| AllowedLimit |
- Type
- string
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Maximum amount that will be paid for the service.
|
| AllowedQuantity |
- Type
- double
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- The maximum quantity allowed of the coverage benefit item.
- This field is available in API Version 62.0 and later.
|
| AllowedQuantityUnitId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The unit of measure for the allowed quantity of the coverage
benefit item.
- This field is a relationship field.
- This field is available in API Version 62.0 and later.
- Relationship Name
- AllowedQuantityUnit
- Refers To
- UnitOfMeasure
|
| AppliedLimit |
- Type
- string
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Specifies whether the benefit has been claimed.
|
| AppliedQuantity |
- Type
- double
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- The quantity of the coverage benefit item already used by the
member.
- This field is available in API Version 62.0 and later.
|
| AppliedQuantityUnitId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- The unit of measure for the applied quantity of the coverage
benefit item.
- This field is a relationship field.
- This field is available in API Version 62.0 and later.
- Relationship Name
- AppliedQuantityUnit
- Refers To
- UnitOfMeasure
|
| CareLimitTypeId |
- Type
- reference
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Specifies whether the limit is a required payment or excluded
service.
- This is a relationship field.
- Relationship Name
- CareLimitType
- Relationship Type
- Lookup
- Refers To
- CareLimitType
|
| CoverageBenefitItemId |
- Type
- reference
- Properties
- Create, Filter, Group, Sort
- Description
- Specific service covered by the insurance plan.
- This is a relationship field.
- Relationship Name
- CoverageBenefitItem
- Relationship Type
- Lookup
- Refers To
- CoverageBenefitItem
|
| CoverageLevel |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- Defines the persons eligible for the benefit item.
- Possible values are:
-
EmployeeSpouse—Employee & Spouse
- Family
- Individual
|
| 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.
|
| LimitNotes |
- Type
- textarea
- Properties
- Create, Nillable, Update
- Description
- General information about the limit.
|
| Name |
- Type
- string
- Properties
- Create, Filter, Group, idLookup, Sort, Update
- Description
- The name of the coverage benefit item limit.
|
| NetworkType |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Restricted picklist, Sort,
Update
- Description
- Specifies whether the benefit refers to in-network providers or
out-of-network providers.
- Possible values are:
-
In—In-network
providers
-
NA—Not applicable
-
Out—Out-of-network
providers
- If the related CoverageBenefitItem record has an
IsInPlanNetwork value of true,
NetworkType is typically In. If the related record has an
IsInPlanNetwork value of false,
NetworkType can be any value.
-
|
| PriorityOrder |
- Type
- double
- Properties
- Create, Filter, Nillable, Sort, Update
- Description
- This limit's position in the sequence for calculating limits.
|
| TermType |
- Type
- picklist
- Properties
- Create, Filter, Group, Nillable, Sort, Update
- Description
- Specifies the type of time period during which the benefit item is
available.
- Possible values are:
- Calendar Year
- Day
- Month
- Year to Date
|
j