HD Health Coverage

To provide information on health coverage

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Position

Element

Name

Type

Requirement

Min

Max

Repeat

HD01

875

Maintenance Type Code

Identifier (ID)

Mandatory

Code identifying the specific type of item maintenance

HD02

1203

Maintenance Reason Code

Identifier (ID)

Optional

Code identifying the reason for the maintenance change

HD03

1205

Insurance Line Code

Identifier (ID)

Optional

Code identifying a group of insurance products

HD04

1204

Plan Coverage Description

String (AN)

Optional

A description or number that identifies the plan or coverage

HD05

1207

Coverage Level Code

Identifier (ID)

Optional

Code indicating the level of coverage being provided for this insured

HD06

609

Count

Numeric (N0)

Optional

Occurrence 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.

HD07

609

Count

Numeric (N0)

Optional

Occurrence 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 who is not in school.

HD08

1209

Underwriting Decision Code

Identifier (ID)

Optional

Code indicating the decision made by the underwriter

HD09

1073

Yes/No Condition or Response Code

Identifier (ID)

Optional

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.

HD10

1211

Drug House Code

Identifier (ID)

Optional

Code indicating a drug house with which the insurance plan is affiliated

HD11

1073

Yes/No Condition or Response Code

Identifier (ID)

Optional

Code indicating a Yes or No condition or response

HD11 is a 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.