Change Request Detail
Type of Request
Premium Payment to a Health Plan
DSMO Process Completed
Business Reason
X12 Insurance Subcommittee (N), the Health Care Task Group (TG2) and the Premium Payments Work Group (WG4) are submitting the following Technical Report Type 3 (TR3) as a version upgrade and replacement for the 820 HIPAA Premium Payment Transaction (820), which is currently adopted and implemented using version 004010X61.

The nex X12 version is 005010 with Implementation Guide (TR3) designated 005010X218 Payroll Deducted and Other Group Premium Payment for Insurance Products (820).
Recommend to NCVHS that the 005010 version of the X12 820 transaction together with its X12 005010 TR3 (Implementation Guide) 005010X218 for Payroll Deducted and Other Group Premium Payment for Insurance Products  be named to replace the current HIPAA mandated transaction 820 version 4010 and its Implementation Guide designated as 004010X061A1.
DSMO Category
Approve. The DSMO appreciates the improvements in the 820 5010 TR3 as outlined in the benefits analysis report as compiled by X12. In addition, the DSMO encourages quick adoption of the TR3, which could occur if the streamlined process, as defined by the standards development organizations and WEDI, for modifications to standards is adopted and followed.
The DSMO acknowledges that the maintenance of administrative transaction standards is an evolving process and looks forward to continuing to work on improving the standards and the business processes they support.
Appeal Recommendation