Co-Payment AmtCo-Payment PctCoverage LimitCoverage Type
| Business Data Model Data Model |
| Description | The coverage to which a subscriber of the insurance plan is entitled. The insurance plan coverage represents a basic set of information about the coverages of an insurance plan known to the healthcare provider. |
| Attributes | |
| Co-Payment Amt |
|
| Co-Payment Pct |
|
| Coverage Limit |
|
| Coverage Type |
|
| Relationship | |
 Health Plan Coverage_Health Plan_FK |
|
| Dependencies | |
 NONE |
|
| Reverse Dependencies | |
| |
|
| Attribute Details |
Co-Payment Amt
| Description | The specific co-payment amount applying to all benefits under the coverage. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Co-Payment Pct
| Description | The specific co-payment percentage applying to all benefits for the coverage. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Coverage Limit
| Description | The maximum amount that can be received in eligible benefits for the coverage. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Coverage Type
| Description | Indicates the type of the benefit coverage. For example: Dental Coverage Hospital Indemnity Coverage Pharmacy Coverage Well-baby Care Preventive Care (such as exams) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Enumeration [VARCHAR(20)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Health Plan Coverage_Health Plan_FK
| Is Identifying Relationship | true |
| Child Table | Insurance Plan Coverage |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Insurance Plan |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Business Data Model Data Model |