Summary of Benefits and Coverage (SBC) FHIR Implementation Guide
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Summary of Benefits and Coverage (SBC) FHIR Implementation Guide, published by SBC FHIR Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jdjkelly/fhir-sbc/ and changes regularly. See the Directory of published versions

Extension: SBC Metadata Extension

Official URL: http://flexpa.com/fhir/sbc/StructureDefinition/sbc-metadata Version: 0.1.0
Draft as of 2025-11-10 Computable Name: SBCMetadata

Extension containing regulatory metadata required for Summary of Benefits and Coverage documents

Context of Use

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

Usage info

Usages:

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.

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension SBC Metadata Extension
... Slices for extension Content/Rules for all slices
.... extension:sbcVersionDate 0..1 Extension SBC Template Version Date
..... extension 0..0 Extension
..... url 1..1 uri "sbcVersionDate"
..... value[x] 0..1 date Value of extension
.... extension:minimumEssentialCoverage 0..1 Extension Minimum Essential Coverage Indicator
..... extension 0..0 Extension
..... url 1..1 uri "minimumEssentialCoverage"
..... value[x] 0..1 boolean Value of extension
.... extension:minimumValue 0..1 Extension Minimum Value Indicator
..... extension 0..0 Extension
..... url 1..1 uri "minimumValue"
..... value[x] 0..1 boolean Value of extension
.... extension:abortionCoverage 0..1 Extension Abortion Coverage Disclosure
..... extension 0..0 Extension
..... url 1..1 uri "abortionCoverage"
..... value[x] 0..1 CodeableConcept Value of extension
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/sbc-metadata"
... value[x] 0..0 Value of extension

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension SBC Metadata Extension
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... extension:sbcVersionDate 0..1 Extension SBC Template Version Date
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "sbcVersionDate"
..... value[x] 0..1 date Value of extension
.... extension:minimumEssentialCoverage 0..1 Extension Minimum Essential Coverage Indicator
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "minimumEssentialCoverage"
..... value[x] 0..1 boolean Value of extension
.... extension:minimumValue 0..1 Extension Minimum Value Indicator
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "minimumValue"
..... value[x] 0..1 boolean Value of extension
.... extension:abortionCoverage 0..1 Extension Abortion Coverage Disclosure
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "abortionCoverage"
..... value[x] 0..1 CodeableConcept Value of extension
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/sbc-metadata"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Extension containing regulatory metadata required for Summary of Benefits and Coverage documents

  • sbcVersionDate: date: The effective date of the SBC template version used
  • minimumEssentialCoverage: boolean: Indicates whether the plan provides minimum essential coverage under section 5000A(f) of the Internal Revenue Code
  • minimumValue: boolean: Indicates whether the plan's share of the total allowed costs of benefits meets the minimum value requirement
  • abortionCoverage: CodeableConcept: For qualified health plans, indicates coverage, exclusion, or limitation to excepted abortion services per 45 CFR 156.280

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension SBC Metadata Extension
... Slices for extension Content/Rules for all slices
.... extension:sbcVersionDate 0..1 Extension SBC Template Version Date
..... extension 0..0 Extension
..... url 1..1 uri "sbcVersionDate"
..... value[x] 0..1 date Value of extension
.... extension:minimumEssentialCoverage 0..1 Extension Minimum Essential Coverage Indicator
..... extension 0..0 Extension
..... url 1..1 uri "minimumEssentialCoverage"
..... value[x] 0..1 boolean Value of extension
.... extension:minimumValue 0..1 Extension Minimum Value Indicator
..... extension 0..0 Extension
..... url 1..1 uri "minimumValue"
..... value[x] 0..1 boolean Value of extension
.... extension:abortionCoverage 0..1 Extension Abortion Coverage Disclosure
..... extension 0..0 Extension
..... url 1..1 uri "abortionCoverage"
..... value[x] 0..1 CodeableConcept Value of extension
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/sbc-metadata"
... value[x] 0..0 Value of extension

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension SBC Metadata Extension
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... extension:sbcVersionDate 0..1 Extension SBC Template Version Date
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "sbcVersionDate"
..... value[x] 0..1 date Value of extension
.... extension:minimumEssentialCoverage 0..1 Extension Minimum Essential Coverage Indicator
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "minimumEssentialCoverage"
..... value[x] 0..1 boolean Value of extension
.... extension:minimumValue 0..1 Extension Minimum Value Indicator
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "minimumValue"
..... value[x] 0..1 boolean Value of extension
.... extension:abortionCoverage 0..1 Extension Abortion Coverage Disclosure
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "abortionCoverage"
..... value[x] 0..1 CodeableConcept Value of extension
... url 1..1 uri "http://flexpa.com/fhir/sbc/StructureDefinition/sbc-metadata"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Extension containing regulatory metadata required for Summary of Benefits and Coverage documents

  • sbcVersionDate: date: The effective date of the SBC template version used
  • minimumEssentialCoverage: boolean: Indicates whether the plan provides minimum essential coverage under section 5000A(f) of the Internal Revenue Code
  • minimumValue: boolean: Indicates whether the plan's share of the total allowed costs of benefits meets the minimum value requirement
  • abortionCoverage: CodeableConcept: For qualified health plans, indicates coverage, exclusion, or limitation to excepted abortion services per 45 CFR 156.280

 

Other representations of profile: CSV, Excel, Schematron

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()