Name | Flags | Card. | Type | Description & Constraints![]() |
---|---|---|---|---|
ID | DomainResource | Details 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 | ||
ΣI | 0..* | Identifier | Identifies this product/plan across multiple systems | |
?!Σ | 0..1 | code | draft | active | retired | unknown PublicationStatus (Required) | |
Σ | 0..* | CodeableConcept | Kind of product/plan ProductPlanType (Example) | |
ΣI | 0..1 | string | Official name | |
0..* | string | A list of alternate names that the product/plan is known as, or was known as in the past | ||
0..1 | Period | The time period the product/plan is available | ||
Σ | 0..1 | Reference(Organization) | Owner of the product/plan | |
Σ | 0..1 | Reference(Organization) | Administrator of the product/plan | |
I | 0..* | Address | An address for the organization + An address of an organization can never be of use 'home' | |
Σ | 0..1 | Reference(Location) | The geographic region in which this product/plan is available | |
0..* | BackboneElement | Contact for the product/plan for a certain purpose | ||
0..1 | CodeableConcept | The type of contact ContactEntityType (Extensible) | ||
0..1 | HumanName | A name associated with the contact | ||
0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | ||
0..1 | Address | Visiting or postal addresses for the contact | ||
0..* | BackboneElement | Details about the coverage offered by the insurance product | ||
1..1 | CodeableConcept | Type of coverage | ||
1..* | BackboneElement | Specific benefits under this type of coverage | ||
1..1 | CodeableConcept | Type of benefit | ||
1..* | BackboneElement | Specific benefit and related value | ||
1..1 | CodeableConcept | Coded Details of the specific benefit (days; visits) | ||
0..1 | Quantity | Value of the specific benefit | ||
0..* | BackboneElement | Details about an insurance plan | ||
0..1 | CodeableConcept | Type of plan | ||
0..1 | string | Additional descriptive content about the plan | ||
0..1 | Money | Plan premium | ||
0..* | BackboneElement | List of the costs associated with plan benefits | ||
0..1 | CodeableConcept | General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health) | ||
0..* | BackboneElement | List of the specific benefits under this category of benefit | ||
1..1 | CodeableConcept | Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care) | ||
0..* | BackboneElement | List of the costs associated with a specific benefit | ||
1..1 | CodeableConcept | Type of cost (copay; individual cap; family cap; coinsurance; deductible) | ||
0..* | Coding | Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other) | ||
0..* | string | Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA) | ||
0..1 | Quantity | The actual cost value | ||
0..* | Reference(Endpoint) | Technical endpoints providing access to services operated for the organization | ||
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