187Premium Audit Request and Return

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.

  • ST
    Transaction Set Header
    M必须(Mandatory)
    Repeat 1

    To indicate the start of a transaction set and to assign a control number

  • BGN
    Beginning Segment
    M必须(Mandatory)
    Repeat 1

    To indicate the beginning of a transaction set

  • MSG
    Message Text
    O可选(Optional)
    Repeat > 1

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

  • REF
    Reference Identification
    O可选(Optional)
    Repeat > 1

    To specify identifying information

  • PER
    Administrative Communications Contact
    O可选(Optional)
    Repeat 3

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

  • DTP
    Date or Time or Period
    O可选(Optional)
    Repeat 10

    To specify any or all of a date, a time, or a time period

  • N1Loop1Name LOOPO可选(Optional)Repeat > 1
    N1N2N3N4REFPER
    • N1
      Name
      M必须(Mandatory)
      Repeat 1

      To identify a party by type of organization, name, and code

    • N2
      Additional Name Information
      O可选(Optional)
      Repeat 2

      To specify additional names

    • N3
      Address Information
      O可选(Optional)
      Repeat 2

      To specify the location of the named party

    • N4
      Geographic Location
      O可选(Optional)
      Repeat 1

      To specify the geographic place of the named party

    • REF
      Reference Identification
      O可选(Optional)
      Repeat 12

      To specify identifying information

    • PER
      Administrative Communications Contact
      O可选(Optional)
      Repeat 3

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

  • HLLoop1Hierarchical Level LOOPM必须(Mandatory)Repeat > 1
    HLLXLoop1NM1Loop1IIILoop1
    • HL
      Hierarchical Level
      M必须(Mandatory)
      Repeat 1

      To identify dependencies among and the content of hierarchically related groups of data segments

    • LXLoop1Assigned Number LOOPO可选(Optional)Repeat 1
      LXVEHVATDVISIPIDMEAREFAMTAD1DTPTXIQTYLoop1EFILoop1
      • LX
        Assigned Number
        M必须(Mandatory)
        Repeat 1

        To reference a line number in a transaction set

      • VEH
        Vehicle Information
        O可选(Optional)
        Repeat 1

        To provide descriptions that identify a specific vehicle

      • VAT
        Vehicle Attribute
        O可选(Optional)
        Repeat 20

        Identifies attributes associated with a vehicle

      • DVI
        Dynamic Vehicle Information
        O可选(Optional)
        Repeat 1

        To provide dynamic information pertaining to a vehicle

      • SI
        Service Characteristic Identification
        O可选(Optional)
        Repeat 8

        To specify service characteristic data

      • PID
        Product/Item Description
        O可选(Optional)
        Repeat 10

        To describe a product or process in coded or free-form format

      • MEA
        Measurements
        O可选(Optional)
        Repeat 10

        To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)

      • REF
        Reference Identification
        O可选(Optional)
        Repeat > 1

        To specify identifying information

      • AMT
        Monetary Amount
        O可选(Optional)
        Repeat 5

        To indicate the total monetary amount

      • AD1
        Adjustment Amount
        O可选(Optional)
        Repeat 20

        To specify the characteristics of an adjustment

      • DTP
        Date or Time or Period
        O可选(Optional)
        Repeat 20

        To specify any or all of a date, a time, or a time period

      • TXI
        Tax Information
        O可选(Optional)
        Repeat > 1

        To specify tax information

      • QTYLoop1Quantity LOOPO可选(Optional)Repeat > 1
        QTYSI
        • QTY
          Quantity
          M必须(Mandatory)
          Repeat 1

          To specify quantity information

        • SI
          Service Characteristic Identification
          O可选(Optional)
          Repeat 1

          To specify service characteristic data

      • EFILoop1Electronic Format Identification LOOPO可选(Optional)Repeat 5
        EFIBIN
        • EFI
          Electronic Format Identification
          M必须(Mandatory)
          Repeat 1

          To provide basic information about the electronic format of the interchange data

        • BIN
          Binary Data
          O可选(Optional)
          Repeat > 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

    • NM1Loop1Individual or Organizational Name LOOPO可选(Optional)Repeat 1
      NM1N2N3N4DMGDMAMEANX2REFPER
      • NM1
        Individual or Organizational Name
        M必须(Mandatory)
        Repeat 1

        To supply the full name of an individual or organizational entity

      • N2
        Additional Name Information
        O可选(Optional)
        Repeat 2

        To specify additional names

      • N3
        Address Information
        O可选(Optional)
        Repeat 2

        To specify the location of the named party

      • N4
        Geographic Location
        O可选(Optional)
        Repeat 1

        To specify the geographic place of the named party

      • DMG
        Demographic Information
        O可选(Optional)
        Repeat 1

        To supply demographic information

      • DMA
        Additional Demographic Information
        O可选(Optional)
        Repeat 1

        To supply additional demographic identification

      • MEA
        Measurements
        O可选(Optional)
        Repeat 10

        To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)

      • NX2
        Location ID Component
        O可选(Optional)
        Repeat 1

        To define types and values of a geographic location

      • REF
        Reference Identification
        O可选(Optional)
        Repeat 10

        To specify identifying information

      • PER
        Administrative Communications Contact
        O可选(Optional)
        Repeat > 1

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

    • IIILoop1Information LOOPO可选(Optional)Repeat > 1
      IIISIPIDMEAREFDTPMSGAMTAD1CRCPCTPDPPDRPDSSUPLoop1QTYLoop2LQLoop1NM1Loop2ITALoop1
      • III
        Information
        M必须(Mandatory)
        Repeat 1

        To report information

      • SI
        Service Characteristic Identification
        O可选(Optional)
        Repeat 2

        To specify service characteristic data

      • PID
        Product/Item Description
        O可选(Optional)
        Repeat 10

        To describe a product or process in coded or free-form format

      • MEA
        Measurements
        O可选(Optional)
        Repeat 10

        To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)

      • REF
        Reference Identification
        O可选(Optional)
        Repeat > 1

        To specify identifying information

      • DTP
        Date or Time or Period
        O可选(Optional)
        Repeat 10

        To specify any or all of a date, a time, or a time period

      • MSG
        Message Text
        O可选(Optional)
        Repeat > 1

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

      • AMT
        Monetary Amount
        O可选(Optional)
        Repeat 10

        To indicate the total monetary amount

      • AD1
        Adjustment Amount
        O可选(Optional)
        Repeat 20

        To specify the characteristics of an adjustment

      • CRC
        Conditions Indicator
        O可选(Optional)
        Repeat 50

        To supply information on conditions

      • PCT
        Percent Amounts
        O可选(Optional)
        Repeat 10

        To qualify percent amounts and supply percent amounts

      • PDP
        Property Description - Personal
        O可选(Optional)
        Repeat > 1

        To provide a description of personal property

      • PDR
        Property Description - Real
        O可选(Optional)
        Repeat > 1

        To provide a description of real property

      • PDS
        Property Description/Legal Description
        O可选(Optional)
        Repeat > 1

        To provide specifics on property or legal description; this segment provides for a simple legal description such as lot, block and subdivision

      • SUPLoop1Supplementary Information LOOPM必须(Mandatory)Repeat > 1
        SUPMEAREFDTPAMTAD1
        • SUP
          Supplementary Information
          M必须(Mandatory)
          Repeat 1

          To provide processible supplementary information

        • MEA
          Measurements
          O可选(Optional)
          Repeat 1

          To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)

        • REF
          Reference Identification
          O可选(Optional)
          Repeat > 1

          To specify identifying information

        • DTP
          Date or Time or Period
          O可选(Optional)
          Repeat > 1

          To specify any or all of a date, a time, or a time period

        • AMT
          Monetary Amount
          O可选(Optional)
          Repeat > 1

          To indicate the total monetary amount

        • AD1
          Adjustment Amount
          O可选(Optional)
          Repeat > 1

          To specify the characteristics of an adjustment

      • QTYLoop2Quantity LOOPO可选(Optional)Repeat > 1
        QTYSI
        • QTY
          Quantity
          M必须(Mandatory)
          Repeat 1

          To specify quantity information

        • SI
          Service Characteristic Identification
          O可选(Optional)
          Repeat 1

          To specify service characteristic data

      • LQLoop1Industry Code LOOPO可选(Optional)Repeat > 1
        LQAMTAD1PCT
        • LQ
          Industry Code
          M必须(Mandatory)
          Repeat 1

          Code to transmit standard industry codes

        • AMT
          Monetary Amount
          O可选(Optional)
          Repeat 10

          To indicate the total monetary amount

        • AD1
          Adjustment Amount
          O可选(Optional)
          Repeat 10

          To specify the characteristics of an adjustment

        • PCT
          Percent Amounts
          O可选(Optional)
          Repeat 10

          To qualify percent amounts and supply percent amounts

      • NM1Loop2Individual or Organizational Name LOOPO可选(Optional)Repeat > 1
        NM1N2N3N4DMGDMANX2REFPER
        • NM1
          Individual or Organizational Name
          M必须(Mandatory)
          Repeat 1

          To supply the full name of an individual or organizational entity

        • N2
          Additional Name Information
          O可选(Optional)
          Repeat 2

          To specify additional names

        • N3
          Address Information
          O可选(Optional)
          Repeat 2

          To specify the location of the named party

        • N4
          Geographic Location
          O可选(Optional)
          Repeat 1

          To specify the geographic place of the named party

        • DMG
          Demographic Information
          O可选(Optional)
          Repeat 1

          To supply demographic information

        • DMA
          Additional Demographic Information
          O可选(Optional)
          Repeat 1

          To supply additional demographic identification

        • NX2
          Location ID Component
          O可选(Optional)
          Repeat 1

          To define types and values of a geographic location

        • REF
          Reference Identification
          O可选(Optional)
          Repeat > 1

          To specify identifying information

        • PER
          Administrative Communications Contact
          O可选(Optional)
          Repeat > 1

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

      • ITALoop1Allowance, Charge or Service LOOPO可选(Optional)Repeat > 1
        ITADTPREFCUR
        • ITA
          Allowance, Charge or Service
          M必须(Mandatory)
          Repeat 1

          To specify allowances, charges, or services

        • DTP
          Date or Time or Period
          O可选(Optional)
          Repeat > 1

          To specify any or all of a date, a time, or a time period

        • REF
          Reference Identification
          O可选(Optional)
          Repeat 5

          To specify identifying information

        • CUR
          Currency
          O可选(Optional)
          Repeat 1

          To specify the currency (dollars, pounds, francs, etc.) used in a transaction

  • TDS
    Total Monetary Value Summary
    M必须(Mandatory)
    Repeat 1

    To specify the total invoice discounts and amounts

  • ITALoop2Allowance, Charge or Service LOOPO可选(Optional)Repeat > 1
    ITADTPREFCUR
    • ITA
      Allowance, Charge or Service
      M必须(Mandatory)
      Repeat 1

      To specify allowances, charges, or services

    • DTP
      Date or Time or Period
      O可选(Optional)
      Repeat > 1

      To specify any or all of a date, a time, or a time period

    • REF
      Reference Identification
      O可选(Optional)
      Repeat > 1

      To specify identifying information

    • CUR
      Currency
      O可选(Optional)
      Repeat 1

      To specify the currency (dollars, pounds, francs, etc.) used in a transaction

  • BALLoop1Balance Detail LOOPO可选(Optional)Repeat > 1
    BALDTP
    • BAL
      Balance Detail
      M必须(Mandatory)
      Repeat 1

      To identify the specific monetary balances associated with a particular account

    • DTP
      Date or Time or Period
      O可选(Optional)
      Repeat > 1

      To specify any or all of a date, a time, or a time period

  • N1Loop2Name LOOPO可选(Optional)Repeat > 1
    N1BALLoop2ITALoop3
    • N1
      Name
      M必须(Mandatory)
      Repeat 1

      To identify a party by type of organization, name, and code

    • BALLoop2Balance Detail LOOPO可选(Optional)Repeat > 1
      BALDTP
      • BAL
        Balance Detail
        M必须(Mandatory)
        Repeat 1

        To identify the specific monetary balances associated with a particular account

      • DTP
        Date or Time or Period
        O可选(Optional)
        Repeat > 1

        To specify any or all of a date, a time, or a time period

    • ITALoop3Allowance, Charge or Service LOOPO可选(Optional)Repeat > 1
      ITADTPREFCUR
      • ITA
        Allowance, Charge or Service
        M必须(Mandatory)
        Repeat 1

        To specify allowances, charges, or services

      • DTP
        Date or Time or Period
        O可选(Optional)
        Repeat > 1

        To specify any or all of a date, a time, or a time period

      • REF
        Reference Identification
        O可选(Optional)
        Repeat > 1

        To specify identifying information

      • CUR
        Currency
        O可选(Optional)
        Repeat 1

        To specify the currency (dollars, pounds, francs, etc.) used in a transaction

  • SE
    Transaction Set Trailer
    M必须(Mandatory)
    Repeat 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)

Segment
X12 EDI Release 00402
To indicate the start of a transaction set and to assign a control number
Elements
  • ST01143Transaction Set Identifier Code
    ID
    M必须(Mandatory)
    Min 3 / Max 3

    Code uniquely identifying a Transaction Set

    Codes (320)
  • ST02329Transaction Set Control Number
    AN
    M必须(Mandatory)
    Min 4 / Max 9

    Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set

  • ST031705Implementation Convention Preference
    AN
    O可选(Optional)
    Min 1 / Max 9

    Reference assigned to identify Implementation Convention