Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding 834 Transaction and Companion Guide
Program Area: Small Business Health Options Program (SHOP)
Question: Do the enrollment scenarios provided include all requirements for the issuers in terms of handling enrollment? If not, can we get all of the requirements and edits from the Companion Guide?
Answer: No, the enrollment scenarios do not provide all the requirements for issuers to handle every enrollment situation. Furthermore, the purpose of the Companion Guide is to assist issuers to successfully send a compliant 834 enrollment transaction when used in conjunction with the ASC X12 834 Benefit Enrollment and Maintenance Transaction Implementation Guide/TR3 Version 5010. The Companion Guide provides specific rules for certain fields and data elements so that the 834 enrollment transaction can be used in the Marketplace, whether for individual or SHOP enrollment.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: June 20, 2013
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