111 Individual Insurance Policy and Client Information
111 Individual Insurance Policy and Client Information
Function Group IF
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.
Position
Segment
Name
Max Use
0100
Transaction Set HeaderMandatory
Max 1
To indicate the start of a transaction set and to assign a control number
0200
Beginning of Hierarchical TransactionMandatory
Max 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
1000Loop
Mandatory
Repeat >1
0300
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
0400
Address InformationOptional
Max 3
To specify the location of the named party
0500
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
0600
Reference IdentificationOptional
Max 9
To specify identifying information
0700
Administrative Communications ContactOptional
Max 3
To identify a person or office to whom administrative communications should be directed
Position
Segment
Name
Max Use
2000Loop
Mandatory
Repeat >1
0100
Hierarchical LevelMandatory
Max 1
To identify dependencies among and the content of hierarchically related groups of data segments
0200
Reference IdentificationOptional
Max >1
To specify identifying information
0300
Action or Status IndicatorOptional
Max >1
To indicate the action to be taken with the information provided or the status of the entity described
0400
Industry CodeOptional
Max >1
Code to transmit standard industry codes
0500
CurrencyOptional
Max 1
To specify the currency being used in the transaction set
0600
Demographic InformationOptional
Max 1
To supply demographic information
0700
Language UseOptional
Max 1
To specify language, type of usage, and proficiency or fluency
0800
Geographic LocationOptional
Max >1
To specify the geographic place of the named party
0900
Baseline Item DataOptional
Max 1
To specify basic item data: item identification, quantity, and price
1000
Item IdentificationOptional
Max >1
To specify basic item identification data
1100
Underwriting ConditionOptional
Max >1
To specify the condition under which insurance coverage is offered
1200
Status of Product or ActivityOptional
Max >1
To indicate the details and status of a product or product activity
1300
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
1400
Balance InformationOptional
Max >1
To provide specific balance information for financial account reporting
1500
QuantityOptional
Max >1
To specify quantity information
1600
Monetary AmountOptional
Max >1
To indicate the total monetary amount
1700
Rate Amounts or PercentsOptional
Max >1
To identify rate amounts or percents for a specific cost or other line item
2100Loop
Optional
Repeat >1
1800
Payment DetailsMandatory
Max 1
To transmit information required to establish payment or remittance activity
1900
Reference IdentificationOptional
Max >1
To specify identifying information
2200Loop
Optional
Repeat >1
2000
InformationMandatory
Max 1
To report information
2100
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
2300Loop
Optional
Repeat >1
2200
Informational ValuesMandatory
Max 1
To specify a code and the amount or quantity or percentage associated with it
2300
InformationOptional
Max >1
To report information
2350
Status of Product or ActivityOptional
Max >1
To indicate the details and status of a product or product activity
2400
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
2500
Monetary AmountOptional
Max >1
To indicate the total monetary amount
2600
QuantityOptional
Max >1
To specify quantity information
2700
Rate Amounts or PercentsOptional
Max >1
To identify rate amounts or percents for a specific cost or other line item
2800
Balance InformationOptional
Max >1
To provide specific balance information for financial account reporting
2900
Reference IdentificationOptional
Max >1
To specify identifying information
2400Loop
Optional
Repeat >1
3000
Individual or Organizational NameMandatory
Max 1
To supply the full name of an individual or organizational entity
3100
Additional Name InformationOptional
Max 3
To specify additional names
3200
Communication Contact InformationOptional
Max >1
To specify a communication contact number
2450Loop
Optional
Repeat >1
3300
Address InformationMandatory
Max 1
To specify the location of the named party
3400
Geographic LocationOptional
Max 1
To specify the geographic place of the named party
3500
Date or Time or PeriodOptional
Max >1
To specify any or all of a date, a time, or a time period
2500Loop
Optional
Repeat >1
3600
Property or Entity IdentificationMandatory
Max 1
To define the attributes of a property or an entity
3700
Reference IdentificationOptional
Max >1
To specify identifying information
3800
Beneficiary or Owner InformationOptional
Max 1
To supply beneficiary, co-participant, and owner information
3900
InformationOptional
Max >1
To report information
4000
Informational ValuesOptional
Max >1
To specify a code and the amount or quantity or percentage associated with it
4100
Individual IdentificationOptional
Max >1
To provide identification of an individual or entity
4200
Transaction Set TrailerMandatory
Max 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)