National Healthcare Directory Attestation and Verification
1.0.0-ballot - ballot United States of America flag

National Healthcare Directory Attestation and Verification, published by HL7 Patient Administration Working Group. This is not an authorized publication; it is the continuous build for version 1.0.0-ballot). This version is based on the current content of https://github.com/HL7/fhir-directory-attestation/ and changes regularly. See the Directory of published versions

: Insurance Plan Type Code System - TTL Representation

Active as of 2022-12-08

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:CodeSystem;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "InsurancePlanTypeCS"]; # 
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://hl7.org/fhir/us/directory-attestation/CodeSystem/InsurancePlanTypeCS</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">platinum<a name=\"InsurancePlanTypeCS-platinum\"> </a></td><td>Platinum-QHP</td><td>Plan with highest monthly premium and lowest costs when you need care	A Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">gold<a name=\"InsurancePlanTypeCS-gold\"> </a></td><td>Gold-QHP</td><td>Plan with high monthly premium and low costs when you need care	A Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">silver<a name=\"InsurancePlanTypeCS-silver\"> </a></td><td>Silver-QHP</td><td>Plan with moderate monthly premium and moderate costs when you need care	A Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">bronze<a name=\"InsurancePlanTypeCS-bronze\"> </a></td><td>Bronze-QHP</td><td>Plan with lowest monthly premium and highest costs when you need care	A Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">catastrophic<a name=\"InsurancePlanTypeCS-catastrophic\"> </a></td><td>Catastrophic-QHP</td><td>A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.</td></tr><tr><td style=\"white-space:nowrap\">lowdeductible<a name=\"InsurancePlanTypeCS-lowdeductible\"> </a></td><td>Low Deductible</td><td>A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style=\"white-space:nowrap\">highdeductible<a name=\"InsurancePlanTypeCS-highdeductible\"> </a></td><td>High Deductible</td><td>A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style=\"white-space:nowrap\">catastrophicplan<a name=\"InsurancePlanTypeCS-catastrophicplan\"> </a></td><td>Catastrophic Plan</td><td>A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan.</td></tr></table></div>"
  ]; # 
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/directory-attestation/CodeSystem/InsurancePlanTypeCS"]; # 
  fhir:CodeSystem.version [ fhir:value "1.0.0-ballot"]; # 
  fhir:CodeSystem.name [ fhir:value "InsurancePlanTypeCS"]; # 
  fhir:CodeSystem.title [ fhir:value "Insurance Plan Type Code System"]; # 
  fhir:CodeSystem.status [ fhir:value "active"]; # 
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean]; # 
  fhir:CodeSystem.date [ fhir:value "2022-12-08T23:25:31+00:00"^^xsd:dateTime]; # 
  fhir:CodeSystem.publisher [ fhir:value "HL7 Patient Administration Working Group"]; # 
  fhir:CodeSystem.contact [
     fhir:index 0;
     fhir:ContactDetail.name [ fhir:value "HL7 Patient Administration Working Group" ];
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "https://www.hl7.org/Special/committees/pafm" ]     ], [
       fhir:index 1;
       fhir:ContactPoint.system [ fhir:value "email" ];
       fhir:ContactPoint.value [ fhir:value "pafm@lists.HL7.org" ]     ]
  ]; # 
  fhir:CodeSystem.description [ fhir:value "Categories of cost-sharing used by plans"]; # 
  fhir:CodeSystem.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ]     ]
  ]; # 
  fhir:CodeSystem.caseSensitive [ fhir:value "false"^^xsd:boolean]; # 
  fhir:CodeSystem.content [ fhir:value "complete"]; # 
  fhir:CodeSystem.count [ fhir:value "8"^^xsd:nonNegativeInteger]; # 
  fhir:CodeSystem.concept [
     fhir:index 0;
     fhir:CodeSystem.concept.code [ fhir:value "platinum" ];
     fhir:CodeSystem.concept.display [ fhir:value "Platinum-QHP" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Plan with highest monthly premium and lowest costs when you need care	A Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans" ]
  ], [
     fhir:index 1;
     fhir:CodeSystem.concept.code [ fhir:value "gold" ];
     fhir:CodeSystem.concept.display [ fhir:value "Gold-QHP" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Plan with high monthly premium and low costs when you need care	A Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans" ]
  ], [
     fhir:index 2;
     fhir:CodeSystem.concept.code [ fhir:value "silver" ];
     fhir:CodeSystem.concept.display [ fhir:value "Silver-QHP" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Plan with moderate monthly premium and moderate costs when you need care	A Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans" ]
  ], [
     fhir:index 3;
     fhir:CodeSystem.concept.code [ fhir:value "bronze" ];
     fhir:CodeSystem.concept.display [ fhir:value "Bronze-QHP" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Plan with lowest monthly premium and highest costs when you need care	A Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans" ]
  ], [
     fhir:index 4;
     fhir:CodeSystem.concept.code [ fhir:value "catastrophic" ];
     fhir:CodeSystem.concept.display [ fhir:value "Catastrophic-QHP" ];
     fhir:CodeSystem.concept.definition [ fhir:value "A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions." ]
  ], [
     fhir:index 5;
     fhir:CodeSystem.concept.code [ fhir:value "lowdeductible" ];
     fhir:CodeSystem.concept.display [ fhir:value "Low Deductible" ];
     fhir:CodeSystem.concept.definition [ fhir:value "A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan." ]
  ], [
     fhir:index 6;
     fhir:CodeSystem.concept.code [ fhir:value "highdeductible" ];
     fhir:CodeSystem.concept.display [ fhir:value "High Deductible" ];
     fhir:CodeSystem.concept.definition [ fhir:value "A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan." ]
  ], [
     fhir:index 7;
     fhir:CodeSystem.concept.code [ fhir:value "catastrophicplan" ];
     fhir:CodeSystem.concept.display [ fhir:value "Catastrophic Plan" ];
     fhir:CodeSystem.concept.definition [ fhir:value "A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan." ]
  ]. # 

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.