DaVinci PDEX Plan Net
0.3.0 - STU1

DaVinci PDEX Plan Net, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 0.3.0). This version is based on the current content of https://github.com/HL7/davinci-pdex-plan-net/ and changes regularly. See the Directory of published versions

Resource Profile: PlannetInsurancePlan

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

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

The official URL for this profile is:

http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan

Implementation Guidance

There is currently no implementation guidance.

Formal Views of Profile Content

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

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan 0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... meta
.... lastUpdated 1..1instantWhen the resource version last changed
... identifier
.... id S0..1stringUnique id for inter-element referencing
.... use S0..1codeusual | official | temp | secondary | old (If known)
.... type S0..1CodeableConceptDescription of identifier
.... system S0..1uriThe namespace for the identifier value
.... value S0..1stringThe value that is unique
.... period S0..1PeriodTime period when id is/was valid for use
.... assigner S0..1Reference(Organization)Organization that issued id (may be just text)
... status S1..1codedraft | active | retired | unknown
Fixed Value: active
... name S0..1stringOfficial name
... alias S0..*stringAlternate names
... ownedBy S1..1Reference(Plan-net Organization)Plan issuer
... administeredBy S1..1Reference(Plan-net Organization)Product administrator
... coverageArea S0..*Reference(Plan-net Location)Where product applies
... contact S0..*BackboneElementContact for the product
.... name S0..1HumanNameA name associated with the contact
..... use S0..1codeusual | official | temp | nickname | anonymous | old | maiden
..... text S0..1stringText representation of the full name
..... family S0..1stringFamily name (often called 'Surname')
..... given S0..*stringGiven names (not always 'first'). Includes middle names
..... prefix S0..*stringParts that come before the name
..... suffix S0..*stringParts that come after the name
..... period S0..1PeriodTime period when name was/is in use
.... telecom S0..*ContactPointContact details (telephone, email, etc.) for a contact
..... contactpoint-availabletime S0..*(Complex)Extension
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary S0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system S0..1codephone | fax | email | pager | url | sms | other
..... value S0..1stringThe actual contact point details
..... use S0..1codehome | work | temp | old | mobile - purpose of this contact point
..... period S0..1PeriodTime period when the contact point was/is in use
... endpoint 0..*Reference(Plan-net Endpoint)Technical endpoint
... network 0..*Reference(Plan-net Network)What networks are Included
... plan 0..*BackboneElementCost sharing details for the plan
.... type S0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type (extensible)
.... coverageArea 0..*Reference(Plan-net Location)Where product applies
.... network 0..*Reference(Plan-net Network)What networks provide coverage

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan I0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId ΣI0..1idVersion specific identifier
.... lastUpdated ΣI1..1instantWhen the resource version last changed
.... source ΣI0..1uriIdentifies where the resource comes from
.... profile ΣI0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security ΣI0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag ΣI0..*CodingTags applied to this resource
Binding: CommonTags (example)
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for Product
.... id S0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!SΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type SΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system SΣI0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣI0..1stringThe value that is unique
Example General: 123456
.... period SΣI0..1PeriodTime period when id is/was valid for use
.... assigner SΣI0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!SΣI1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required)
Fixed Value: active
... type SΣI1..1CodeableConceptProduct Type
Binding: Insurance Product Type (extensible)
... name SΣI0..1stringOfficial name
... alias SI0..*stringAlternate names
... period I0..1PeriodWhen the product is available
... ownedBy SΣI1..1Reference(Plan-net Organization)Plan issuer
... administeredBy SΣI1..1Reference(Plan-net Organization)Product administrator
... coverageArea SΣI0..*Reference(Plan-net Location)Where product applies
... contact SI0..*BackboneElementContact for the product
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose I0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible)
.... name SI0..1HumanNameA name associated with the contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required)
..... text SΣI0..1stringText representation of the full name
..... family SΣI0..1stringFamily name (often called 'Surname')
..... given SΣI0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣI0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣI0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period SΣI0..1PeriodTime period when name was/is in use
.... telecom SI0..*ContactPointContact details (telephone, email, etc.) for a contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... contactpoint-availabletime SI0..*(Complex)Optional Extensions Element
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary SI0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system SΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
..... value SΣI0..1stringThe actual contact point details
..... use ?!SΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
..... rank ΣI0..1positiveIntSpecify preferred order of use (1 = highest)
..... period SΣI0..1PeriodTime period when the contact point was/is in use
.... address I0..1AddressVisiting or postal addresses for the contact
... endpoint I0..*Reference(Plan-net Endpoint)Technical endpoint
... network I0..*Reference(Plan-net Network)What networks are Included
... coverage I0..*BackboneElementCoverage details
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type I1..1CodeableConceptType of coverage
.... network I0..*Reference(Organization)What networks provide coverage
.... benefit I1..*BackboneElementList of benefits
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type I1..1CodeableConceptType of benefit
..... requirement I0..1stringReferral requirements
..... limit I0..*BackboneElementBenefit limits
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... value I0..1QuantityMaximum value allowed
...... code I0..1CodeableConceptBenefit limit details
... plan I0..*BackboneElementCost sharing details for the plan
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier ΣI0..*IdentifierBusiness Identifier for Product
.... type SI0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type (extensible)
.... coverageArea ΣI0..*Reference(Plan-net Location)Where product applies
.... network I0..*Reference(Plan-net Network)What networks provide coverage
.... generalCost I0..*BackboneElementOverall costs
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type I0..1CodeableConceptType of cost
..... groupSize I0..1positiveIntNumber of enrollees
..... cost I0..1MoneyCost value
..... comment I0..1stringAdditional cost information
.... specificCost I0..*BackboneElementSpecific costs
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... category I1..1CodeableConceptGeneral category of benefit
..... benefit I0..*BackboneElementBenefits list
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type I1..1CodeableConceptType of specific benefit
...... cost I0..*BackboneElementList of the costs
....... id 0..1stringUnique id for inter-element referencing
....... extension I0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... type I1..1CodeableConceptType of cost
....... applicability I0..1CodeableConceptin-network | out-of-network | other
Binding: BenefitCostApplicability (required)
....... qualifiers I0..*CodeableConceptAdditional information about the cost
....... value I0..1QuantityThe actual cost value

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan I0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... identifier ΣI0..*IdentifierBusiness Identifier for Product
.... id 0..1stringUnique id for inter-element referencing
.... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system ΣI0..1uriThe namespace for the identifier value
.... value ΣI0..1stringThe value that is unique
.... period ΣI0..1PeriodTime period when id is/was valid for use
.... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!ΣI1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required)
Fixed Value: active
... type ΣI1..1CodeableConceptProduct Type
Binding: Insurance Product Type (extensible)
... alias I0..*stringAlternate names
... ownedBy ΣI1..1Reference(Plan-net Organization)Plan issuer
... administeredBy ΣI1..1Reference(Plan-net Organization)Product administrator
... coverageArea ΣI0..*Reference(Plan-net Location)Where product applies
... contact I0..*BackboneElementContact for the product
.... name I0..1HumanNameA name associated with the contact
..... use ?!ΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required)
..... text ΣI0..1stringText representation of the full name
..... family ΣI0..1stringFamily name (often called 'Surname')
..... given ΣI0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix ΣI0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix ΣI0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period ΣI0..1PeriodTime period when name was/is in use
.... telecom I0..*ContactPointContact details (telephone, email, etc.) for a contact
..... contactpoint-availabletime I0..*(Complex)Optional Extensions Element
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary I0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system ΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
..... value ΣI0..1stringThe actual contact point details
..... use ?!ΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
..... period ΣI0..1PeriodTime period when the contact point was/is in use
... plan I0..*BackboneElementCost sharing details for the plan
.... type I0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type (extensible)

doco Documentation for this format

Differential View

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan 0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... meta
.... lastUpdated 1..1instantWhen the resource version last changed
... identifier
.... id S0..1stringUnique id for inter-element referencing
.... use S0..1codeusual | official | temp | secondary | old (If known)
.... type S0..1CodeableConceptDescription of identifier
.... system S0..1uriThe namespace for the identifier value
.... value S0..1stringThe value that is unique
.... period S0..1PeriodTime period when id is/was valid for use
.... assigner S0..1Reference(Organization)Organization that issued id (may be just text)
... status S1..1codedraft | active | retired | unknown
Fixed Value: active
... name S0..1stringOfficial name
... alias S0..*stringAlternate names
... ownedBy S1..1Reference(Plan-net Organization)Plan issuer
... administeredBy S1..1Reference(Plan-net Organization)Product administrator
... coverageArea S0..*Reference(Plan-net Location)Where product applies
... contact S0..*BackboneElementContact for the product
.... name S0..1HumanNameA name associated with the contact
..... use S0..1codeusual | official | temp | nickname | anonymous | old | maiden
..... text S0..1stringText representation of the full name
..... family S0..1stringFamily name (often called 'Surname')
..... given S0..*stringGiven names (not always 'first'). Includes middle names
..... prefix S0..*stringParts that come before the name
..... suffix S0..*stringParts that come after the name
..... period S0..1PeriodTime period when name was/is in use
.... telecom S0..*ContactPointContact details (telephone, email, etc.) for a contact
..... contactpoint-availabletime S0..*(Complex)Extension
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary S0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system S0..1codephone | fax | email | pager | url | sms | other
..... value S0..1stringThe actual contact point details
..... use S0..1codehome | work | temp | old | mobile - purpose of this contact point
..... period S0..1PeriodTime period when the contact point was/is in use
... endpoint 0..*Reference(Plan-net Endpoint)Technical endpoint
... network 0..*Reference(Plan-net Network)What networks are Included
... plan 0..*BackboneElementCost sharing details for the plan
.... type S0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type (extensible)
.... coverageArea 0..*Reference(Plan-net Location)Where product applies
.... network 0..*Reference(Plan-net Network)What networks provide coverage

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan I0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId ΣI0..1idVersion specific identifier
.... lastUpdated ΣI1..1instantWhen the resource version last changed
.... source ΣI0..1uriIdentifies where the resource comes from
.... profile ΣI0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security ΣI0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag ΣI0..*CodingTags applied to this resource
Binding: CommonTags (example)
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for Product
.... id S0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!SΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type SΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system SΣI0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣI0..1stringThe value that is unique
Example General: 123456
.... period SΣI0..1PeriodTime period when id is/was valid for use
.... assigner SΣI0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!SΣI1..1codedraft | active | retired | unknown
Binding: PublicationStatus (required)
Fixed Value: active
... type SΣI1..1CodeableConceptProduct Type
Binding: Insurance Product Type (extensible)
... name SΣI0..1stringOfficial name
... alias SI0..*stringAlternate names
... period I0..1PeriodWhen the product is available
... ownedBy SΣI1..1Reference(Plan-net Organization)Plan issuer
... administeredBy SΣI1..1Reference(Plan-net Organization)Product administrator
... coverageArea SΣI0..*Reference(Plan-net Location)Where product applies
... contact SI0..*BackboneElementContact for the product
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose I0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible)
.... name SI0..1HumanNameA name associated with the contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required)
..... text SΣI0..1stringText representation of the full name
..... family SΣI0..1stringFamily name (often called 'Surname')
..... given SΣI0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣI0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣI0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period SΣI0..1PeriodTime period when name was/is in use
.... telecom SI0..*ContactPointContact details (telephone, email, etc.) for a contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... contactpoint-availabletime SI0..*(Complex)Optional Extensions Element
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary SI0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system SΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
..... value SΣI0..1stringThe actual contact point details
..... use ?!SΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
..... rank ΣI0..1positiveIntSpecify preferred order of use (1 = highest)
..... period SΣI0..1PeriodTime period when the contact point was/is in use
.... address I0..1AddressVisiting or postal addresses for the contact
... endpoint I0..*Reference(Plan-net Endpoint)Technical endpoint
... network I0..*Reference(Plan-net Network)What networks are Included
... coverage I0..*BackboneElementCoverage details
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type I1..1CodeableConceptType of coverage
.... network I0..*Reference(Organization)What networks provide coverage
.... benefit I1..*BackboneElementList of benefits
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type I1..1CodeableConceptType of benefit
..... requirement I0..1stringReferral requirements
..... limit I0..*BackboneElementBenefit limits
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... value I0..1QuantityMaximum value allowed
...... code I0..1CodeableConceptBenefit limit details
... plan I0..*BackboneElementCost sharing details for the plan
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier ΣI0..*IdentifierBusiness Identifier for Product
.... type SI0..1CodeableConceptCategorization of the cost sharing for the plan
Binding: Insurance Plan Type (extensible)
.... coverageArea ΣI0..*Reference(Plan-net Location)Where product applies
.... network I0..*Reference(Plan-net Network)What networks provide coverage
.... generalCost I0..*BackboneElementOverall costs
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type I0..1CodeableConceptType of cost
..... groupSize I0..1positiveIntNumber of enrollees
..... cost I0..1MoneyCost value
..... comment I0..1stringAdditional cost information
.... specificCost I0..*BackboneElementSpecific costs
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... category I1..1CodeableConceptGeneral category of benefit
..... benefit I0..*BackboneElementBenefits list
...... id 0..1stringUnique id for inter-element referencing
...... extension I0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type I1..1CodeableConceptType of specific benefit
...... cost I0..*BackboneElementList of the costs
....... id 0..1stringUnique id for inter-element referencing
....... extension I0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... type I1..1CodeableConceptType of cost
....... applicability I0..1CodeableConceptin-network | out-of-network | other
Binding: BenefitCostApplicability (required)
....... qualifiers I0..*CodeableConceptAdditional information about the cost
....... value I0..1QuantityThe actual cost value

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet / Code
InsurancePlan.meta.securityextensibleAll Security Labels
InsurancePlan.meta.tagexampleCommonTags
InsurancePlan.languagepreferredCommonLanguages
Max Binding: AllLanguages
InsurancePlan.identifier.userequiredIdentifierUse
InsurancePlan.identifier.typeextensibleIdentifier Type Codes
InsurancePlan.statusrequiredFixed Value: active
InsurancePlan.typeextensibleInsuranceProductTypeVS
InsurancePlan.contact.purposeextensibleContactEntityType
InsurancePlan.contact.name.userequiredNameUse
InsurancePlan.contact.telecom.systemrequiredContactPointSystem
InsurancePlan.contact.telecom.userequiredContactPointUse
InsurancePlan.plan.typeextensibleInsurancePlanTypeVS
InsurancePlan.plan.specificCost.benefit.cost.applicabilityrequiredBenefitCostApplicability