X12 transaction guide · Healthcare and insurance

EDI 273 Insurance/Annuity Application Status

The X12 document insurers use to tell trading partners the current status of a life insurance or annuity application during underwriting.

Sent by
Insurance company
Received by
Distributor, such as an agent or broker-dealer
Standard
ANSI ASC X12

What is an EDI 273?

The EDI 273 Insurance/Annuity Application Status is the ANSI X12 transaction set insurance providers use to inform their trading partners of the current status of a life insurance or annuity application during underwriting.

Applicants ask their agents how their applications are progressing. Status updates show which requirements are outstanding, whether the application is approved and on what terms, or why it was declined, so agents can keep clients informed and help clear outstanding items. Final updates confirm issue and delivery of the policy, or explain a decline or postponement, so the distributor can close its own case record.

How the EDI 273 worksDiagram of the EDI 273 Insurance/Annuity Application Status. Insurance company sends it to distributor, such as an agent or broker-dealer. It usually follows 267. It is usually followed by 997. Inside the ISA, GS and ST envelopes, X12 release 008010 requires, in the heading: BGN (Beginning Segment) and detail: the required ACT loop with ACT (Account Identification) and the required LX loop with LX (Transaction Set Line Number). 4 optional loops are listed by their first segment.How the EDI 273 worksInsurance/Annuity Application Status: who sends it, where it fits and what the standard marks required1 WHERE IT FITSUSUALLY FOLLOWS267Individual Life, Annuityand Disability ApplicationEDI 273SENDERInsurance companyRECEIVERDistributor, such as anagent or broker-dealer997 or 999 acknowledgment back, if the partners agreeUSUALLY FOLLOWED BY997FunctionalAcknowledgment2 WHAT X12 RELEASE 008010 REQUIRESInterchange: sender and receiver IDsISA … IEAFunctional group, ID code IDGS … GETransaction set 273ST … SEHEADINGBGNBeginning Segment+ 1 optional loop, starting with:NM1DETAILRequired loop ACT · repeats many timesACTAccount IdentificationRequired loop LX · repeats many timesLXTransaction Set Line Number+ 3 optional loops, starting with:BENENTMSGBlue box: required loop. Optional loops are listed by the segment that starts them; when a loop is used, that first segment is required. Optional segmentsoutside loops are not drawn.Structure: required segments and loops in the X12 008010 listing for the 273. Your trading partner's implementation guide adds its own requirements.
How the EDI 273 worksDiagram of the EDI 273 Insurance/Annuity Application Status. Insurance company sends it to distributor, such as an agent or broker-dealer. It usually follows 267. It is usually followed by 997. Inside the ISA, GS and ST envelopes, X12 release 008010 requires, in the heading: BGN (Beginning Segment) and detail: the required ACT loop with ACT (Account Identification) and the required LX loop with LX (Transaction Set Line Number). 4 optional loops are listed by their first segment.How the EDI 273 worksInsurance/Annuity Application Status: whosends it, where it fits and what the standardmarks required1 WHERE IT FITSUSUALLY FOLLOWS267Individual Life, Annuity and DisabilityApplicationEDI 273SENDERInsurancecompanyRECEIVERDistributor, suchas an agent orbroker-dealer997 or 999 acknowledgment back, if the partnersagreeUSUALLY FOLLOWED BY997Functional Acknowledgment2 WHAT X12 RELEASE 008010 REQUIRESInterchange: sender and receiver IDs (ISA… IEA)Functional group, ID code ID (GS … GE)Transaction set 273 (ST … SE)HEADINGBGNBeginning Segment+ 1 optional loop, starting with:NM1DETAILRequired loop ACT · repeatsmany timesACTAccount IdentificationRequired loop LX · repeatsmany timesLXTransaction Set LineNumber+ 3 optional loops, starting with:BENENTMSGBlue box: required loop. Optional loops are listedby the segment that starts them; when a loop isused, that first segment is required. Optionalsegments outside loops are not drawn.Structure: required segments and loops in the X12008010 listing for the 273. Your trading partner'simplementation guide adds its own requirements.

How to read this diagram: the top row shows who sends the 273, to whom, and which documents usually come before and after it. The lower part shows what X12 release 008010 itself requires: the envelopes around the 273 and the segments and loops the standard marks as required, area by area. Optional loops are listed by the segment that starts them rather than drawn in full. This is the standard's minimum, not a trading partner's requirement: each partner's implementation guide usually makes some optional loops mandatory, restricts the codes and may use a different release.

Expand diagram Download SVG

When it is used

  • Reporting outstanding underwriting requirements
  • Reporting approval, decline or postponement
  • Reporting issue and delivery of the policy

Where it fits in the document flow

This document 273 Insurance/Annuity Application Status
Usually followed by 997 Functional Acknowledgment

Structure

Mandatory segments in the 273 (X12 release 008010)

The segments X12 release 008010 marks as mandatory at their level, in order. Segments inside optional loops are needed only when the loop is used. This is the standard's requirement, not your trading partner's: each partner's implementation guide names the release it uses, adds the optional segments it requires and restricts the values. The requirement status comes from one published X12 reference listing and has not been checked against a second source.

  • ST
  • BGN
  • NM1
  • ACT
  • LX
  • BEN
  • ENT
  • LQ
  • BLI
  • MSG
  • SE

Practical example

The 273 in practice

An agent submitted a life application two weeks ago. The insurer sends a 273 showing the exam and lab results received but a physician statement still outstanding. A week later, another 273 reports approval at standard rates, and the agent arranges policy delivery.

Implementation

Implementation considerations for the 273

  • Send updates at each underwriting milestone.
  • Describe outstanding requirements clearly.
  • Protect applicants' personal data under applicable law.
  • Match status messages to the agent's application records.

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