ACH Implementation Guide for Electronic Funds Transfer:
Industry
NIPR Version 1.3
October 2012
NIPR
NATIONAL INSURANCE PRODUCER REGISTRY
For more information, please contact:
NIPR Marketing Department
816-783-8467 marketing@nipr.com
NIPR
NATIONAL INSURANCE PRODUCER REGISTRY
TABLE OF CONTENTS
Introduction: What is ACH?........................................................................
4
How ACH Works for Electronic Funds Transfer (EFT).............................
4
Implementing EFT
Step 1: Request Participation.................................................................
5
Step 2: Determine Cash Accounting Procedures ...............................
6
Step 3: Determine Detailed Accounting Procedures.........................
6
Step 4: Determine Licensing Procedures...........................................
7
Step 5: Communicate Setup Configuration.........................................
8
Step 6: Execute E-Commerce Agreement…………………………….
8
Step 7: Complete Testing and Certification........................................
8
Step 8: Implementation.........................................................................
9
Contact Information.......................................................................................
October 22, 2012
10
Page 2 of 26
Introduction
Although the term ACH – Automated Clearing House encompasses a variety of
technologies - credit card, wire transfer, private network/accounts, and Electronic Funds
Transfer (EFT) - NIPR has limited the scope in this document to EFT. This technology is
widely available, standard, secure and inexpensive.
NIPR strives to utilize electronic payments whenever possible. NIPR does support
electronic payment options of Electronic Check Processing, Credit Card Payments, and
Electronic Funds Transfer (EFT), however this guide will only concentrate on the
implementation of payment through EFT. Use of EFT allows benefits for moving data
electronically with accuracy, timeliness, efficiency and cost reduction.
This document will detail the ACH process of EFT for NIPR’s ABPs/Industry Customers
(hereafter referred to as Industry Customers) and will describe the steps required to
implement ACH transfer technology for EFT when utilizing NIPR processes.
How EFT Works
The Industry Customers will enroll in the EFT payment option through NIPR. Setup for this
process includes identifying the customer’s chosen bank accounts and the Industry
Customer providing authorization to the NIPR to withdraw funds. This process will certify
NIPR to proceed. Only after proper certification through NIPR Marketing and thorough
testing with NIPR Billing are complete, the NIPR will notify the Industry Customer that they
can start sending transactions that will include licensing related State fees the NIPR will
collect, and then send to the States via EFT processing.
As is true today, Industry systems interface with the NIPR via Gateway transactions. The
NIPR Gateway Layout Documents have been modified to include fields for an Industry
Customer’s account number and a payment code. The Industry Customer must update their
transmissions to include this number and code. Access to this Layout Document is through
a secure Sign-on, through NIPR Subscriber Services, available from our home page. Only
NIPR Subscribers have access to this document.
The NIPR system interfaces with a NAIC system called Centralized E-Commerce Initiative
(CECI). This system provides a tracking number to NIPR that allows for detailed transaction
tracing capabilities.
On a daily basis (with exceptions for banking holidays) the CECI system summarizes all of
an Industry Customer’s transactions and produces a single EFT transaction per account.
Of the many available EFT type transactions, CECI uses two: CTX (Corporate Trade
Exchange) and CTX Addenda transactions.
October 22, 2012
Page 3 of 26
1) One CTX transaction is analogous to a “check”.
2) The CTX Addenda transactions (1 to 9,999 per CTX transaction) serve as an “envelope”
to contain ANSI x.12 EDI 820 Transactions. These transactions provide detailed licensing
information, and travel through the banking system along with the CTX transactions.
The CTX transactions “pull” money from the bank account of the Industry Customer, places
the funds in the NIPR account and then “pushes” the money from the NIPR account to the
appropriate State bank accounts. The NIPR uses national banking and Electronic Data
Interchange (EDI) standards to provide the widest possible interoperability among its trading
partners.
To verify processing for daily Industry Customers, EFT transactions are recorded and
communicated on NIPR’s E-Commerce Report. This report is available via NIPR’s Gateway
Reports and is secure and available only to the particular Industry Customer that transmitted
the transactions as well as to the States that receive the deposit and the transactions. There
is a wide variety of selection criteria available at both the summary and detail levels, and the
report is available with or without header information. There are various E-Commerce report
options to assure the information can be received in a desired format and one, if desired,
that can be incorporated into the Industry Customer’s system. The formats available are
HTML, PDF, Excel or Delimited.
Implementing the EFT Payment Option
Although there are only eight steps to implement EFT, it generally takes up to four functional
areas within an Industry Customer organization to complete the set up process.
1.
2.
3.
4.
Those responsible for administering the firm’s bank accounts – generally the
Accounting Department
Accounts Payable for Industry
Those responsible for licensing transactions
Technical Personnel responsible for integrating with external sources
The following steps need to be followed for full implementation.
October 22, 2012
Page 4 of 26
Step 1: Request Participation
Objective
The Industry Customer will indicate the desire to participate with NIPR in a process for
Electronic Funds Transfer as an option for payment of State fees associated with NIPR
processes. The Industry Customer will indicate a commitment for testing and implementing
this option by cooperating with NIPR.
Process
Complete the “E-Commerce Agreement” in Exhibit A and return this signed document to
NIPR Marketing.
Step 2: Determine Cash Accounting Procedures
Objective
Correctly account for cash flows from or to company bank account(s) and develop the
journal entries to any company-specific general ledger account(s). Ensure that the process
meets security, authority, and auditing standards for your company.
Process
Generally this step is performed by the Industry Customer or State’s Accounting
Department. Sometimes this step is combined with the next step. There are several
techniques available. Although not exhaustive, these instructions will provide a starting point
for how your company will implement EFT payment processing.
1. Read ACH transmission from the bank:
Since the NIPR, through NAIC Finance, uses standard banking transactions, you may
be able to leverage banking processes already in place. Most banks can provide a copy
of ACH transactions affecting the Industry Customer’s account. Many standard
accounting packages are able to read ACH format files. The CTX transaction contains
the amount of the withdrawal and descriptive information. Included in the descriptive
information, is an up to 15-character identifier, provided by the Industry Customer for a
specific number that could map to their general ledger account.
If your firm does not currently have the ability to decode ACH transactions, this will
require a technical change to your systems. If you are already receiving some ACH
formats, adding the CTX format will be a relatively minor change. See Exhibit C for
details on how the NAIC and NIPR uses the company reference fields contained within
the ACH transaction.
October 22, 2012
Page 5 of 26
2. Use current banking documents to record transactions manually:
ACH withdrawals, as do all withdrawals – appear on the monthly bank statement. The
date and descriptive information should make it possible for the Industry Customer to
create manual journal entries for each day, or on a summary basis. Amounts may be
verified by using the NIPR E- Commerce Report. The E-Commerce report is available
only through an ID and Password provided by NIPR Marketing, and accessible through
the ‘Log in to Subscription Services’ available from the NIPR Home page, NIPR.com.
3. Use NIPR E-Commerce Report to make manual entries:
This technique reverses option 2. In this case, entries are made on a daily or summary
basis based on the NIPR E-Commerce report. Amounts are verified against the bank
statement on a monthly basis.
Step 3: Determine Detailed Accounting Procedures
Objective
Correctly account for the licensing fees paid. Ensure that the process meets Industry
Customer security, authority and auditing standards.
Process
This step may be combined with either step 2 or 4, or may stand on its own. The technique
used will depend on how the other steps are implemented.
1. Read CTX Addenda records and 820 details:
If your bank provides detailed EFT transactions, the transmission will include both the
CTX and CTX addenda records. The CTX Addenda records act as an “envelope” to
ANSI x.12. See Exhibit C and D for CTX Format Information.
EDI 820 records affect the company’s account. Some standard accounting packages
are able to read CTX Addenda records, including the EDI 820 records. The 820 records
provide detailed information about individual transactions – who, why, and how much.
Included in the data are transaction identifiers that allow you to tie the information back
to the NIPR system.
If your firm does not currently have the ability to decode EDI 820 transactions, this will
require a technical change or new system. This may be a moderately difficult task since
there are several records within the 820 record set, and they are compressed within the
CTX Addenda record. See Exhibit D for details about how the NAIC uses the EDI 820
transaction set.
October 22, 2012
Page 6 of 26
2. Obtain 820 data/report from your bank:
Although 820 translations are not necessarily widespread within industry, most banks
have this capability. Your bank may be able to provide either 820 reports or data. If this
information is used primarily for auditing purposes, this may suffice.
3. Use NIPR E-Commerce Report:
The NIPR E-Commerce Report contains detailed information about license related
transactions, processed through the Gateway and the associated State fee information
concerning those transactions. The report is available over a selected time frame, and is
available in Microsoft Excel format as well as HTML, PDF and Delimited formats.
Step 4: Determine Licensing Procedures
Objective
The licensing department must be able to identify the detailed, processed transactions that
are directly associated with a State fee bank deposit.
Process
In many cases, the detailed licensing information must be recorded in an Industry Customer
system. Using a technique that includes data transfer would be most appropriate. The
techniques for this step are very similar to those in the previous step.
1. Read CTX Addenda records and 820 details:
Financial, licensing, and demographic data are included on 820 transactions. If your firm
has the ability to read 820 data, this would be the easiest way to interface the licensing
system. Any automated interface with your licensing system would require a technical
change. See Exhibit D for details about how the NAIC and NIPR uses the EDI 820
transaction set.
2. Obtain 820 data/report from your bank:
This option is identical to Option 2, Step 3. If you do not require an automated interface,
this may be a viable option.
3. Use NIPR E-Commerce Report:
The NIPR E-Commerce Report contains detailed information about licensing related
transactions. Since it is available in Microsoft Excel format, it may be possible to
integrate with an Industry Customer system.
October 22, 2012
Page 7 of 26
Step 5: Communicate Setup Configuration
Once you have made the decisions about how you will implement E-Commerce, you must
communicate that to the NIPR staff. Complete the E-Commerce Configuration Template
found in Exhibit B
Step 6: Execute E-Commerce Agreement
By definition, E-Commerce is the movement of money in electronic form. NIPR must have
the authority to access Industry Customer accounts. The E-Commerce agreement (see
Exhibit A) must be properly executed before testing can begin. For questions about the
contents of the agreement, please contact:
Ms. Sarah Heidenreich
NAIC Legal Counsel
816-783-8064
sheidenreich@naic.org
Step 7: Complete Testing and Certification
There is no “test” banking system, so thorough component testing is vital. This testing must
be carefully coordinated between the Industry Customer and NIPR. The E-Commerce
process is a closed-loop system. Data originates and terminates at the Industry Customer.
The NAIC and NIPR will help coordinate the following testing process:
1. Unit Test – The purpose of the unit test is to ensure that the Industry Customer system
can properly handle ACH for 820 transactions. The Industry Customer staff will send a
test transaction file that will contain specified data conditions to NIPR. NIPR will process
the file and return results to the Industry Customer in a timely manner. This procedure
will ensure the Industry Customer can properly submit and process ACH transactions.
2. Pre -Notification Test – This test is performed by the NIPR. Once the banking
information is received, the pre-note process verifies that the account information has
been entered accurately and is capable of electronic funds processing.
3. “Penny” System Test – The purpose of the system test is to ensure that
communications work among all parts of the system. The Industry Customer staff will
send another test transaction file that will contain specified data conditions to NIPR.
NIPR will originate the transmission of approximately ten “test” transactions, for $0.01
apiece. Due to the fact that there is no test banking system, these transactions will
occur through the normal banking system, and your account will be debited $0.10 plus
October 22, 2012
Page 8 of 26
bank processing fees, if applicable. All reports and transaction files will be processed
using the same process as production. If requested, this step may be repeated until all
parties are satisfied the process performs accurately.
4. Final Production Test – Essentially this process is the same as the “Penny” test.
However, 1 to 3 live production transactions will be submitted to NIPR. Full fund
amounts will be withdrawn from the Industry Customer bank account via EFT and
transferred to the appropriate State Departments of Insurance also via EFT.
Additional testing of the various steps can occur at the Industry Customer’s
request
Step 8: Implementation
Once NIPR and the Industry Customer agree on the success of the transactions, the
Industry Customer will notify the NIPR in writing of the official begin date for ACH processing
for EFT. Both parties should monitor the system closely during the first week to ensure that
things are processing appropriately. NIPR will also check with the State to insure State fees
are received and E-Commerce reports reflect correct payment and transaction data.
CONTACT INFORMATION
Set-Up or General Inquiries
Testing and Implementation
NIPR Marketing
NIPR Gateway Support
816-783-8467
eft@nipr.com
816-783-8468 marketing@nipr.com
October 22, 2012
Page 9 of 26
Exhibit A: Electronic Funds Transfer Agreement, Authorization for Electronic Debit and
Credit Entries, EFT Enrollment Form
Exhibit B: E-Commerce Configuration Template
Exhibit C: CTX Format
Exhibit D: EDI 820 Transaction Set
October 22, 2012
Page 10 of 26
Exhibit A
ELECTRONIC FUNDS TRANSFER AND INDEMNIFICATION AGREEMENT
This Electronic Funds Transfer and Indemnification Agreement (“EFT Agreement”) is entered
into on this day ________________ Year 20__ by the National Insurance Producer Registry
(“NIPR”) located at 1100 Walnut Street, Suite 1500, Kansas City, Missouri 64106 and
(“Company”) located at
A.
NIPR is a Missouri nonprofit corporation providing information and services to
facilitate the uniform licensing of insurance producers.
B.
NIPR and Company have entered into an NIPR License Agreement
(“License Agreement”) in which NIPR provides access to the NIPR Gateway for the
Company to perform NIPR Gateway licensing related transactions.
C.
Pursuant to the License Agreement, Company is required to submit to NIPR
transaction fees for the above-referenced transactions and is also required to remit State
Insurance Department fees for licensing transactions which are then forwarded by NIPR
to the appropriate State Insurance Department.
D.
NIPR and Company desire to utilize the Automated Clearing House Operating
System for purposes of allowing the Company to electronic ally submit the State
insurance department fees (“DOI Fees) through and Electronic Funds Transfer (EFT)
process.
E.
The parties intend for the Electronic Funds Transfer Agreement to govern the
party’s respective rights and obligations relating to utilization of the Automated Clearing
House Operating System for the above-stated purpose and do not intend to supersede or
affect the party’s obligations under the License Agreement.
NOW, THEREFORE, in consideration of the mutual promises and agreements contained
herein, it is hereby agreed to as follows:
1.
AUTHORITY
Company hereby authorizes NIPR and/or its agent, namely the National Association of
Insurance Commissioners (“NAIC”), to initiate debit entries and, if necessary, credit
entries and adjustments through the Automated Clearing House (“ACH”) Operating
System for the purpose of (EFT) electronically transferring State Fees from Company to
NIPR.
October 22, 2012
Page 11 of 26
2.
3.
NIPR’S OBLIGATIONS
a.
NIPR will initiate a daily electronic process to debit the Company’s
bank account through the ACH Operating System for the amounts due the
State insurance departments based on the electronic calculation of the State
Fees incurred by the Company as a result of the number of transactions,
including NIPR Gateway licensing related transactions as submitted by the
Company on its own behalf or on behalf of its customers.
b.
NIPR will initiate a daily electronic process to transfer to the appropriate
State insurance departments’ bank accounts through the ACH Operating
System the amounts due to the State insurance departments based on the
electronic calculation of the number of licensing transactions submitted to
NIPR by the Company.
c.
NIPR will, if necessary, initiate an electronic process to credit the
Company’s bank account through the ACH Operating System for any a
mounts due the Company by NIPR. NIPR will not credit the Company’s
bank account for any amounts due the Company by NIPR or a State
insurance department if NIPR has already sent the fee for the transaction at
issue to the State insurance department.
COMPANY’S OBLIGATIONS
a.
The Company will provide the information required in Exhibit A as
well as hereby authorizes the NAIC to disclose, if necessary, the
information in Exhibit A to the NAIC’s financial institution and to the
Company’s financial institution.
b.
The Company will, at all times, have sufficient funds in the bank account
identified in Exhibit A to cover the amount of State Fees incurred by the
Company as a result of the number of licensing transactions performed by
NIPR on behalf of the Company.
c.
The Company also agrees to indemnify and hold harmless NIPR for any and
all existing or future obligations, indebtedness or liabilities owed by the NIPR
to NIPR’s financial institution and/or the State insurance departments
caused directly or indirectly by the Company’s failure to have sufficient
funds available to cover State Fees at the time NIPR’s debit entries were
processed through the ACH Operating System. Within five (5) days after
NIPR incurs an obligation, indebtedness or liability caused directly or
October 22, 2012
Page 12 of 26
indirectly by the Company’s failure to have sufficient funds available, the
Company shall reimburse the NIPR for all amounts NIPR was required to
pay to satisfy said obligation including penalties and other charges. For
amounts not paid within five (5) days, interest shall accrue at the rate of
Nine and One-Half Percent (9.5%) compounded annually until said amounts
including interest are paid in full. The Company’s indemnification and
reimbursement obligations hereunder are unconditional and are
independent of and exclusive of any defenses, claims or set-offs the
Company may have against its financial institution, its customers, or the
organization(s) directly or indirectly responsible for causing the Company’s
failure to have sufficient funds.
4.
DISCLAIMER AN D LIMITATION OF LIABILITY
The Company acknowledges NIPR will not determine the sufficiency of funds available
from the Company’s account to cover DOI Fees prior to the time NIPR transfers the DOI
Fees to the appropriate State insurance departments. The Company agrees NIPR shall
have no liability to the Company for transferring DOI Fees to the appropriate State
insurance departments on behalf of the Company or its customers even though the
Company does not have sufficient funds available to cover the DOI Fees.
NIPR has MADE NO WARRANTY OR PROMISE, EITHER EXPRESS OR IMPLIED, with
respect to the Automated Clearing House Operating System covered by this Agreement.
NIPR expressly disclaims THE IMPLIED WARRANTY OF MERCHANTABILITY AND
FITNESS FOR ANY PARTICULAR PURPOSE. NIPR SHALL NOT BE LIABLE FOR
AND COMPANY EXPRESSLY WAIVES ANY CLAIM FOR ANY LOSS, COST, OR
INJURY, DIRECT OR INDIRECT (INCLUDING, BUT NOT LIMITED TO, LOST SALES,
LOST PROFIT, BUSINESS INTERRUPTION, OR THIRD PARTY CLAIMS), SUFFERED
BY COMPANY AS A RESULT OF RELIANCE ON OR USE OF SAID PRODUCT.
In the event of any dispute brought by Company against NIPR, it is mutually agreed and
understood that Company’s sole remedy and NIPR’s sole liability shall in no event exceed
the actual monetary amount transferred from Company’s account to NIPR’s account
through the ACH Operating System, whether such claim is based on tort, negligence, or
other legal or equitable theory.
October 22, 2012
Page 13 of 26
5.
NON -ASSIGNABILITY
Neither party shall transfer or assign its rights or obligations under this Agreement without
the express prior written permission of the other party.
6.
GOVERNING LAW
This Agreement shall be governed by and construed under the laws of the State
of Missouri.
7.
EFFECT OF AGREEMENT
This Agreement governs the parties respective rights and obligations relating to
utilization of the Automated Clearing House Operating system and does not supersede,
modify or affect the parties obligations under the License Agreement. Where this
Agreement is silent on a term or condition, the License Agreement will govern. Where the
terms of this Agreement are inconsistent with the terms of the License Agreement, the
terms of the License Agreement will govern.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day
and year first above written.
National Insurance Producer Registry
Company
By:________________________
By:_____________________________
Title: _______________________
Title: _________________________
October 22, 2012
Page 14 of 26
Exhibit A (continued)
AUTHORIZATION FOR ELECTRONIC DEBIT AND CREDIT ENTRIES
The National Insurance Producer Registry (“NIPR”) and the National Association of
Insurance Commissioners (“NAIC”) are authorized to initiate debit entries and to initiate, if
necessary, credit entries and adjustments for the correction of any debit entries in error
from or to the account indicated below of institution indicated below:
Name of Financial Institution:
Address of Financial Institution:
Routing & Transit No:
Account No.:
Account Name (if applicable):
**NOTE**
Attach a deposit slip or voided check which shows the Routing and
Transit Number & Account Number.
The Company authorizes the above-named Financial Institution to honor such requests
from NIPR or the NAIC and to debit or if applicable, to credit, the same to the account
indicated above. The debit entries initiated by NIPR or the NAIC are for the payment of
DOI fees as those terms are defined in the Agreement between the Company and NIPR.
This authorization shall remain in full force and effect until the above-named Financial
Institution as well as NIPR or the NAIC have received written notice from the Company of
termination of authority in such time and manner as to afford the Financial Institution as
well as NIPR or the NAIC a reasonable time to act on said termination. Notwithstanding
the foregoing, this authorization shall terminate no later than thirty (30) days after written
notice of termination is received by NIPR or the NAIC.
Signature of Authorizing Party:
Name & Title of Authorized Party:
Name of Company:
Address:
Telephone Number:
Date :
October 22, 2012
Page 15 of 26
Exhibit A (continued)
EFT Enrollment Form
Company Name
Treasury/Cash Management/Bank Account Manager Contact
Name:
Phone:
Fax:
Email:
Licensing Department Accounting/Accounts Payable Contact
Name:
Phone:
Fax:
Email:
Licensing Department Contact
Name:
Phone:
Fax:
Email:
October 22, 2012
Page 16 of 26
Exhibit B
NIPR E-Commerce Configuration Template
APPOINTMENTS
Will you process and charge a fee for appointments electronically?
Yes
No
Internal Account number for Appointments
Bank Account
Routing Number
TERMINATIONS
Will you process and charge a fee for terminations electronically?
Yes
No
Internal Account number for terminations
Bank Account
Routing Number
October 22, 2012
Page 17 of 26
NON-RESIDENT LICENSES
Will you process and charge a fee for non-resident licenses electronically?
Yes
No
Internal Account number for non-resident license terminations
Bank Account
Routing Number
October 22, 2012
Page 18 of 26
Exhibit C
Number
10
Reserved
N/A
11
Discretionary Data
O
12
Addenda Record Indicator
M
13
Trace Number
M
M – Mandatory R – Required O - Optional
Position
M
M
M
M
R
M
O
M
R
Requirement*
Contents
Field Inclusion
Name
Record Type Code
Transaction Code
Receiving DFI Identification
Check Digit
DFI Account Number
Total Amount
Identification Number
Number of Addenda Records
Receiving Company Name/ID
Length
1
2
3
4
5
6
7
8
9
Data Element
Field #
Transaction CTX Corporate Entry Detail Record
“6”
Numeric
TTTTAAAA
Numeric
Alphanumeric
$$$$$$$$¢¢
Internal Account #
Numeric
Alphanumeric
1
2
8
1
17
10
15
4
16
01-01
02-03
04-11
12-12
13-29
30-39
40-54
55-58
59-74
Blank
Alphanumeric
Numeric
Numeric
2
2
1
15
75-76
77-78
79-79
80-84
October 22, 2012
“7”
“05”
See 820 Layout
Numeric
Numeric
Position
M
M
O
M
M
Requirement
Contents
Field Inclusion
Name
Record Type Code
Addenda Type Code
Payment Related Information
Addenda Sequence Number
Entry Detail Sequence Number
Length
1
2
3
4
5
Data Element
Field #
Transaction CTX Addenda Record
1
2
80
4
7
01-01
02-03
04-11
84-87
88-94
Page 19 of 26
Exhibit D
Transaction Set 820 Version 4010 ANSI Electronic Funds Transfer
Segment: ISA
INTERCHANGE CONTROL HEADER
Loop: Max Use: 1
MANDATORY
Level: ENVELOPE
Max Use:
PURPOSE: To start and identify an interchange of one or more functional groups.
Data Element Name
Authorization Information Qualifier
Authorization Information
Security Information Qualifier
Security Information
NAIC Codes/Values
"00"
Ten blank positions.
"00"
Ten blank positions.
"01" for Production
ISA05
ISA06
ISA07
ISA08
ISA09
ISA10
Interchange
Qualifier
Interchange ID
Sender
ID
Interchange ID Qualifier
Interchange Receiver Id
Interchange Date
Interchange Time
Interchange Control Standards
"ZZ"
for Testing.
"123456789"
"01"
178923231
YYMMDD
HHMM
ISA11
ISA12
ISA13
ISA14
ISA15
ISA16
Identifier
Interchange
Control Version
Interchange
Control Number
Number
Acknowledgment Requested
Test Indication
Sub-element Separator
"U" = ACS X12.
"00401"
ISA13/IEA02 Sequential Number.
"0"
"P" for Production. "T" for Testing.
"~"
ISA01
ISA02
ISA03
ISA04
October 22, 2012
Page 20 of 26
Exhibit D (continued)
Segment: GS
FUNCTIONAL GROUP HEADER
Loop: Max Use: 1
MANDATORY
Level: GROUP
Max Use:
PURPOSE: To start and identify a functional group of related transaction sets and
provide control and application identification information.
GS01
GS02
GS03
GS04
GS05
GS06
GS07
Data Element Name
Functional Identifier Code
Application Sender's Code
Application Receiver's Code
Date
Time
Group Control Number
Responsible Agency Code
Version/Release/Industry Identifier
NAIC Codes/Values
"RA" = Remittance Advice
"123456789"
Vendor Routing Number
CCYYMMDD.
HHMM.
GS06/ES02 Sequential Number.
"X" - X12.
GS08
Code
"004010".
Segment: ST
TRANSACTION SET HEADER
Loop: Max Use: 1
MANDATORY
Level: HEADER
Max Use:
PURPOSE: To indicate the start of a remittance advice payment transaction set and
to assign a control number
ST01
ST02
October 22, 2012
Data Element Name
Transaction ID
Control Number
NAIC Codes/Values
"820"
ST02/SE02 Sequential Number.
Page 21 of 26
Exhibit D (continued)
Segment: BPR
BEGINNING SEGMENT FOR 820
Loop: Max Use: 1
MANDATORY
Level: HEADER
Max Use:
PURPOSE: To indicate the beginning of a Payment Order/Remittance Advice and
total payment amount.
BPR01
BPR02
Data Element Name
Transaction Handling Code
Monetary Amount
BPR03
Credit/Debit Flag Code
BPR04
Payment Method Code
BPR05
Payment Format Code
BPR06
ID Number Qualifier
BPR07
BPR08
BPR10
BRP12
ID Number Number
Account Number Qualifier Code
Originating Company Identifier
(DFI) ID Number Qualifier
NAIC Codes/Values
"C" = Payment Accompanies
Amount
"C" for "checks" "D" for "deposits"
from/to NAIC account
"ACH" = Automated Clearing
House
"CTX" = Corporate Trade
Exchange
"01" = ABA Transit Routing
Number
UMB ABA Transit Routing Number
"DA" = Demand Deposit
NAIC Company Identifier
"01" = ABA Transit Routing
Number for Receiving Bank
Receiving Bank ABA Number
"DA" = Demand Deposit
Receiver's Bank Account Number
CCYYMMDD (Settlement Date)
BPR13
(DFI) ID Number Number
BPR14
Account Number Qualifier Code
BPR15
Account Number
1 Effective Entry Date
BPR16
1 Next Banking Day. Must account for weekends and bank holidays.
October 22, 2012
Page 22 of 26
Exhibit D (continued)
Segment: DTM
Level: HEADER
DATE/TIME REFERENCE
Loop: Max Use: 1
Max Use: OPTIONAL
PURPOSE: To specify pertinent dates and times.
DTM01
DTM02
Data Element Name
Date/Time Qualifier
Date
NAIC Codes/Values
"097" = Transaction Creation
CCYYMMDD
Segment: N1
Level: HEADER
NAME
Loop: N1 Repeat >1
Max Use: 1 Max Use: OPTIONAL
PURPOSE: To identify a party by type of organization, name and code.
N101
N102
Data Element Name
Entity Identifier Code
Name
NAIC Codes/Values
"PR" = Payer
NAIC
Segment: N1
Level: HEADER
NAME
Loop: N1 Repeat >1
Max Use: 1 Max Use: OPTIONAL
PURPOSE: To identify a party by type of organization, name and code.
N101
N102
N103
N104
October 22, 2012
Data Element Name
Entity Identifier Code
Name
Identification Code Qualifier
Identification Code
NAIC Codes/Values
"PE" = Payee
Vendor Name
"1" = Duns Number
Payee Duns Number
Page 23 of 26
Exhibit D (continued)
Segment: RMR
REMITTANCE ADVICE/ AR OPEN ITEM
Loop: ENT/RMR Repeat >1
Level: DETAIL
Max Use: 1 Max Use: OPTIONAL
PURPOSE: To specify the Accounts Receivable open items to be included in the
cash application.
RMR01
RMR02
RMR04
RMR05
RMR06
Data Element Name
Reference Number Qualifier
Reference Number
Monetary Amount
Total Invoice or Credit/Debit
Amount of Discount Taken
NAIC Codes/Values
"IV"
Invoice Number
Monetary Amount
Document Amount
0
Segment: REF
REFERENCE NUMBERS
Loop: ENT/RMR Repeat >1
Level: DETAIL
Max Use: 1 Max Use: OPTIONAL
PURPOSE: To specify identifying numbers.
REF01
REF02
Data Element Name
Reference Number Qualifier
Reference Number
NAIC Codes/Values
"DB"
PIN Transaction Number
Trans Type 2
01-appt; 02 -term; 04-NRL
PIN Batch
15
PIN Cust Trans
REF03
Description
Name/Firm
20
30
Tax ID 9
Lic Class
October 22, 2012
4
Page 24 of 26
Exhibit D (continued)
Segment: DTM
DATE/TIME REFERENCE
Loop: ENTR/RMR Max Use: 1
Level: DETAIL
Max Use: OPTIONAL
PURPOSE: To specify pertinent dates and times.
DTM01
DTM02
Data Element Name
Date/Time Qualifier
Date
NAIC Codes/Values
"003" = Transaction Creation
CCYYMMDD
Segment: SE
TRANSACTION SET TRAILER
Loop: Max Use: 1
MANDATORY
Level: SUMMARY
Max Use:
PURPOSE: To indicate the end of the transaction set and provide the count of the
transmitted segments.
SE01
SE02
October 22, 2012
Data Element Name
Number of Segments
Control Number
NAIC Codes/Values
Include ST and SE segments.
ST02/SE02 Sequential Number.
Page 25 of 26
Segment: GE
FUNCTIONAL GROUP TRAILER
Level: SUMMARY
Loop: Max Use: 1
MANDATORY
Max Use:
PURPOSE: To define the end of a functional group of related transaction sets.
GE01
Data Element Name
Number of Transaction Sets
Included
NAIC Code s/Values
2Total Number of Transaction
Sets.
GE02
Group Control Number
GS06/ES02 Sequential Number.
2 Include GS and ES Transactions
Segment: IEA - INTERCHANGE CONTROL
TRAILER
Level: ENVELOPE
Loop: Max Use: 1
MANDATORY
Max Use:
PURPOSE: To define the end of an interchange of one or more functional groups and
related control.
IEA01
IEA02
Data Element Name
Number of Included Functional
NAIC Codes/Values
3 Count of GS Segments in
Groups
Interchange Control Number
Transmission.
ISA13/IEA02 Sequential Number.
3 Include ISA/IE
October 22, 2012
Page 26 of 26