INS Insured Benefit

To provide benefit information on insured entities

Position
Element
Name
Type
Requirement
Min
Max
Repeat
INS01
Yes/No Condition or Response Code
Identifier (ID)
Mandatory
1
1
-
Code indicating a Yes or No condition or response
INS01 indicates status of the insured. A "Y" value indicates the insured is a subscriber: an "N" value indicates the insured is a dependent.
INS02
Individual Relationship Code
Identifier (ID)
Mandatory
2
2
-
Code indicating the relationship between two individuals or entities
INS03
Maintenance Type Code
Identifier (ID)
Optional
3
3
-
Code identifying the specific type of item maintenance
INS04
Maintenance Reason Code
Identifier (ID)
Optional
2
3
-
Code identifying the reason for the maintenance change
INS05
Benefit Status Code
Identifier (ID)
Optional
1
1
-
The type of coverage under which benefits are paid
INS06
Medicare Plan Code
Identifier (ID)
Optional
1
1
-
Code identifying the Medicare Plan
INS07
Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event Code
Identifier (ID)
Optional
1
2
-
A Qualifying Event is any of the following which results in loss of coverage for a Qualified Beneficiary
INS08
Employment Status Code
Identifier (ID)
Optional
2
2
-
Code showing the general employment status of an employee/claimant
INS09
Student Status Code
Identifier (ID)
Optional
1
1
-
Code indicating the student status of the patient if 19 years of age or older, not handicapped and not the insured
INS10
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
-
Code indicating a Yes or No condition or response
INS10 is the handicapped status indicator. A "Y" value indicates an individual is handicapped; an "N" value indicates an individual is not handicapped.
INS11
Date Time Period Format Qualifier
Identifier (ID)
Conditional
2
3
-
Code indicating the date format, time format, or date and time format
P1112: If either INS-11 or INS-12 is present, then the other is required
INS12
Date Time Period
String (AN)
Conditional
1
35
-
Expression of a date, a time, or range of dates, times or dates and times
INS12 is the date of death.
INS13
Confidentiality Code
Identifier (ID)
Optional
1
1
-
Code indicating the access to insured information
INS14
City Name
String (AN)
Optional
2
30
-
Free-form text for city name
INS14, INS15, and INS16 identify where the employee works.
INS15
State or Province Code
Identifier (ID)
Optional
2
2
-
Code (Standard State/Province) as defined by appropriate government agency
INS16
Country Code
Identifier (ID)
Optional
2
3
-
Code identifying the country
INS17
Number
Numeric (N0)
Optional
1
9
-
A generic number
INS17 is the number assigned to each family member born with the same birth date. This number identifies birth sequence for multiple births allowing proper tracking and response of benefits for each dependent (i.e., twins, triplets, etc.).

Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference is provided for marketing purposes and is free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.