Medium City of Claremont-Sunlife 834 Enrollment and Demographic change type.
This enhancement is related to EDI-22
After moving to change file testing, the only remaining issue we have is INS03 and INS04. They want a code based on the type of change. Please see below.
This is absolute requirement for Sun Life and we cannot pass testing without coding for this. How quickly can this achieved?
I have a call on Friday, 4/1 with the Broker and Carrier and need to have some indication of what how long this will take.
INS04:
INS04 maintenance code '25' should ONLY be used for a member SSN change.
You are sending member change INS03 ='001' with an INS04 value '25'.
For member demographic change, NON SSN, INS03 = '001' please use INS04 = '33'.
If INS04 = '25' is received for an existing client the transactions reject because we are trying to update an existing SSN with the same SSN.
General Guidelines:
Initial Enrollment - INS03 = '021'
USE: INS04 ='28' (initial enrollment)
Termination - INS03 = '024'
USE INS04 = '07' (benefit termination) or '08' (EE termination)
SSN Change - INS03 = '001'
USE: INS04 ='25'
Any Other Demographic Change: Address, Salary, Name etc. - INS03 = '001'
Use: INS04 = '33'
Rehire - INS03 = '021'
USE: INS04 = '41' (re-enrollment)
Unknown/Unidentified Change: INS03 ='001'
Use: INS04 = 'AI'
Thanks,
Chris
