HD Health Coverage

To provide information on health coverage

Position: HD-01 · Element: 875 · Name: Maintenance Type Code · Type: Identifier (ID) · Requirement: Mandatory · Min: 3 · Max: 3 · Repeat: 1

Code identifying the specific type of item maintenance

Position: HD-02 · Element: 1203 · Name: Maintenance Reason Code · Type: Identifier (ID) · Requirement: Optional · Min: 2 · Max: 3 · Repeat: 1

Code identifying the reason for the maintenance change

Position: HD-03 · Element: 1205 · Name: Insurance Line Code · Type: Identifier (ID) · Requirement: Optional · Min: 2 · Max: 3 · Repeat: 1

Code identifying a group of insurance products

Position: HD-04 · Element: 1204 · Name: Plan Coverage Description · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 50 · Repeat: 1

A description or number that identifies the plan or coverage

Position: HD-05 · Element: 1207 · Name: Coverage Level Code · Type: Identifier (ID) · Requirement: Optional · Min: 3 · Max: 3 · Repeat: 1

Code indicating the level of coverage being provided for this insured

Position: HD-06 · Element: 609 · Name: Count · Type: Numeric (N0) · Requirement: Optional · Min: 1 · Max: 9 · Repeat: 1

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.

Position: HD-07 · Element: 609 · Name: Count · Type: Numeric (N0) · Requirement: Optional · Min: 1 · Max: 9 · Repeat: 1

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.

Position: HD-08 · Element: 1209 · Name: Underwriting Decision Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: 1

Code indicating the decision made by the underwriter

Position: HD-09 · Element: 1073 · Name: Yes/No Condition or Response Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: 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.

Position: HD-10 · Element: 1211 · Name: Drug House Code · Type: Identifier (ID) · Requirement: Optional · Min: 2 · Max: 3 · Repeat: 1

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

Position: HD-11 · Element: 1073 · Name: Yes/No Condition or Response Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: 1

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.