Appendix D. Change Summary

This Implementation Guide (007030X346) defines the X12 requirements for the Health Insurance Exchange: Enrollment. It is based on version/release/subrelease 007030 of the ASC X12 standards.

LocationX346 | Health Insurance Exchange: Enrollment
2.3 Transaction Set Listing
ActionModify Segment Repeat
PER: in implementation for Loops 2100A, 2100E, 2100F, 2100I (position 0400)
Change segment repeat from 1 To 5
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment
2.3 Transaction Set Listing
ActionModify Segment Repeat
Loop 2000 Coverage Specific Exchange Assigned Qualified Health Plan Identifier (REF):
From 1 to 5
CR 1110The HIX 834 guide has an inconsistency in the 2000 loop for Coverage Specific Issuer Assigned QHP Identifier and the Coverage specific Exchange Assigned Identifier REF segments. The segment has only one repeat but the note states multiple coverages can be reported.
LocationX346 | Health Insurance Exchange: Enrollment
2.3 Transaction Set Listing
ActionModify Segment Repeat
Loop 2000 Coverage Specific Issuer Assigned Qualified Health Plan Identifier (REF):
From 1 to 5
CR 1110The HIX 834 guide has an inconsistency in the 2000 loop for Coverage Specific Issuer Assigned QHP Identifier and the Coverage specific Exchange Assigned Identifier REF segments. The segment has only one repeat but the note states multiple coverages can be reported.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0100
ST - Transaction Set Header
ActionModify Data Element Note
Transaction Set Header/ST02 Transaction Set Control Number

Changed to "The Transaction Set Control Numbers in ST02 and SE02 must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). For example, start with the number 0001 and increment from there. The number also aids in error resolution research."
CR 999Revise the ST02 notes across the TR3's to make them consistent.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0600
QTY - Transaction Set Control Totals
ActionAdd Segment Note
#3:
Since an individual member's record may be transmitted more than once within the ST-SE, the quantity in QTY02 when QTY01 = TO, does not necessarily reflect a count of unique member records.
CR 476Clarify that the QTY02 quantity is a record count that may not represent the number of unique members in the transmission.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1800 | 1100EA
AMT - Employer Contribution
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0200 | 2000
REF - Coverage Specific Exchange Assigned Qualified Health Plan Identifier
ActionModify Segment Repeat
:
From 1 to 5
CR 1110The HIX 834 guide has an inconsistency in the 2000 loop for Coverage Specific Issuer Assigned QHP Identifier and the Coverage specific Exchange Assigned Identifier REF segments. The segment has only one repeat but the note states multiple coverages can be reported.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0200 | 2000
REF - Coverage Specific Issuer Assigned Qualified Health Plan Identifier
ActionModify Segment Repeat
:
From 1 to 5
CR 1110The HIX 834 guide has an inconsistency in the 2000 loop for Coverage Specific Issuer Assigned QHP Identifier and the Coverage specific Exchange Assigned Identifier REF segments. The segment has only one repeat but the note states multiple coverages can be reported.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Value
to DTP01:
AEC (Medicare Part A Coverage Effective Date)
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Value
to DTP01:
AEG (Medicare Part B Coverage Effective Date)
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Value
to DTP01:
AFC (Medicare Part D Coverage Effective Date)
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Value
to DTP01:
AED (Medicare Part A Coverage Termination Date)
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Value
to DTP01:
AEH (Medicare Part B Coverage Termination Date)
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Value
to DTP01:
AFD (Medicare Part D Coverage Termination Date)
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Note
To DTP01 Code 338 (Medicare Begin):
Use for Medicare Part C (Medicare Advantage) Coverage Effective Date
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Enrollee Level Dates
ActionAdd Data Element Code Note
To DTP01 Code 339 (Medicare End):
Use for Medicare Part C (Medicare Advantage) Coverage Termination Date
CR 1492Need the capability to associate specific member-level dates and coverages (such as Part A or Part D) for enrollment purposes.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0250 | 2000
DTP - Online Application Date/Time
ActionAdd Segment
DTP - Online/Application Date/Time segment
CR 1352Add a date and time stamp indicating when the enrollee completed the application submission.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Segment Note
#3:
Send communication information in the order of preference when contacting the member.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionModify Segment Repeat
:
From 1 To 5
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Value
To PER03:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Value
To PER05:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Value
To PER07:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code OT (Other Residential Telephone Number):
Use when reporting a TTY communication number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code EA (Internet Email Address):
Use when reporting a secondary or alternate email address.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code AP (Alternate Telephone):
Use when reporting the phone number for the individual's closest relative.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code TE (Telephone):
Use when identifying the primary phone number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100A
PER - Enrollee Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code CP (Cellular Phone):
Use when the cellular phone ownership is unknown.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100A
DMG - Enrollee Demographics
ActionModify Data Element Usage
on DMG05-01:
From Situational to Not Used.
Race and ethnicity is reported in DMG05-02 and DMG05-03.
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100A
DMG - Enrollee Demographics
ActionModify Data Element Usage
of DMG05-02:
From Situational to Required.
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100A
DMG - Enrollee Demographics
ActionModify Data Element Usage
of DMG05-03:
From Situational to Required
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100A
DMG - Enrollee Demographics
ActionDelete Data Element Note
on DMG05:
Race and ethnicity is only reported in DMG05-02 and DMG05-03.
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionModify Data Element Situational Rule
on HLH01-02:
From
Required when an `S', `T', or `X' is sent in the health related code. If not required by this implementation guide, do not send.
To
Required when a `P', `S', `T', or `X' is sent in the health related code. If not required by this implementation guide, do not send.
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Situational Rule
to HLH01-01:
Required on initial enrollment to report tobacco use, substance abuse or pregnancy status when the enrollee's information is available.
OR
Required on an enrollment update to report tobacco use, substance abuse or pregnancy status when an enrollee's information is available.
If not required by this implementation guide, do not send.
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionModify Data Element Usage
on HLH01:
From Required to Situational
CR 1117Revise the HLH Situational Rule to allow transmission during an enrollment period.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Code Value
to HLH01-01:
P (Pregnancy)
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Situational Rule
to HLH01-02:
Required when a `P', `S', `T', or `X' is sent in the health related code. If not required by this implementation guide, do not send.
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Note
to HLH01-02:
Use to report a health related condition is present, not present (N) or unknown.
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Code Value
to HLH01-03:
771 (Status)
W02 (Status Change)
ABC (Estimated Date of Birth)
CR 1116Smoking is a rating factor for many policies. Issuers who do not do their own applications need to know the dates someone stopped smoking or began smoking.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Situational Rule
to HLH01-03:
Required when a status effective date for tobacco use or substance abuse is available.
Or
Required when an estimated pregnancy due date is available.
If not required, do not send.
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Situational Rule
to HLH01-03:
Required when a status effective date for tobacco use or substance abuse is available.
Or
Required when an estimated pregnancy due date is available.
If not required, do not send.
CR 1116Smoking is a rating factor for many policies. Issuers who do not do their own applications need to know the dates someone stopped smoking or began smoking.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Situational Rule
to HLH01-04:
Required when C061-03 is populated. If not required, do not send.
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Situational Rule
to HLH01-04:
Required when C061-03 is populated. If not required, do not send.
CR 1116Smoking is a rating factor for many policies. Issuers who do not do their own applications need to know the dates someone stopped smoking or began smoking.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Code Note
to HLH01-03 code 771 (Status):
Use when reporting a tobacco use or substance abuse status for the first time.
CR 1116Smoking is a rating factor for many policies. Issuers who do not do their own applications need to know the dates someone stopped smoking or began smoking.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Code Note
to HLH01-03 code W02 (Status Change):
Use when reporting a change in tobacco use or substance abuse status for the first time or when reporting a change of estimated date of birth.
CR 1116Smoking is a rating factor for many policies. Issuers who do not do their own applications need to know the dates someone stopped smoking or began smoking.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Code Note
to HLH01-03 code ABC (Estimated Date of Birth):
Use when reporting the estimated date of birth for the first time.
CR 1115Add a pregnant indicator and the ability to indicate a changes in status between "No", "Yes", and "Unknown".
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionModify Segment Situational Rule
:
From
Required on initial enrollment of an enrollee when appropriate medical information about the enrollee is available. If not required by this implementation guide, do not send.

to
Required on initial enrollment of an enrollee when appropriate medical information about the enrollee is available
Or
Required on an enrollment update when an enrollee's medical information has changed and is available.
If not required by this implementation guide, do not send.
CR 1117Revise the HLH Situational Rule to allow transmission during an enrollment period.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1300 | 2100A
HLH - Enrollee Health Information
ActionAdd Data Element Situational Rule
to HLH01:
Required on initial enrollment to report tobacco use, substance abuse or pregnancy status when the enrollee's information is available.
OR
Required on an enrollment update to report tobacco use, substance abuse or pregnancy status when an enrollee's information is available.
If not required by this implementation guide, do not send.
CR 1117Revise the HLH Situational Rule to allow transmission during an enrollment period.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 1400 | 2100A
HI - Enrollment Amount Information
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100B
DMG - Incorrect Enrollee Demographics
ActionModify Data Element Situational Rule
on DMG05-01:
From Situational to Not Used.
Race and ethnicity is reported in DMG05-02 and DMG05-03.
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100B
DMG - Incorrect Enrollee Demographics
ActionModify Data Element Usage
on DMG05-02:
From Situational to Required.
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100B
DMG - Incorrect Enrollee Demographics
ActionModify Data Element Usage
on DMG05-03:
From Situational to Required
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0800 | 2100B
DMG - Incorrect Enrollee Demographics
ActionDelete Data Element Note
on DMG05:
Race and ethnicity is only reported in DMG05-02 and DMG05-03.
CR 1335Need to modify the race/ethnicity reporting in the 834 to support the OMB guidance. Refer to the requirements at http://www.whitehouse.gov/omb/fedreg_1997standards/.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100D
PER - Enrollee Employer Communications Numbers
ActionAdd Segment Note
#2:
Send communication information in the order of preference when contacting the member.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0300 | 2100E
NM1 - Custodial Parent
ActionModify Data Element Usage
on NM104:
From Required To Situational
CR 1113Change 2100F - Custodial Parent First Name (NM104) to situational for consistency.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0300 | 2100E
NM1 - Custodial Parent
ActionAdd Data Element Situational Rule
To NM104:
Required when NM102 is equal to "1" (person) and the person has a first name. If not required by this implementation guide, do not send.
CR 1113Change 2100F - Custodial Parent First Name (NM104) to situational for consistency.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Segment Note
#2:
Send communication information in the order of preference when contacting the member.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionModify Segment Repeat
:
From 1 To 5
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Value
To PER03:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Value
To PER05:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Value
to PER07:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code OT (Other Residential Telephone Number):
Use when reporting a TTY communication number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code EA (Internet Email Address):
Use when reporting a secondary or alternate email address.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code AP (Alternate Telephone):
Use when reporting the phone number for the individual's closest relative.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code TE (Telephone):
Use when identifying the primary phone number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100E
PER - Custodial Parent Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code CP (Cellular Phone):
Use when the cellular phone ownership is unknown.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Segment Note
#2:
Send communication information in the order of preference when contacting the member.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionModify Segment Repeat
:
From 1 To 5
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Data Element Code Value
To PER03:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Data Element Code Value
To PER05:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code OT (Other Residential Telephone Number):
Use when reporting a TTY communication number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code EA (Internet Email Address):
Use when reporting a secondary or alternate email address.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code AP (Alternate Telephone):
Use when reporting the phone number for the individual's closest relative.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code TE (Telephone):
Use when identifying the primary phone number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100F
PER - Responsible Person Communications Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code CP (Cellular Phone):
Use when the cellular phone ownership is unknown.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Segment Note
#2:
Send communication information in the order of preference when contacting the member.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionModify Segment Repeat
:
From 1 To 5
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Value
To PER03:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Value
To PER05:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Value
To PER07:
TS (Text Messaging Address)
OT (Other Residential Telephone number )
EA (Internet Email Address)
WC (Work Cellular)
PC (Personal Cellular)
NP (Night Phone)
PP (Personal Phone)
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code OT (Other Residential Telephone Number):
Use when reporting a TTY communication number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code EA (Internet Email Address):
Use when reporting a secondary or alternate email address.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code AP (Alternate Telephone):
Use when reporting the phone number for the individual's closest relative.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code TE (Telephone):
Use when identifying the primary phone number.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 0400 | 2100I
PER - APTC Contributor/Tax Payer Communication Numbers
ActionAdd Data Element Code Note
To PER03, PER05, PER07 code CP (Cellular Phone):
Use when the cellular phone ownership is unknown.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 2600 | 2300
HD - Health Coverage
ActionAdd Data Element Code Value
to HD03:
CDV (Combined Dental and Vision)
CR 1453An additional code is required in HD03 for ancillary products that do not required the same level of member identification as other health care products.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 2600 | 2300
HD - Health Coverage
ActionAdd Data Element Code Value
to HD03:
COM (Combined insurance lines other than dental and vision)
CR 1453An additional code is required in HD03 for ancillary products that do not required the same level of member identification as other health care products.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 2600 | 2300
HD - Health Coverage
ActionAdd Data Element Code Note
to HD03 code COM (Combined insurance lines other than dental and vision):
Use when identifying combined insurance lines other than dental and vision that are not QHP Products under Exchange business.
CR 1453An additional code is required in HD03 for ancillary products that do not required the same level of member identification as other health care products.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 2700 | 2300
DTP - Health Coverage Dates
ActionAdd Data Element Code Value
to DTP01:
606 (Certification Period Start)
CR 1555Add a Certification Date DTP segment in Loop 2300 so the payer knows how long the member is currently eligible to be in the program.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 2700 | 2300
DTP - Health Coverage Dates
ActionModify Segment Repeat
:
From 7 to 8
CR 1555Add a Certification Date DTP segment in Loop 2300 so the payer knows how long the member is currently eligible to be in the program.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 2700 | 2300
DTP - Health Coverage Dates
ActionAdd Data Element Code Note
on DTP01 code 606 (Certification Period Start):
Use when reporting the member's date of certification or qualification for the coverage being sent in Loop 2300. Benefit Begin Date is reported using code value 348. Certification Period Start and Benefit Begin Date may or may not be the same.
CR 1555Add a Certification Date DTP segment in Loop 2300 so the payer knows how long the member is currently eligible to be in the program.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 2700 | 2300
DTP - Online Application Date/Time
ActionAdd Segment
DTP - Online/Application Date/Time segment
CR 1352Add a date and time stamp indicating when the enrollee completed the application submission.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 3700 | 2310
PER - Provider Communications Numbers
ActionAdd Segment Note
#2:
Send communication information in the order of preference when contacting the member.
CR 1114There is a need for more contact numbers than the TR3 currently supports. There also needs to be guidance for how to identify the preferred contact method. May need additional qualifiers for other contact methods such as text and an alternate contact not living in your household.
LocationX346 | Health Insurance Exchange: Enrollment | 834 | 6900
SE - Transaction Set Trailer
ActionModify Data Element Note
Transaction Set Trailer/SE02 Transaction Set Control Number

Changed to "The Transaction Set Control Numbers in ST02 and SE02 must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). For example, start with the number 0001 and increment from there. The number also aids in error resolution research."
CR 999Revise the ST02 notes across the TR3's to make them consistent.