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EDI 259 Residential Mortgage Insurance Explanation of Benefits

Functional Group MG

X12F Finance Subcommittee

This Draft Standard for Trial Use contains the format and establishes the data contents of the Residential Mortgage Insurance Explanation of Benefits Transaction Set (259) for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to transmit the results of a claim for mortgage insurance benefits, referred to as an explanation of benefits (EOB), between a mortgage insurer and the customer receiving the financial benefit. This standard can be used for transmitting the results of both pool and primary mortgage insurance claims.

Heading

Position
Segment
Name
Max use
  1. To indicate the start of a transaction set and to assign a control number

  2. To indicate the beginning of a transaction set

  3. 0100 Loop Mandatory
    Repeat >1
    1. To identify a party by type of organization, name, and code

      The 0100 loop repeats for each individual company.
    2. To specify additional names

    3. To specify the location of the named party

    4. To specify the geographic place of the named party

    5. To specify identifying information

    6. To identify a person or office to whom administrative communications should be directed

Detail

Position
Segment
Name
Max use
  1. 0200 Loop Mandatory
    Repeat >1
    1. To transmit identifying information as specified by the Reference Identification Qualifier

      The 0200 Loop contains all information needed for a residential mortgage insurance explanation of benefits document.
    2. To specify pertinent dates and times

    3. To indicate the total monetary amount

    4. To specify mortgage loan default information

    5. To specify identifying information

    6. To identify a person or office to whom administrative communications should be directed

    7. To qualify percent amounts and supply percent amounts

    8. To provide a free-form format that allows the transmission of text information

    9. 0300 Loop Mandatory
      Repeat >1
      1. To identify a party by type of organization, name, and code

        The 0300 Loop contains the borrower's name and insured property address.
      2. To specify additional names

      3. To specify the location of the named party

      4. To specify the geographic place of the named party

    10. 0400 Loop Optional
      Repeat >1
      1. To specify pertinent dates and times

        The 0400 Loop contains the event items and dates, along with mortgage interest rate intervals and amounts for adjustable interest loans.
      2. To specify quantity information

      3. To specify interest rate and type and the applicable time period

      4. To indicate the total monetary amount

      5. To report information

    11. 0500 Loop Optional
      Repeat >1
      1. To specify mortgage loan fiscal data when applying for insurance claim benefits

        The 0500 Loop contains detail claimable expense items submitted, the amount authorized for payment, and an explanation of any adjustments.
      2. To report information

      3. 0510 Loop Optional
        Repeat >1
        1. To specify a code and/or description with an associated amount

        2. To indicate the total monetary amount

        3. To report information

  2. To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

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