abstractbaseDefinitioncopyrightdate- Values Differ
descriptionexperimentalfhirVersionjurisdiction
jurisdiction[0]kindnamepublisher- Values Differ
purposestatustitletypeurlversion- Values Differ
| Left: | Plan-Net InsurancePlan (http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan) |
| Right: | Plan-Net InsurancePlan (http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan) |
| Error | StructureDefinition.version | Values for version differ: '1.1.0' vs '1.2.0' |
| Information | StructureDefinition.date | Values for date differ: '2022-04-04T14:02:01+00:00' vs '2024-06-07T17:45:15+00:00' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 Financial Management Working Group' vs 'HL7 International / Financial Management' |
| Information | StructureDefinition.definition | Values for definition differ: 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.' vs 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.' |
| Information | StructureDefinition.definition | Values for definition differ: 'A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).' vs 'A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/InsurancePlan | ||
| copyright | |||
| date | 2022-04-04T14:02:01+00:00 | 2024-06-07T17:45:15+00:00 |
|
| description | An InsurancePlan 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. | ||
| experimental | |||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | PlannetInsurancePlan | ||
| publisher | HL7 Financial Management Working Group | HL7 International / Financial Management |
|
| purpose | |||
| status | active | ||
| title | Plan-Net InsurancePlan | ||
| type | InsurancePlan | ||
| url | http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan | ||
| version | 1.1.0 | 1.2.0 |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 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 network-or-plan-Network: If an insuranceplan does not define a network, then each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type. | 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 network-or-plan-Network: If an insuranceplan does not define a network, then each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type. | |||||||||
 id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
 meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
 Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| versionId | Σ | 0..1 | id | Version specific identifier | Σ | 0..1 | id | Version specific identifier | |||||||||
| lastUpdated | Σ | 1..1 | instant | When the resource version last changed | Σ | 1..1 | instant | When the resource version last changed | |||||||||
| source | Σ | 0..1 | uri | Identifies where the resource comes from | Σ | 0..1 | uri | Identifies where the resource comes from | |||||||||
| profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | |||||||||
| security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | |||||||||
| tag | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | |||||||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
| language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
| identifier | ΣC | 0..* | Identifier | Business Identifier for Product | ΣC | 0..* | Identifier | Business Identifier for Product | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . | |||||||||
| type | SΣ | 0..1 | CodeableConcept | Description of identifier Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | SΣ | 0..1 | CodeableConcept | Description of identifier Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | |||||||||
| system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | Σ | 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 | SΣ | 0..1 | string | The value that is unique Example General: 123456 | |||||||||
| period | Σ | 0..1 | Period | Time period when id is/was valid for use | Σ | 0..1 | Period | Time period when id is/was valid for use | |||||||||
| assigner | SΣ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | SΣ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||||||
| status | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: ?? (required): The lifecycle status of an artifact. Fixed Value: active | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: ?? (required): The lifecycle status of an artifact. Fixed Value: active | |||||||||
| type | SΣ | 1..1 | CodeableConcept | Product Type Binding: ?? (extensible) | SΣ | 1..1 | CodeableConcept | Product Type Binding: ?? (extensible) | |||||||||
| name | SΣC | 0..1 | string | Official name | SΣC | 0..1 | string | Official name | |||||||||
| alias | S | 0..* | string | Alternate names | S | 0..* | string | Alternate names | |||||||||
| period | S | 0..1 | Period | When the product is available | S | 0..1 | Period | When the product is available | |||||||||
| ownedBy | SΣ | 1..1 | Reference(Plan-Net Organization) | Plan issuer | SΣ | 1..1 | Reference(Plan-Net Organization) | Plan issuer | |||||||||
| administeredBy | SΣ | 1..1 | Reference(Plan-Net Organization) | Product administrator | SΣ | 1..1 | Reference(Plan-Net Organization) | Product administrator | |||||||||
| coverageArea | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | |||||||||
| contact | S | 0..* | BackboneElement | Contact for the product | S | 0..* | BackboneElement | Contact for the product | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| purpose | 0..1 | CodeableConcept | The type of contact Binding: ?? (extensible): The purpose for which you would contact a contact party. | 0..1 | CodeableConcept | The type of contact Binding: ?? (extensible): The purpose for which you would contact a contact party. | |||||||||||
| name | S | 0..1 | HumanName | A name associated with the contact | S | 0..1 | HumanName | A name associated with the contact | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: ?? (required): The use of a human name. | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: ?? (required): The use of a human name. | |||||||||
| text | SΣ | 0..1 | string | Text representation of the full name | SΣ | 0..1 | string | Text representation of the full name | |||||||||
| family | Σ | 0..1 | string | Family name (often called 'Surname') | Σ | 0..1 | string | Family name (often called 'Surname') | |||||||||
| given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name | Σ | 0..* | 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 | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | |||||||||
| suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | |||||||||
| period | Σ | 0..1 | Period | Time period when name was/is in use | Σ | 0..1 | Period | Time period when name was/is in use | |||||||||
| telecom | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| system | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ?? (required): Telecommunications form for contact point. | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ?? (required): Telecommunications form for contact point. | |||||||||
| value | SΣ | 0..1 | string | The actual contact point details | SΣ | 0..1 | string | The actual contact point details | |||||||||
| use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ?? (required): Use of contact point. | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ?? (required): Use of contact point. | |||||||||
| rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest) | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest) | |||||||||
| period | Σ | 0..1 | Period | Time period when the contact point was/is in use | Σ | 0..1 | Period | Time period when the contact point was/is in use | |||||||||
| address | 0..1 | Address | Visiting or postal addresses for the contact | 0..1 | Address | Visiting or postal addresses for the contact | |||||||||||
| endpoint | S | 0..* | Reference(Plan-Net Endpoint) | Technical endpoint | S | 0..* | Reference(Plan-Net Endpoint) | Technical endpoint | |||||||||
| network | S | 0..* | Reference(Plan-Net Network) | What networks are Included | S | 0..* | Reference(Plan-Net Network) | What networks are Included | |||||||||
| coverage | 0..* | BackboneElement | Coverage details | 0..* | BackboneElement | Coverage details | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | 1..1 | CodeableConcept | Type of coverage | 1..1 | CodeableConcept | Type of coverage | |||||||||||
| network | 0..* | Reference(Organization) | What networks provide coverage | 0..* | Reference(Organization) | What networks provide coverage | |||||||||||
 benefit | 1..* | BackboneElement | List of benefits | 1..* | BackboneElement | List of benefits | |||||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | 1..1 | CodeableConcept | Type of benefit | 1..1 | CodeableConcept | Type of benefit | |||||||||||
| requirement | 0..1 | string | Referral requirements | 0..1 | string | Referral requirements | |||||||||||
| limit | 0..* | BackboneElement | Benefit limits | 0..* | BackboneElement | Benefit limits | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| value | 0..1 | Quantity | Maximum value allowed | 0..1 | Quantity | Maximum value allowed | |||||||||||
| code | 0..1 | CodeableConcept | Benefit limit details | 0..1 | CodeableConcept | Benefit limit details | |||||||||||
| plan | 0..* | BackboneElement | Cost sharing details for the plan | 0..* | BackboneElement | Cost sharing details for the plan | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| identifier | Σ | 0..* | Identifier | Business Identifier for Product | Σ | 0..* | Identifier | Business Identifier for Product | |||||||||
| type | S | 0..1 | CodeableConcept | Categorization of the cost sharing for the plan Binding: ?? (extensible) | S | 0..1 | CodeableConcept | Categorization of the cost sharing for the plan Binding: ?? (extensible) | |||||||||
| coverageArea | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | |||||||||
| network | 0..* | Reference(Plan-Net Network) | What networks provide coverage | 0..* | Reference(Plan-Net Network) | What networks provide coverage | |||||||||||
| generalCost | 0..* | BackboneElement | Overall costs | 0..* | BackboneElement | Overall costs | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | 0..1 | CodeableConcept | Type of cost | 0..1 | CodeableConcept | Type of cost | |||||||||||
| groupSize | 0..1 | positiveInt | Number of enrollees | 0..1 | positiveInt | Number of enrollees | |||||||||||
| cost | 0..1 | Money | Cost value | 0..1 | Money | Cost value | |||||||||||
| comment | 0..1 | string | Additional cost information | 0..1 | string | Additional cost information | |||||||||||
| specificCost | 0..* | BackboneElement | Specific costs | 0..* | BackboneElement | Specific costs | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| category | 1..1 | CodeableConcept | General category of benefit | 1..1 | CodeableConcept | General category of benefit | |||||||||||
| benefit | 0..* | BackboneElement | Benefits list | 0..* | BackboneElement | Benefits list | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | 1..1 | CodeableConcept | Type of specific benefit | 1..1 | CodeableConcept | Type of specific benefit | |||||||||||
| cost | 0..* | BackboneElement | List of the costs | 0..* | BackboneElement | List of the costs | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | 1..1 | CodeableConcept | Type of cost | 1..1 | CodeableConcept | Type of cost | |||||||||||
| applicability | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: ?? (required): Whether the cost applies to in-network or out-of-network providers. | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: ?? (required): Whether the cost applies to in-network or out-of-network providers. | |||||||||||
| qualifiers | 0..* | CodeableConcept | Additional information about the cost | 0..* | CodeableConcept | Additional information about the cost | |||||||||||
| value | 0..1 | Quantity | The actual cost value | 0..1 | Quantity | The actual cost value | |||||||||||
| Documentation for this format | |||||||||||||||||