EDI 273 Insurance/Annuity Application Status

Functional Group ID

X12N Insurance Subcommittee

This X12 Transaction Set 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.

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Heading

Position

Segment

Name

Max use

0100Transaction Set HeaderMandatory->Max 1
To indicate the start of a transaction set and to assign a control number
0200Beginning SegmentMandatory->Max 1
To indicate the beginning of a transaction set
0300CurrencyOptional->Max 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction
0350Underwriting StatusOptional->Max 1
To identify and describe underwriting status of submitted applications
NM1 Loop Optional
Repeat 2
1. 0400Individual or Organizational NameMandatory->Max 1
  To supply the full name of an individual or organizational entity
2. 0500Address InformationOptional->Max 3
  To specify the location of the named party
3. 0600Geographic LocationOptional->Max 1
  To specify the geographic place of the named party
4. 0700Reference IdentificationOptional->Max 9
  To specify identifying information
5. 0800Administrative Communications ContactOptional->Max 3
  To identify a person or office to whom administrative communications should be directed

Detail

Position

Segment

Name

Max use

ACT Loop Mandatory
Repeat >1
1. 0100Account IdentificationMandatory->Max 1
  To specify account information
  The ACT loop repeats for each individual case.
2. 0200Administrative Communications ContactOptional->Max 3
  To identify a person or office to whom administrative communications should be directed
3. 0300Underwriting StatusOptional->Max 1
  To identify and describe underwriting status of submitted applications
4. 0400Date or Time or PeriodOptional->Max 19
  To specify any or all of a date, a time, or a time period
5. 0500Baseline Item DataOptional->Max 1
  To specify basic item data: item identification, quantity, and price
6. 0600Monetary AmountOptional->Max 9
  To indicate the total monetary amount
7. 0700Item IdentificationOptional->Max 1
  To specify basic item identification data
8. 0800Reference IdentificationOptional->Max 9
  To specify identifying information
9. 0900File InformationOptional->Max 3
  To transmit a fixed-format record or matrix contents
10. LX Loop Mandatory
  Repeat >1
  1. 1000Assigned NumberMandatory->Max 1
    To reference a line number in a transaction set
    The LX loop is required to avoid collision with the BLI loop.
  2. 1100Baseline Item DataOptional->Max 1
    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. 1200Investment Vehicle SelectionOptional->Max 9
    To specify type of investment vehicle or account and other basic data about the investment
  4. 1300Underwriting StatusOptional->Max 1
    To identify and describe underwriting status of submitted applications
  5. 1350InsuranceOptional->Max 1
    To specify details related to insurance
  6. 1400Date or Time or PeriodOptional->Max 9
    To specify any or all of a date, a time, or a time period
  7. 1500Rate Amounts or PercentsOptional->Max 1
    To identify rate amounts or percents for a specific cost or other line item
  8. 1600File InformationOptional->Max 3
    To transmit a fixed-format record or matrix contents
  9. BEN Loop Optional
    Repeat >1
    1700Beneficiary or Owner InformationMandatory->Max 1
    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 2/1000- 2/1600.
    1800Individual or Organizational NameOptional->Max 1
    To supply the full name of an individual or organizational entity
    1900Additional Name InformationOptional->Max 1
    To specify additional names
    1920Address InformationOptional->Max 1
    To specify the location of the named party
    1950Geographic LocationOptional->Max 1
    To specify the geographic place of the named party
    1970Date or Time or PeriodOptional->Max 1
    To specify any or all of a date, a time, or a time period
  10. ENT Loop Optional
    Repeat >1
    2000EntityMandatory->Max 1
    To designate the entities which are parties to a transaction and specify a reference meaningful to those entities
    2100Individual or Organizational NameOptional->Max 1
    To supply the full name of an individual or organizational entity
    2200Additional Name InformationOptional->Max 2
    To specify additional names
    2300Reference IdentificationOptional->Max 9
    To specify identifying information
    2400Address InformationOptional->Max 3
    To specify the location of the named party
    2500Geographic LocationOptional->Max 1
    To specify the geographic place of the named party
    2600Administrative Communications ContactOptional->Max 3
    To identify a person or office to whom administrative communications should be directed
    2700Demographic InformationOptional->Max 1
    To supply demographic information
    2750Additional Demographic InformationOptional->Max 1
    To supply additional demographic identification
    2800RelationshipOptional->Max 1
    To specify relationship and birth order of entity
    2900Underwriting StatusOptional->Max 1
    To identify and describe underwriting status of submitted applications
    3000Date or Time or PeriodOptional->Max 9
    To specify any or all of a date, a time, or a time period
    3100QuantityOptional->Max 9
    To specify quantity information
    3200File InformationOptional->Max 3
    To transmit a fixed-format record or matrix contents
    LQ Loop Optional
    Repeat >1
    3300Industry CodeMandatory->Max 1
    Code to transmit standard industry codes
    The LQ loop contains the underwriting requirements.
    3400Event DetailOptional->Max 1
    To specify information about a specific event
    3450Status of Product or ActivityOptional->Max >1
    To indicate the details and status of a product or product activity
    3500Date or Time or PeriodOptional->Max 9
    To specify any or all of a date, a time, or a time period
    3600File InformationOptional->Max 3
    To transmit a fixed-format record or matrix contents
    NM1 Loop Optional
    Repeat >1
    3700Individual or Organizational NameMandatory->Max 1
    To supply the full name of an individual or organizational entity
    3800Address InformationOptional->Max 3
    To specify the location of the named party
    3900Geographic LocationOptional->Max 1
    To specify the geographic place of the named party
    4000ContactOptional->Max 9
    To identify a person or office to whom communications should be directed
    BEN Loop Optional
    Repeat >1
    4100Beneficiary or Owner InformationMandatory->Max 1
    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 2/2000 - 2/3200.
    4200Individual or Organizational NameOptional->Max 1
    To supply the full name of an individual or organizational entity
    4300Additional Name InformationOptional->Max 1
    To specify additional names
    4320Address InformationOptional->Max 1
    To specify the location of the named party
    4350Geographic LocationOptional->Max 1
    To specify the geographic place of the named party
    4370Date or Time or PeriodOptional->Max 1
    To specify any or all of a date, a time, or a time period
    BLI Loop Optional
    Repeat >1
    4400Baseline Item DataMandatory->Max 1
    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 2/2000 - 2/3200.
    4500Investment Vehicle SelectionOptional->Max 9
    To specify type of investment vehicle or account and other basic data about the investment
    4600Underwriting StatusOptional->Max 1
    To identify and describe underwriting status of submitted applications
    4620Underwriting ConditionOptional->Max >1
    To specify the condition under which insurance coverage is offered
    4650InsuranceOptional->Max 1
    To specify details related to insurance
    4700Date or Time or PeriodOptional->Max 9
    To specify any or all of a date, a time, or a time period
    4750QuantityOptional->Max >1
    To specify quantity information
    4800Rate Amounts or PercentsOptional->Max >1
    To identify rate amounts or percents for a specific cost or other line item
    4900File InformationOptional->Max 3
    To transmit a fixed-format record or matrix contents
    BEN Loop Optional
    Repeat >1
    5000Beneficiary or Owner InformationMandatory->Max 1
    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 2/4400- 2/4900.
    5100Individual or Organizational NameOptional->Max 1
    To supply the full name of an individual or organizational entity
    5200Additional Name InformationOptional->Max 1
    To specify additional names
    5220Address InformationOptional->Max 1
    To specify the location of the named party
    5250Geographic LocationOptional->Max 1
    To specify the geographic place of the named party
    5270Date or Time or PeriodOptional->Max 1
    To specify any or all of a date, a time, or a time period
11. MSG Loop Optional
  Repeat >1
  1. 5300Message TextMandatory->Max 1
    To provide a free-form format that allows the transmission of text information
  2. 5400Date or Time or PeriodOptional->Max 1
    To specify any or all of a date, a time, or a time period
  3. 5500Individual or Organizational NameOptional->Max 1
    To supply the full name of an individual or organizational entity
5600Transaction Set TrailerMandatory->Max 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)