ASC X12 Version: 005010 | Transaction Set: 834 | TR3 ID: 005010X220
Example 7: Terminate Eligibility for a Subscriber
The eligibility for John Doe is being canceled because he terminated employment on 10/1/1996.
Used to indicate the start of a transaction set and to specify a transaction set control number.
This is an original transaction uniquely identified by the sender with reference #12456. The transaction was created on 5/20/1998 at 12:00 Noon.
Specifies the sponsor/sender's tax ID number.
Specifies the insurance company/receiver's tax ID number.
Beginning of Table 2. Indicates that the subscriber (John Doe) is terminating all coverage.
John's subscriber ID number.
This is the group number assigned by the carrier.
The benefits under this plan are terminating 10/01/1996.
End of transaction set. 10 segments were sent and the control number in the ST segment is 12345.