Value Set CoveredPartyRoleType 2011‑07‑26

• CoveredPartyRoleType DEFN=UV=VO=1360-20160323 - 2014‑03‑26

A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.

Example: An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.

Discussion: The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.