<?xml version="1.0" encoding="UTF-8"?><CoverageEligibilityResponse xmlns="http://hl7.org/fhir">
	<id value="E2502"/>

	<text>
		<status value="generated"/>
		<div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the CoverageEligibilityResponse.</div>
	</text>

	<contained>
		<Coverage>
			<id value="coverage-1"/>

			<identifier>
				<system value="http://benefitsinc.com/certificate"/>
				<value value="12345"/>
			</identifier>

			<status value="active"/>
			
			<kind value="insurance"/>

			<type>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
					<code value="EHCPOL"/>
				</coding>
			</type>

			<subscriber>
				<reference value="Patient/f201"/>
			</subscriber>

			<beneficiary>
				<reference value="Patient/f201"/>
			</beneficiary>
			<dependent value="1"/>

			<relationship>
				<coding>
					<code value="self"/>
				</coding>
			</relationship>

			<insurer>
				<identifier>
					<system value="http://www.bindb.com/bin"/>
					<value value="123456"/>
				</identifier>
			</insurer>

			<class>
				<type>
					<coding>
						<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
						<code value="EHCPOL"/>
					</coding>
				</type>
				<value>
					<value value="CBI35"/>
				</value>
				<name value="Corporate Baker's Inc. Plan#35"/>
			</class>

			<class>
				<type>
					<coding>
						<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
						<code value="subplan"/>
					</coding>
				</type>
				<value>
					<value value="123"/>
				</value>
				<name value="Trainee Part-time Benefits"/>
			</class>

			<class>
				<type>
					<coding>
						<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
						<code value="sequence"/>
					</coding>
				</type>
				<value>
					<value value="1"/>
				</value>
			</class>

		</Coverage>
	</contained>

	<identifier>
		<system value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"/>
		<value value="8812342"/>
	</identifier>

	<status value="active"/>
	
	<purpose value="validation"/>
	<purpose value="benefits"/>

	<patient>
		<reference value="Patient/f201"/>
	</patient>

	<created value="2014-09-16"/>

	<requestor>
		<identifier>
			<system value="http://national.org/clinic"/>
			<value value="OR1234"/>
		</identifier>   
	</requestor>

	<request>
		<reference value="http://www.BenefitsInc.com/fhir/coverageeligibilityrequest/225476332405"/>
	</request>

	<outcome value="complete"/>

	<disposition value="Policy is currently in-force."/>

	<insurer>
		<reference value="Organization/2"/>
	</insurer>

	<insurance>
		<coverage>
			<reference value="#coverage-1"/>
		</coverage>

		<inforce value="true"/>

		<item>
			<category>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
					<code value="30"/>
					<display value="Health Benefit Plan Coverage"/>
				</coding>
			</category>

			<network>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
					<code value="in"/>
				</coding>
			</network>

			<unit>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
					<code value="individual"/>
				</coding>
			</unit>

			<term>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
					<code value="annual"/>
				</coding>
			</term>

			<benefit>
				<type>
					<coding>
						<code value="benefit"/>
					</coding>
				</type>

				<allowedMoney>
					<value value="500000"/>
					<currency value="USD"/> 
				</allowedMoney>

				<usedMoney>
					<value value="3748.00"/>
					<currency value="USD"/> 
				</usedMoney>

			</benefit>

			<benefit>
				<type>
					<coding>
						<code value="copay-maximum"/>
					</coding>
				</type>

				<allowedMoney>
					<value value="100"/>
					<currency value="USD"/> 
				</allowedMoney>
			</benefit>

			<benefit>
				<type>
					<coding>
						<code value="copay-percent"/>
					</coding>
				</type>

				<allowedUnsignedInt value="20"/>
			</benefit>
		</item>

		<item>
			<category>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
					<code value="69"/>
					<display value="Maternity"/>
				</coding>
			</category>

			<network>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
					<code value="in"/>
				</coding>
			</network>

			<unit>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
					<code value="individual"/>
				</coding>
			</unit>

			<term>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
					<code value="annual"/>
				</coding>
			</term>

			<benefit>
				<type>
					<coding>
						<code value="benefit"/>
					</coding>
				</type>

				<allowedMoney>
					<value value="15000"/>
					<currency value="USD"/> 
				</allowedMoney>
			</benefit>

		</item>
		<item>
			<category>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
					<code value="F3"/>
					<display value="Dental Coverage"/>
				</coding>
			</category>

			<network>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
					<code value="in"/>
				</coding>
			</network>

			<unit>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
					<code value="individual"/>
				</coding>
			</unit>

			<term>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
					<code value="annual"/>
				</coding>
			</term>

			<benefit>
				<type>
					<coding>
						<code value="benefit"/>
					</coding>
				</type>

				<allowedMoney>
					<value value="2000"/>
					<currency value="USD"/> 
				</allowedMoney>
			</benefit>

		</item>
		<item>
			<category>
				<coding>
					<system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
					<code value="F6"/>
					<display value="Vision Coverage"/>
				</coding>
			</category>

			<excluded value="true"/>   <!--  this benefit category is not covered under the plan  -->
			<name value="Vision"/>
			<description value="Vision products and services such as exams, glasses and contact lenses."/>

		</item>
	</insurance>

	<form>
		<coding>
			<system value="http://national.org/form"/>
			<code value="ELRSP/2017/01"/>
		</coding>
	</form>

</CoverageEligibilityResponse>