careMESH NPD - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON

Resource Profile: careMESH InsurancePlan

The details of a health insurance product/plan

Usage:

• Examples for this Resource Profile: Olympus of CT QHP Bronze and Olympus of CT QHP Gold

Formal Views of Profile Content

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

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

This structure is derived from PlannetInsurancePlan

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan		0..*	PlannetInsurancePlan	Details of a Health Insurance product/plan provided by an organization
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	C	0..*	PlannetInsurancePlan	Details of a Health Insurance product/plan provided by an organization ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one network-or-plan-Network: If an insuranceplan does not define a network, then each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	ΣC	0..*	Identifier	Business Identifier for Product
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
value	SΣ	0..1	string	The value that is unique Example General: 123456
assigner	SΣ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active
type	SΣ	1..1	CodeableConcept	Product Type Binding: Insurance Product Type VS (extensible)
name	SΣC	0..1	string	Official name
alias	S	0..*	string	Alternate names
period	S	0..1	Period	When the product is available
ownedBy	SΣ	1..1	Reference(Plan-Net Organization)	Plan issuer
administeredBy	SΣ	1..1	Reference(Plan-Net Organization)	Product administrator
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
contact	S	0..*	BackboneElement	Contact for the product
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
name	S	0..1	HumanName	A name associated with the contact
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	SΣ	0..1	string	Text representation of the full name
telecom	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
endpoint	S	0..*	Reference(Plan-Net Endpoint)	Technical endpoint
network	S	0..*	Reference(Plan-Net Network)	What networks are Included
plan		0..*	BackboneElement	Cost sharing details for the plan
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	S	0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible)
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	Fixed Value: active http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	extensible	InsuranceProductTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.type	extensible	InsurancePlanTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsurancePlanTypeVS

Constraints

Id	Grade	Path(s)	Details	Requirements
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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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	**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()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0
network-or-plan-Network	error	InsurancePlan	If an insuranceplan does not define a network, then each plan must define one : network.exists() or plan.network.exists.allTrue()
plan-type-is-distinct	error	InsurancePlan	Each InsurancePlan.plan should have a distinct plan.type. : plan.type.coding.code.isDistinct()

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	C	0..*	PlannetInsurancePlan	Details of a Health Insurance product/plan provided by an organization ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one network-or-plan-Network: If an insuranceplan does not define a network, then each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	1..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	ΣC	0..*	Identifier	Business Identifier for Product
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	SΣ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active
type	SΣ	1..1	CodeableConcept	Product Type Binding: Insurance Product Type VS (extensible)
name	SΣC	0..1	string	Official name
alias	S	0..*	string	Alternate names
period	S	0..1	Period	When the product is available
ownedBy	SΣ	1..1	Reference(Plan-Net Organization)	Plan issuer
administeredBy	SΣ	1..1	Reference(Plan-Net Organization)	Product administrator
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
contact	S	0..*	BackboneElement	Contact for the product
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
purpose		0..1	CodeableConcept	The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.
name	S	0..1	HumanName	A name associated with the contact
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	SΣ	0..1	string	Text representation of the full name
family	Σ	0..1	string	Family name (often called 'Surname')
given	Σ	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
address		0..1	Address	Visiting or postal addresses for the contact
endpoint	S	0..*	Reference(Plan-Net Endpoint)	Technical endpoint
network	S	0..*	Reference(Plan-Net Network)	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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value		0..1	Quantity	Maximum value allowed
code		0..1	CodeableConcept	Benefit limit details
plan		0..*	BackboneElement	Cost sharing details for the plan
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier	Σ	0..*	Identifier	Business Identifier for Product
type	S	0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible)
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
network		0..*	Reference(Plan-Net Network)	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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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	Conformance	ValueSet / Code	URI
InsurancePlan.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
InsurancePlan.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
InsurancePlan.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	Fixed Value: active http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	extensible	InsuranceProductTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS
InsurancePlan.contact.purpose	extensible	ContactEntityType http://hl7.org/fhir/ValueSet/contactentity-type from the FHIR Standard
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.type	extensible	InsurancePlanTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsurancePlanTypeVS
InsurancePlan.plan.specificCost.benefit.cost.applicability	required	BenefitCostApplicability http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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	**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()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0
network-or-plan-Network	error	InsurancePlan	If an insuranceplan does not define a network, then each plan must define one : network.exists() or plan.network.exists.allTrue()
plan-type-is-distinct	error	InsurancePlan	Each InsurancePlan.plan should have a distinct plan.type. : plan.type.coding.code.isDistinct()

This structure is derived from PlannetInsurancePlan

Summary

Differential View

This structure is derived from PlannetInsurancePlan

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan		0..*	PlannetInsurancePlan	Details of a Health Insurance product/plan provided by an organization
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	C	0..*	PlannetInsurancePlan	Details of a Health Insurance product/plan provided by an organization ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one network-or-plan-Network: If an insuranceplan does not define a network, then each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	ΣC	0..*	Identifier	Business Identifier for Product
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
value	SΣ	0..1	string	The value that is unique Example General: 123456
assigner	SΣ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active
type	SΣ	1..1	CodeableConcept	Product Type Binding: Insurance Product Type VS (extensible)
name	SΣC	0..1	string	Official name
alias	S	0..*	string	Alternate names
period	S	0..1	Period	When the product is available
ownedBy	SΣ	1..1	Reference(Plan-Net Organization)	Plan issuer
administeredBy	SΣ	1..1	Reference(Plan-Net Organization)	Product administrator
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
contact	S	0..*	BackboneElement	Contact for the product
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
name	S	0..1	HumanName	A name associated with the contact
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	SΣ	0..1	string	Text representation of the full name
telecom	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
endpoint	S	0..*	Reference(Plan-Net Endpoint)	Technical endpoint
network	S	0..*	Reference(Plan-Net Network)	What networks are Included
plan		0..*	BackboneElement	Cost sharing details for the plan
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	S	0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible)
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	Fixed Value: active http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	extensible	InsuranceProductTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.type	extensible	InsurancePlanTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsurancePlanTypeVS

Constraints

Id	Grade	Path(s)	Details	Requirements
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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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	**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()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0
network-or-plan-Network	error	InsurancePlan	If an insuranceplan does not define a network, then each plan must define one : network.exists() or plan.network.exists.allTrue()
plan-type-is-distinct	error	InsurancePlan	Each InsurancePlan.plan should have a distinct plan.type. : plan.type.coding.code.isDistinct()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
InsurancePlan	C	0..*	PlannetInsurancePlan	Details of a Health Insurance product/plan provided by an organization ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one network-or-plan-Network: If an insuranceplan does not define a network, then each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	1..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	ΣC	0..*	Identifier	Business Identifier for Product
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	SΣ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active
type	SΣ	1..1	CodeableConcept	Product Type Binding: Insurance Product Type VS (extensible)
name	SΣC	0..1	string	Official name
alias	S	0..*	string	Alternate names
period	S	0..1	Period	When the product is available
ownedBy	SΣ	1..1	Reference(Plan-Net Organization)	Plan issuer
administeredBy	SΣ	1..1	Reference(Plan-Net Organization)	Product administrator
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
contact	S	0..*	BackboneElement	Contact for the product
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
purpose		0..1	CodeableConcept	The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.
name	S	0..1	HumanName	A name associated with the contact
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	SΣ	0..1	string	Text representation of the full name
family	Σ	0..1	string	Family name (often called 'Surname')
given	Σ	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣC	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use
address		0..1	Address	Visiting or postal addresses for the contact
endpoint	S	0..*	Reference(Plan-Net Endpoint)	Technical endpoint
network	S	0..*	Reference(Plan-Net Network)	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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value		0..1	Quantity	Maximum value allowed
code		0..1	CodeableConcept	Benefit limit details
plan		0..*	BackboneElement	Cost sharing details for the plan
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier	Σ	0..*	Identifier	Business Identifier for Product
type	S	0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible)
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies
network		0..*	Reference(Plan-Net Network)	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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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	Conformance	ValueSet / Code	URI
InsurancePlan.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
InsurancePlan.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
InsurancePlan.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
InsurancePlan.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
InsurancePlan.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
InsurancePlan.status	required	Fixed Value: active http://hl7.org/fhir/ValueSet/publication-status|4.0.1 from the FHIR Standard
InsurancePlan.type	extensible	InsuranceProductTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsuranceProductTypeVS
InsurancePlan.contact.purpose	extensible	ContactEntityType http://hl7.org/fhir/ValueSet/contactentity-type from the FHIR Standard
InsurancePlan.contact.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.system	required	ContactPointSystem http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1 from the FHIR Standard
InsurancePlan.contact.telecom.use	required	ContactPointUse http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1 from the FHIR Standard
InsurancePlan.plan.type	extensible	InsurancePlanTypeVS http://hl7.org/fhir/us/davinci-pdex-plan-net/ValueSet/InsurancePlanTypeVS
InsurancePlan.plan.specificCost.benefit.cost.applicability	required	BenefitCostApplicability http://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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	**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()
ipn-1	error	InsurancePlan	The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0
network-or-plan-Network	error	InsurancePlan	If an insuranceplan does not define a network, then each plan must define one : network.exists() or plan.network.exists.allTrue()
plan-type-is-distinct	error	InsurancePlan	Each InsurancePlan.plan should have a distinct plan.type. : plan.type.coding.code.isDistinct()

This structure is derived from PlannetInsurancePlan

Summary

Other representations of profile: CSV, Excel, Schematron