Mortgagee Coverage Notification, Billing and Payment of Insurance Premium. Electronic Data Interchange Transaction Set Implementation Guide
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1 Electronic Data Interchange Transaction Set Implementation Guide 811/820 MORTGAGEE COVERAGE NOTIFICATION, BILLING AND PAYMENT OF INSURANCE PREMIUM Implementation Guide Version 2.0 (3030) 1
2 1. State 2. State Mortgagee Coverage Notification, Billing and Payment of Insurance Premium State Farm Insurance Companies Specific information for using the ANSI Standard Format Farm will send the two position Operation Center Code in the REF02 (REF*32) of the 811 invoice which must be returned in the REF02 element (REF*32) of the 820 remittance. Farm expects the following information to be supplied in the BPR segment of the 820 remittance. BPR12 01 BPR BPR14 DA BPR BPR16 The settlement date BPR17 VEN 3. State Farm will only accept a 15-position trace number in the TRN02 element of the 820 remittance. Additionally, the TRN02 element of the 820 remittance must be unique with each transmission sent to State Farm. 4. State Farm requires the REF02 element (REF*IV) in the 820 remittance be returned with the same number that was sent in the BIG02 element of the 811 invoice. 5. State Farm requires the use of code LN in the ENT03 element of the 820 remittance and the existing loan number in the ENT04. When the loan number is a corrected loan number, then code CL should be used. If the billing cannot be identified, then the ENT03 and ENT04 need not be sent. 6. State Farm will receive in the 820 remittance both escrow and non-escrow policy information. Non Escrow policy information will be identified by returning zero in the RMR05 element of the 820 remittance. Escrow policy information will be identified by returning the value of the IT104 element in the 811 invoice in the RMR05 element of the 820 remittance. 7. Reason Codes H1, H2, H3 H4, H5, H7, H9, K1, and K2 in the ADX02 element of the 820 remittance should only be sent when the RMR04 element is zero. 8. Reason Code H6 in the ADX02 element of the 820 remittance should only be used when the RMR04 element is less than the RMR05 element 9. Reason Code K3 in the ADX02 element of the 820 remittance should not be used. 2
3 10. State Farm Numbers State Farm Tax ID State Farm Fire NAIC State Farm Lloyds NAIC State Farm General NAIC State Farm Florida NAIC
4 Table of Contents State Farm Insurance Companies...2 Table of Contents...4 Preface...7 Background Information (811 and 820)...7 Document Mapping...8 How to Use the Tables and Segment Definitions...9 Special Notes for Financial EDI...10 Interchange Control Structure...10 Interchange Control Structure...12 Functional Group Control Segments...12 Transaction Set Control Segments...12 Segment: ISA - Interchange Control Header...13 Segment: IEA - Interchange Control Trailer...16 Segment: GS - Functional Group Header...17 Segment: GE - Functional Group Trailer Mapping - Segment Uses and Sequence...20 Header (Table 1)...20 Detail (Table 2)...21 Trailer (Table 3)...27 Segment: ST - Transaction Set Header...28 Segment: BIG - Beginning Segment for Invoice...29 Segment: N1 - Name...30 Segment: N2 - Additional Name Information...32 Segment: N3 - Address Information...33 Segment: N4 - Geographic Location...34 Segment: PER - Administrative Communications Contact...36 Segment N1- Name...38 Segment: N2 - Additional Name Information...40 Segment: N3 - Address Information...41 Segment: N4 - Geographic Location...42 Segment: HL - Hierarchical Level...44 Segment: LX - Assigned Number...45 Segment: REF - Reference Numbers...46 Segment: HL - Hierarchical Level...48 Segment: LX - Assigned Number...49 Segment: AMT - Monetary...50 Segment: DTM - Date/Time Reference...51 Segment: QTY - Quantity...52 Segment: N1 - Name...53 Segment: N2 - Additional Name Information...54 Segment: N3 - Address Information...55 Segment: N4 - Geographic Location...56 Segment: HL - Hierarchical Level
5 Segment: LX - Assigned Number...59 Segment: PID - Product Item Description...60 Segment: REF - Reference Numbers...62 Segment: AMT - Monetary Amount...64 Segment: DTM - Date/Time Reference...66 Segment: IT1 - Baseline Item Data...68 Segment: SI - Service Characteristic Identification...71 Segment: MSG - Message Text...73 Segment: N1 - Name...74 Segment: N2 - Additional Name Information...75 Segment: N3 - Address Information...76 Segment: N4 - Geographic Location...77 Segment: HL - Hierarchical Level...78 Segment: SLN - Subline Item Detail...79 Segment: SI - Service Characteristic Identification...82 Segment: REF - Reference Numbers...84 Segment: DTM - Date/Time...86 Segment: TDS - Total Monetary Value Summary...87 Segment: CTT - Transaction Totals...88 Segment: SE - Transaction Set Trailer Mapping - Segment Uses and Sequence...90 Header (Table 1)...90 Detail (Table 2)...91 Trailer (Table 3)...92 Segment: ST - Transaction Set Header...93 Segment: BPR - Beginning Segment for Payment Order/Remittance Advice...94 Segment: TRN - Trace...99 Segment: REF - Reference Numbers Segment: DTM - Date/Time Reference Segment: N1 - Name Segment: N2 - Additional Name Information Segment: N3 - Address Information Segment: N4 - Geographic Location Segment: PER - Administrative Communications Contact Segment: N1 - Name Segment: N2 - Additional Name Information Segment: N3 - Address Information Segment: N4 - Geographic Location Segment: REF - Reference Numbers Segment: PER - Administrative Communications Contact Segment: N1 - Name Segment: N2 - Additional Name Information Segment: N3 - Address Information Segment: N4 - Geographic Location Segment: PER - Administrative Communications Contact Segment: ENT Entity
6 Segment: N1 - Name Segment: N2 - Additional Name Information Segment: N3 - Address Information Segment: N4 - Geographic Location Segment: RMR - Remittance Advice Segment: REF - Reference Numbers Segment: DTM - Date/Time Reference Segment: ADX - Adjustment Segment: SE - Transaction Set Trailer Appendix A: Payment Alternatives Appendix B: 811 Example Appendix C: 820 Example Appendix D: Payment Exception Codes Appendix E: Acord Table Line of Business Appendix F: Acord Table Type of Trans Appendix G: Functional Acknowledgment Change Summary
7 Preface This implementation guide contains the recommended format and data standards for use of the ANSI X12 Consolidated Service Invoice/Statement (811 transaction) and Payment Order/Remittance Advice (820 transaction) developed for "Mortgagee Coverage Notification, Billing and Payment of Insurance Premiums." Mortgage Companies and Insurance Companies are to be considered as "Trading Partners" in this endeavor. The following recommendations were developed by the Property and Casualty Policy Task Group within the ANSI X12 Insurance Sub-committee. The group includes representatives from insurance carriers, mortgage companies and service providers, banks, software companies, ACORD and independent agencies. Background Information (811 and 820) The ANSI 811 and 820 formats are being used for an electronic application to eliminate the need for insurance companies to send paper billing and coverage documents to mortgage companies (or their servicing agents), as well as to simplify the payment of these insurance premiums. The project capitalizes on the ANSI 811 Invoice as the method of billing and coverage notification from an insurance company to a mortgage company. The 811 insurance "invoice" includes data to indicate whether the policy premiums are held in escrow (impound) by the mortgage company, or whether they are direct billed (non-impound) to the customer. The ANSI 820 Remittance Advice is used for the payment information from the mortgage company to the insurance company for those premiums that were held in Escrow. The 820 may be "enveloped" into addenda records as an ACH (CTX) electronic payment transaction originated by the mortgage company bank to the insurance company bank. Or, it may be used as an EDI remittance transmission from the mortgage company to the insurance company, with the funds to be settled separately. This option allows some flexibility for varying systems capabilities between the trading partners. The basic data elements conform to requirements set forth by the MBA (Mortgage Bankers Association). These facts are important in order to understand the concept and vision of the project. The Task Group envisions that this format will ultimately be used by most insurance companies and mortgage companies using national EDI and EFT network(s). Using this format, insurance companies may (if they so choose) direct invoices from multiple branches too many mortgage companies through one "mailbox" network. A mortgage company may receive data from many insurance companies, in one transmission, by "connecting" to the same mailbox network. The mortgage company may, (if they so choose) subsequently pay all of the invoices too many insurance companies through one (ACH or EDI) network in one process. 7
8 Document Mapping 1. Purpose The purpose of this section is to present and explain the application of the ANSI X12 standards. This will enable the user of these guidelines to successfully translate their own internal format to the ANSI standards. The following data element list is based on the definitions of the ANSI X12 version Consolidated Service Invoice/Statement (811) document and version of the Payment Order/Remittance Advice (820) document. This document does not specifically state all of the ANSI syntax, and the reader should reference ANSI requirements. 2. X12 Standards Each element within a segment is separated by a "Data Element Separator". An asterisk (*) will be used as the separator, unless otherwise agreed upon as an exception by specific trading partners. "*" is HEX '5C' in EBCDIC, HEX '2A' in ASCII. The element separator is defined in the ISA envelope. The end of a segment is denoted by a "segment terminator" or "new line" character. "N/L" will be used as the terminator, unless otherwise agreed upon as an exception by specific trading partners. "N/L" is HEX '15' in EBCDIC, and a HEX 'OD' (carriage control) in ASCII. The segment terminator is defined in the ISA envelope. Optional data elements are not required to be transmitted unless specifically agreed upon by the trading partners. When an optional data element is not used, the separator is used to acknowledge the omitted optional data. This will result in back-to-back separators (**). When the data element(s) being omitted is at the end of a segment, the segment terminator immediately follows the last data element being used. The ANSI standard provides means for verifying the content and completeness of each transmission. Every transmission should be monitored to be certain it has successfully completed. 3. Mapping Documentation - ANSI X12 Attributes (Codes) Data Element Attributes M X Mandatory - must be transmitted. Relational - dependant on the value or presence of other data elements within the segment. 8
9 O NU Optional - appearance of this element is at the option of the sending party, or by agreement of the trading partners. Not used in this application (Mortgagee Billing/Remittance Usage Only) Data Element Type AN Nn R ID DT Alpha Numeric - left justified and space filled if field is required to be a specific length. Numeric - the first "N" signifies numeric, the second "n" signifies the number of decimal places to the right of a fixed decimal point. (The decimal point is not transmitted for this data element type.) Numeric decimal - the decimal point is required to be transmitted when fractional values are present. Contains a code value - Codes are contained within predetermined lists maintained by the ANSI X12 standards committee. Date format - yymmdd is: yy - last two digits of year (00-99) mm - numeric month (01-12) dd - numeric day (01-31) TM Time format - hhmm is: Data Element Length hh - military hour (00-23) mm - minute (00-59) The number to the left of the "/" specifies the minimum length of the field as required by the standard. The number to the right of the "/" specifies the maximum length of the field as required by the standard. The field has a fixed length when the minimum and maximum lengths are the same. For data type "R", the length does not include the sign or decimal point. How to Use the Tables and Segment Definitions Table 1 is essentially "header" data that identifies the transaction originator, the transaction receiver, other routing information, and the payment total. Table 2 provides the details: loan and policy data, insurance customer names, addresses, policy line codes, and payment amounts. 9
10 Table 3 is essentially trailer information and provides segment counts and totals used to generate functional acknowledgements to the sender. In the following examples for Table 1 and Table 2, note the sequence that the Segment ID's are listed. The subsequent pages, that provide the details for these segments, follow the same sequence as Table 1 and Table 2. These examples are provided as an aid in understanding the format of the transaction set tables and the segment definitions. The tables show the ANSI X12 requirements. (Remember, trading partner options can be used only with "optional" fields.) The Segment ID (Seg. ID), Sequence Number (Seq. ), and Reference Number (Ref. ) columns are ANSI X12 identifiers. The data in the column labeled ANSI X12 Attributes is identified in Item 3, above. The Maximum Use (Max. Use) and the Loop Repeat are also ANSI standard. Special Notes for Financial EDI To standardize the use of the ISA/IEA envelope for financial EDI transactions that move through the banking system, the following convention is recommended: 1. All financial EDI transactions should be treated as point-to-point so that the addresses carried in the ISA/IEA envelop will reflect the identity of the immediate sender and receiver as they move through the banking system. 2. Receivers of financial EDI transactions that move through the banking system can obtain the originating company ID from the BPR10 element. In order to facilitate this process, the originating company must consistently provide the originating company ID when formatting the BPR segment. 3. The sender and receiver codes in the GS loop should be passed along without modification. Interchange Control Structure An EDI message is comprised of several components. These include the Interchange Control Header/Trailer (ISA/IEA), Functional Group Header/Trailer (GS/GE), Transaction Set Header/Trailer (ST/SE), and Detail Segments. A transaction set is the collection of data that is exchanged between trading partners equivalent to an electronic business document intended to convey pertinent information. A hierarchical structure of headers and trailers allows transaction sets of different types to be transmitted from one trading partner to another in the same transmission. This allows the information to be separated logically for easy interpretation by the receiver. The hierarchical structure of an EDI message is illustrated below. 10
11 ISA Interchange Control Header I GS Functional Group Header F T N U E ST Transaction Set Header T N R R C C A T H N I A Detail Data S O N N G S E E T G SE Transaction Set Trailer R E P N GE Functional Group Trailer V IEA Interchange Control Trailer L E Note: The shaded area above represents the Consolidated Service/Invoice (811 Transaction Set) or the Payment Order/Remittance Advice (820 Transaction Set) described in their own sections later in this document. 11
12 Interchange Control Structure Interchange Control Header/Trailer (ISA/IEA) An interchange "envelope" consists of an "ISA" header and an "IEA" trailer. The interchange header and trailer envelop one or more functional groups in a transmission. The interchange control segments (ISA/IEA) provide identifying information between communicating partners that applies to the entire transmission as defined in ANSI X12.5 Interchange Control Structures standard. Functional Group Control Segments Functional Group Header/Trailer (GS/GE) A functional group "envelope" consists of a "GS" header and a "GE" trailer. The functional group envelops like transaction sets. The functional group segments (GS/GE) provide information including the application sender code, application receiver code, version number, and control information. The GS/GE segments may be used to envelop batches of similar transactions for audit and control purposes. Transaction Set Control Segments Transaction Set Header/Trailer (ST/SE) A transaction set consists of segments that are intended to communicate pertinent business related information (for example, an invoice or a payment order/remittance advice). The ST/SE segments are used to indicate the beginning and end of a transaction set and provide identifying control numbers and a count of transmitted segments. 12
13 Segment: ISA - Interchange Control Header Level: Control Loop: Usage: Mandatory Max Use: 1 Purpose: To start and identify an interchange of one or more functional groups and interchange-related control segments. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes ISA01 I01 Authorization Information Qualifier M M ID 02/02 ISA02 I02 Authorization Information M M AN 10/10 ISA03 I03 Security Information Qualifier M M ID 02/02 ISA04 I04 Security Information M M AN 10/10 ISA05 I05 Interchange ID Qualifier M M ID 02/02 ISA06 I06 Interchange Sender ID M M AN 15/15 ISA07 I05 Interchange ID Qualifier M M ID 02/02 ISA08 I07 Interchange Receiver ID M M AN 15/15 ISA09 I08 Interchange Date M M DT 06/06 ISA10 I09 Interchange Time M M TM 04/04 ISA11 I10 Interchange Control Std ID M M ID 01/01 ISA12 I11 Interchange Version Number M M ID 05/05 ISA13 I12 Interchange Control Number M M N0 09/09 ISA14 I13 Acknowledgement Requested M M ID 01/01 13
14 Seq. Ref. ANSI X12 Name Mrtg Req ANSI X12 Attributes ISA15 I14 Test Indicator M M ID 01/01 ISA16 I15 Subelement Separator M M AN 01/01 Mortgagee Billing/Payment Usage Notes This segment is required. It is used to indicate the start of an interchange. ISA01 ISA02 ISA03 ISA04 ISA05 ISA06 ISA07 ISA08 ISA09 ISA10 This element contains a code to identify the type of information in the Authorization Information. This element contains information used for additional identification or authorization of the sender or the data in the interchange. The type of information is sent by the Authorization Information Qualifier. This element contains a code to identify the type of information in the Security Information. This element is used for identifying the security information about the sender or the data in the interchange. The type of information is set by the Security Information Qualifer. This element contains a qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified. This element will contain an identification code published by the sender for other parties to use as the receiver ID to route data to them. The sender always codes this number in the sender ID element. Typically this number is a 9-digit DUNS number or other number agreed upon trading partner/mailbox identifier. This element contains a qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified. This element will contain the identification code published by the receiver of the data. When sending, it is used by the sender as their sender ID, thus other parties sending to them will use this as a receiving ID to route data to them. This element contains the interchange date (YYMMDD). This element contains the interchange time (HHMM). 14
15 Mortgagee Billing/Payment Usage Notes ISA11 ISA12 ISA13 ISA14 ISA15 ISA16 This element contains a code identifying the agency responsible for the control standard used by the message that is enclosed by the interchange header and trailer. This element should be coded as "U", U.S. EDI Community of ASC X12, TDCC, and UCS. This element contains a version number which covers the interchange control segments. The recommended value is "00303", Draft Standard for Trial Use Aproved for Publication by ASC X12 Procedures Review Board Through October This element will contain a unique control number assigned by the sender. Typically this number is automatically assigned by the sending software. It is suggested that the sender, receiver and all third parties be able to maintain an audit trail of interchanges using this number. This element contains a code sent by the sender to request an interchange acknowledgment. This element contains a code to indicate whether data enclosed by this interchange envelope is test or production. This element should be coded "T" during testing and altered to a "P" when the trading partners are ready to enter production status. This element is reserved for future expansion in separating data element subgroups. (In the interest of a migration to international standards, this must be different from the data element separator.) Example: ISA*00*THEINSCO*00** *01* *070125*1448*U*00303* * 1*P*;(NL) Note: * = blanks 15
16 Segment: IEA - Interchange Control Trailer Level: Trailer Loop: Usage: Mandatory Max Use: 1 Purpose: To define the end of an interchange of one or more functional groups and interchange-related control segments. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes IEA01 I16 Number of Included Functional Groups M M N0 01/05 IEA02 I12 Interchange Control Number M M N0 09/09 Mortgagee Billing/Payment Usage Notes This segment is required. It is used to indicate the end of an interchange. IEA01 IEA02 This element contains the total number of functional groups in this interchange. This element contains the control number used in the corresponding header (ISA13). Example: IEA*1* (NL) 16
17 Segment: GS - Functional Group Header Level: Control Loop: Usage: Mandatory Max Use: 1 Purpose: To indicate the beginning of a functional group and to provide control information. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes GS Functional ID Code M M ID 02/02 GS Application Sender's Code M M AN 02/15 GS Application Receiver's Code M M AN 02/15 GS Group Date M M DT 06/06 GS Group Time M M TM 04/04 GS Group Control Number M M N0 01/09 GS Responsible Agency Code M M ID 01/02 GS Version/Release Identifier Code M M ID 01/12 17
18 Mortgagee Billing/Payment Usage Notes This segment is required. It is used to indicate the beginning of a functional group. GS01 GS02 GS03 GS04 GS05 GS06 GS07 GS08 This element contains a code identifying a group of application related Transaction Sets. For Mortgagee Billing, it should be coded "CI", Consolidated Service Invoice/Statement (811). For Mortgagee Payment, it should be coded "RA", Payment Order/Remittance Advice (820). This element contains a code identifying the party sending the transmission. Codes are agreed to by trading partners. This element contains a code identifying the party receiving the transmission. Codes are agreed to by trading partners. This element contains the date (YYMMDD) format. This element contains the time (HHMMSS) format. This element will contain an assigned number originated and maintained by the sender. It must be identical to the same data element in the associated Functional Group Trailer GE02 element. This element is used to identify the issuer of the standard. It will be coded "X", Accredited Standards Committee X12. This element contains a code indicating the version, release, and sub release and industry identifier of the EDI standard being used, including the GS and GE segments. Positions 1-3, version number; positions 4-6, release and sub release level of version; positions 7-12, industry or trade association identifier (optionally assigned by the user). Recommended value is "003030". Example: GS*RA* * *070125*1448*2*X*003030(NL) 18
19 Segment: GE - Functional Group Trailer Level: Trailer Loop: Usage: Mandatory Max Use: 1 Purpose: To indicate the end of a functional group and to provide control information. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes GE Number of Included Sets M M N0 01/06 GE Group Control Number M M N0 01/09 Mortgagee Billing/Payment Usage Notes This segment is required. It is used to indicate the end of a functional group. GE01 GE02 This element contains the total number of transaction sets in the functional group. This element contains the control number used in the corresponding header (GS06). Example: GE*1*2(NL) 19
20 811 Mapping - Segment Uses and Sequence Header (Table 1) Page Pos. Seg ID Name Mrtg X1 Max. Use Loop Repeat ST Transaction Set Header M M BIG Beginning Segment for Invoice M M NTE Note/Special Instruction NU O CUR Currency NU O REF Reference Numbers NU O >1 060 PER Administrative Communications Contact NU O ITD Terms of Sale/Deferred Terms of Sale NU O DTM Date/Time Reference NU O >1 090 TXI Tax Information NU O N1 Name Insurance Company (Sending Partner) M O 1 N1/>1 110 N2 Additional Name Information O O N3 Address Information O O N4 Geographic Location O O REF Reference Number NU O PER Administrative Communication Contact O O Occurrence 1: Sending Partner (Insurance Entity) Occurrence 2: Receiving Partner (Mortgage Co./Service Bureau) 20
21 Detail (Table 2) Page Pos. Seg ID Name HL Hierarchical Level Level 1 (Branch/Region) Mrtg X12 Max. Use Loop Repeat M M 1 HL/> LX Assigned Number M O 1 LX/>1 025 VEH Vehicle Information NU O SI Service Characteristic Identification NU O PID Product/Item Description NU O MEA Measurements NU O REF Reference Numbers Occurrence 1: Routing Transit Number Occurrence 2: Account Number Occurrence 3: Branch Number M O >1 060 AMT Monetary Amount NU O DTM Date/Time Reference NU O TXI Tax Information NU O >1 090 QTY Quantity NU O 1 QTY/ SI Service Characteristic Ident. NU O 1 HL Hierarchical Level 2 NU HL Hierarchical Level Level 3 (Mortgagee Level) M M 1 HL/> LX Assigned Number M O 1 LX/>1 025 VEH Vehicle Information NU O SI Service Characteristic Identification NU O PID Product/Item Description NU O MEA Measurements NU O REF Reference Numbers NU O > AMT Monetary Amount Total Policy Premiums DTM Date/Time Reference Remittance Due Date M O 5 M O TXI Tax Information NU O > QTY Quantity Total Number of Policies M O 1 QTY/ SI Service Characteristic Ident. NU O 1 21
22 Page Pos. Seg ID Name Mrtg X12 Max. Use Loop Repeat N1 Name Mortgagee Name N2 Additional Name Information Mortgagee Name Line 2 Mortgagee Name Line 3 M O 1 N1/1 O O N3 Address Information O O N4 Geographic Location O O REF Reference Numbers NU O PER Administrative Communications NU O >1 170 TXI Tax Information NU O > HL Hierarchical Level Level 4 (Policy Detail) M M 1 HL/> LX Assigned Number M O 1 LX/>1 025 VEH Vehicle Information NU O SI Service Characteristic Identification NU O PID Product/Item Description M O MEA Measurements NU O REF Reference Numbers Occurrence 1: Line of Business M O >1 Occurrence 2: NAIC Co. Code Occurrence 3: Loan Number Occurrence 4: Policy Number Occurrence 5: Account Number Occurrence 6: Number of Units in Building AMT Monetary Amount Occurrence 1: Dwelling Coverage Occurrence 2: Policy Premium Occurrence 3: Estimated Replacement Cost M O DTM Date/Time Reference Occurrence 1: Effective Date Occurrence 2: Expiration Date Occurrence 3: Cancellation Date Occurrence 4: Policy Issue Date M O TXI Tax Information NU O >1 090 QTY Quantity NU O 1 QTY/ SI Service Characteristic Ident. NU O 1 22
23 Page Pos. Seg ID Name Mrtg X12 Max. Use Loop Repeat 110 N1 Name NU O 1 N1/1 120 N2 Additional Name Information NU O N3 Address Information NU O N4 Geographic Location NU O REF Reference Numbers NU O PER Administrative Communications NU O >1 170 TXI Tax Information NU O >1 180 ITA Allowance, Charge or Service NU O 1 ITA/>1 190 DTM Date/Time Reference NU O TXI Tax Information NU O > IT1 Baseline Item Data(Invoice) M O 1 IT1/ SI Service Characteristic Identification M O PID Product/Item Description NU O MEA Measurements NU O INC Installment Information NU O TXI Tax Information NU O >1 260 REF Reference Numbers NU O DTM Date/Time Reference NU O MSG Message Text O O >1 285 AMT Monetary Amount NU O QTY Quantity NU O 1 QTY/>1 300 SI Service Characteristic Ident. NU O ITA Allowance, Charge or Service NU O 1 ITA/ DTM Date/Time Reference NU O 1 23
24 330 TXI Tax Information NU O >1 24
25 Page Pos. Seg ID Name Mrtg X12 Max. Use Loop Repeat N1 Name M O 1 N1/> N2 Additional Name Information O O N3 Address Information M O N4 Geographic Location M O PER Administrative Communications NU O 3 HL Hierarchical Level 5-7 NU HL Hierarchical Level Level 8 (Policy Transaction Detail) O M 1 HL/> SLN Subline Item Detail M O 1 SLN/> SI Service Characteristic Identification M O PID Product/Item Description NU O MEA Measurements NU O CUR Currency NU O INC Installment Information NU O ITA Allowance, Charge or Service NU O TXI Tax Information NU O > REF Reference Numbers Occurrence 1: Policy Number Occurrence 2: Line of Business Occurrence 3: Account Number M O >1 470 PER Administrative Communications NU O DTM Date/Time Reference M O AMT Monetary Amount NU O MSG Message Text NU O >1 510 QTY Quantity NU O 1 QTY/>1 520 SI Service Characteristic Identification NU O N1 Name NU O 1 N1/>1 540 N2 Additional Name Information NU O N3 Address Information NU O 2 25
26 Page Pos. Seg ID Name Mrtg X12 Max. Use Loop Repeat 560 N4 Geographic Location NU O REF Reference Numbers NU O PER Administrative Communications NU O TCD Itemized Call Detail NU O 1 TCD/>1 600 SI Service Characteristic Identification NU O TXI Tax Information NU O >1 620 USD Usage sensitive Detail NU O 1 USD/>1 630 ITA Allowance, Charge or Service NU O TRF Rating Factors NU O QTY Quantity NU O 1 QTY/>1 660 SI Service Characteristic Identification NU O 1 26
27 Trailer (Table 3) Page Pos. Seg ID Name Mrtg X12 Max. Use Loop Repeat TDS Total Monetary Value Summary M M ITA Allowance, Charge or Service NU O 1 ITA/>1 030 DTM Date/Time Reference NU O BAL Balance Detail NU O 1 BAL/>1 050 DTM Date/Time Reference NU O N1 Name NU O 1 N1/>1 070 BAL Balance Detail NU O 1 BAL/>1 080 DTM Date/Time Reference NU O ITA Allowance, Charge or Service NU O 1 ITA/>1 100 DTM Date/Time Reference NU O CTT Transaction Totals M O SE Transaction Trailer Set M M 1 27
28 Segment: ST - Transaction Set Header Level: Heading Loop: Usage: Mandatory Max Use: 1 Purpose: To indicate the start of a transaction set and to assign a control number. Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes ST Transaction Set ID M M ID 03/03 ST Transaction Set Control Number M M AN 04/09 Mortgagee Billing Usage Notes This segment is required and indicates the transaction set number '811'. ST01 ST02 This element contains a code uniquely identifying a Transaction Set. It should be coded "811", Consolidated Service Invoice Statement. This element contains an identifying control number that must be unique within the transaction set function group assigned by the originator for a transaction set. This number is used to aid in error reconciliation and research and must be the same as the number in the SE02 element. Example: ST*811*0002(NL) 28
29 Segment: BIG - Beginning Segment for Invoice Level: Heading Loop: Usage: Mandatory Max Use: 1 Purpose: To indicate the start of an invoice transaction set and to transmit identifying numbers and dates. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes BIG Invoice Date M M DT 06/06 BIG02 76 Invoice Number Assigned by Sender M M AN 01/22 BIG PO Date NU O DT 06/06 BIG PO Number NU O AN 01/22 BIG Release Number NU O AN 01/30 BIG Change Order Sequence Number NU O AN 01/08 BIG Transaction Type Code NU O ID 02/02 Mortgagee Billing Usage Notes This segment is required. It provides information that uniquely identifies the bill. BIG01 BIG02 This element should contain the billing cycle date of the 811 as YYMMDD.. This element should contain the invoice number assigned to the 811 transaction. Example: BIG*070125* A (NL) 29
30 Segment: N1 - Name Level: Heading Loop: N1 Repeat: >1 Usage: Mandatory Max Use: 1 Purpose: To identify party by type of organization. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Entity ID Code M M ID 02/02 N Name O X AN 01/35 N ID Code Qualifier M X ID 01/02 N ID Code M X AN 02/17 Mortgagee Billing Usage Notes At least two N1 loops should be used for all transaction sets to identify the sending partner (Insurance Entity) and receiving partner (Mortgage Entity/Service Bureau) as parties to the transaction. Occurrence 1: This segment is required and is used to communicate insurance company identification information. N101 N102 N103 N104 This element should be coded "IN" to indicate an insurance company is sending the data. If used, this element will contain the name of the insurance company. This element should be coded "FI" to indicate the taxpayer identification number is being used. This element should contain the taxpayer ID number of the insurance company. 30
31 Example: N1*IN**FI* (NL) 31
32 Segment: N2 - Additional Name Information Level: Heading Loop: N1 Repeat: >1 Usage: Optional Max Use: 2 Purpose: To specify additional names or those longer than 35 characters in length. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Name O M AN 01/35 N Name O O AN 01/35 Mortgagee Billing Usage Notes Occurrence 1: This segment is optional. If used, it will contain additional name information for the insurance company. N201 N202 If used, this element should contain additional name information that would not fit in N102. If used, this element should contain additional name information that would not fit in N201. Example: N2*ADDITIONAL NAME*AND MORE NAME(NL) 32
33 Segment: N3 - Address Information Level: Heading Loop: N1 Repeat: >1 Usage: Optional Max Use: 1 Purpose: To specify the location of the named party. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Address Information O M AN 01/35 N Address Information O O AN 01/35 Mortgagee Billing Usage Notes Occurrence 1: This segment is optional. If used, it will occur once containing the address of the insurance company. N301 N302 This element contains the first 35 characters of the address of the insurance company. This element may be used if the address specified in element N301 is longer than 35 characters, or requires two lines. Example: N3*P O BOX *RURAL ROUTE 1(NL) 33
34 Segment: N4 - Geographic Location Level: Heading Loop: N1 Repeat: >1 Usage: Optional Max Use: 1 Purpose: To specify the geographic place of the named party. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N City Name O X AN 02/19 N State/Prov. Code O O ID 02/02 N Postal Code O O ID 04/09 N Country Code O O ID 02/02 N Location Qualifier NU X ID 01/02 N Location Identifier NU X AN 01/25 Mortgagee Billing Usage Notes Occurrence 1: This segment is optional for the insurance company. N401 N402 N403 N404 If used, this element contains the trading partner city name. If used, this element contains the trading partner state or province name. If used, this element contains the trading partner postal code. If used, this element is used to indicate a country code other than the United States. 34
35 Example: N4*CITY NAME*IL*61761(NL) 35
36 Segment: PER - Administrative Communications Contact Level: Heading Loop: N1 Repeat: >1 Usage: Optional Max Use: 1 Purpose: To specify a contact name to be called for trading partner issues. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes PER Contact Function Code O M ID 02/02 PER02 93 Name O O AN 01/35 PER Communication Number Qualifier O X AN 02/02 PER Communication Number O X AN 07/21 PER Communication Number Qualifier NU X ID 02/02 PER Communication Number NU X AN 01/25 Mortgagee Billing Usage Notes Occurrence 1: This segment is optional. If used, it appears once for the insurance company and contains information on a contact person. PER01 PER02 PER03 If used, this element should be coded as one of the following: "AD" - Indicating the contact is the Accounting Department. "AR" - Indicating the contact is the Accounts Receivable Department. "EA" - Indicating the contact is the EDI Coordinator. If used, this element should contain the name of the person to be contacted for trading partner communication. If used, this element should be coded as "TE", to indicate the communication number will be a telephone number. 36
37 Mortgagee Billing Usage Notes PER04 If used, this element should contain the telephone number of the communication contact listed in PER02. Example: PER*AD*JOHN DOE*TE* (NL) 37
38 Segment N1- Name Level: Heading Loop: N1 Repeat: >1 Usage: Mandatory Max Use: 1 Purpose: To identify party by type of organization. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Entity ID Code M M ID 02/02 N Name O X AN 01/35 N ID Code Qualifier M X ID 01/02 N ID Code M X AN 02/17 Mortgagee Billing Usage Notes Occurrence 2: This segment is required. The second occurrence in the N1 Loop describes the recipient of the transaction set. N101 N102 N103 N104 This element should be coded as one of the following: "SQ" - Indicating the recipient is a service bureau. "MM" - Indicating the recipient is a mortgage company. If used, this element should contain the name of the recipient. This element should be coded "FI" to indicate the taxpayer identification number is being used. This element should contain the taxpayer ID number of the service bureau or mortgage company. 38
39 Example: N1*SQ*SERVICE BUREAU NAME*FI* (NL) 39
40 Segment: N2 - Additional Name Information Level: Heading Loop: N1 Repeat: >1 Usage: Optional Max Use: 2 Purpose: To specify additional names or those longer than 35 characters in length. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Name O M AN 01/35 N Name O M AN 01/35 Mortgagee Billing Usage Notes Occurrence 2: This segment is optional. If used, it will contain additional name information for the recipient. N201 N202 If used, this element should contain additional name information that would not fit in N102. If used, this element should contain additional name information that would not fit in N201. Example: N2*ADDITIONAL NAME*MORE ADDITIONAL NAME(NL) 40
41 Segment: N3 - Address Information Level: Heading Loop: N1 Repeat: >1 Usage: Optional Max Use: 1 Purpose: To specify the location of the named party. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Address Information O M AN 01/35 N Address Information O O AN 01/35 Mortgagee Billing Usage Notes Occurrence 2: This segment is optional. If used, it will contain address information for the recipient. N301 N302 This element contains the first 35 characters of the address of the recipient. This element may be used if the address specified in element N301 is longer than 35 characters, or requires two lines. Example: N3*P O BOX *RURAL ROUTE 1(NL) 41
42 Segment: N4 - Geographic Location Level: Heading Loop: N1 Repeat: >1 Usage: Optional Max Use: 1 Purpose: To specify the geographic place of the named party. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N City Name O X AN 02/19 N State/Prov. Code O O ID 02/02 N Postal Code O O ID 04/09 N Country Code O O ID 02/02 N Location Qualifier O X ID 01/02 N Location Identifier O X AN 01/25 Mortgagee Billing Usage Notes Occurrence 2: This segment is optional. If used, it provides the branch or region information identification number of the recipient. N401 N402 N403 If used, this element contains the service bureau or mortgage company city name. If used, this element contains the service bureau or mortgage company state or province name. If used, this element contains the service bureau or mortgage company postal code. 42
43 N404 N405 N406 If used, this element contains the country code of the service bureau or mortgage company that is different from the United States. If used, this element should be coded "RJ" to indicate the following location ID will be the branch or regional office of the service bureau or mortgage company. If used, this element contains the service bureau or mortgage company branch or regional office identification. Example: N4****RJ*01(NL) 43
44 Segment: HL - Hierarchical Level Level: Level 1 (Insurance Company Branch or Billing Center) Loop: HL Repeat: >1 Usage: Mandatory Max Use: 1 Purpose: To identify dependencies among the content of hierarchically related groups of data segments. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes HL Hierarchical ID Number M M AN 01/12 HL Hierarchical Parent ID M O AN 01/12 HL Hierarchical Level Code M M ID 01/02 HL Hierarchical Child Code NU O ID 01/01 Mortgagee Billing Usage Notes This segment is required. It will occur once for every insurance company region or billing center. HL01 HL02 This element should be valued with a unique number to identify a particular HL data segment within the transaction set. This element is omitted at the first HL level. This element contains the number of the next higher hierarchical data segment that the current HL level is subordinate to. Since HL level 1 is the highest level in the hierarchy, this element is not needed. HL03 This element should be valued with a '1', indicating that this hierarchical level 1, Service Billing Provider (Insurance Company Branch or Billing Center). Example: HL*1**1(NL) 44
45 Segment: LX - Assigned Number Level: Level 1 (Branch or Billing Center) Loop: HL/LX Repeat: >1 Usage: Optional Max Use: 1 Purpose: To reference a line number in a transaction set. Data Element Summary Seq. Ref. ANSI X12 Name Mrt ANSI X12 Attributes LX Assigned Number M M N0 01/06 Mortgagee Billing Usage Notes This segment is required. LX01 This element should be assigned a value of "1" in the HL level 1 loop. Example: LX*1(NL) 45
46 Segment: REF - Reference Numbers Level: Loop: Usage: Level 1 (Branch or Billing Center) HL/LX Optional Max Use: >1 Purpose: To specify identifying numbers. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes REF Reference Number Qualifier M M ID 02/02 REF Reference Number M X AN 01/30 REF Description NU X AN 01/80 Mortgagee Billing Usage Notes This segment is required and will occur three times. The REF segments in HL level 1 (Branch or Billing Center) are used to communicate Branch or Billing Center Number, Bank Routing Number and Transit Numbers. This information is coded using the following sequence. Occurrence 1: REF01 REF02 This element should be coded "01", indicating that the following REF02 contains a Bank Routing Transit Number. This element will contain the Bank Routing number of the Branch or Billing Center that is to receive the payment for the policies listed in this bill. Occurrence 2: REF01 REF02 This element should be coded "11", indicating that the following REF02 contains a Bank Account Number. This element will contain the Bank Account Number of the Branch or Billing Center that is to receive the payment for the policies listed in this bill. 46
47 Occurrence 3: REF01 REF02 This element should be coded "BF", indicating that the following REF02 contains a Branch or Billing Center Number. This element will contain the Branch or Billing Center Number. Example: REF*RR* (NL) REF*11* (NL) REF*BF*01(NL) 47
48 Segment: HL - Hierarchical Level Level: Level 3 (Mortgage Company) Loop: HL Repeat: >1 Usage: Mandatory Max Use: 1 Purpose: To identify dependencies among the content of hierarchically related groups of data segments. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes HL Hierarchical ID Number M M AN 01/12 HL Hierarchical Parent ID M O AN 01/12 HL Hierarchical Level Code M M ID 01/02 HL Hierarchical Child Code NU O ID 01/01 Mortgagee Billing Usage Notes This segment is required. It provides mortgage company identification information and will occur once for every mortgage company included on the bill. HL01 HL02 This element should be valued with a unique number to identify a particular HL data segment in the transaction set. This element should contain the number of the next higher hierarchical data segment that the current HL level is subordinate to. The HL01 value of the corresponding level 1 HL. HL03 This element should be valued with '3', indicating that this is hierarchical level 3, Group (Mortgage Company). Example: HL*2*1*3(NL) 48
49 Segment: LX - Assigned Number Level: Level 3 (Mortgage Company) Loop: HL/LX Repeat: >1 Usage: Optional Max Use: 1 Purpose: To reference a line number in a transaction set. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes LX Assigned Number M M N0 01/06 Mortgagee Billing Usage Notes This segment is required. LX01 This element should be assigned a value of "1" in the HL level 3 loop. Example: LX*1(NL) 49
50 Segment: AMT - Monetary Level: Loop: Usage: Level 3 (Mortgage Company) HL/LX Optional Max Use: 10 Purpose: To indicate the total monetary amount. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes AMT Amount Qualifier Code M M ID 01/02 AMT Monetary Amount M M R 01/15 Mortgagee Billing Usage Notes This segment is required. It occurs only once per Mortgage Company and describes the total of all the line item premium amounts indicated in IT104. AMT01 AMT02 This element should be coded as '1' indicating the following amount is the total of all the line items. This element should contain the total of all premium amounts (escrow and nonescrow) found in the IT104 in Level 4. Example: AMT*1*60000(NL) 50
51 Segment: DTM - Date/Time Reference Level: Loop: Usage: Level 3 (Mortgage Company) HL/LX Mandatory Max Use: 1 Purpose: To specify pertinent dates and times. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes DTM Date/Time Qualifier M M ID 03/03 DTM Date M X DT 06/06 DTM Time NU X TM 04/06 DTM Time Code NU O ID 02/02 DTM Century O O N0 02/02 Mortgagee Billing Usage Notes This segment is required. It is used to communicate the Remittance Due Date. DTM01 DTM02 DTM05 This element must be coded as "013", indicating that the following element contains a "Due Date". This element will contain the due date for the policies billed. Optional. If used, this element contains the century of the remittance due date. Example: DTM*013*071103***20(NL) 51
52 Segment: QTY - Quantity Level: Loop: Usage: Level 3 (Mortgage Company) HL/LX/QTY Optional Max Use: 10 Purpose: To indicate a quantity count. Data Element Summary Seq. Ref. ANSI X12 Name Mrt ANSI X12 Attributes QTY Quantity Qualifier M M ID 02/02 QTY Quantity M M R 01/15 QTY Unit or Basis for Measurement Code NU O ID 02/02 Mortgagee Billing Usage Notes This segment is required. It occurs once per Mortgage Company and indicates the number of policies (escrow and non-escrow) that are included in Level 4. QTY01 This element should be coded as "46", indicating that the quantity is the total number of transactions, for a Mortgage Company. QTY02 This element should contain the total number of policies included in Level 4. Example: QTY*46*1(NL) 52
53 Segment: N1 - Name Level: Level 3 (Mortgage Company) Loop: HL/N1 Repeat: 1 Usage: Mandatory Max Use: 1 Purpose: To identify party by type of organization. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Entity ID Code M M ID 02/02 N Name O X AN 01/35 N ID Code Qualifier M X AN 01/02 N Identification Code M X AN 02/17 Mortgagee Billing Usage Notes This segment is required and is used to communicate the taxpayer number of the mortgage company. N101 N102 N103 N104 This element should be assigned a value of "MM", indicating the entity identified by the N1 segment is a mortgage company. This element's use is optional, if used this element will contain the mortgage company's name. This element should be assigned a value of "FI", indicating the next element is the mortgage company's "Federal Tax Id Number". This element contains the mortgage company's tax id number. Example: N1*MM**FI* (NL) 53
54 Segment: N2 - Additional Name Information Level: Loop: Usage: Level 3 (Mortgage Company) HL/N1 Optional Max Use: 2 Purpose: To specify additional names or those longer than 35 characters in length. Data Element Summary Seq. Ref. ANSI X12 Name Mrtg ANSI X12 Attributes N Name O M AN 01/35 N Name O O AN 01/35 Mortgagee Billing Usage Notes The segment is optional. If used, it will contain additional mortgage company name information. N201 N202 If used, this element will contain additional name information that would not fit in N102. If used, this element should contain additional name information that would not fit in N201. Example: Use of this field should not be necessary. Tax Identification Number (TIN) should be sufficient to identify the Mortgage Company and therefore, no example is given. 54
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