EDI

API DocsTerminal
NEW!
Programmatically translate EDI to JSON with the EDI Core REST API
Get started in minutes →
Transaction Set
in
X12 Release 004030

187 Premium Audit Request and Return

Functional Group AE

This Draft Standard for Trial Use contains the format and establishes the data contents of the Premium Audit Request and Return Transaction Set (187) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate premium audit information between property and casualty insurers, and independent premium audit service providers. This information includes, but is not limited to: premium audit request information (i.e., type of audit being requested, policyholder name, business locations, class codes, estimated exposures, date of coverage, producing agency, endorsements); and completed audit information (i.e., actual classification codes and exposures, description of operations, sources of financial information, subcontractor exposures) for the auditable general liability, commercial automobile and worker's compensation lines of insurance.

Heading

Sequence
Segment
Name
Max use
0100
Transaction Set HeaderMandatory
Max 1
To indicate the start of a transaction set and to assign a control number
0200
Beginning SegmentMandatory
Max 1
To indicate the beginning of a transaction set
0300
Message Text
Max >1
To provide a free-form format that allows the transmission of text information
0400
Reference Identification
Max >1
To specify identifying information
0500
Administrative Communications Contact
Max 3
To identify a person or office to whom administrative communications should be directed
0600
Date or Time or Period
Max 10
To specify any or all of a date, a time, or a time period
1000 Loop
Repeat >1
0700
Name
Max 1
To identify a party by type of organization, name, and code
0800
Additional Name Information
Max 2
To specify additional names
0900
Address Information
Max 2
To specify the location of the named party
1000
Geographic Location
Max 1
To specify the geographic place of the named party
1100
Reference Identification
Max 12
To specify identifying information
1200
Administrative Communications Contact
Max 3
To identify a person or office to whom administrative communications should be directed

Detail

Sequence
Segment
Name
Max use
2000 Loop
Repeat >1
0100
Hierarchical LevelMandatory
Max 1
To identify dependencies among and the content of hierarchically related groups of data segments
Valid codes for HL03 to define levels for this transaction set are given below: AA - Insurer 19 - Provider of Service 34 - Location Record 35 - Company/Corporation 36 - Operating Unit 64 - Employee 65 - Insurance Policy 66 - Vehicle SD - Support Document
At least one occurrence each of the insurer level, company/corporation level, and insurance policy level is required. The insurer level and the company/corporation level will always be the first two hierarchical levels and must be in that (hierarchical) order. If the premium audit is documented by location, the insurance policy level will immediately follow the location record level. If the premium audit is documented by policy, the insurance policy level will immediately follow the company/corporation level or the operating unit level, whichever is the lower level to which the hierarchy extends.
The operating unit level is optional and if used, must immediately follow the company/corporation level.
The location record level is optional. If the premium audit is documented by location and the operating unit level is NOT used, the location record level will immediately follow the company/corporation level. If the operating unit level is used, the location record level will immediately follow that level. If the premium audit is documented by policy, the location record level will immediately follow the insurance policy level.
The provider of service level, employee level, and vehicle level are all optional and are hierarchically equal. If the premium audit is documented by location, any of these levels (if used) would be a child of the insurance policy level and would immediately follow (in any order) the insurance policy level. If the premium audit is documented by policy any of these levels (if used) would be a child of and would immediately follow either the insurance policy level or the location record level, whichever is the lower level to which the hierarchy extends.
The support document level is optional and when used, will always immediately follow the provider of service level.
2100 Loop
Repeat 1
0200
Assigned Number
Max 1
To reference a line number in a transaction set
Loop 2100 is used (at HL35 or HL65) to encapsulate loop 2120 for the attachment of premium audit data in formats external to the transaction set (e.g., an electronic spreadsheet file). At HL66 it contains information on vehicles being audited.
0300
Vehicle Information
Max 1
To provide descriptions that identify a specific vehicle
0400
Vehicle Attribute
Max 20
Identifies attributes associated with a vehicle
0500
Dynamic Vehicle Information
Max 1
To provide dynamic information pertaining to a vehicle
0600
Service Characteristic Identification
Max 8
To specify service characteristic data
0700
Product/Item Description
Max 10
To describe a product or process in coded or free-form format
0800
Measurements
Max 10
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
0900
Reference Identification
Max >1
To specify identifying information
1000
Monetary Amount
Max 5
To indicate the total monetary amount
1100
Adjustment Amount
Max 20
To specify the characteristics of an adjustment
1200
Date or Time or Period
Max 20
To specify any or all of a date, a time, or a time period
1300
Tax Information
Max >1
To specify tax information
2110 Loop
Repeat >1
1400
Quantity
Max 1
To specify quantity information
1500
Service Characteristic Identification
Max 1
To specify service characteristic data
2120 Loop
Repeat 5
1600
Electronic Format Identification
Max 1
To provide basic information about the electronic format of the interchange data
1700
Binary Data
Max >1
To transfer binary data in a single data segment and allow identification of the end of the data segment through a count; there is no identification of the internal structure of the binary data in this segment
2200 Loop
Repeat 1
1800
Individual or Organizational Name
Max 1
To supply the full name of an individual or organizational entity
Loop 2200 contains information to identify the insurer (HLAA), the insured (HL35), the insured business (HL36), an insured location (HL34), an insurance policy (HL65), an employee (HL64), a subcontractor (HL19), or a vehicle garaging location (HL66).
1900
Additional Name Information
Max 2
To specify additional names
2000
Address Information
Max 2
To specify the location of the named party
2100
Geographic Location
Max 1
To specify the geographic place of the named party
2200
Demographic Information
Max 1
To supply demographic information
2300
Additional Demographic Information
Max 1
To supply additional demographic identification
2400
Measurements
Max 10
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
2500
Location ID Component
Max 1
To define types and values of a geographic location
2600
Reference Identification
Max 10
To specify identifying information
2700
Administrative Communications Contact
Max >1
To identify a person or office to whom administrative communications should be directed
2300 Loop
Repeat >1
2800
Information
Max 1
To report information
Loop 2300 contains premium audit detail information related to the insured business records (HL36), an insured location (HL34), an insurance policy (HL65), split audits (HL65), officer compensation (HL65), endorsements (HL65), classification codes (HL65), premium modifications (HL65), audit notes information (HL65), an employee (HL64), a subcontractor, (Hl19) or subcontractor insurance coverage (HLSD).
2900
Service Characteristic Identification
Max 2
To specify service characteristic data
3000
Product/Item Description
Max 10
To describe a product or process in coded or free-form format
3100
Measurements
Max 10
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
3200
Reference Identification
Max >1
To specify identifying information
3300
Date or Time or Period
Max 10
To specify any or all of a date, a time, or a time period
3400
Message Text
Max >1
To provide a free-form format that allows the transmission of text information
3500
Monetary Amount
Max 10
To indicate the total monetary amount
3600
Adjustment Amount
Max 20
To specify the characteristics of an adjustment
3700
Conditions Indicator
Max 50
To supply information on conditions
3800
Percent Amounts
Max 10
To qualify percent amounts and supply percent amounts
3900
Property Description - Personal
Max >1
To provide a description of personal property
4000
Property Description - Real
Max >1
To provide a description of real property
4100
Property Description/Legal Description
Max >1
To provide specifics on property or legal description; this segment provides for a simple legal description such as lot, block and subdivision
2310 Loop
Repeat >1
4200
Supplementary InformationMandatory
Max 1
To provide processible supplementary information
Loop 2310 contains supporting detail by specified date for an insurance policy (HL65) or an employee (HL64).
4300
Measurements
Max 1
To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)
4400
Reference Identification
Max >1
To specify identifying information
4500
Date or Time or Period
Max >1
To specify any or all of a date, a time, or a time period
4600
Monetary Amount
Max >1
To indicate the total monetary amount
4700
Adjustment Amount
Max >1
To specify the characteristics of an adjustment
2320 Loop
Repeat >1
4800
Quantity
Max 1
To specify quantity information
Loop 2320 contains quantitative detail necessary to the audit of certain types of insurance policies (HL65).
4900
Service Characteristic Identification
Max 1
To specify service characteristic data
2330 Loop
Repeat >1
5000
Industry Code
Max 1
Code to transmit standard industry codes
Loop 2330 contains monetary or financial detail necessary to the audit of certain types of insurance policies (HL65).
5100
Monetary Amount
Max 10
To indicate the total monetary amount
5200
Adjustment Amount
Max 10
To specify the characteristics of an adjustment
5300
Percent Amounts
Max 10
To qualify percent amounts and supply percent amounts
2340 Loop
Repeat >1
5400
Individual or Organizational Name
Max 1
To supply the full name of an individual or organizational entity
Loop 2340 contains information to identify the issuing insurer (HLAA), the insured business records location (HL36), the insured location records location (HL34), the producing agent (HL65), various state jurisdictions applicable to an insurance policy (HL65), or the insurance carrier for a subcontractor (HLSD).
5500
Additional Name Information
Max 2
To specify additional names
5600
Address Information
Max 2
To specify the location of the named party
5700
Geographic Location
Max 1
To specify the geographic place of the named party
5800
Demographic Information
Max 1
To supply demographic information
5900
Additional Demographic Information
Max 1
To supply additional demographic identification
6000
Location ID Component
Max 1
To define types and values of a geographic location
6100
Reference Identification
Max >1
To specify identifying information
6200
Administrative Communications Contact
Max >1
To identify a person or office to whom administrative communications should be directed
2350 Loop
Repeat >1
6300
Allowance, Charge or Service
Max 1
To specify allowances, charges, or services
Loop 2350 contains information to document the premium auditor�s time and fee, either for audits to be billed by the policy (HL65) or those to be billed by location (HL34).
6400
Date or Time or Period
Max >1
To specify any or all of a date, a time, or a time period
6500
Reference Identification
Max 5
To specify identifying information
6600
Currency
Max 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction

Summary

Sequence
Segment
Name
Max use
0100
Total Monetary Value SummaryMandatory
Max 1
To specify the total invoice discounts and amounts
3000 Loop
Repeat >1
0200
Allowance, Charge or Service
Max 1
To specify allowances, charges, or services
0300
Date or Time or Period
Max >1
To specify any or all of a date, a time, or a time period
0400
Reference Identification
Max >1
To specify identifying information
0500
Currency
Max 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction
3100 Loop
Repeat >1
0600
Balance Detail
Max 1
To identify the specific monetary balances associated with a particular account
0700
Date or Time or Period
Max >1
To specify any or all of a date, a time, or a time period
3200 Loop
Repeat >1
0800
Name
Max 1
To identify a party by type of organization, name, and code
3210 Loop
Repeat >1
0900
Balance Detail
Max 1
To identify the specific monetary balances associated with a particular account
1000
Date or Time or Period
Max >1
To specify any or all of a date, a time, or a time period
3220 Loop
Repeat >1
1100
Allowance, Charge or Service
Max 1
To specify allowances, charges, or services
1200
Date or Time or Period
Max >1
To specify any or all of a date, a time, or a time period
1300
Reference Identification
Max >1
To specify identifying information
1400
Currency
Max 1
To specify the currency (dollars, pounds, francs, etc.) used in a transaction
1500
Transaction Set TrailerMandatory
Max 1
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)
Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.
Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.