Validated Healthcare Directory
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Validated Healthcare Directory, published by HL7 International - Patient Administration Work Group. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/VhDir/ and changes regularly. See the Directory of published versions

Resource Profile: VhDir Insurance Plan

Official URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/vhdir-insuranceplan Version: 0.2.0
Active as of 2017-12-05 Computable Name: VhdirInsurancePlan

Copyright/Legal: Used by permission of HL7 International all rights reserved Creative Commons License

The details of a health insurance product/plan

This profile sets minimum expectations for searching for and fetching information associated with a health insurance product/plan. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the InsurancePlan resource when using this profile.

Background & Scope

A product is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits).

InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.

This profile modifies the base InsurancePlan resource in the following manner:

  • Constrains the cardinality of InsurancePlan.status (1..1), InsurancePlan.ownedBy (1..1), InsurancePlan.administeredBy (1..1), InsurancePlan.contact.name.family (1..1), InsurancePlan.contact.name.given (1..*), InsurancePlan.contact.telecom.system (1..1), and InsurancePlan.contact.telecom.value (1..1)

  • All references SHALL conform to the appropriate Validated Healthcare Directory Implementation Guide profile

  • Adds extensions:

  1. Identifier status (1..1) - indicates the status of a product or plan’s identifier
  2. Via intermediary (0..1) - a reference to an alternative point of contact for this InsurancePlan
  3. Available time (0..*) - indicates when the point of contact for an InsurancePlan is available
  4. Restriction (0..*) - indicates whether disclosure of any data associated with a service is restricted

Examples:

The following are example uses for the vhdir-insuranceplan profile:

Mandatory Data Elements

The following data-elements are mandatory (i.e data MUST be present). These are presented below in a simple human-readable explanation. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each insurancePlan resource must have:

  1. A coded value in InsurancePlan.status
  2. A reference to an organization that issues the product/plan in InsurancePlan.ownedBy
  3. A reference to an organization that administers the product/plan in InsurancePlan.administeredBy
  4. For each set of coverage details, one coded type of coverage in InsurancePlan.coverage.type
  5. For each set of coverage details, at least one covered benefit in InsurancePlan.coverage.benefit, including a coded type of benefit in InsurancePlan.coverage.benefit.type
  6. For each set of specific costs associated with a Plan, a coded value indicating the general category of benefit the cost applies to in InsurancePlan.plan.specificCost.category
  7. For each set specific costs associated with a covered benefit, a coded type of benefit in InsurancePlan.plan.specificCost.benefit.type
  8. For each set of specific costs associated with covered benefits, a coded type of cost in InsurancePlan.plan.specificCost.benefit.cost.type

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan 0..* InsurancePlan Details of a Health Insurance product/plan provided by an organization
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... restriction S 0..* Reference(VhDir Restriction) Restriction
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction
... identifier S 0..* Identifier Business Identifier for Product
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... status S 1..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
.... use S 0..1 code usual | official | temp | secondary | old (If known)
.... type S 0..1 CodeableConcept Description of identifier
.... system S 0..1 uri The namespace for the identifier value
.... value S 0..1 string The value that is unique
.... period S 0..1 Period Time period when id is/was valid for use
.... assigner S 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
... status S 1..1 code draft | active | retired | unknown
... type S 0..* CodeableConcept Kind of product
... name S 0..1 string Official name
... alias S 0..* string Alternate names
... period S 0..1 Period When the product is available
... ownedBy S 1..1 Reference(VhDir Organization) Plan issuer
... administeredBy S 1..1 Reference(VhDir Organization) Product administrator
... coverageArea S 0..* Reference(VhDir Location) Where product applies
... contact S 0..* BackboneElement Contact for the product
.... purpose S 0..1 CodeableConcept The type of contact
.... name S 0..1 HumanName A name associated with the contact
..... use S 0..1 code usual | official | temp | nickname | anonymous | old | maiden
..... text S 0..1 string Text representation of the full name
..... family S 1..1 string Family name (often called 'Surname')
..... given S 1..* string Given names (not always 'first'). Includes middle names
..... prefix S 0..* string Parts that come before the name
..... suffix S 0..* string Parts that come after the name
..... period S 0..1 Period Time period when name was/is in use
.... telecom S 0..* ContactPoint Contact details (telephone, email, etc.) for a contact
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... viaintermediary S 0..1 Reference(VhDir Practitioner Role | VhDir Organization | VhDir Organization Affiliation | VhDir Location) viaintermediary
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary
..... availabletime S 0..* (Complex) Available time
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime
..... system S 1..1 code phone | fax | email | pager | url | sms | other
..... value S 1..1 string The actual contact point details
..... use S 0..1 code home | work | temp | old | mobile - purpose of this contact point
..... rank S 0..1 positiveInt Specify preferred order of use (1 = highest)
..... period S 0..1 Period Time period when the contact point was/is in use
.... address S 0..1 Address Visiting or postal addresses for the contact
... endpoint S 0..* Reference(VhDir Endpoint) Technical endpoint
... network S 0..* Reference(VhDir Network) What networks are Included
... coverage S 0..* BackboneElement Coverage details
.... type S 1..1 CodeableConcept Type of coverage
Binding: VhDir Coverage Type (example)
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... benefit S 1..* BackboneElement List of benefits
..... type S 1..1 CodeableConcept Type of benefit
Binding: VhDir Benefit Type (example)
..... requirement S 0..1 string Referral requirements
..... limit S 0..* BackboneElement Benefit limits
...... value S 0..1 Quantity Maximum value allowed
...... code S 0..1 CodeableConcept Benefit limit details
Binding: VhDir Limit Unit (example)
... plan S 0..* BackboneElement Plan details
.... identifier S 0..* Identifier Business identifier for plan
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... status S 0..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
..... use S 0..1 code usual | official | temp | secondary | old (If known)
..... type S 0..1 CodeableConcept Description of identifier
..... system S 0..1 uri The namespace for the identifier value
..... value S 0..1 string The value that is unique
..... period S 0..1 Period Time period when id is/was valid for use
..... assigner S 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
.... type S 0..1 CodeableConcept Type of plan
Binding: VhDir Plan Type (example)
.... coverageArea S 0..* Reference(VhDir Location) Where plan applies
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... generalCost S 0..* BackboneElement Overall costs
..... type S 0..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Cost Type (example)
..... groupSize S 0..1 positiveInt Number of enrollees
..... cost S 0..1 Money Cost value
..... comment S 0..1 string Additional cost information
.... specificCost S 0..* BackboneElement Specific costs
..... category S 1..1 CodeableConcept General category of benefit
Binding: VhDir Insurance Plan Cost Category (example)
..... benefit S 0..* BackboneElement Benefits list
...... type S 1..1 CodeableConcept Type of specific benefit
Binding: VhDir Insurance Plan Benefit Type (example)
...... cost S 0..* BackboneElement List of the costs
....... type S 1..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Benefit Cost Type (example)
....... applicability S 0..1 CodeableConcept in-network | out-of-network | other
....... qualifiers S 0..* CodeableConcept Additional information about the cost
Binding: VhDir Insurance Plan Cost Qualifier (example)
....... value S 0..1 Quantity The actual cost value

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
InsurancePlan.coverage.typeexampleVhDirCoverageType
http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type
from this IG
InsurancePlan.coverage.benefit.typeexampleVhDirBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type
from this IG
InsurancePlan.coverage.benefit.limit.codeexampleVhDirLimitUnit
http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit
from this IG
InsurancePlan.plan.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type
from this IG
InsurancePlan.plan.generalCost.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype
from this IG
InsurancePlan.plan.specificCost.categoryexampleVhDirInsPlanCostCategory
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory
from this IG
InsurancePlan.plan.specificCost.benefit.typeexampleVhDirInsPlanBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.typeexampleVhDirInsPlanBenefitCostType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.qualifiersexampleVhDirInsPlanQualifier
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C 0..* InsurancePlan Details of a Health Insurance product/plan provided by an organization
ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... restriction S 0..* Reference(VhDir Restriction) Restriction
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣC 0..* Identifier Business Identifier for Product
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... status S 1..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
.... use ?!SΣ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type SΣ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system SΣ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 0..1 string The value that is unique
Example General: 123456
.... period SΣ 0..1 Period Time period when id is/was valid for use
.... assigner SΣ 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... type SΣ 0..* CodeableConcept Kind of product
Binding: InsurancePlanType (example): Used to categorize the product/plan.


... name SΣC 0..1 string Official name
... alias S 0..* string Alternate names
... period S 0..1 Period When the product is available
... ownedBy SΣ 1..1 Reference(VhDir Organization) Plan issuer
... administeredBy SΣ 1..1 Reference(VhDir Organization) Product administrator
... coverageArea SΣ 0..* Reference(VhDir Location) Where product applies
... contact S 0..* BackboneElement Contact for the product
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... purpose S 0..1 CodeableConcept The type of contact
Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.

.... name S 0..1 HumanName A name associated with the contact
..... use ?!SΣ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

..... text SΣ 0..1 string Text representation of the full name
..... family SΣ 1..1 string Family name (often called 'Surname')
..... given SΣ 1..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period SΣ 0..1 Period Time period when name was/is in use
.... telecom S 0..* ContactPoint Contact details (telephone, email, etc.) for a contact
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... viaintermediary S 0..1 Reference(VhDir Practitioner Role | VhDir Organization | VhDir Organization Affiliation | VhDir Location) viaintermediary
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary
..... availabletime S 0..* (Complex) Available time
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime
..... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

..... value SΣ 1..1 string The actual contact point details
..... use ?!SΣ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

..... rank SΣ 0..1 positiveInt Specify preferred order of use (1 = highest)
..... period SΣ 0..1 Period Time period when the contact point was/is in use
.... address S 0..1 Address Visiting or postal addresses for the contact
... endpoint S 0..* Reference(VhDir Endpoint) Technical endpoint
... network S 0..* Reference(VhDir Network) What networks are Included
... coverage S 0..* BackboneElement Coverage details
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type S 1..1 CodeableConcept Type of coverage
Binding: VhDir Coverage Type (example)
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... benefit S 1..* BackboneElement List of benefits
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type S 1..1 CodeableConcept Type of benefit
Binding: VhDir Benefit Type (example)
..... requirement S 0..1 string Referral requirements
..... limit S 0..* BackboneElement Benefit limits
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... value S 0..1 Quantity Maximum value allowed
...... code S 0..1 CodeableConcept Benefit limit details
Binding: VhDir Limit Unit (example)
... plan S 0..* BackboneElement Plan details
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier SΣ 0..* Identifier Business identifier for plan
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... status S 0..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
..... use ?!SΣ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type SΣ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 0..1 string The value that is unique
Example General: 123456
..... period SΣ 0..1 Period Time period when id is/was valid for use
..... assigner SΣ 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
.... type S 0..1 CodeableConcept Type of plan
Binding: VhDir Plan Type (example)
.... coverageArea SΣ 0..* Reference(VhDir Location) Where plan applies
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... generalCost S 0..* BackboneElement Overall costs
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type S 0..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Cost Type (example)
..... groupSize S 0..1 positiveInt Number of enrollees
..... cost S 0..1 Money Cost value
..... comment S 0..1 string Additional cost information
.... specificCost S 0..* BackboneElement Specific costs
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category S 1..1 CodeableConcept General category of benefit
Binding: VhDir Insurance Plan Cost Category (example)
..... benefit S 0..* BackboneElement Benefits list
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... type S 1..1 CodeableConcept Type of specific benefit
Binding: VhDir Insurance Plan Benefit Type (example)
...... cost S 0..* BackboneElement List of the costs
....... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
....... type S 1..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Benefit Cost Type (example)
....... applicability S 0..1 CodeableConcept in-network | out-of-network | other
Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.

....... qualifiers S 0..* CodeableConcept Additional information about the cost
Binding: VhDir Insurance Plan Cost Qualifier (example)
....... value S 0..1 Quantity The actual cost value

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
InsurancePlan.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
InsurancePlan.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
InsurancePlan.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
InsurancePlan.typeexampleInsurancePlanType
http://hl7.org/fhir/ValueSet/insuranceplan-type
from the FHIR Standard
InsurancePlan.contact.purposeextensibleContactEntityType
http://hl7.org/fhir/ValueSet/contactentity-type
from the FHIR Standard
InsurancePlan.contact.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
InsurancePlan.contact.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
InsurancePlan.contact.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
InsurancePlan.coverage.typeexampleVhDirCoverageType
http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type
from this IG
InsurancePlan.coverage.benefit.typeexampleVhDirBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type
from this IG
InsurancePlan.coverage.benefit.limit.codeexampleVhDirLimitUnit
http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit
from this IG
InsurancePlan.plan.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
InsurancePlan.plan.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
InsurancePlan.plan.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type
from this IG
InsurancePlan.plan.generalCost.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype
from this IG
InsurancePlan.plan.specificCost.categoryexampleVhDirInsPlanCostCategory
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory
from this IG
InsurancePlan.plan.specificCost.benefit.typeexampleVhDirInsPlanBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.typeexampleVhDirInsPlanBenefitCostType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.applicabilityrequiredBenefitCostApplicability
http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1
from the FHIR Standard
InsurancePlan.plan.specificCost.benefit.cost.qualifiersexampleVhDirInsPlanQualifier
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C 0..* InsurancePlan Details of a Health Insurance product/plan provided by an organization
ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... restriction S 0..* Reference(VhDir Restriction) Restriction
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣC 0..* Identifier Business Identifier for Product
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... status S 1..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
.... use ?!SΣ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type SΣ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system SΣ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 0..1 string The value that is unique
Example General: 123456
.... period SΣ 0..1 Period Time period when id is/was valid for use
.... assigner SΣ 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... type SΣ 0..* CodeableConcept Kind of product
Binding: InsurancePlanType (example): Used to categorize the product/plan.


... name SΣC 0..1 string Official name
... alias S 0..* string Alternate names
... period S 0..1 Period When the product is available
... ownedBy SΣ 1..1 Reference(VhDir Organization) Plan issuer
... administeredBy SΣ 1..1 Reference(VhDir Organization) Product administrator
... coverageArea SΣ 0..* Reference(VhDir Location) Where product applies
... contact S 0..* BackboneElement Contact for the product
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... purpose S 0..1 CodeableConcept The type of contact
Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.

.... name S 0..1 HumanName A name associated with the contact
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

..... text SΣ 0..1 string Text representation of the full name
..... family SΣ 1..1 string Family name (often called 'Surname')
..... given SΣ 1..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period SΣ 0..1 Period Time period when name was/is in use
.... telecom S 0..* ContactPoint Contact details (telephone, email, etc.) for a contact
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... viaintermediary S 0..1 Reference(VhDir Practitioner Role | VhDir Organization | VhDir Organization Affiliation | VhDir Location) viaintermediary
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary
..... availabletime S 0..* (Complex) Available time
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime
..... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

..... value SΣ 1..1 string The actual contact point details
..... use ?!SΣ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

..... rank SΣ 0..1 positiveInt Specify preferred order of use (1 = highest)
..... period SΣ 0..1 Period Time period when the contact point was/is in use
.... address S 0..1 Address Visiting or postal addresses for the contact
... endpoint S 0..* Reference(VhDir Endpoint) Technical endpoint
... network S 0..* Reference(VhDir Network) What networks are Included
... coverage S 0..* BackboneElement Coverage details
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type S 1..1 CodeableConcept Type of coverage
Binding: VhDir Coverage Type (example)
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... benefit S 1..* BackboneElement List of benefits
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type S 1..1 CodeableConcept Type of benefit
Binding: VhDir Benefit Type (example)
..... requirement S 0..1 string Referral requirements
..... limit S 0..* BackboneElement Benefit limits
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... value S 0..1 Quantity Maximum value allowed
...... code S 0..1 CodeableConcept Benefit limit details
Binding: VhDir Limit Unit (example)
... plan S 0..* BackboneElement Plan details
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier SΣ 0..* Identifier Business identifier for plan
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... status S 0..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
..... use ?!SΣ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type SΣ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 0..1 string The value that is unique
Example General: 123456
..... period SΣ 0..1 Period Time period when id is/was valid for use
..... assigner SΣ 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
.... type S 0..1 CodeableConcept Type of plan
Binding: VhDir Plan Type (example)
.... coverageArea SΣ 0..* Reference(VhDir Location) Where plan applies
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... generalCost S 0..* BackboneElement Overall costs
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type S 0..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Cost Type (example)
..... groupSize S 0..1 positiveInt Number of enrollees
..... cost S 0..1 Money Cost value
..... comment S 0..1 string Additional cost information
.... specificCost S 0..* BackboneElement Specific costs
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category S 1..1 CodeableConcept General category of benefit
Binding: VhDir Insurance Plan Cost Category (example)
..... benefit S 0..* BackboneElement Benefits list
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... type S 1..1 CodeableConcept Type of specific benefit
Binding: VhDir Insurance Plan Benefit Type (example)
...... cost S 0..* BackboneElement List of the costs
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
....... type S 1..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Benefit Cost Type (example)
....... applicability S 0..1 CodeableConcept in-network | out-of-network | other
Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.

....... qualifiers S 0..* CodeableConcept Additional information about the cost
Binding: VhDir Insurance Plan Cost Qualifier (example)
....... value S 0..1 Quantity The actual cost value

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
InsurancePlan.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
InsurancePlan.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
InsurancePlan.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
InsurancePlan.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
InsurancePlan.typeexampleInsurancePlanType
http://hl7.org/fhir/ValueSet/insuranceplan-type
from the FHIR Standard
InsurancePlan.contact.purposeextensibleContactEntityType
http://hl7.org/fhir/ValueSet/contactentity-type
from the FHIR Standard
InsurancePlan.contact.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
InsurancePlan.contact.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
InsurancePlan.contact.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
InsurancePlan.coverage.typeexampleVhDirCoverageType
http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type
from this IG
InsurancePlan.coverage.benefit.typeexampleVhDirBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type
from this IG
InsurancePlan.coverage.benefit.limit.codeexampleVhDirLimitUnit
http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit
from this IG
InsurancePlan.plan.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
InsurancePlan.plan.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
InsurancePlan.plan.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type
from this IG
InsurancePlan.plan.generalCost.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype
from this IG
InsurancePlan.plan.specificCost.categoryexampleVhDirInsPlanCostCategory
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory
from this IG
InsurancePlan.plan.specificCost.benefit.typeexampleVhDirInsPlanBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.typeexampleVhDirInsPlanBenefitCostType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.applicabilityrequiredBenefitCostApplicability
http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1
from the FHIR Standard
InsurancePlan.plan.specificCost.benefit.cost.qualifiersexampleVhDirInsPlanQualifier
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier
from this IG

Differential View

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan 0..* InsurancePlan Details of a Health Insurance product/plan provided by an organization
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... restriction S 0..* Reference(VhDir Restriction) Restriction
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction
... identifier S 0..* Identifier Business Identifier for Product
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... status S 1..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
.... use S 0..1 code usual | official | temp | secondary | old (If known)
.... type S 0..1 CodeableConcept Description of identifier
.... system S 0..1 uri The namespace for the identifier value
.... value S 0..1 string The value that is unique
.... period S 0..1 Period Time period when id is/was valid for use
.... assigner S 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
... status S 1..1 code draft | active | retired | unknown
... type S 0..* CodeableConcept Kind of product
... name S 0..1 string Official name
... alias S 0..* string Alternate names
... period S 0..1 Period When the product is available
... ownedBy S 1..1 Reference(VhDir Organization) Plan issuer
... administeredBy S 1..1 Reference(VhDir Organization) Product administrator
... coverageArea S 0..* Reference(VhDir Location) Where product applies
... contact S 0..* BackboneElement Contact for the product
.... purpose S 0..1 CodeableConcept The type of contact
.... name S 0..1 HumanName A name associated with the contact
..... use S 0..1 code usual | official | temp | nickname | anonymous | old | maiden
..... text S 0..1 string Text representation of the full name
..... family S 1..1 string Family name (often called 'Surname')
..... given S 1..* string Given names (not always 'first'). Includes middle names
..... prefix S 0..* string Parts that come before the name
..... suffix S 0..* string Parts that come after the name
..... period S 0..1 Period Time period when name was/is in use
.... telecom S 0..* ContactPoint Contact details (telephone, email, etc.) for a contact
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... viaintermediary S 0..1 Reference(VhDir Practitioner Role | VhDir Organization | VhDir Organization Affiliation | VhDir Location) viaintermediary
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary
..... availabletime S 0..* (Complex) Available time
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime
..... system S 1..1 code phone | fax | email | pager | url | sms | other
..... value S 1..1 string The actual contact point details
..... use S 0..1 code home | work | temp | old | mobile - purpose of this contact point
..... rank S 0..1 positiveInt Specify preferred order of use (1 = highest)
..... period S 0..1 Period Time period when the contact point was/is in use
.... address S 0..1 Address Visiting or postal addresses for the contact
... endpoint S 0..* Reference(VhDir Endpoint) Technical endpoint
... network S 0..* Reference(VhDir Network) What networks are Included
... coverage S 0..* BackboneElement Coverage details
.... type S 1..1 CodeableConcept Type of coverage
Binding: VhDir Coverage Type (example)
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... benefit S 1..* BackboneElement List of benefits
..... type S 1..1 CodeableConcept Type of benefit
Binding: VhDir Benefit Type (example)
..... requirement S 0..1 string Referral requirements
..... limit S 0..* BackboneElement Benefit limits
...... value S 0..1 Quantity Maximum value allowed
...... code S 0..1 CodeableConcept Benefit limit details
Binding: VhDir Limit Unit (example)
... plan S 0..* BackboneElement Plan details
.... identifier S 0..* Identifier Business identifier for plan
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... status S 0..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
..... use S 0..1 code usual | official | temp | secondary | old (If known)
..... type S 0..1 CodeableConcept Description of identifier
..... system S 0..1 uri The namespace for the identifier value
..... value S 0..1 string The value that is unique
..... period S 0..1 Period Time period when id is/was valid for use
..... assigner S 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
.... type S 0..1 CodeableConcept Type of plan
Binding: VhDir Plan Type (example)
.... coverageArea S 0..* Reference(VhDir Location) Where plan applies
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... generalCost S 0..* BackboneElement Overall costs
..... type S 0..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Cost Type (example)
..... groupSize S 0..1 positiveInt Number of enrollees
..... cost S 0..1 Money Cost value
..... comment S 0..1 string Additional cost information
.... specificCost S 0..* BackboneElement Specific costs
..... category S 1..1 CodeableConcept General category of benefit
Binding: VhDir Insurance Plan Cost Category (example)
..... benefit S 0..* BackboneElement Benefits list
...... type S 1..1 CodeableConcept Type of specific benefit
Binding: VhDir Insurance Plan Benefit Type (example)
...... cost S 0..* BackboneElement List of the costs
....... type S 1..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Benefit Cost Type (example)
....... applicability S 0..1 CodeableConcept in-network | out-of-network | other
....... qualifiers S 0..* CodeableConcept Additional information about the cost
Binding: VhDir Insurance Plan Cost Qualifier (example)
....... value S 0..1 Quantity The actual cost value

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
InsurancePlan.coverage.typeexampleVhDirCoverageType
http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type
from this IG
InsurancePlan.coverage.benefit.typeexampleVhDirBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type
from this IG
InsurancePlan.coverage.benefit.limit.codeexampleVhDirLimitUnit
http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit
from this IG
InsurancePlan.plan.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type
from this IG
InsurancePlan.plan.generalCost.typeexampleVhDirPlanType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype
from this IG
InsurancePlan.plan.specificCost.categoryexampleVhDirInsPlanCostCategory
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory
from this IG
InsurancePlan.plan.specificCost.benefit.typeexampleVhDirInsPlanBenefitType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.typeexampleVhDirInsPlanBenefitCostType
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype
from this IG
InsurancePlan.plan.specificCost.benefit.cost.qualifiersexampleVhDirInsPlanQualifier
http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan C 0..* InsurancePlan Details of a Health Insurance product/plan provided by an organization
ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
... restriction S 0..* Reference(VhDir Restriction) Restriction
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣC 0..* Identifier Business Identifier for Product
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... status S 1..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
.... use ?!SΣ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type SΣ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system SΣ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 0..1 string The value that is unique
Example General: 123456
.... period SΣ 0..1 Period Time period when id is/was valid for use
.... assigner SΣ 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... type SΣ 0..* CodeableConcept Kind of product
Binding: InsurancePlanType (example): Used to categorize the product/plan.


... name SΣC 0..1 string Official name
... alias S 0..* string Alternate names
... period S 0..1 Period When the product is available
... ownedBy SΣ 1..1 Reference(VhDir Organization) Plan issuer
... administeredBy SΣ 1..1 Reference(VhDir Organization) Product administrator
... coverageArea SΣ 0..* Reference(VhDir Location) Where product applies
... contact S 0..* BackboneElement Contact for the product
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... purpose S 0..1 CodeableConcept The type of contact
Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.

.... name S 0..1 HumanName A name associated with the contact
..... use ?!SΣ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

..... text SΣ 0..1 string Text representation of the full name
..... family SΣ 1..1 string Family name (often called 'Surname')
..... given SΣ 1..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period SΣ 0..1 Period Time period when name was/is in use
.... telecom S 0..* ContactPoint Contact details (telephone, email, etc.) for a contact
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... viaintermediary S 0..1 Reference(VhDir Practitioner Role | VhDir Organization | VhDir Organization Affiliation | VhDir Location) viaintermediary
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary
..... availabletime S 0..* (Complex) Available time
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime
..... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

..... value SΣ 1..1 string The actual contact point details
..... use ?!SΣ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

..... rank SΣ 0..1 positiveInt Specify preferred order of use (1 = highest)
..... period SΣ 0..1 Period Time period when the contact point was/is in use
.... address S 0..1 Address Visiting or postal addresses for the contact
... endpoint S 0..* Reference(VhDir Endpoint) Technical endpoint
... network S 0..* Reference(VhDir Network) What networks are Included
... coverage S 0..* BackboneElement Coverage details
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type S 1..1 CodeableConcept Type of coverage
Binding: VhDir Coverage Type (example)
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... benefit S 1..* BackboneElement List of benefits
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type S 1..1 CodeableConcept Type of benefit
Binding: VhDir Benefit Type (example)
..... requirement S 0..1 string Referral requirements
..... limit S 0..* BackboneElement Benefit limits
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... value S 0..1 Quantity Maximum value allowed
...... code S 0..1 CodeableConcept Benefit limit details
Binding: VhDir Limit Unit (example)
... plan S 0..* BackboneElement Plan details
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier SΣ 0..* Identifier Business identifier for plan
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... status S 0..1 code Status
URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
Binding: VhDir Identifier Status Value Set (required)
..... use ?!SΣ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type SΣ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 0..1 string The value that is unique
Example General: 123456
..... period SΣ 0..1 Period Time period when id is/was valid for use
..... assigner SΣ 0..1 Reference(VhDir Organization) Organization that issued id (may be just text)
.... type S 0..1 CodeableConcept Type of plan
Binding: VhDir Plan Type (example)
.... coverageArea SΣ 0..* Reference(VhDir Location) Where plan applies
.... network S 0..* Reference(VhDir Network) What networks provide coverage
.... generalCost S 0..* BackboneElement Overall costs
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... type S 0..1 CodeableConcept Type of cost
Binding: VhDir Insurance Plan Cost Type (example)
..... groupSize S 0..1 positiveInt Number of enrollees
..... cost S 0..1 Money Cost value
..... comment S 0..1 string Additional cost information
.... specificCost S 0..* BackboneElement Specific costs
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category S 1..1 CodeableConcept General category of benefit
Binding: VhDir Insurance Plan Cost Category (example)
.....