PlanBenefit

Represents the standard benefits available under a plan that the purchaser offers to their members.

Supported Calls

create(), delete(), describeLayout(), describeSObjects(), getDeleted(), getUpdated(), query(), retrieve(), search(), undelete(), update(), upsert()

Fields

Field Name	Details
BenefitNotes	Type textarea Properties Create, Nillable, Update Description Additional information about the benefits available to members under this plan’s coverage.
CoinsuranceNotes	Type textarea Properties Create, Nillable, Update Description Information about the contribution a member makes towards treatment.
CopayNotes	Type textarea Properties Create, Nillable, Update Description Additional information on the copayment amounts that members contribute.
DeductibleNotes	Type textarea Properties Create, Nillable, Update Description Additional information about a member’s deductibles.
DocumentLocation	Type url Properties Create, Nillable, Update Description Hyperlink to internal or external resources.
EffectiveDate	Type date Properties Create, Filter, Group, Nillable, Sort, Update Description The date on which these benefits are communicated to plan members.
EffectiveFrom	Type date Properties Create, Filter, Group, Nillable, Sort, Update Description The date on which these benefits become effective.
EffectiveTo	Type date Properties Create, Filter, Group, Nillable, Sort, Update Description The date on which these benefits ceased to be effective.
EmergencyDepartmentCopay	Type currency Properties Create, Filter, Nillable, Sort, Update Description Patient's portion of payment for using emergency department services.
FamilyInNetworkDeductible	Type currency Properties Create, Filter, Nillable, Sort, Update Description The amount a member pays for health care provided by the health plan’s preferred providers for all family members. When this amount is reached, the plan starts to contribute towards treatment.
FamilyInNetworkOutofPocket	Type currency Properties Create, Filter, Nillable, Sort, Update Description The most a member pays during a coverage year for health care provided by the health plan’s preferred providers for all family members. It includes deductibles, copayments, and coinsurance, but is in addition to premiums.
FamilyOutofNetworkDeductible	Type currency Properties Create, Filter, Nillable, Sort, Update Description The amount a member pay for health care provided by non-preferred providers for all family members before this plan starts to contribute towards treatment.
FamilyOutofNetworkOutofPocket	Type currency Properties Create, Filter, Nillable, Sort, Update Description The most a member pays during a coverage year for health care provided by non-preferred providers for all family members. It includes deductibles, copayments, and coinsurance, but is in addition to premiums.
IndividualInNetworkDeductible	Type currency Properties Create, Filter, Nillable, Sort, Update Description The amount a member pays for health care provided by the health plan’s preferred providers to any one family member. When this amount is reached, the plan starts to contribute towards treatment.
IndividualInNetworkOutofPocket	Type currency Properties Create, Filter, Nillable, Sort, Update Description The most a member pays during a coverage year for health care provided by the health plan’s preferred providers for any one family member. It includes deductibles, copayments, and coinsurance, but excludes premiums.
IndividualOutofNetworkDeductible	Type currency Properties Create, Filter, Nillable, Sort, Update Description The amount a member pays for health care provided by non-preferred providers to any one family member before this plan starts to contribute towards treatment.
IndividualOutofNetworkOutofPocket	Type currency Properties Create, Filter, Nillable, Sort, Update Description The most a member pays during a coverage year for health care provided by non-preferred providers for any one family member. It includes deductibles, copayments, and coinsurance, but excludes premiums.
InNetworkCoinsuranceAmount	Type double Properties Create, Filter, Nillable, Sort, Update Description The amount a member contributes towards each treatment undertaken by the health plan’s preferred providers.
InNetworkCoinsurancePercentage	Type double Properties Create, Filter, Nillable, Sort, Update Description The percentage of treatment cost the member pays for each treatment undertaken by the health plan’s preferred providers.
InNetworkLifetimeMaximum	Type currency Properties Create, Filter, Nillable, Sort, Update Description The most a member pays during the lifetime membership on this plan for health care provided by the health plan’s preferred providers. It includes deductibles, copayments, and coinsurance, but excludes premiums.
LastReferencedDate	Type datetime Properties Filter, Nillable, Sort Description The timestamp for when the current user last viewed a record related to this record.
LastViewedDate	Type datetime Properties Filter, Nillable, Sort Description The timestamp for when the current user last viewed this record. If this value is null, it’s possible that this record was referenced (LastReferencedDate) and not viewed.
LifetimeMaximumNotes	Type textarea Properties Create, Nillable, Update Description Additional information about a member’s maximum lifetime payments.
Name	Type string Properties Create, Filter, Group, Sort, Update Description Name of these plan coverage benefits.
OutofNetworkCoinsuranceAmount	Type double Properties Create, Filter, Nillable, Sort, Update Description The amount a member contributes towards treatment undertaken by non-preferred providers.
OutofNetworkCoinsurancePercentage	Type double Properties Create, Filter, Nillable, Sort, Update Description The percentage of treatment cost the member pays for treatment undertaken by non-preferred providers.
OutofNetworkLifetimeMaximum	Type currency Properties Create, Filter, Nillable, Sort, Update Description The most a member pays during the lifetime membership on this plan for health care provided by non-preferred providers. It includes deductibles, copayments, and coinsurance, but excludes premiums.
OutofPocketNotes	Type textarea Properties Create, Nillable, Update Description Additional information about the out-of-pocket payment a member makes.
OwnerId	Type reference Properties Create, Defaulted on create, Filter, Group, Sort, Update Description The ID of the user who owns this record.
PrimaryCareCopay	Type currency Properties Create, Filter, Nillable, Sort, Update Description The amount a member contributes towards primary care treatment.
PurchaserPlanId	Type reference Properties Create, Filter, Group, Sort Description The ID of the purchaser plan offering these benefits.
SourceSystem	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description The name of the system this benefits record came from.
SourceSystemIdentifier	Type string Properties Create, Filter, Group, Nillable, Sort, Update Description The ID of this benefits record on its source system.
SourceSystemModified	Type date Properties Create, Filter, Group, Nillable, Sort, Update Description The date on which these benefits were last changed on their source system.
SpecialistCopay	Type currency Properties Create, Filter, Nillable, Sort, Update Description The amount a member contributes towards specialist consultations.
Status	Type picklist Properties Create, Filter, Group, Nillable, Sort, Update Description The status of these benefits. The default the picklist values are: Active Inactive
UrgentCareCopay	Type currency Properties Create, Filter, Nillable, Sort, Update Description The amount a member contributes towards urgent care.

Associated Objects

This object has the following associated objects. Unless noted, they are available in the same API version as this object.

PlanBenefitFeed: Feed tracking is available for the object.
PlanBenefitHistory: History is available for tracked fields of the object.
PlanBenefitOwnerSharingRule: Sharing rules are available for the object.
PlanBenefitShare: Sharing is available for the object.

Salesforce Health Cloud Developer Guide

PlanBenefit

Supported Calls

Fields

Associated Objects