Extensions for Using Data Elements from FHIR R4 in FHIR R5 - Downloaded Version null See the Directory of published versions

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Resource Profile: Profile_R4_InsurancePlan_R5

This cross-version profile allows R4 InsurancePlan content to be represented via FHIR R5 InsurancePlan resources.

Usages:

• This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
InsurancePlan	C	0..*	InsurancePlan(5.0.0)	Details of a Health Insurance product/plan provided by an organization Constraints: ipn-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!Σ	0..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
InsurancePlan.status	Base	required	PublicationStatus	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	InsurancePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	InsurancePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	InsurancePlan	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	InsurancePlan.implicitRules, InsurancePlan.modifierExtension, InsurancePlan.status	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	InsurancePlan.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an identifier, and possibly more than one	(identifier.count() + name.count()) > 0

This structure is derived from InsurancePlan

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
InsurancePlan		0..*	InsurancePlan(5.0.0)	Details of a Health Insurance product/plan provided by an organization
contact
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:purpose		0..1	CodeableConcept	​R4: The type of contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.purpose Binding: http://terminology.hl7.org/ValueSet/contactentity-type|0.5.0 (extensible): The purpose for which you would contact a contact party.
extension:name		0..1	HumanName	R4: A name associated with the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.name
extension:telecom		0..*	ContactPoint	R4: Contact details (telephone, email, etc.) for a contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.telecom
extension:address		0..1	Address	R4: Visiting or postal addresses for the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.address
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
InsurancePlan	C	0..*	InsurancePlan(5.0.0)	Details of a Health Insurance product/plan provided by an organization Constraints: ipn-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	ΣC	0..*	Identifier	Business Identifier for Product
status	?!Σ	0..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
type	Σ	0..*	CodeableConcept	Kind of product Binding: InsurancePlanType (example): Used to categorize the product/plan.
name	ΣC	0..1	string	Official name
alias		0..*	string	Alternate names
period		0..1	Period	When the product is available
ownedBy	Σ	0..1	Reference(Organization)	Product issuer
administeredBy	Σ	0..1	Reference(Organization)	Product administrator
coverageArea	Σ	0..*	Reference(Location)	Where product applies
contact		0..*	ExtendedContactDetail	Official contact details relevant to the health insurance plan/product
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:purpose		0..1	CodeableConcept	​R4: The type of contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.purpose Binding: http://terminology.hl7.org/ValueSet/contactentity-type|0.5.0 (extensible): The purpose for which you would contact a contact party. Constraints: ext-1
extension:name		0..1	HumanName	R4: A name associated with the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.name Constraints: ext-1
extension:telecom		0..*	ContactPoint	R4: Contact details (telephone, email, etc.) for a contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.telecom Constraints: ext-1
extension:address		0..1	Address	R4: Visiting or postal addresses for the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.address Constraints: ext-1
purpose	Σ	0..1	CodeableConcept	The type of contact Binding: ContactEntityType (2.0.0) (preferred): The purpose for which an extended contact detail should be used.
name	Σ	0..*	HumanName	Name of an individual to contact
telecom	Σ	0..*	ContactPoint	Contact details (e.g.phone/fax/url)
address	Σ	0..1	Address	Address for the contact
organization	Σ	0..1	Reference(Organization)	This contact detail is handled/monitored by a specific organization
period	Σ	0..1	Period	Period that this contact was valid for usage
endpoint		0..*	Reference(Endpoint)	Technical endpoint
network		0..*	Reference(Organization)	What networks are Included
coverage		0..*	BackboneElement	Coverage details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of coverage
network		0..*	Reference(Organization)	What networks provide coverage
benefit		1..*	BackboneElement	List of benefits
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of benefit
requirement		0..1	string	Referral requirements
limit		0..*	BackboneElement	Benefit limits
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
value		0..1	Quantity	Maximum value allowed
code		0..1	CodeableConcept	Benefit limit details
plan		0..*	BackboneElement	Plan details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for Product
type		0..1	CodeableConcept	Type of plan
coverageArea	Σ	0..*	Reference(Location)	Where product applies
network		0..*	Reference(Organization)	What networks provide coverage
generalCost		0..*	BackboneElement	Overall costs
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		0..1	CodeableConcept	Type of cost
groupSize		0..1	positiveInt	Number of enrollees
cost		0..1	Money	Cost value
comment		0..1	string	Additional cost information
specificCost		0..*	BackboneElement	Specific costs
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
category		1..1	CodeableConcept	General category of benefit
benefit		0..*	BackboneElement	Benefits list
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of specific benefit
cost		0..*	BackboneElement	List of the costs
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of cost
applicability		0..1	CodeableConcept	in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.
qualifiers		0..*	CodeableConcept	Additional information about the cost
value		0..1	Quantity	The actual cost value
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
InsurancePlan.language	Base	required	All Languages	📍5.0.0	FHIR Std.
InsurancePlan.status	Base	required	PublicationStatus	📍5.0.0	FHIR Std.
InsurancePlan.type	Base	example	Insurance Plan Type	📍5.0.0	FHIR Std.
InsurancePlan.contact.​purpose	Base	preferred	Contact entity type	📍2.0.0	THO v7.1
InsurancePlan.plan.specificCost.​benefit.cost.applicability	Base	required	Benefit Cost Applicability	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	InsurancePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	InsurancePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	InsurancePlan	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	InsurancePlan.meta, InsurancePlan.implicitRules, InsurancePlan.language, InsurancePlan.text, InsurancePlan.extension, InsurancePlan.modifierExtension, InsurancePlan.identifier, InsurancePlan.status, InsurancePlan.type, InsurancePlan.name, InsurancePlan.alias, InsurancePlan.period, InsurancePlan.ownedBy, InsurancePlan.administeredBy, InsurancePlan.coverageArea, InsurancePlan.contact, InsurancePlan.contact.extension, InsurancePlan.contact.extension:purpose, InsurancePlan.contact.extension:name, InsurancePlan.contact.extension:telecom, InsurancePlan.contact.extension:address, InsurancePlan.contact.purpose, InsurancePlan.contact.name, InsurancePlan.contact.telecom, InsurancePlan.contact.address, InsurancePlan.contact.organization, InsurancePlan.contact.period, InsurancePlan.endpoint, InsurancePlan.network, InsurancePlan.coverage, InsurancePlan.coverage.extension, InsurancePlan.coverage.modifierExtension, InsurancePlan.coverage.type, InsurancePlan.coverage.network, InsurancePlan.coverage.benefit, InsurancePlan.coverage.benefit.extension, InsurancePlan.coverage.benefit.modifierExtension, InsurancePlan.coverage.benefit.type, InsurancePlan.coverage.benefit.requirement, InsurancePlan.coverage.benefit.limit, InsurancePlan.coverage.benefit.limit.extension, InsurancePlan.coverage.benefit.limit.modifierExtension, InsurancePlan.coverage.benefit.limit.value, InsurancePlan.coverage.benefit.limit.code, InsurancePlan.plan, InsurancePlan.plan.extension, InsurancePlan.plan.modifierExtension, InsurancePlan.plan.identifier, InsurancePlan.plan.type, InsurancePlan.plan.coverageArea, InsurancePlan.plan.network, InsurancePlan.plan.generalCost, InsurancePlan.plan.generalCost.extension, InsurancePlan.plan.generalCost.modifierExtension, InsurancePlan.plan.generalCost.type, InsurancePlan.plan.generalCost.groupSize, InsurancePlan.plan.generalCost.cost, InsurancePlan.plan.generalCost.comment, InsurancePlan.plan.specificCost, InsurancePlan.plan.specificCost.extension, InsurancePlan.plan.specificCost.modifierExtension, InsurancePlan.plan.specificCost.category, InsurancePlan.plan.specificCost.benefit, InsurancePlan.plan.specificCost.benefit.extension, InsurancePlan.plan.specificCost.benefit.modifierExtension, InsurancePlan.plan.specificCost.benefit.type, InsurancePlan.plan.specificCost.benefit.cost, InsurancePlan.plan.specificCost.benefit.cost.extension, InsurancePlan.plan.specificCost.benefit.cost.modifierExtension, InsurancePlan.plan.specificCost.benefit.cost.type, InsurancePlan.plan.specificCost.benefit.cost.applicability, InsurancePlan.plan.specificCost.benefit.cost.qualifiers, InsurancePlan.plan.specificCost.benefit.cost.value	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	InsurancePlan.extension, InsurancePlan.modifierExtension, InsurancePlan.contact.extension, InsurancePlan.contact.extension:purpose, InsurancePlan.contact.extension:name, InsurancePlan.contact.extension:telecom, InsurancePlan.contact.extension:address, InsurancePlan.coverage.extension, InsurancePlan.coverage.modifierExtension, InsurancePlan.coverage.benefit.extension, InsurancePlan.coverage.benefit.modifierExtension, InsurancePlan.coverage.benefit.limit.extension, InsurancePlan.coverage.benefit.limit.modifierExtension, InsurancePlan.plan.extension, InsurancePlan.plan.modifierExtension, InsurancePlan.plan.generalCost.extension, InsurancePlan.plan.generalCost.modifierExtension, InsurancePlan.plan.specificCost.extension, InsurancePlan.plan.specificCost.modifierExtension, InsurancePlan.plan.specificCost.benefit.extension, InsurancePlan.plan.specificCost.benefit.modifierExtension, InsurancePlan.plan.specificCost.benefit.cost.extension, InsurancePlan.plan.specificCost.benefit.cost.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an identifier, and possibly more than one	(identifier.count() + name.count()) > 0

This structure is derived from InsurancePlan

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.purpose|0.1.0
• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.name|0.1.0
• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.telecom|0.1.0
• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.address|0.1.0

Maturity: 0

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
InsurancePlan	C	0..*	InsurancePlan(5.0.0)	Details of a Health Insurance product/plan provided by an organization Constraints: ipn-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!Σ	0..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
InsurancePlan.status	Base	required	PublicationStatus	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	InsurancePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	InsurancePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	InsurancePlan	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	InsurancePlan.implicitRules, InsurancePlan.modifierExtension, InsurancePlan.status	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	InsurancePlan.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an identifier, and possibly more than one	(identifier.count() + name.count()) > 0

Differential View

This structure is derived from InsurancePlan

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
InsurancePlan		0..*	InsurancePlan(5.0.0)	Details of a Health Insurance product/plan provided by an organization
contact
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:purpose		0..1	CodeableConcept	​R4: The type of contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.purpose Binding: http://terminology.hl7.org/ValueSet/contactentity-type|0.5.0 (extensible): The purpose for which you would contact a contact party.
extension:name		0..1	HumanName	R4: A name associated with the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.name
extension:telecom		0..*	ContactPoint	R4: Contact details (telephone, email, etc.) for a contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.telecom
extension:address		0..1	Address	R4: Visiting or postal addresses for the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.address
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
InsurancePlan	C	0..*	InsurancePlan(5.0.0)	Details of a Health Insurance product/plan provided by an organization Constraints: ipn-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	ΣC	0..*	Identifier	Business Identifier for Product
status	?!Σ	0..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
type	Σ	0..*	CodeableConcept	Kind of product Binding: InsurancePlanType (example): Used to categorize the product/plan.
name	ΣC	0..1	string	Official name
alias		0..*	string	Alternate names
period		0..1	Period	When the product is available
ownedBy	Σ	0..1	Reference(Organization)	Product issuer
administeredBy	Σ	0..1	Reference(Organization)	Product administrator
coverageArea	Σ	0..*	Reference(Location)	Where product applies
contact		0..*	ExtendedContactDetail	Official contact details relevant to the health insurance plan/product
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:purpose		0..1	CodeableConcept	​R4: The type of contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.purpose Binding: http://terminology.hl7.org/ValueSet/contactentity-type|0.5.0 (extensible): The purpose for which you would contact a contact party. Constraints: ext-1
extension:name		0..1	HumanName	R4: A name associated with the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.name Constraints: ext-1
extension:telecom		0..*	ContactPoint	R4: Contact details (telephone, email, etc.) for a contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.telecom Constraints: ext-1
extension:address		0..1	Address	R4: Visiting or postal addresses for the contact (new) URL: http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.address Constraints: ext-1
purpose	Σ	0..1	CodeableConcept	The type of contact Binding: ContactEntityType (2.0.0) (preferred): The purpose for which an extended contact detail should be used.
name	Σ	0..*	HumanName	Name of an individual to contact
telecom	Σ	0..*	ContactPoint	Contact details (e.g.phone/fax/url)
address	Σ	0..1	Address	Address for the contact
organization	Σ	0..1	Reference(Organization)	This contact detail is handled/monitored by a specific organization
period	Σ	0..1	Period	Period that this contact was valid for usage
endpoint		0..*	Reference(Endpoint)	Technical endpoint
network		0..*	Reference(Organization)	What networks are Included
coverage		0..*	BackboneElement	Coverage details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of coverage
network		0..*	Reference(Organization)	What networks provide coverage
benefit		1..*	BackboneElement	List of benefits
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of benefit
requirement		0..1	string	Referral requirements
limit		0..*	BackboneElement	Benefit limits
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
value		0..1	Quantity	Maximum value allowed
code		0..1	CodeableConcept	Benefit limit details
plan		0..*	BackboneElement	Plan details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for Product
type		0..1	CodeableConcept	Type of plan
coverageArea	Σ	0..*	Reference(Location)	Where product applies
network		0..*	Reference(Organization)	What networks provide coverage
generalCost		0..*	BackboneElement	Overall costs
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		0..1	CodeableConcept	Type of cost
groupSize		0..1	positiveInt	Number of enrollees
cost		0..1	Money	Cost value
comment		0..1	string	Additional cost information
specificCost		0..*	BackboneElement	Specific costs
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
category		1..1	CodeableConcept	General category of benefit
benefit		0..*	BackboneElement	Benefits list
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of specific benefit
cost		0..*	BackboneElement	List of the costs
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Type of cost
applicability		0..1	CodeableConcept	in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.
qualifiers		0..*	CodeableConcept	Additional information about the cost
value		0..1	Quantity	The actual cost value
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
InsurancePlan.language	Base	required	All Languages	📍5.0.0	FHIR Std.
InsurancePlan.status	Base	required	PublicationStatus	📍5.0.0	FHIR Std.
InsurancePlan.type	Base	example	Insurance Plan Type	📍5.0.0	FHIR Std.
InsurancePlan.contact.​purpose	Base	preferred	Contact entity type	📍2.0.0	THO v7.1
InsurancePlan.plan.specificCost.​benefit.cost.applicability	Base	required	Benefit Cost Applicability	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	InsurancePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	InsurancePlan	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	InsurancePlan	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	InsurancePlan	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	InsurancePlan.meta, InsurancePlan.implicitRules, InsurancePlan.language, InsurancePlan.text, InsurancePlan.extension, InsurancePlan.modifierExtension, InsurancePlan.identifier, InsurancePlan.status, InsurancePlan.type, InsurancePlan.name, InsurancePlan.alias, InsurancePlan.period, InsurancePlan.ownedBy, InsurancePlan.administeredBy, InsurancePlan.coverageArea, InsurancePlan.contact, InsurancePlan.contact.extension, InsurancePlan.contact.extension:purpose, InsurancePlan.contact.extension:name, InsurancePlan.contact.extension:telecom, InsurancePlan.contact.extension:address, InsurancePlan.contact.purpose, InsurancePlan.contact.name, InsurancePlan.contact.telecom, InsurancePlan.contact.address, InsurancePlan.contact.organization, InsurancePlan.contact.period, InsurancePlan.endpoint, InsurancePlan.network, InsurancePlan.coverage, InsurancePlan.coverage.extension, InsurancePlan.coverage.modifierExtension, InsurancePlan.coverage.type, InsurancePlan.coverage.network, InsurancePlan.coverage.benefit, InsurancePlan.coverage.benefit.extension, InsurancePlan.coverage.benefit.modifierExtension, InsurancePlan.coverage.benefit.type, InsurancePlan.coverage.benefit.requirement, InsurancePlan.coverage.benefit.limit, InsurancePlan.coverage.benefit.limit.extension, InsurancePlan.coverage.benefit.limit.modifierExtension, InsurancePlan.coverage.benefit.limit.value, InsurancePlan.coverage.benefit.limit.code, InsurancePlan.plan, InsurancePlan.plan.extension, InsurancePlan.plan.modifierExtension, InsurancePlan.plan.identifier, InsurancePlan.plan.type, InsurancePlan.plan.coverageArea, InsurancePlan.plan.network, InsurancePlan.plan.generalCost, InsurancePlan.plan.generalCost.extension, InsurancePlan.plan.generalCost.modifierExtension, InsurancePlan.plan.generalCost.type, InsurancePlan.plan.generalCost.groupSize, InsurancePlan.plan.generalCost.cost, InsurancePlan.plan.generalCost.comment, InsurancePlan.plan.specificCost, InsurancePlan.plan.specificCost.extension, InsurancePlan.plan.specificCost.modifierExtension, InsurancePlan.plan.specificCost.category, InsurancePlan.plan.specificCost.benefit, InsurancePlan.plan.specificCost.benefit.extension, InsurancePlan.plan.specificCost.benefit.modifierExtension, InsurancePlan.plan.specificCost.benefit.type, InsurancePlan.plan.specificCost.benefit.cost, InsurancePlan.plan.specificCost.benefit.cost.extension, InsurancePlan.plan.specificCost.benefit.cost.modifierExtension, InsurancePlan.plan.specificCost.benefit.cost.type, InsurancePlan.plan.specificCost.benefit.cost.applicability, InsurancePlan.plan.specificCost.benefit.cost.qualifiers, InsurancePlan.plan.specificCost.benefit.cost.value	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	InsurancePlan.extension, InsurancePlan.modifierExtension, InsurancePlan.contact.extension, InsurancePlan.contact.extension:purpose, InsurancePlan.contact.extension:name, InsurancePlan.contact.extension:telecom, InsurancePlan.contact.extension:address, InsurancePlan.coverage.extension, InsurancePlan.coverage.modifierExtension, InsurancePlan.coverage.benefit.extension, InsurancePlan.coverage.benefit.modifierExtension, InsurancePlan.coverage.benefit.limit.extension, InsurancePlan.coverage.benefit.limit.modifierExtension, InsurancePlan.plan.extension, InsurancePlan.plan.modifierExtension, InsurancePlan.plan.generalCost.extension, InsurancePlan.plan.generalCost.modifierExtension, InsurancePlan.plan.specificCost.extension, InsurancePlan.plan.specificCost.modifierExtension, InsurancePlan.plan.specificCost.benefit.extension, InsurancePlan.plan.specificCost.benefit.modifierExtension, InsurancePlan.plan.specificCost.benefit.cost.extension, InsurancePlan.plan.specificCost.benefit.cost.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an identifier, and possibly more than one	(identifier.count() + name.count()) > 0

This structure is derived from InsurancePlan

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.purpose|0.1.0
• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.name|0.1.0
• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.telecom|0.1.0
• http://hl7.org/fhir/4.0/StructureDefinition/extension-InsurancePlan.contact.address|0.1.0

Maturity: 0

Other representations of profile: CSV, Excel, Schematron