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Payroll Deducted and Other Group Premium Payment

The ASC X12N Payroll Deducted and Other Group Premium Payment for Insurance Products (820) transaction allows entities such as employers to make payments to a health plan for insurance premiums.  This transaction contains remittance details relative to the payment, including information needed for balancing, reporting, and reconciling the payment and payment method.

The ASC X12N Payroll Deducted and Other Group Premium Payment for Insurance Products (820) transaction supports payments made by paper check and electronic funds transfer (EFT), including wire transfers and transfers through the Automated Clearinghouse (ACH) network.

  • Payroll Deducted / Premium Payment

    • Standards

      Current Standard

      The current mandated version of the ASC X12N Payroll Deducted and Other Group Premium Payment for Insurance Products (820) transaction is 5010.

      The Technical Report Type 3 ASC X12N/005010X218 Payroll Deducted and Other Group Premium Payment for Insurance Products (820) can be purchased at the ASC X12 Store.

      Anticipated Standard

      The next anticipated version of the ASC X12N Payroll Deducted and Other Group Premium Payment for Insurance Products (820) transaction is 7030. This TR3 will be available for public review and comment from September 1 through October 30, 2016.

      Online ASC X12 Public Review Forum

    • Operating Rules

      Regulation

      Although CAQH CORE® has developed operating rules pertaining to the Payroll Deducted and Other Group Premium Payment for Insurance Products (820) for their voluntary Phase IV certification program, the National Committee on Vital and Health Statistics (NCVHS), advisory body to the Department of Health and Human Services, recommended that the Phase IV Operating Rules not be adopted under regulatory mandate. No federal regulation is anticipated.

      Voluntary Certification

      CAQH CORE offers a voluntary certification program for their Phase IV Operating Rules, which cover the ASC X12N Payroll Deducted and Other Group Premium Payment for Insurance Products (820) transaction.

      Claims and Encounters / Health Plan Enrollment / Health Plan Premium Payment / Referral and Authorization Operating Rules