NameFlagsCard.TypeDescription & Constraintsdoco
.. ProductPlan IDDomainResourceDetails of a Health Insurance product/plan provided by an organization
+ The organization SHALL at least have a name or an id, and possibly more than one
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier ΣI0..*IdentifierIdentifies this product/plan across multiple systems
... status ?!Σ0..1codedraft | active | retired | unknown
PublicationStatus (Required)
... type Σ0..*CodeableConceptKind of product/plan
ProductPlanType (Example)
... name ΣI0..1stringOfficial name
... alias 0..*stringA list of alternate names that the product/plan is known as, or was known as in the past
... period 0..1PeriodThe time period the product/plan is available
... ownedBy Σ0..1Reference(Organization)Owner of the product/plan
... administeredBy Σ0..1Reference(Organization)Administrator of the product/plan
... address I0..*AddressAn address for the organization
+ An address of an organization can never be of use 'home'
... coverageArea Σ0..1Reference(Location)The geographic region in which this product/plan is available
... contact 0..*BackboneElementContact for the product/plan for a certain purpose
.... purpose 0..1CodeableConceptThe type of contact
ContactEntityType (Extensible)
.... name 0..1HumanNameA name associated with the contact
.... telecom 0..*ContactPointContact details (telephone, email, etc.) for a contact
.... address 0..1AddressVisiting or postal addresses for the contact
... coverage 0..*BackboneElementDetails about the coverage offered by the insurance product
.... type 1..1CodeableConceptType of coverage
.... benefit 1..*BackboneElementSpecific benefits under this type of coverage
..... type 1..1CodeableConceptType of benefit
..... item 1..*BackboneElementSpecific benefit and related value
...... code 1..1CodeableConceptCoded Details of the specific benefit (days; visits)
...... benefitValue 0..1QuantityValue of the specific benefit
... plan 0..*BackboneElementDetails about an insurance plan
.... type 0..1CodeableConceptType of plan
.... description 0..1stringAdditional descriptive content about the plan
.... premium 0..1MoneyPlan premium
.... category 0..*BackboneElementList of the costs associated with plan benefits
..... code 0..1CodeableConceptGeneral category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health)
..... benefit 0..*BackboneElementList of the specific benefits under this category of benefit
...... type 1..1CodeableConceptType of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care)
...... cost 0..*BackboneElementList of the costs associated with a specific benefit
....... type 1..1CodeableConceptType of cost (copay; individual cap; family cap; coinsurance; deductible)
....... applicability 0..*CodingWhether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other)
....... qualifiers 0..*stringAdditional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA)
....... value 0..1QuantityThe actual cost value
... endpoint 0..*Reference(Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format