186Insurance Underwriting Requirements Reporting

This Draft Standard for Trial Use contains the format and establishes the data contents of the Insurance Underwriting Requirements Reporting Transaction Set (186) for use within the context of an Electronic Data Interchange (EDI) environment. The standard can be used by the information providers to report the results of specific services to their trading partners for information to complete the insurance underwriting process on individually underwritten life and health insurance.

  • ST
    Transaction Set Header
    M必须(Mandatory)
    Repeat 1

    To indicate the start of a transaction set and to assign a control number

  • BGN
    Beginning Segment
    M必须(Mandatory)
    Repeat 1

    To indicate the beginning of a transaction set

  • CUR
    Currency
    O可选(Optional)
    Repeat 1

    To specify the currency (dollars, pounds, francs, etc.) used in a transaction

  • LTR
    Laboratory Test Results
    O可选(Optional)
    Repeat 99

    To describe laboratory testing results, normal result ranges, or both

  • NM1Loop1Individual or Organizational Name LOOPO可选(Optional)Repeat 2
    NM1N3N4REFPER
    • NM1
      Individual or Organizational Name
      M必须(Mandatory)
      Repeat 1

      To supply the full name of an individual or organizational entity

    • N3
      Address Information
      O可选(Optional)
      Repeat 3

      To specify the location of the named party

    • N4
      Geographic Location
      O可选(Optional)
      Repeat 1

      To specify the geographic place of the named party

    • REF
      Reference Identification
      O可选(Optional)
      Repeat 9

      To specify identifying information

    • PER
      Administrative Communications Contact
      O可选(Optional)
      Repeat 3

      To identify a person or office to whom administrative communications should be directed

  • ACTLoop1Account Identification LOOPM必须(Mandatory)Repeat > 1
    ACTLXLoop1
    • ACT
      Account Identification
      M必须(Mandatory)
      Repeat 1

      To specify account information

    • LXLoop1Assigned Number LOOPM必须(Mandatory)Repeat > 1
      LXNM1Loop2BORLoop1
      • LX
        Assigned Number
        M必须(Mandatory)
        Repeat 1

        To reference a line number in a transaction set

      • NM1Loop2Individual or Organizational Name LOOPM必须(Mandatory)Repeat > 1
        NM1REFN3N4DMGDTPAM1PWKMSGDMAQTY
        • NM1
          Individual or Organizational Name
          M必须(Mandatory)
          Repeat 1

          To supply the full name of an individual or organizational entity

        • REF
          Reference Identification
          O可选(Optional)
          Repeat > 1

          To specify identifying information

        • N3
          Address Information
          O可选(Optional)
          Repeat 1

          To specify the location of the named party

        • N4
          Geographic Location
          O可选(Optional)
          Repeat 1

          To specify the geographic place of the named party

        • DMG
          Demographic Information
          O可选(Optional)
          Repeat 1

          To supply demographic information

        • DTP
          Date or Time or Period
          O可选(Optional)
          Repeat 5

          To specify any or all of a date, a time, or a time period

        • AM1
          Informational Values
          O可选(Optional)
          Repeat 9

          To specify a code and the amount or quantity or percentage associated with it

        • PWK
          Paperwork
          O可选(Optional)
          Repeat 1

          To identify the type or transmission or both of paperwork or supporting information

        • MSG
          Message Text
          O可选(Optional)
          Repeat > 1

          To provide a free-form format that allows the transmission of text information

        • DMA
          Additional Demographic Information
          O可选(Optional)
          Repeat 1

          To supply additional demographic identification

        • QTY
          Quantity
          O可选(Optional)
          Repeat > 1

          To specify quantity information

      • BORLoop1Beginning of Report LOOPM必须(Mandatory)Repeat > 1
        BORDTPMSGNM1Loop3SPKLoop1LTRLoop1UCLoop1LSLoop1
        • BOR
          Beginning of Report
          M必须(Mandatory)
          Repeat 1

          To identify characteristic information of the report being transmitted

        • DTP
          Date or Time or Period
          O可选(Optional)
          Repeat > 1

          To specify any or all of a date, a time, or a time period

        • MSG
          Message Text
          O可选(Optional)
          Repeat > 1

          To provide a free-form format that allows the transmission of text information

        • NM1Loop3Individual or Organizational Name LOOPO可选(Optional)Repeat > 1
          NM1REFPERN3N4DMAREL
          • NM1
            Individual or Organizational Name
            M必须(Mandatory)
            Repeat 1

            To supply the full name of an individual or organizational entity

          • REF
            Reference Identification
            O可选(Optional)
            Repeat > 1

            To specify identifying information

          • PER
            Administrative Communications Contact
            O可选(Optional)
            Repeat 1

            To identify a person or office to whom administrative communications should be directed

          • N3
            Address Information
            O可选(Optional)
            Repeat 1

            To specify the location of the named party

          • N4
            Geographic Location
            O可选(Optional)
            Repeat 1

            To specify the geographic place of the named party

          • DMA
            Additional Demographic Information
            O可选(Optional)
            Repeat 1

            To supply additional demographic identification

          • REL
            Relationship
            O可选(Optional)
            Repeat 1

            To specify relationship and birth order of entity

        • SPKLoop1Specimen Kit Information LOOPO可选(Optional)Repeat > 1
          SPKCD2DTPREFMSGNM1Loop4
          • SPK
            Specimen Kit Information
            M必须(Mandatory)
            Repeat 1

            To identify and describe laboratory specimen kit information and handling requirements

          • CD2
            Multi-Valued Characteristics
            O可选(Optional)
            Repeat 9

            To provide characteristics that may have multiple values

          • DTP
            Date or Time or Period
            O可选(Optional)
            Repeat 9

            To specify any or all of a date, a time, or a time period

          • REF
            Reference Identification
            O可选(Optional)
            Repeat 1

            To specify identifying information

          • MSG
            Message Text
            O可选(Optional)
            Repeat > 1

            To provide a free-form format that allows the transmission of text information

          • NM1Loop4Individual or Organizational Name LOOPO可选(Optional)Repeat > 1
            NM1N4
            • NM1
              Individual or Organizational Name
              M必须(Mandatory)
              Repeat 1

              To supply the full name of an individual or organizational entity

            • N4
              Geographic Location
              O可选(Optional)
              Repeat 1

              To specify the geographic place of the named party

        • LTRLoop1Laboratory Test Results LOOPO可选(Optional)Repeat > 1
          LTRCD2DTPNM1MSG
          • LTR
            Laboratory Test Results
            M必须(Mandatory)
            Repeat 1

            To describe laboratory testing results, normal result ranges, or both

          • CD2
            Multi-Valued Characteristics
            O可选(Optional)
            Repeat 9

            To provide characteristics that may have multiple values

          • DTP
            Date or Time or Period
            O可选(Optional)
            Repeat 9

            To specify any or all of a date, a time, or a time period

          • NM1
            Individual or Organizational Name
            O可选(Optional)
            Repeat 9

            To supply the full name of an individual or organizational entity

          • MSG
            Message Text
            O可选(Optional)
            Repeat > 1

            To provide a free-form format that allows the transmission of text information

        • UCLoop1Underwriting Category LOOPO可选(Optional)Repeat > 1
          UCHLLoop1
          • UC
            Underwriting Category
            M必须(Mandatory)
            Repeat 1

            To identify the category of underwriting data being transmitted

          • HLLoop1Hierarchical Level LOOPO可选(Optional)Repeat > 1
            HLUQSNM1N1N3N4DTPQTYMSGDMAAM1DMGAMTECPERREFIN1EMSASLTOATOVIIISINUCSFHUDCDSCEDYNQMPIEFILoop1
            • HL
              Hierarchical Level
              M必须(Mandatory)
              Repeat 1

              To identify dependencies among and the content of hierarchically related groups of data segments

            • UQS
              Underwriting Question
              O可选(Optional)
              Repeat 1

              To report information provider underwriting data in a question and answer format

            • NM1
              Individual or Organizational Name
              O可选(Optional)
              Repeat 1

              To supply the full name of an individual or organizational entity

            • N1
              Name
              O可选(Optional)
              Repeat 1

              To identify a party by type of organization, name, and code

            • N3
              Address Information
              O可选(Optional)
              Repeat 1

              To specify the location of the named party

            • N4
              Geographic Location
              O可选(Optional)
              Repeat 1

              To specify the geographic place of the named party

            • DTP
              Date or Time or Period
              O可选(Optional)
              Repeat > 1

              To specify any or all of a date, a time, or a time period

            • QTY
              Quantity
              O可选(Optional)
              Repeat > 1

              To specify quantity information

            • MSG
              Message Text
              O可选(Optional)
              Repeat > 1

              To provide a free-form format that allows the transmission of text information

            • DMA
              Additional Demographic Information
              O可选(Optional)
              Repeat 1

              To supply additional demographic identification

            • AM1
              Informational Values
              O可选(Optional)
              Repeat 1

              To specify a code and the amount or quantity or percentage associated with it

            • DMG
              Demographic Information
              O可选(Optional)
              Repeat 1

              To supply demographic information

            • AMT
              Monetary Amount
              O可选(Optional)
              Repeat 1

              To indicate the total monetary amount

            • EC
              Employment Class
              O可选(Optional)
              Repeat 1

              To provide class of employment information

            • PER
              Administrative Communications Contact
              O可选(Optional)
              Repeat 1

              To identify a person or office to whom administrative communications should be directed

            • REF
              Reference Identification
              O可选(Optional)
              Repeat 1

              To specify identifying information

            • IN1
              Individual Identification
              O可选(Optional)
              Repeat 1

              To provide identification of an individual or entity

            • EMS
              Employment Position
              O可选(Optional)
              Repeat 1

              To describe employment position

            • ASL
              Asset Liability
              O可选(Optional)
              Repeat > 1

              To report financial information

            • TOA
              Type of Activity
              O可选(Optional)
              Repeat 1

              To specify type of activity information

            • TOV
              Vehicle Use Information
              O可选(Optional)
              Repeat 1

              To report usage of a vehicle

            • III
              Information
              O可选(Optional)
              Repeat > 1

              To report information

            • SIN
              Substance Use
              O可选(Optional)
              Repeat 1

              To report use of tobacco, alcohol, drugs or other substances

            • UCS
              Underwriting Considerations
              O可选(Optional)
              Repeat 1

              To report personal health and medical history data

            • FH
              Family History
              O可选(Optional)
              Repeat 1

              To report information about a person's family health history

            • UD
              Underwriting Status
              O可选(Optional)
              Repeat 1

              To identify and describe underwriting status of submitted applications

            • CDS
              Case Description
              O可选(Optional)
              Repeat 1

              To identify and describe a specific court case

            • CED
              Administration of Justice Event Description
              O可选(Optional)
              Repeat 1

              To describe specific administration of justice events and actions

            • YNQ
              Yes/No Question
              O可选(Optional)
              Repeat 1

              To identify and answer yes and no questions, including the date, time, and comments further qualifying the condition

            • MPI
              Military Personnel Information
              O可选(Optional)
              Repeat 1

              To report military service data

            • EFILoop1Electronic Format Identification LOOPO可选(Optional)Repeat > 1
              EFIBIN
              • EFI
                Electronic Format Identification
                M必须(Mandatory)
                Repeat 1

                To provide basic information about the electronic format of the interchange data

              • BIN
                Binary Data
                M必须(Mandatory)
                Repeat 1

                To transfer binary data in a single data segment and allow identification of the end of the data segment through a count; there is no identification of the internal structure of the binary data in this segment

        • LSLoop1Loop Header LOOPO可选(Optional)Repeat 1
          LSUDLoop1LE
          • LS
            Loop Header
            M必须(Mandatory)
            Repeat 1

            To indicate that the next segment begins a loop

          • UDLoop1Underwriting Status LOOPO可选(Optional)Repeat > 1
            UDNM1N4RELDTPEFILoop2
            • UD
              Underwriting Status
              M必须(Mandatory)
              Repeat 1

              To identify and describe underwriting status of submitted applications

            • NM1
              Individual or Organizational Name
              O可选(Optional)
              Repeat 1

              To supply the full name of an individual or organizational entity

            • N4
              Geographic Location
              O可选(Optional)
              Repeat 1

              To specify the geographic place of the named party

            • REL
              Relationship
              O可选(Optional)
              Repeat 1

              To specify relationship and birth order of entity

            • DTP
              Date or Time or Period
              O可选(Optional)
              Repeat 1

              To specify any or all of a date, a time, or a time period

            • EFILoop2Electronic Format Identification LOOPO可选(Optional)Repeat > 1
              EFIBIN
              • EFI
                Electronic Format Identification
                M必须(Mandatory)
                Repeat 1

                To provide basic information about the electronic format of the interchange data

              • BIN
                Binary Data
                M必须(Mandatory)
                Repeat 1

                To transfer binary data in a single data segment and allow identification of the end of the data segment through a count; there is no identification of the internal structure of the binary data in this segment

          • LE
            Loop Trailer
            M必须(Mandatory)
            Repeat 1

            To indicate that the loop immediately preceding this segment is complete

  • SE
    Transaction Set Trailer
    M必须(Mandatory)
    Repeat 1

    To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

Segment
X12 EDI Release 00401
To indicate the start of a transaction set and to assign a control number
Elements
  • ST01143Transaction Set Identifier Code
    ID
    M必须(Mandatory)
    Min 3 / Max 3

    Code uniquely identifying a Transaction Set

    Codes (320)
  • ST02329Transaction Set Control Number
    AN
    M必须(Mandatory)
    Min 4 / Max 9

    Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set

  • ST031705Implementation Convention Preference
    AN
    O可选(Optional)
    Min 1 / Max 9