Details of a Health Insurance product provided by an organization.

Business identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.

The current state of the health insurance product.

Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

The kind of health insurance product.

Official name of the health insurance product as designated by the owner.

If the name of the product changes, consider putting the old name in the alias column so that it can still be located through searches.

A list of alternate names that the product is known as, or was known as in the past.

Over time products go through many changes and can be known by different names.

For searching knowing previous names that the product was known by can be very useful.

There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the product.

The period of time that the health insurance product is available.

The entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as 'payers'.

An organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner.

The geographic region in which a health insurance product's benefits apply.

The contact details of communication devices available relevant to the specific Insurance Product. This can include addresses, phone numbers, fax numbers, mobile numbers, email addresses and web sites.

Need to keep track of both simple contact details and also assigned contacts within larger organizations.

The address/telecom use code 'home' are not to be used.

The technical endpoints providing access to services operated for the health insurance product.

Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

Reference to the network included in the health insurance product.

Networks are represented as a hierarchy of organization resources.

Details about the coverage offered by the insurance product.

Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).

Reference to the network that providing the type of coverage.

Networks are represented as a hierarchy of organization resources.

Specific benefits under this type of coverage.

Type of benefit (primary care; specialty care; inpatient; outpatient).

The referral requirements to have access/coverage for this benefit.

The specific limits on the benefit.

The maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses.

May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”.

The specific limit on the benefit.

Use CodeableConcept.text element if the data is free (uncoded) text.

Another product that is related to this product. Often used to create relationships to parents or families of products.

The Related Product reference.

The relationship of this product to the related product. an example would be 'sub-plan' where this product is a sub-plan of the related.product.

Use CodeableConcept.text element if the data is free (uncoded) text.

Period of time that the product relationship is valid. The start and/or end dates can be empty if this is an open ended relationship.