Segment
X12 EDI Release 00303
To specify the retirement product characteristics
Elements
Code identifying the specific type of item maintenance.
Codes (16)- 001Change
- 002Delete
- 003Add Full Item Detail
- 004Withdraw Item (Temporary)
- 005Restore Item
- 021Addition
- 022Change in Status
- 023Change in Rate Factors
- 024Cancellation or Termination
- 025Reinstatement
- 026Correction
- 028Policy Adjustment
- 029Inquiry
- 030Audit or Compare
- 032Employee Information Not Applicable
- ZZZMutually Defined
Code identifying a group of insurance products.
Codes (37)- 401
- 403403(B) Tax Sheltered Annuity
- 457
- ACBasic Life
- AFSupplemental Life
- APPaid Up Life
- ARDependent Life
- BCDeath and Dismemberment
- BESupplemental Death and Dismemberment
- BHWeekly Indemnity
- BKWeekly Indemnity - New York Employees
- CVEmployee Comprehensive
- LLLifestyle Life (Individualized Basic Life)
- NQNon-Qualified
- ULUniversal Life
- URUtilization Review
- ADDAccidental Death or Dismemberment
- CLFContributory Life
- DENDental
- FSAFlexible Spending
- GDC457(B) Government Deferred Compensation
- HLTHealth
- HMOHealth Maintenance Organization
- IRAGroup Individual Retirement Account
- IRC408(B) Individual Retirement Account (IRA) Annuity Contract
- LTCLong-Term Care
- LTDLong-Term Disability
- MODMail Order Drug
- NGD457(F) Non-Government Deferred Compensation
- PDGPrescription Drug
- PSPProfit-Sharing Plan
- QDA401(K) Qualified Cash or Deferred Arrangement
- QDC401(A) Qualified Defined Contribution
- STDShort-Term Disability
- TSA
- VISVision
- ZZZMutually Defined
Code identifying the reason for the maintenance change.
Codes (42)- 10Consolidation Omnibus Budget Reconciliation Act (COBRA) Premium Paid
- 11Surviving Spouse
- 12Lay Off
- 13Leave of Absence
- 14Voluntary Withdrawal
- 15Primary Care Provider (PCP) Change
- 16Quit
- 17Fired
- 18Suspended
- 19Sabbatical
- 20Active
- 21Disability
- 22Plan Change
- 23Furloughed
- 24Resigned
- 25Change in Identifying Data Elements
- 26Declined Coverage
- 27Pre-Enrollment
- 28Initial Enrollment
- 29Benefit Selection
- 30Discrimination Test
- 31Legal Separation
- 32Marriage
- 33Personnel Data
- 34Investment Elections and Contribution Rates
- 35Loan Repayment
- 36Contribution or Plan Allocation
- 37Leave of Absence with Benefits
- 38Leave of Absence without Benefits
- 39Lay Off with Benefits
- 40Lay Off without Benefits
- 41Re-enrollment
- 01Divorce
- 02Birth
- 03Death
- 04Retirement
- 05Adoption
- 06Strike
- 07Termination of Benefits
- 08Termination of Employment
- 09Consolidation Omnibus Budget Reconciliation Act (COBRA)
- ZZMutually Defined
Code indicating the status of an individual in a benefit plan
Codes (27)- AActive
- CDeath Not Processed
- DDisabled
- NNew
- RReinstated
- SSuspended
- ANActive Non-Vested
- AVActive Vested
- CDContract Discontinuance
- DBTermination - Death
- DNDeferral - Not Vested
- DPDelete or Pending Purge
- DRDistribution Restricted
- DVDeferral - Vested
- GAGolden Age
- KPKeep Participant
- PDPlan Discontinuance
- PFPotentially Forfeitable
- RTRetired
- S1Suspended From Contributing For 1 Year
- S2Suspended From Contributing For 2 Years
- TDTermination - Disability
- TNTerminated Non-Vested
- TRTermination - Retirement
- TSTermination - Severance
- TVTerminated Vested
- USUnit Sale