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X12 transaction guide · Healthcare and insurance

EDI 100 Insurance Plan Description

The X12 document used to transmit life insurance, annuity and disability product features, performance, investment options and company information.

Sent by
Insurance company
Received by
Distributors such as broker-dealers, agents and banks
Standard
ANSI ASC X12

What is an EDI 100?

The EDI 100 Insurance Plan Description is the ANSI X12 transaction set used to transmit life insurance, annuity and disability insurance product availability and features, historical performance, investment options, distribution channels and offering company information.

Distributors sell products from many insurers and need accurate, current product data to compare products, present them to clients and meet suitability requirements. Receiving product descriptions as structured data lets their sales and compliance systems stay synchronized with the insurers' offerings, instead of relying on brochures and rate sheets that quickly go out of date.

How the EDI 100 worksDiagram of the EDI 100 Insurance Plan Description. Insurance company sends it to distributors such as broker-dealers, agents and banks. It usually starts the exchange. It is usually followed by 267 and 997. Inside the ISA, GS and ST envelopes, X12 release 008010 requires, in the heading: BGN (Beginning Segment) and the required NM1 loop with NM1 (Individual or Organizational Name) and detail: the required N1 loop with N1 (Party Identification). 2 optional loops are listed by their first segment.How the EDI 100 worksInsurance Plan Description: who sends it, where it fits and what the standard marks required1 WHERE IT FITSUSUALLY FOLLOWSStarts the exchangeEDI 100SENDERInsurance companyRECEIVERDistributors such asbroker-dealers, agentsand banks997 or 999 acknowledgment back, if the partners agreeUSUALLY FOLLOWED BY267Individual Life, Annuityand Disability Application997FunctionalAcknowledgment2 WHAT X12 RELEASE 008010 REQUIRESInterchange: sender and receiver IDsISA … IEAFunctional group, ID code PGGS … GETransaction set 100ST … SEHEADINGBGNBeginning SegmentRequired loop NM1 · repeats many timesNM1Individual or Organizational NameDETAILRequired loop N1 · repeats many timesN1Party Identification+ 2 optional loops, starting with:PERPIDBlue box: required loop. Optional loops are listed by the segment that starts them; when a loop is used, that first segment is required. Optional segmentsoutside loops are not drawn.Structure: required segments and loops in the X12 008010 listing for the 100. Your trading partner's implementation guide adds its own requirements.
How the EDI 100 worksDiagram of the EDI 100 Insurance Plan Description. Insurance company sends it to distributors such as broker-dealers, agents and banks. It usually starts the exchange. It is usually followed by 267 and 997. Inside the ISA, GS and ST envelopes, X12 release 008010 requires, in the heading: BGN (Beginning Segment) and the required NM1 loop with NM1 (Individual or Organizational Name) and detail: the required N1 loop with N1 (Party Identification). 2 optional loops are listed by their first segment.How the EDI 100 worksInsurance Plan Description: who sends it,where it fits and what the standard marksrequired1 WHERE IT FITSUSUALLY FOLLOWSStarts the exchangeEDI 100SENDERInsurancecompanyRECEIVERDistributorssuch asbroker-dealers,agents andbanks997 or 999 acknowledgment back, if the partnersagreeUSUALLY FOLLOWED BY267Individual Life, Annuity and DisabilityApplication997Functional Acknowledgment2 WHAT X12 RELEASE 008010 REQUIRESInterchange: sender and receiver IDs (ISA… IEA)Functional group, ID code PG (GS … GE)Transaction set 100 (ST … SE)HEADINGBGNBeginning SegmentRequired loop NM1 · repeatsmany timesNM1Individual orOrganizational NameDETAILRequired loop N1 · repeats manytimesN1Party Identification+ 2 optional loops, starting with:PERPIDBlue box: required loop. Optional loops are listedby the segment that starts them; when a loop isused, that first segment is required. Optionalsegments outside loops are not drawn.Structure: required segments and loops in the X12008010 listing for the 100. Your trading partner'simplementation guide adds its own requirements.

How to read this diagram: the top row shows who sends the 100, to whom, and which documents usually come before and after it. The lower part shows what X12 release 008010 itself requires: the envelopes around the 100 and the segments and loops the standard marks as required, area by area. Optional loops are listed by the segment that starts them rather than drawn in full. This is the standard's minimum, not a trading partner's requirement: each partner's implementation guide usually makes some optional loops mandatory, restricts the codes and may use a different release.

Expand diagram Download SVG

When it is used

  • Publishing product features to distributors
  • Sharing investment option performance
  • Announcing product availability by state or channel

Where it fits in the document flow

This document 100 Insurance Plan Description
Usually followed by 267 Individual Life, Annuity and Disability Application997 Functional Acknowledgment

Structure

Mandatory segments in the 100 (X12 release 008010)

The segments X12 release 008010 marks as mandatory at their level, in order. Segments inside optional loops are needed only when the loop is used. This is the standard's requirement, not your trading partner's: each partner's implementation guide names the release it uses, adds the optional segments it requires and restricts the values. The requirement status comes from one published X12 reference listing and has not been checked against a second source.

  • ST
  • BGN
  • NM1
  • N1
  • PER
  • PID
  • BLI
  • SI
  • AM1
  • PO1
  • N4
  • SE

Practical example

The 100 in practice

An insurer launches a new variable annuity. It sends its broker-dealer partners a 100 with the product's features, fees, investment options and their historical performance, and the states where it is approved. The broker-dealers load the data into their product comparison tools before advisors begin offering it.

Implementation

Implementation considerations for the 100

  • Keep product data current as features and approvals change.
  • Include the disclosures distributors need for suitability reviews.
  • Identify products and investment options consistently over time.
  • Coordinate data releases with product launch dates.

How ECOM helps

Automate the 100 with ECOM

Industry

Financial Services

Secure file transfer and B2B integration for banks and financial institutions.

Solution

B2B Integration

Connect every customer, supplier, carrier and bank across EDI, API, file and portal channels.

Solution

EDI Integration

Exchange X12 and EDIFACT documents with partners and integrate them directly with your ERP.

More general questions about EDI are answered in the EDI FAQ.

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