HD Health Coverage

To provide information on health coverage

Position
Element
Name
Type
Requirement
Min
Max
Repeat
HD-01
Maintenance Type Code
Identifier (ID)
Mandatory
3
3
-
Code identifying the specific type of item maintenance.
HD-02
Maintenance Reason Code
Identifier (ID)
Optional
2
3
-
Code identifying the reason for the maintenance change.
HD-03
Insurance Line Code
Identifier (ID)
Optional
2
3
-
Code identifying a group of insurance products.
HD-04
Plan Coverage Description
String (AN)
Optional
1
50
-
A description or number that identifies the plan or coverage.
HD-05
Coverage Level Code
Identifier (ID)
Optional
3
3
-
Code indicating the level of coverage being provided for this insured
HD-06
Count
Numeric (N0)
Optional
1
6
-
Occurence counter
HD06 is the number of collateral dependents for the primary insured. A collateral dependent is a relative related by blood or marriage who resides in the home and is dependent on the employee for support.
HD-07
Count
Numeric (N0)
Optional
1
6
-
Occurence counter
HD07 is the number of sponsored dependents for the primary insured. A sponsored dependent is a dependent between the ages of 19 and 25, not in school.
HD-08
Underwriting Decision Code
Identifier (ID)
Optional
1
1
-
Code indicating the decision made by the underwriter
HD-09
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
-
Code indicating a Yes or No condition or response.
HD09 is a late enrollee indicator. A ``Y'' value indicates the insured is a late enrollee, which can result in a reduction of benefits. An ``N'' value indicates the insured is a regular enrollee.
HD-10
Drug House Code
Identifier (ID)
Optional
2
3
-
Code indicating a drug house that the insurance plan is affiliated with.
HD-11
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
-
Code indicating a Yes or No condition or response.
HD11 is Prescription Drug Service Coverage Indicator. A ``Y'' value indicates that Prescription Drug Service coverage applies. An ``N'' value indicates that Prescription Drug Service coverage does not apply.

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