CARIN Digital Insurance Card
2.0.0-ballot - STU 2 Ballot

CARIN Digital Insurance Card - Downloaded Version 2.0.0-ballot See the Directory of published versions

## Extension: SBC Metadata Extension (Experimental)

Official URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/sbc-metadata | Version: 2.0.0-ballot
Standards status: Informative | Computable Name: SBCMetadata
Other Identifiers: OID:2.16.840.1.113883.4.642.40.9.42.19

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):

- Element ID InsurancePlan

Usage info

Usages:

- Use this Extension: SBC Insurance Plan Profile
- Examples for this Extension: Sample Health HMO Gold Plan

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: 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

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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://hl7.org/fhir/us/insurance-card/StructureDefinition/sbc-metadata"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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://hl7.org/fhir/us/insurance-card/StructureDefinition/sbc-metadata"
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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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://hl7.org/fhir/us/insurance-card/StructureDefinition/sbc-metadata"
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 | 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://hl7.org/fhir/us/insurance-card/StructureDefinition/sbc-metadata"
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Constraints

Id | Grade | Path(s) | Description | Expression