{

"resourceType": "Coverage",
"id": "9876B1",
"identifier": [
  {
    "system": "http://benefitsinc.com/certificate",
    "value": "12345"
  }
],
"status": "active",
"type": {
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
      "code": "EHCPOL",
      "display": "extended healthcare"
    }
  ]
},
"policyHolder": {
  "reference": "http://benefitsinc.com/FHIR/Organization/CBI35"
},
"subscriber": {
  "reference": "Patient/4"
},
"beneficiary": {
  "reference": "Patient/4"
},
"dependent": "0",
"relationship": {
  "coding": [
    {
      "code": "self"
    }
  ]
},
"period": {
  "start": "2011-05-23",
  "end": "2012-05-23"
},
"payor": [
  {
    "reference": "Organization/2"
  }
],
"class": [
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "group"
        }
      ]
    },
    "value": "CB135",
    "name": "Corporate Baker's Inc. Local #35"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "subgroup"
        }
      ]
    },
    "value": "123",
    "name": "Trainee Part-time Benefits"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "plan"
        }
      ]
    },
    "value": "B37FC",
    "name": "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "subplan"
        }
      ]
    },
    "value": "P7",
    "name": "Includes afterlife benefits"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "class"
        }
      ]
    },
    "value": "SILVER",
    "name": "Silver: Family Plan spouse only"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "subclass"
        }
      ]
    },
    "value": "Tier2",
    "name": "Low deductable, max $20 copay"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "sequence"
        }
      ]
    },
    "value": "9"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "rxid"
        }
      ]
    },
    "value": "MDF12345"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "rxbin"
        }
      ]
    },
    "value": "987654"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "rxgroup"
        }
      ]
    },
    "value": "M35PT"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "rxpcn"
        }
      ]
    },
    "value": "234516"
  },
  {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
          "code": "sequence"
        }
      ]
    },
    "value": "9"
  }
],
"meta": {
  "tag": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
      "code": "HTEST",
      "display": "test health data"
    }
  ]
}

}