This abstract class is used as the parent of HealthPlan and HealthcarePolicy because there are many instances where one needs to refer to one or another. HealthPlan can be thought of as a generic product offering (e.g., Bronze, Silver, Gold plans), whereas the HealthcarePolicy is an individual instance of the Plan contracted to a given entity (either an individual or an organization such as an employer). However, some HealthPlans, such as a governmetn benefits plan do not have individual policies. Therefore, this superclass is used to generically reference either subclass as needed.

Attributes
Organization	administeredBy	"An organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner." - HL7 FHIR, InsurancePlan.administeredBy
ProviderNetwork	network	"The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the in-network rate, otherwise out-of-network terms and conditions apply." - HL7 FHIR, Coverage.network "Reference to the network included in the health insurance product." - HL7 FHIR, InsurancePlan.network "Reference to the network that providing the type of coverage." - HL7 FHIR, InsurancePlan.plan.network
Payer	payer	Pointer to the Payer which offers the Health Plan or the Healthcare Policy. "The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements." - HL7 FHIR, Coverage.payor "The entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as Payers." - HL7 FHIR, InsurancePlan.ownedBy

 administeredBy

Public Organization administeredBy

"An organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner." - HL7 FHIR, InsurancePlan.administeredBy

Constraints:

Properties:

Aggregation	None
Alias
Association	planOrPolicy_administeredBy
Association End
Class	PlanOrPolicy
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	administeredBy
Name Expression
Namespace	PlanOrPolicy
Opposite
Owner	PlanOrPolicy
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::PlanOrPolicy::administeredBy
Stereotype
Template Parameter
Type	Organization
Upper	1
Upper Value	(1)
Visibility	Public

 network

Public ProviderNetwork network

"The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the in-network rate, otherwise out-of-network terms and conditions apply." - HL7 FHIR, Coverage.network
"Reference to the network included in the health insurance product." - HL7 FHIR, InsurancePlan.network
"Reference to the network that providing the type of coverage." - HL7 FHIR, InsurancePlan.plan.network

Constraints:

Properties:

Aggregation	None
Alias
Association	planOrPolicy_network
Association End
Class	PlanOrPolicy
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	network
Name Expression
Namespace	PlanOrPolicy
Opposite
Owner	PlanOrPolicy
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::PlanOrPolicy::network
Stereotype
Template Parameter
Type	ProviderNetwork
Upper	1
Upper Value	(1)
Visibility	Public

 payer

Public Payer payer

Pointer to the Payer which offers the Health Plan or the Healthcare Policy.
"The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements." - HL7 FHIR, Coverage.payor
"The entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as Payers." - HL7 FHIR, InsurancePlan.ownedBy

Constraints:

Properties:

Aggregation	None
Alias
Association	payer_planOrPolicy
Association End
Class	PlanOrPolicy
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	payer
Name Expression
Namespace	PlanOrPolicy
Opposite	planOrPolicy
Owner	PlanOrPolicy
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::PlanOrPolicy::payer
Stereotype
Template Parameter
Type	Payer
Upper	1
Upper Value	(1)
Visibility	Public