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
9
-
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.
HD-07
Count
Numeric (N0)
Optional
1
9
-
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.
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 with which the insurance plan is affiliated
HD-11
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
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.