INS Insured Benefit
Opt
AtMax 1
To provide benefit information on insured entities
Elements
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| 1 | 1073 | Yes/No Condition or Response Code | Mandatory | ID | 1/1 | Exact 1 |
| 2 | 1069 | Individual Relationship Code | Mandatory | ID | 2/2 | Exact 1 |
| 3 | 875 | Maintenance Type Code | Opt | ID | 3/3 | Exact 1 |
| 4 | 1203 | Maintenance Reason Code | Opt | ID | 2/3 | Exact 1 |
| 5 | 1216 | Benefit Status Code | Opt | ID | 1/1 | Exact 1 |
| 6 | 1218 | Medicare Plan Code | Opt | ID | 1/1 | Exact 1 |
| 7 | 1219 | Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event Code | Opt | ID | 1/2 | Exact 1 |
| 8 | 584 | Employment Status Code | Opt | ID | 2/2 | Exact 1 |
| 9 | 1220 | Student Status Code | Opt | ID | 1/1 | Exact 1 |
| 10 | 1073 | Yes/No Condition or Response Code | Opt | ID | 1/1 | Exact 1 |
| 11 | 1250 | Date Time Period Format Qualifier | Rel | ID | 2/3 | Exact 1 |
| 12 | 1251 | Date Time Period | Rel | Alphanumeric | 1/35 | Exact 1 |
| 13 | 1165 | Confidentiality Code | Opt | ID | 1/1 | Exact 1 |
| 14 | 19 | City Name | Opt | Alphanumeric | 2/30 | Exact 1 |
| 15 | 156 | State or Province Code | Opt | ID | 2/2 | Exact 1 |
| 16 | 26 | Country Code | Opt | ID | 2/3 | Exact 1 |
| 17 | 1470 | Number | Opt | Number | 1/9 | Exact 1 |
Element Details
ID1073
NameYes/No Condition or Response Code
LengthMin 1 / Max 1
Position1
RequirementMandatory
Codes
- <>WNot Applicable
- <>NNo
- <>UUnknown
- <>YYes