v3-xRoleClassCoverage
type: ValueSet
node role: treeRoot
id:
  v: v3-xRoleClassCoverage
language:
  v: en
text:
  status:
    v: extensions
  div: Generated Narrative: ValueSet v3-xRoleClassCoverage Language: en Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-RoleClass version ?4.0.0 Code Display Definition COVPTY covered party A role class played by a person who receives benefit coverage under the terms of a particular insurance policy. The underwriter of that policy is the scoping entity. The covered party receives coverage because of some contractual or other relationship with the holder of that policy. *Discussion:*This reason for coverage is captured in 'Role.code' and a relationship link with type code of indirect authority should be included using the policy holder role as the source, and the covered party role as the target. Note that a particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder. POLHOLD policy holder A role played by a person or organization that holds an insurance policy. The underwriter of that policy is the scoping entity. *Discussion:*The identifier of the policy is captured in 'Role.id' when the Role is a policy holder. A particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder. SPNSR coverage sponsor A role played by an entity, usually an organization that is the sponsor of an insurance plan or a health program. A sponsor is the party that is ultimately accountable for the coverage by employment contract or by law. A sponsor can be an employer, union, government agency, or association. Fully insured sponsors establish the terms of the plan and contract with health insurance plans to assume the risk and to administer the plan. Self-insured sponsors delegate coverage administration, but not risk, to third-party administrators. Program sponsors designate services to be covered in accord…
extension:
  extension:
    url:
      v: name
    value: string
      v: Name:Class
  extension:
    url:
      v: value
    value: string
      v: planCoverage
  url:
    v: http://terminology.hl7.org/StructureDefinition/ext-mif-assocConceptProp
extension:
  extension:
    url:
      v: name
    value: string
      v: Name:Role:player:Entity
  extension:
    url:
      v: value
    value: string
      v: covered&
  url:
    v: http://terminology.hl7.org/StructureDefinition/ext-mif-assocConceptProp
extension:
  extension:
    url:
      v: name
    value: string
      v: Name:Role:scoper:Entity
  extension:
    url:
      v: value
    value: string
      v: coverageSponsor
  url:
    v: http://terminology.hl7.org/StructureDefinition/ext-mif-assocConceptProp
extension:
  extension:
    url:
      v: name
    value: string
      v: Sort:Entity:playedRole:Role
  extension:
    url:
      v: value
    value: string
      v: AAAAI____
  url:
    v: http://terminology.hl7.org/StructureDefinition/ext-mif-assocConceptProp
extension:
  extension:
    url:
      v: name
    value: string
      v: Sort:Entity:scopedRole:Role
  extension:
    url:
      v: value
    value: string
      v: AAAAI____
  url:
    v: http://terminology.hl7.org/StructureDefinition/ext-mif-assocConceptProp
url:
  v: http://terminology.hl7.org/ValueSet/v3-xRoleClassCoverage
identifier:
  system:
    v: urn:ietf:rfc:3986
  value:
    v: urn:oid:2.16.840.1.113883.1.11.14008
version:
  v: 3.0.0
name:
  v: XRoleClassCoverage
title:
  v: x_RoleClassCoverage
status:
  v: active
experimental:
  v: false
date:
  v: 2014-03-26
publisher:
  v: Health Level Seven International
contact:
  telecom:
    system:
      v: url
    value:
      v: http://hl7.org
  telecom:
    system:
      v: email
description:
  v: An abstract domain that encompasses the roles that arise in the context of providing, purchasing, and managing health care coverage and insurance.
copyright:
  v: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
compose:
  include:
    system:
      v: http://terminology.hl7.org/CodeSystem/v3-RoleClass
    concept:
      code:
        v: COVPTY
    concept:
      code:
        v: POLHOLD
    concept:
      code:
        v: SPNSR
    concept:
      code:
        v: UNDWRT