the format and establishes the data contents of the Individual Insurance Policy and Client Information Transaction Set (111) for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to exchange policy and client information among organizations administering individual life and health insurance contracts and their trading partners (e.g., agents, brokers). It is not intended to be used for group insurance.
Heading
- 0100Transaction Set HeaderMandatoryMax 1
To indicate the start of a transaction set and to assign a control number
- 0200Beginning of Hierarchical TransactionMandatoryMax 1
To define the business hierarchical structure of the transaction set and identify the business application purpose and reference data, i.e., number, date, and time
- 1000 Loop MandatoryRepeat >1
- 0300Individual or Organizational NameMandatoryMax 1
To supply the full name of an individual or organizational entity
The 1000 loop provides information about the sending and receiving parties. - 0400Address InformationOptionalMax 3
To specify the location of the named party
- 0500Geographic LocationOptionalMax 1
To specify the geographic place of the named party
- 0600Reference IdentificationOptionalMax 9
To specify identifying information
- 0700Administrative Communications ContactOptionalMax 3
To identify a person or office to whom administrative communications should be directed
- 0300Individual or Organizational NameMandatoryMax 1
Detail
- 2000 Loop MandatoryRepeat >1
- 0100Hierarchical LevelMandatoryMax 1
To identify dependencies among and the content of hierarchically related groups of data segments
The structure of the transaction is defined in BHT01 at 1/0200. - 0200Reference IdentificationOptionalMax >1
To specify identifying information
- 0300Action or Status IndicatorOptionalMax >1
To indicate the action to be taken with the information provided or the status of the entity described
- 0400Industry CodeOptionalMax >1
Code to transmit standard industry codes
- 0500CurrencyOptionalMax 1
To specify the currency being used in the transaction set
- 0600Demographic InformationOptionalMax 1
To supply demographic information
- 0700Language UseOptionalMax 1
To specify language, type of usage, and proficiency or fluency
- 0800Geographic LocationOptionalMax >1
To specify the geographic place of the named party
- 0900Baseline Item DataOptionalMax 1
To specify basic item data: item identification, quantity, and price
- 1000Item IdentificationOptionalMax >1
To specify basic item identification data
- 1100Underwriting ConditionOptionalMax >1
To specify the condition under which insurance coverage is offered
- 1200Status of Product or ActivityOptionalMax >1
To indicate the details and status of a product or product activity
- 1300Date or Time or PeriodOptionalMax >1
To specify any or all of a date, a time, or a time period
- 1400Balance InformationOptionalMax >1
To provide specific balance information for financial account reporting
- 1500QuantityOptionalMax >1
To specify quantity information
- 1600Monetary AmountOptionalMax >1
To indicate the total monetary amount
- 1700Rate Amounts or PercentsOptionalMax >1
To identify rate amounts or percents for a specific cost or other line item
- 2100 Loop OptionalRepeat >1
- 1800Payment DetailsMandatoryMax 1
To transmit information required to establish payment or remittance activity
- 1900Reference IdentificationOptionalMax >1
To specify identifying information
- 1800Payment DetailsMandatoryMax 1
- 2200 Loop OptionalRepeat >1
- 2000InformationMandatoryMax 1
To report information
- 2100Date or Time or PeriodOptionalMax >1
To specify any or all of a date, a time, or a time period
- 2000InformationMandatoryMax 1
- 2300 Loop OptionalRepeat >1
- 2200Informational ValuesMandatoryMax 1
To specify a code and the amount or quantity or percentage associated with it
The 2300 loop can be used to provide additional information at the level of the specific policy, coverage, component, account, etc., being described. - 2300InformationOptionalMax >1
To report information
- 2350Status of Product or ActivityOptionalMax >1
To indicate the details and status of a product or product activity
- 2400Date or Time or PeriodOptionalMax >1
To specify any or all of a date, a time, or a time period
- 2500Monetary AmountOptionalMax >1
To indicate the total monetary amount
- 2600QuantityOptionalMax >1
To specify quantity information
- 2700Rate Amounts or PercentsOptionalMax >1
To identify rate amounts or percents for a specific cost or other line item
- 2800Balance InformationOptionalMax >1
To provide specific balance information for financial account reporting
- 2900Reference IdentificationOptionalMax >1
To specify identifying information
- 2200Informational ValuesMandatoryMax 1
- 2400 Loop OptionalRepeat >1
- 3000Individual or Organizational NameMandatoryMax 1
To supply the full name of an individual or organizational entity
- 3100Additional Name InformationOptionalMax 3
To specify additional names
- 3200Communication Contact InformationOptionalMax >1
To specify a communication contact number
- 2450 Loop OptionalRepeat >1
- 3300Address InformationMandatoryMax 1
To specify the location of the named party
- 3400Geographic LocationOptionalMax 1
To specify the geographic place of the named party
- 3500Date or Time or PeriodOptionalMax >1
To specify any or all of a date, a time, or a time period
- 3300Address InformationMandatoryMax 1
- 3000Individual or Organizational NameMandatoryMax 1
- 2500 Loop OptionalRepeat >1
- 3600Property or Entity IdentificationMandatoryMax 1
To define the attributes of a property or an entity
The 2500 loop provides details about the role(s) played by a client at the given level. For example, this could contain specifics for the owner of a policy, or for a beneficiary for a given coverage. - 3700Reference IdentificationOptionalMax >1
To specify identifying information
- 3800Beneficiary or Owner InformationOptionalMax 1
To supply beneficiary, co-participant, and owner information
- 3900InformationOptionalMax >1
To report information
- 4000Informational ValuesOptionalMax >1
To specify a code and the amount or quantity or percentage associated with it
- 4100Individual IdentificationOptionalMax >1
To provide identification of an individual or entity
The IN1 segment identifies parties related to the client in the given role. For example, if the client is a beneficiary, the IN1 segment could be used to provide the reference number for the trustee for that beneficiary.
- 3600Property or Entity IdentificationMandatoryMax 1
- 0100Hierarchical LevelMandatoryMax 1
- 4200Transaction Set TrailerMandatoryMax 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)