PlannetInsurancePlan

Plan-Net InsurancePlan

activeDa Vinci PDEX Plan-Net1.2.0resource21 key elements

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.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan
ID
plannet-InsurancePlan
Type
Base Definition
Derivation
constraint
Mandatory and Must-Support Elements

Elements with cardinality > 0 or marked as Must Support (S)

PathCard.TypeFlagsDescription
identifier.type
S
identifier.value
S
identifier.assigner
S
status
S1+
type1..1
S1+
Product Type
name
S
alias
S
period
S
ownedBy
Reference
S1+
administeredBy
Reference
S1+
coverageArea
Reference
S
contact
S
contact.name
S
contact.name.text
S
contact.telecom
S
contact.telecom.system
S
contact.telecom.value
S
endpoint
Reference
S
network
Reference
S
plan.type
S
Categorization of the cost sharing for the plan
plan.coverageArea
Reference
S