N1

Other Insurance Company Name

Pos: 410	Max: 1
Detail - Optional
Loop: 2320	Elements: 4

Ref

Id

Element Name

Req

Type

Min/Max

Usage

N101

98

Entity Identifier Code
Description: Code identifying an organizational entity, a physical location, property or an individual

M

ID

2/3

Required

Code

Name

IN

Insurer

N102

93

Name
Description: Free-form name
Industry: Insurer Name
Send the insurance company name if no standard identifier is available to pass in N104.

C

AN

1/60

Situational

N103

66

Identification Code Qualifier
Description: Code designating the system/method of code structure used for Identification Code (67)
Send when required by X12 syntax.

C

ID

1/2

Situational

Code

Name

FI

Federal Taxpayer's Identification Number

NI

National Association of Insurance Commissioners (NAIC) Identification

XV

Health Care Financing Administration National Payer Identification Number (PAYERID)

CODE SOURCE:

540: Health Care Financing Administration National PlanID

N104

67

Identification Code
Description: Code identifying a party or other code
Industry: Insured Group or Policy Number
Use the National Payer ID until that ID is available the Federal Tax ID should be used.
Send when supplied by the employee to the sponsor.

C

AN

2/80

Situational

ExternalCodeList

Name: 540

Description: Health Care Financing Administration National PlanID

1.

R0203 - At least one of N102,N103 is required

2.

P0304 - If either N103,N104 is present, then all are required

1.

This segment, used alone, provides the most efficient method of providing organizational identification. To obtain this efficiency the "ID Code" (N104) must provide a key to the table maintained by the transaction processing party.

2.

N105 and N106 further define the type of entity in N101.

Notes:

1. Use this segment to send the name of the insurance company when provided to the sponsor.

Example:

N1*IN**NI*12345678~