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X12 transaction guide · Healthcare and insurance

EDI 267 Individual Life, Annuity and Disability Application

The X12 document used to transmit new business applications among distributors, insurers and reinsurers for underwriting.

Sent by
Distributor, such as an agent or broker-dealer
Received by
Insurance company or reinsurer
Standard
ANSI ASC X12

What is an EDI 267?

The EDI 267 Individual Life, Annuity and Disability Application is the ANSI X12 transaction set used to transmit new business application information among distributors, such as agents and broker-dealers, insurance companies and reinsurance companies, for the purpose of underwriting an individual policy or contract.

Paper applications cause delays and errors through missing answers and rekeying. Electronic applications arrive complete and can be validated before submission. The insurer reports progress with the 273 and orders underwriting services with the 255. Applications can include several coverages.

How the EDI 267 worksDiagram of the EDI 267 Individual Life, Annuity and Disability Application. Distributor, such as an agent or broker-dealer sends it to insurance company or reinsurer. It usually follows 100. It is usually followed by 273, 255 and 997. Inside the ISA, GS and ST envelopes, X12 release 008010 requires, in the heading: BGN (Beginning Segment) and detail: the required N1 loop with N1 (Party Identification) and the required ACT loop with ACT (Account Identification). 8 optional loops are listed by their first segment.How the EDI 267 worksIndividual Life, Annuity and Disability Application: who sends it, where it fits and what the standard marksrequired1 WHERE IT FITSUSUALLY FOLLOWS100Insurance PlanDescriptionEDI 267SENDERDistributor, such as anagent or broker-dealerRECEIVERInsurance company orreinsurer997 or 999 acknowledgment back, if the partners agreeUSUALLY FOLLOWED BY273Insurance/AnnuityApplication Status255Underwriting InformationServices997FunctionalAcknowledgment2 WHAT X12 RELEASE 008010 REQUIRESInterchange: sender and receiver IDsISA … IEAFunctional group, ID code ADGS … GETransaction set 267ST … SEHEADINGBGNBeginning Segment+ 1 optional loop, starting with:NM1DETAILRequired loop N1 · repeats many timesN1Party IdentificationRequired loop ACT · repeats many timesACTAccount Identification+ 7 optional loops, starting with:LQSIPIDENTPWKLXK2Blue 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 267. Your trading partner's implementation guide adds its own requirements.
How the EDI 267 worksDiagram of the EDI 267 Individual Life, Annuity and Disability Application. Distributor, such as an agent or broker-dealer sends it to insurance company or reinsurer. It usually follows 100. It is usually followed by 273, 255 and 997. Inside the ISA, GS and ST envelopes, X12 release 008010 requires, in the heading: BGN (Beginning Segment) and detail: the required N1 loop with N1 (Party Identification) and the required ACT loop with ACT (Account Identification). 8 optional loops are listed by their first segment.How the EDI 267 worksIndividual Life, Annuity and DisabilityApplication: who sends it, where it fits andwhat the standard marks required1 WHERE IT FITSUSUALLY FOLLOWS100Insurance Plan DescriptionEDI 267SENDERDistributor, suchas an agent orbroker-dealerRECEIVERInsurancecompany orreinsurer997 or 999 acknowledgment back, if the partnersagreeUSUALLY FOLLOWED BY273Insurance/Annuity Application Status255Underwriting Information Services997Functional Acknowledgment2 WHAT X12 RELEASE 008010 REQUIRESInterchange: sender and receiver IDs (ISA… IEA)Functional group, ID code AD (GS … GE)Transaction set 267 (ST … SE)HEADINGBGNBeginning Segment+ 1 optional loop, starting with:NM1DETAILRequired loop N1 · repeats manytimesN1Party IdentificationRequired loop ACT · repeatsmany timesACTAccount Identification+ 7 optional loops, starting with:LQSIPIDENTPWKLXK2Blue 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 267. Your trading partner'simplementation guide adds its own requirements.

How to read this diagram: the top row shows who sends the 267, 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 267 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

  • Submitting life insurance applications
  • Submitting annuity applications
  • Submitting disability insurance applications

Where it fits in the document flow

Usually follows 100 Insurance Plan Description
This document 267 Individual Life, Annuity and Disability Application
Usually followed by 273 Insurance/Annuity Application Status255 Underwriting Information Services997 Functional Acknowledgment

Structure

Mandatory segments in the 267 (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
  • ACT
  • LQ
  • SI
  • PID
  • INV
  • BEN
  • ENT
  • N3
  • PDL
  • UC
  • HL
  • PWK
  • EFI
  • BIN
  • LX
  • AMT
  • AM1
  • K2
  • SE

Practical example

The 267 in practice

A financial advisor completes an annuity application with a client on a laptop. The broker-dealer's system checks suitability rules and sends the insurer a 267 with the owner, annuitant, product, funding amount and investment allocations. The insurer issues the contract and confirms the status with a 273.

Implementation

Implementation considerations for the 267

  • Validate completeness before submission.
  • Protect applicants' personal and financial data.
  • Capture required signatures and disclosures electronically.
  • Check whether insurers use newer industry XML standards instead.

How ECOM helps

Automate the 267 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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