CARIN Digital Insurance Card
2.0.0 - STU 2.0

CARIN Digital Insurance Card, published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-digital-insurance-card/ and changes regularly. See the Directory of published versions

## Extension: Plan Beneficiaries

Official URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension | Version: 2.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: PlanBeneficiaries

This extension allows for the representation of all of the members on the plan with corresponding Names and MemberIDs. This enables health plans to pass this information along with the Coverage resources to align with how this content is printed on physical insurance cards.

Context of Use

This extension may be used on the following element(s):

- Element ID Coverage

Usage info

Usages:

- Use this Extension: C4DIC Coverage
- Examples for this Extension: Coverage/Example-Coverage-FSH and Coverage/Example-Coverage1

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

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

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from Extension

Summary

Complex Extension: This extension allows for the representation of all of the members on the plan with corresponding Names and MemberIDs. This enables health plans to pass this information along with the Coverage resources to align with how this content is printed on physical insurance cards.

- memberId: id, string: An Extension
- name: HumanName: An Extension
- personReference: Reference: An Extension

Maturity: 2

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Plan Beneficiaries
extension |  | 2..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:memberId | S | 1..1 | Extension | Member Id as string
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "memberId"
value[x] |  | 1..1 |  | Value of extension
valueId |  |  | id |
valueString |  |  | string |
extension:name | S | 1..1 | Extension | Member Name
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "name"
value[x] |  | 1..1 | HumanName | Value of extension
family | S | 1..1 | string | Family name (often called 'Surname')
given | S | 0..* | string | Given names (not always 'first'). Includes middle names
extension:personReference |  | 0..1 | Extension | Reference to the Person resource
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "personReference"
value[x] |  | 1..1 | Reference(Person) | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Plan Beneficiaries
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Open by value:url
extension:memberId | S | 1..1 | Extension | Member Id as string
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "memberId"
value[x] |  | 1..1 |  | Value of extension
valueId |  |  | id |
valueString |  |  | string |
extension:name | S | 1..1 | Extension | Member Name
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "name"
value[x] |  | 1..1 | HumanName | Value of extension
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 | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | S 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
suffix | 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
extension:personReference |  | 0..1 | Extension | Reference to the Person resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "personReference"
value[x] |  | 1..1 | Reference(Person) | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension allows for the representation of all of the members on the plan with corresponding Names and MemberIDs. This enables health plans to pass this information along with the Coverage resources to align with how this content is printed on physical insurance cards.

- memberId: id, string: An Extension
- name: HumanName: An Extension
- personReference: Reference: An Extension

Maturity: 2

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Plan Beneficiaries
extension |  | 2..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:memberId | S | 1..1 | Extension | Member Id as string
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "memberId"
value[x] |  | 1..1 |  | Value of extension
valueId |  |  | id |
valueString |  |  | string |
extension:name | S | 1..1 | Extension | Member Name
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "name"
value[x] |  | 1..1 | HumanName | Value of extension
family | S | 1..1 | string | Family name (often called 'Surname')
given | S | 0..* | string | Given names (not always 'first'). Includes middle names
extension:personReference |  | 0..1 | Extension | Reference to the Person resource
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "personReference"
value[x] |  | 1..1 | Reference(Person) | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Plan Beneficiaries
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Open by value:url
extension:memberId | S | 1..1 | Extension | Member Id as string
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "memberId"
value[x] |  | 1..1 |  | Value of extension
valueId |  |  | id |
valueString |  |  | string |
extension:name | S | 1..1 | Extension | Member Name
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "name"
value[x] |  | 1..1 | HumanName | Value of extension
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 | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text | Σ | 0..1 | string | Text representation of the full name
family | S Σ | 1..1 | string | Family name (often called 'Surname')
given | S 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
suffix | 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
extension:personReference |  | 0..1 | Extension | Reference to the Person resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "personReference"
value[x] |  | 1..1 | Reference(Person) | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-PlanBeneficiaries-extension"
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:name.​value[x].use | Base | required | NameUse | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`