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:

• Patriot PPO Standard

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	C	0..*	InsurancePlan	Details of a Health Insurance product/plan provided by an organization dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
restriction	S	0..*	Reference(VhDir Restriction)	Restriction URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣC	0..*	Identifier	Business Identifier for Product ele-1: All FHIR elements must have a @value or children
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	S	1..1	code	Status URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status Binding: VhDir Identifier Status Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children
assigner	SΣ	0..1	Reference(VhDir Organization)	Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. ele-1: All FHIR elements must have a @value or children
type	SΣ	0..*	CodeableConcept	Kind of product Binding: InsurancePlanType (example): Used to categorize the product/plan. ele-1: All FHIR elements must have a @value or children
name	SΣC	0..1	string	Official name ele-1: All FHIR elements must have a @value or children
alias	S	0..*	string	Alternate names ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	When the product is available ele-1: All FHIR elements must have a @value or children
ownedBy	SΣ	1..1	Reference(VhDir Organization)	Plan issuer ele-1: All FHIR elements must have a @value or children
administeredBy	SΣ	1..1	Reference(VhDir Organization)	Product administrator ele-1: All FHIR elements must have a @value or children
coverageArea	SΣ	0..*	Reference(VhDir Location)	Where product applies ele-1: All FHIR elements must have a @value or children
contact	S	0..*	BackboneElement	Contact for the product ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
purpose	S	0..1	CodeableConcept	The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. ele-1: All FHIR elements must have a @value or children
name	S	0..1	HumanName	A name associated with the contact ele-1: All FHIR elements must have a @value or children
use	?!SΣ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. ele-1: All FHIR elements must have a @value or children
text	SΣ	0..1	string	Text representation of the full name ele-1: All FHIR elements must have a @value or children
family	SΣ	1..1	string	Family name (often called 'Surname') ele-1: All FHIR elements must have a @value or children
given	SΣ	1..*	string	Given names (not always 'first'). Includes middle names ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	SΣ	0..*	string	Parts that come after the name ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
telecom	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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 ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
availabletime	S	0..*	(Complex)	Available time URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point. ele-1: All FHIR elements must have a @value or children
value	SΣ	1..1	string	The actual contact point details ele-1: All FHIR elements must have a @value or children
use	?!SΣ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point. ele-1: All FHIR elements must have a @value or children
rank	SΣ	0..1	positiveInt	Specify preferred order of use (1 = highest) ele-1: All FHIR elements must have a @value or children
period	SΣ	0..1	Period	Time period when the contact point was/is in use ele-1: All FHIR elements must have a @value or children
address	S	0..1	Address	Visiting or postal addresses for the contact ele-1: All FHIR elements must have a @value or children
endpoint	S	0..*	Reference(VhDir Endpoint)	Technical endpoint ele-1: All FHIR elements must have a @value or children
network	S	0..*	Reference(VhDir Network)	What networks are Included ele-1: All FHIR elements must have a @value or children
coverage	S	0..*	BackboneElement	Coverage details ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of coverage Binding: VhDir Coverage Type (example) ele-1: All FHIR elements must have a @value or children
network	S	0..*	Reference(VhDir Network)	What networks provide coverage ele-1: All FHIR elements must have a @value or children
benefit	S	1..*	BackboneElement	List of benefits ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of benefit Binding: VhDir Benefit Type (example) ele-1: All FHIR elements must have a @value or children
requirement	S	0..1	string	Referral requirements ele-1: All FHIR elements must have a @value or children
limit	S	0..*	BackboneElement	Benefit limits ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
value	S	0..1	Quantity	Maximum value allowed ele-1: All FHIR elements must have a @value or children
code	S	0..1	CodeableConcept	Benefit limit details Binding: VhDir Limit Unit (example) ele-1: All FHIR elements must have a @value or children
plan	S	0..*	BackboneElement	Plan details ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	0..*	Identifier	Business identifier for plan ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	S	0..1	code	Status URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status Binding: VhDir Identifier Status Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children
assigner	SΣ	0..1	Reference(VhDir Organization)	Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children
type	S	0..1	CodeableConcept	Type of plan Binding: VhDir Plan Type (example) ele-1: All FHIR elements must have a @value or children
coverageArea	SΣ	0..*	Reference(VhDir Location)	Where plan applies ele-1: All FHIR elements must have a @value or children
network	S	0..*	Reference(VhDir Network)	What networks provide coverage ele-1: All FHIR elements must have a @value or children
generalCost	S	0..*	BackboneElement	Overall costs ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	0..1	CodeableConcept	Type of cost Binding: VhDir Insurance Plan Cost Type (example) ele-1: All FHIR elements must have a @value or children
groupSize	S	0..1	positiveInt	Number of enrollees ele-1: All FHIR elements must have a @value or children
cost	S	0..1	Money	Cost value ele-1: All FHIR elements must have a @value or children
comment	S	0..1	string	Additional cost information ele-1: All FHIR elements must have a @value or children
specificCost	S	0..*	BackboneElement	Specific costs ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
category	S	1..1	CodeableConcept	General category of benefit Binding: VhDir Insurance Plan Cost Category (example) ele-1: All FHIR elements must have a @value or children
benefit	S	0..*	BackboneElement	Benefits list ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of specific benefit Binding: VhDir Insurance Plan Benefit Type (example) ele-1: All FHIR elements must have a @value or children
cost	S	0..*	BackboneElement	List of the costs ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of cost Binding: VhDir Insurance Plan Benefit Cost Type (example) ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
qualifiers	S	0..*	CodeableConcept	Additional information about the cost Binding: VhDir Insurance Plan Cost Qualifier (example) ele-1: All FHIR elements must have a @value or children
value	S	0..1	Quantity	The actual cost value ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	example	InsurancePlanType http://hl7.org/fhir/ValueSet/insuranceplan-type from the FHIR Standard
InsurancePlan.contact.purpose	extensible	ContactEntityType http://hl7.org/fhir/ValueSet/contactentity-type from the FHIR Standard
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.coverage.type	example	VhDirCoverageType http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type from this IG
InsurancePlan.coverage.benefit.type	example	VhDirBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type from this IG
InsurancePlan.coverage.benefit.limit.code	example	VhDirLimitUnit http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit from this IG
InsurancePlan.plan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.plan.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type from this IG
InsurancePlan.plan.generalCost.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype from this IG
InsurancePlan.plan.specificCost.category	example	VhDirInsPlanCostCategory http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory from this IG
InsurancePlan.plan.specificCost.benefit.type	example	VhDirInsPlanBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype from this IG
InsurancePlan.plan.specificCost.benefit.cost.type	example	VhDirInsPlanBenefitCostType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype from this IG
InsurancePlan.plan.specificCost.benefit.cost.applicability	required	BenefitCostApplicability http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1 from the FHIR Standard
InsurancePlan.plan.specificCost.benefit.cost.qualifiers	example	VhDirInsPlanQualifier http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier from this IG

This structure is derived from InsurancePlan

Name	Flags	Card.	Type	Description & Constraints
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		1..*	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
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
InsurancePlan.coverage.type	example	VhDirCoverageType http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type from this IG
InsurancePlan.coverage.benefit.type	example	VhDirBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type from this IG
InsurancePlan.coverage.benefit.limit.code	example	VhDirLimitUnit http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit from this IG
InsurancePlan.plan.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type from this IG
InsurancePlan.plan.generalCost.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype from this IG
InsurancePlan.plan.specificCost.category	example	VhDirInsPlanCostCategory http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory from this IG
InsurancePlan.plan.specificCost.benefit.type	example	VhDirInsPlanBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype from this IG
InsurancePlan.plan.specificCost.benefit.cost.type	example	VhDirInsPlanBenefitCostType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype from this IG
InsurancePlan.plan.specificCost.benefit.cost.qualifiers	example	VhDirInsPlanQualifier http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier from this IG

Name	Flags	Card.	Type	Description & Constraints
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 Bindings Purpose 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		1..*	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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
InsurancePlan.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	example	InsurancePlanType http://hl7.org/fhir/ValueSet/insuranceplan-type from the FHIR Standard
InsurancePlan.contact.purpose	extensible	ContactEntityType http://hl7.org/fhir/ValueSet/contactentity-type from the FHIR Standard
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.coverage.type	example	VhDirCoverageType http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type from this IG
InsurancePlan.coverage.benefit.type	example	VhDirBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type from this IG
InsurancePlan.coverage.benefit.limit.code	example	VhDirLimitUnit http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit from this IG
InsurancePlan.plan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.plan.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type from this IG
InsurancePlan.plan.generalCost.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype from this IG
InsurancePlan.plan.specificCost.category	example	VhDirInsPlanCostCategory http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory from this IG
InsurancePlan.plan.specificCost.benefit.type	example	VhDirInsPlanBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype from this IG
InsurancePlan.plan.specificCost.benefit.cost.type	example	VhDirInsPlanBenefitCostType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype from this IG
InsurancePlan.plan.specificCost.benefit.cost.applicability	required	BenefitCostApplicability http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1 from the FHIR Standard
InsurancePlan.plan.specificCost.benefit.cost.qualifiers	example	VhDirInsPlanQualifier http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	C	0..*	InsurancePlan	Details of a Health Insurance product/plan provided by an organization dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
restriction	S	0..*	Reference(VhDir Restriction)	Restriction URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣC	0..*	Identifier	Business Identifier for Product ele-1: All FHIR elements must have a @value or children
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	S	1..1	code	Status URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status Binding: VhDir Identifier Status Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children
assigner	SΣ	0..1	Reference(VhDir Organization)	Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. ele-1: All FHIR elements must have a @value or children
type	SΣ	0..*	CodeableConcept	Kind of product Binding: InsurancePlanType (example): Used to categorize the product/plan. ele-1: All FHIR elements must have a @value or children
name	SΣC	0..1	string	Official name ele-1: All FHIR elements must have a @value or children
alias	S	0..*	string	Alternate names ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	When the product is available ele-1: All FHIR elements must have a @value or children
ownedBy	SΣ	1..1	Reference(VhDir Organization)	Plan issuer ele-1: All FHIR elements must have a @value or children
administeredBy	SΣ	1..1	Reference(VhDir Organization)	Product administrator ele-1: All FHIR elements must have a @value or children
coverageArea	SΣ	0..*	Reference(VhDir Location)	Where product applies ele-1: All FHIR elements must have a @value or children
contact	S	0..*	BackboneElement	Contact for the product ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
purpose	S	0..1	CodeableConcept	The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. ele-1: All FHIR elements must have a @value or children
name	S	0..1	HumanName	A name associated with the contact ele-1: All FHIR elements must have a @value or children
use	?!SΣ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. ele-1: All FHIR elements must have a @value or children
text	SΣ	0..1	string	Text representation of the full name ele-1: All FHIR elements must have a @value or children
family	SΣ	1..1	string	Family name (often called 'Surname') ele-1: All FHIR elements must have a @value or children
given	SΣ	1..*	string	Given names (not always 'first'). Includes middle names ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	SΣ	0..*	string	Parts that come after the name ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
telecom	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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 ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
availabletime	S	0..*	(Complex)	Available time URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
system	SΣC	1..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point. ele-1: All FHIR elements must have a @value or children
value	SΣ	1..1	string	The actual contact point details ele-1: All FHIR elements must have a @value or children
use	?!SΣ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point. ele-1: All FHIR elements must have a @value or children
rank	SΣ	0..1	positiveInt	Specify preferred order of use (1 = highest) ele-1: All FHIR elements must have a @value or children
period	SΣ	0..1	Period	Time period when the contact point was/is in use ele-1: All FHIR elements must have a @value or children
address	S	0..1	Address	Visiting or postal addresses for the contact ele-1: All FHIR elements must have a @value or children
endpoint	S	0..*	Reference(VhDir Endpoint)	Technical endpoint ele-1: All FHIR elements must have a @value or children
network	S	0..*	Reference(VhDir Network)	What networks are Included ele-1: All FHIR elements must have a @value or children
coverage	S	0..*	BackboneElement	Coverage details ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of coverage Binding: VhDir Coverage Type (example) ele-1: All FHIR elements must have a @value or children
network	S	0..*	Reference(VhDir Network)	What networks provide coverage ele-1: All FHIR elements must have a @value or children
benefit	S	1..*	BackboneElement	List of benefits ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of benefit Binding: VhDir Benefit Type (example) ele-1: All FHIR elements must have a @value or children
requirement	S	0..1	string	Referral requirements ele-1: All FHIR elements must have a @value or children
limit	S	0..*	BackboneElement	Benefit limits ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
value	S	0..1	Quantity	Maximum value allowed ele-1: All FHIR elements must have a @value or children
code	S	0..1	CodeableConcept	Benefit limit details Binding: VhDir Limit Unit (example) ele-1: All FHIR elements must have a @value or children
plan	S	0..*	BackboneElement	Plan details ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	SΣ	0..*	Identifier	Business identifier for plan ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	S	0..1	code	Status URL: http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status Binding: VhDir Identifier Status Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use	?!SΣ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
system	SΣ	0..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
period	SΣ	0..1	Period	Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children
assigner	SΣ	0..1	Reference(VhDir Organization)	Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children
type	S	0..1	CodeableConcept	Type of plan Binding: VhDir Plan Type (example) ele-1: All FHIR elements must have a @value or children
coverageArea	SΣ	0..*	Reference(VhDir Location)	Where plan applies ele-1: All FHIR elements must have a @value or children
network	S	0..*	Reference(VhDir Network)	What networks provide coverage ele-1: All FHIR elements must have a @value or children
generalCost	S	0..*	BackboneElement	Overall costs ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	0..1	CodeableConcept	Type of cost Binding: VhDir Insurance Plan Cost Type (example) ele-1: All FHIR elements must have a @value or children
groupSize	S	0..1	positiveInt	Number of enrollees ele-1: All FHIR elements must have a @value or children
cost	S	0..1	Money	Cost value ele-1: All FHIR elements must have a @value or children
comment	S	0..1	string	Additional cost information ele-1: All FHIR elements must have a @value or children
specificCost	S	0..*	BackboneElement	Specific costs ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
category	S	1..1	CodeableConcept	General category of benefit Binding: VhDir Insurance Plan Cost Category (example) ele-1: All FHIR elements must have a @value or children
benefit	S	0..*	BackboneElement	Benefits list ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of specific benefit Binding: VhDir Insurance Plan Benefit Type (example) ele-1: All FHIR elements must have a @value or children
cost	S	0..*	BackboneElement	List of the costs ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	S	1..1	CodeableConcept	Type of cost Binding: VhDir Insurance Plan Benefit Cost Type (example) ele-1: All FHIR elements must have a @value or children
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. ele-1: All FHIR elements must have a @value or children
qualifiers	S	0..*	CodeableConcept	Additional information about the cost Binding: VhDir Insurance Plan Cost Qualifier (example) ele-1: All FHIR elements must have a @value or children
value	S	0..1	Quantity	The actual cost value ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	example	InsurancePlanType http://hl7.org/fhir/ValueSet/insuranceplan-type from the FHIR Standard
InsurancePlan.contact.purpose	extensible	ContactEntityType http://hl7.org/fhir/ValueSet/contactentity-type from the FHIR Standard
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.coverage.type	example	VhDirCoverageType http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type from this IG
InsurancePlan.coverage.benefit.type	example	VhDirBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type from this IG
InsurancePlan.coverage.benefit.limit.code	example	VhDirLimitUnit http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit from this IG
InsurancePlan.plan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.plan.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type from this IG
InsurancePlan.plan.generalCost.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype from this IG
InsurancePlan.plan.specificCost.category	example	VhDirInsPlanCostCategory http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory from this IG
InsurancePlan.plan.specificCost.benefit.type	example	VhDirInsPlanBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype from this IG
InsurancePlan.plan.specificCost.benefit.cost.type	example	VhDirInsPlanBenefitCostType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype from this IG
InsurancePlan.plan.specificCost.benefit.cost.applicability	required	BenefitCostApplicability http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1 from the FHIR Standard
InsurancePlan.plan.specificCost.benefit.cost.qualifiers	example	VhDirInsPlanQualifier http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier from this IG

Differential View

This structure is derived from InsurancePlan

Name	Flags	Card.	Type	Description & Constraints
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		1..*	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
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
InsurancePlan.coverage.type	example	VhDirCoverageType http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type from this IG
InsurancePlan.coverage.benefit.type	example	VhDirBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type from this IG
InsurancePlan.coverage.benefit.limit.code	example	VhDirLimitUnit http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit from this IG
InsurancePlan.plan.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type from this IG
InsurancePlan.plan.generalCost.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype from this IG
InsurancePlan.plan.specificCost.category	example	VhDirInsPlanCostCategory http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory from this IG
InsurancePlan.plan.specificCost.benefit.type	example	VhDirInsPlanBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype from this IG
InsurancePlan.plan.specificCost.benefit.cost.type	example	VhDirInsPlanBenefitCostType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype from this IG
InsurancePlan.plan.specificCost.benefit.cost.qualifiers	example	VhDirInsPlanQualifier http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
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 Bindings Purpose 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		1..*	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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
InsurancePlan.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	example	InsurancePlanType http://hl7.org/fhir/ValueSet/insuranceplan-type from the FHIR Standard
InsurancePlan.contact.purpose	extensible	ContactEntityType http://hl7.org/fhir/ValueSet/contactentity-type from the FHIR Standard
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.coverage.type	example	VhDirCoverageType http://hl7.org/fhir/uv/vhdir/ValueSet/coverage-type from this IG
InsurancePlan.coverage.benefit.type	example	VhDirBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/benefit-type from this IG
InsurancePlan.coverage.benefit.limit.code	example	VhDirLimitUnit http://hl7.org/fhir/uv/vhdir/ValueSet/limit-unit from this IG
InsurancePlan.plan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.plan.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/plan-type from this IG
InsurancePlan.plan.generalCost.type	example	VhDirPlanType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancosttype from this IG
InsurancePlan.plan.specificCost.category	example	VhDirInsPlanCostCategory http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostcategory from this IG
InsurancePlan.plan.specificCost.benefit.type	example	VhDirInsPlanBenefitType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefittype from this IG
InsurancePlan.plan.specificCost.benefit.cost.type	example	VhDirInsPlanBenefitCostType http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplanbenefitcosttype from this IG
InsurancePlan.plan.specificCost.benefit.cost.applicability	required	BenefitCostApplicability http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1 from the FHIR Standard
InsurancePlan.plan.specificCost.benefit.cost.qualifiers	example	VhDirInsPlanQualifier http://hl7.org/fhir/uv/vhdir/ValueSet/insuranceplancostqualifier from this IG

This structure is derived from InsurancePlan

Summary

Mandatory: 3 elements(6 nested mandatory elements)
Must-Support: 73 elements

Structures

This structure refers to these other structures:

• VhDir Organization (http://hl7.org/fhir/uv/vhdir/StructureDefinition/vhdir-organization)
• VhDir Location (http://hl7.org/fhir/uv/vhdir/StructureDefinition/vhdir-location)
• VhDir Endpoint (http://hl7.org/fhir/uv/vhdir/StructureDefinition/vhdir-endpoint)
• VhDir Network (http://hl7.org/fhir/uv/vhdir/StructureDefinition/vhdir-network)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction
• http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
• http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary
• http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime

Maturity: 2