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    Trading partner integration

    Insurance EDI and API integration

    Property and casualty carriers, life and group benefits insurers, health insurers and payers, and reinsurers. ECOM connects your business with insurance companies through EDI, APIs, managed file transfer and portal automation, integrated with your ERP.

    Discuss your insurance partners Insurance industry overview

    How the exchange works

    How insurance companies exchange business documents

    Insurance data moves between carriers, agencies, administrators, employers, providers and reinsurers. Group benefits and health coverage use X12 transactions such as the 834 for enrollment, the 820 for premium payment, and the 837 and 835 for claims and payment advice. Property and casualty, life and reinsurance exchanges often run as ACORD data, XML, agreed flat files or spreadsheets, and each partner implements the formats a little differently.

    Common documents with insurance companies
    DocumentWhat it does in this relationship
    EDI 834Benefit Enrollment and Maintenance Benefit enrollment and maintenance: new hires, changes and terminations sent to a carrier or administrator.
    EDI 820Payment Order/Remittance Advice Premium payment with remittance, tying the amount paid to groups or members.
    EDI 837Health Care Claim A health claim sent by a provider or billing service to a payer.
    EDI 835Health Care Claim Payment/Advice Claim payment and remittance advice returned by the payer.
    ACORD Policy, billing, commission and claim data exchanged between agencies, carriers and administrators. ECOM can read and integrate ACORD data; formats and versions are confirmed during scoping.

    What onboarding a new insurance partner usually involves

    1. Say which line of business you are connecting: group benefits, health, property and casualty, life or reinsurance.
    2. Collect the partner’s companion guide or file layout if you have it; if not, ECOM can help gather it.
    3. Map each file to your policy, benefits, claims or finance system, then test with rejected and corrected records before going live.

    Trading partner directory

    Insurance companies directory

    50 insurance companies, by name and business segment. Each company links to its integration guide, covering the documents and files typically exchanged and what to confirm before setup. Being listed does not mean a company is an ECOM customer or partner.

    Company names and logos are trademarks of their respective owners. Listing does not imply a customer relationship with, endorsement of, or a partnership with, ECOM Specialist.

    General EDI flow

    How EDI with your trading partner typically works

    Insurance exchanges depend on the line of business: group benefits, health, property and casualty, life or reinsurance. Group benefits and health coverage commonly use the X12 transactions below. Property and casualty, life and reinsurance often use ACORD data, XML or agreed flat files instead. Many trading partners do not publish their EDI or API specifications. This is the general flow most partners in this industry follow. It describes common industry practice, not any one partner's requirements: the documents, their order and the timing vary by partner and program.

    1. 834 Benefit enrollment and maintenance

      You to the carrier or payer

      An employer or administrator sends new hires, changes and terminations to the carrier.

    2. 820 Premium payment and remittance

      You to the carrier or payer

      The payer sends the premium with the detail that ties the amount to groups or members.

    3. 837 Health care claim

      You to the carrier or payer

      A provider or billing service sends a claim to the payer.

    4. 835 Claim payment and remittance advice

      Carrier or payer to you

      The payer returns what it paid, adjusted or denied, for each claim.

    5. 999 Implementation acknowledgment

      Both directions

      Each side confirms that every file it received was readable. A rejected file is corrected and resent.

    From first contact to live files

    1. Identify the line of business

      Say whether you are connecting group benefits, health, property and casualty, life or reinsurance, and which files each side sends.

    2. Get the specification

      Ask your trading partner for its companion guide, file layout or API specification, usually through its onboarding or technical contact.

    3. Choose the connection

      Agree how files move: AS2, SFTP, a VAN or an API, and how each side identifies itself.

    4. Map to your systems

      Map each file between the partner's format and your policy, benefits, claims or finance system.

    5. Test and go live

      Exchange test files, including rejected and corrected records, until the partner accepts them. Then go live and monitor every file, so a rejection is fixed before it affects coverage, claims or payments.

    Need the specification?

    Some trading partners keep their EDI and API specifications private and share them only with authorized partners, for security reasons. You are welcome to contact ECOM. We will see whether we can share the specification with you; each request is reviewed case by case, and sharing depends on the partner's rules. Do not send passwords or EDI identifiers with your request.

    Ask about a partner's specification Discuss trading partner onboarding

    Connecting with an insurance partner not listed here?

    ECOM connects businesses with partners of every size using their published EDI, API or file requirements.

    Talk to an EDI/API Expert Request a Demo Discuss trading partner onboarding