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111Individual Insurance Policy and Client Information

This X12 Transaction Set contains the format and establishes the data contents of the Individual Insurance Policy and Client Information Transaction Set (111) for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to exchange policy and client information among organizations administering individual life and health insurance contracts and their trading partners (e.g., agents, brokers). It is not intended to be used for group 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

  • BHT
    Beginning of Hierarchical Transaction
    M必须(Mandatory)
    Repeat 1

    To define the business hierarchical structure of the transaction set and identify the business application purpose and reference data, i.e., number, date, and time

  • NM1Loop1Individual or Organizational Name LOOPM必须(Mandatory)Repeat > 1
    NM1N3N4REFPER
    • NM1
      Individual or Organizational Name
      M必须(Mandatory)
      Repeat 1

      To supply the full name of an individual or organizational entity

    • N3
      Party Location
      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 Information
      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

  • HLLoop1Hierarchical Level LOOPM必须(Mandatory)Repeat > 1
    HLREFASILQC3DMGLUIN4BLILINUDASPADTPBLNQTYAMTRPAPDLLoop1IIILoop1AM1Loop1NM1Loop2NX1Loop1
    • HL
      Hierarchical Level
      M必须(Mandatory)
      Repeat 1

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

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

      To specify identifying information

    • ASI
      Action or Status Indicator
      O可选(Optional)
      Repeat > 1

      To indicate the action to be taken with the information provided or the status of the entity described

    • LQ
      Industry Code Identification
      O可选(Optional)
      Repeat > 1

      To identify standard industry codes

    • C3
      Currency Identifier
      O可选(Optional)
      Repeat 1

      To specify the currency being used in the transaction set

    • DMG
      Demographic Information
      O可选(Optional)
      Repeat 1

      To supply demographic information

    • LUI
      Language Use
      O可选(Optional)
      Repeat 1

      To specify language, type of usage, and proficiency or fluency

    • N4
      Geographic Location
      O可选(Optional)
      Repeat > 1

      To specify the geographic place of the named party

    • BLI
      Basic Baseline Item Data
      O可选(Optional)
      Repeat 1

      To specify basic item data: item identification, quantity, and price

    • LIN
      Item Identification
      O可选(Optional)
      Repeat > 1

      To specify basic item identification data

    • UDA
      Underwriting Condition
      O可选(Optional)
      Repeat > 1

      To specify the condition under which insurance coverage is offered

    • SPA
      Status of Product or Activity
      O可选(Optional)
      Repeat > 1

      To indicate the details and status of a product or product activity

    • 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

    • BLN
      Balance Information
      O可选(Optional)
      Repeat > 1

      To provide specific balance information for financial account reporting

    • QTY
      Quantity Information
      O可选(Optional)
      Repeat > 1

      To specify quantity information

    • AMT
      Monetary Amount Information
      O可选(Optional)
      Repeat > 1

      To indicate the total monetary amount

    • RPA
      Rate Amounts or Percents
      O可选(Optional)
      Repeat > 1

      To identify rate amounts or percents for a specific cost or other line item

    • PDLLoop1Payment Details LOOPO可选(Optional)Repeat > 1
      PDLREF
      • PDL
        Payment Details
        M必须(Mandatory)
        Repeat 1

        To transmit information required to establish payment or remittance activity

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

        To specify identifying information

    • IIILoop1Information LOOPO可选(Optional)Repeat > 1
      IIIDTP
      • III
        Information
        M必须(Mandatory)
        Repeat 1

        To report information

      • 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

    • AM1Loop1Informational Values LOOPO可选(Optional)Repeat > 1
      AM1IIISPADTPAMTQTYRPABLNREF
      • AM1
        Informational Values
        M必须(Mandatory)
        Repeat 1

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

      • III
        Information
        O可选(Optional)
        Repeat > 1

        To report information

      • SPA
        Status of Product or Activity
        O可选(Optional)
        Repeat > 1

        To indicate the details and status of a product or product activity

      • 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

      • AMT
        Monetary Amount Information
        O可选(Optional)
        Repeat > 1

        To indicate the total monetary amount

      • QTY
        Quantity Information
        O可选(Optional)
        Repeat > 1

        To specify quantity information

      • RPA
        Rate Amounts or Percents
        O可选(Optional)
        Repeat > 1

        To identify rate amounts or percents for a specific cost or other line item

      • BLN
        Balance Information
        O可选(Optional)
        Repeat > 1

        To provide specific balance information for financial account reporting

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

        To specify identifying information

    • NM1Loop2Individual or Organizational Name LOOPO可选(Optional)Repeat > 1
      NM1N2COMN3Loop1
      • NM1
        Individual or Organizational Name
        M必须(Mandatory)
        Repeat 1

        To supply the full name of an individual or organizational entity

      • N2
        Additional Name Information
        O可选(Optional)
        Repeat 3

        To specify additional names

      • COM
        Communication Contact Information
        O可选(Optional)
        Repeat > 1

        To specify a communication contact number

      • N3Loop1Party Location LOOPO可选(Optional)Repeat > 1
        N3N4DTP
        • N3
          Party Location
          M必须(Mandatory)
          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

    • NX1Loop1Property or Entity Identification LOOPO可选(Optional)Repeat > 1
      NX1REFBENIIIAM1IN1
      • NX1
        Property or Entity Identification
        M必须(Mandatory)
        Repeat 1

        To define the attributes of a property or an entity

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

        To specify identifying information

      • BEN
        Beneficiary or Owner Information
        O可选(Optional)
        Repeat 1

        To supply beneficiary, co-participant, and owner information

      • III
        Information
        O可选(Optional)
        Repeat > 1

        To report information

      • AM1
        Informational Values
        O可选(Optional)
        Repeat > 1

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

      • IN1
        Individual Identification
        O可选(Optional)
        Repeat > 1

        To provide identification of an individual or entity

  • 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 00503
STTransaction Set Header
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

    Reference assigned to identify Implementation Convention

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