<!--
The notices below are provided with respect to licensed content incorporated herein:
Copyright HR-XML Consortium. All Rights Reserved. http://www.hrxmlconsortium.org and http://www.hr-xml.org. Terms of license can be found in license.pdf.
Copyright (c) 1997-2009 Open Applications Group, Inc. All Rights Reserved. http://www.openapplications.org
-->
<xsd:schema xmlns="http://www.hr-xml.org/3" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:ccts="urn:un:unece:uncefact:documentation:1.1" xmlns:oa="http://www.openapplications.org/oagis/9" targetNamespace="http://www.hr-xml.org/3" elementFormDefault="qualified" attributeFormDefault="unqualified" version="3.0">
<xsd:annotation>
<xsd:documentation>
Name: USEnrollment.xsd
Status: 3.0 Public Release
Date this version: 2009-Sep-23
</xsd:documentation>
</xsd:annotation>
<xsd:import namespace="http://www.openapplications.org/oagis/9" schemaLocation="../../../../org_openapplications_platform/1_1/Common/OAGi/Components/Components.xsd"/>
<xsd:include schemaLocation="../Common/Components.xsd"/>
<xsd:element name="USEnrollment" type="USEnrollmentType"/>
<xsd:complexType name="USEnrollmentType">
<xsd:annotation>
<xsd:documentation source="http://www.hr-xml.org" xml:lang="en">
<ccts:DictionaryEntryName>US Enrollment. Details</ccts:DictionaryEntryName>
<ccts:DefinitionText>A collection of information to execute subscriber enrollments and maintenance within tier coverages (health care) and spending account accounts within the U.S. market.</ccts:DefinitionText>
</xsd:documentation>
</xsd:annotation>
<xsd:sequence>
<xsd:group ref="DocumentIDGroup" minOccurs="0"/>
<xsd:element ref="DocumentSequence" minOccurs="0"/>
<xsd:element ref="CustomerParty" minOccurs="0"/>
<xsd:element ref="BenefitsAdministratorID" minOccurs="0"/>
<xsd:element ref="SubscriberDetails" minOccurs="0"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
<xsd:attributeGroup ref="EffectiveDateAttributeGroup"/>
</xsd:complexType>
<xsd:element name="SubscriberDetails" type="SubscriberDetailsType"/>
<xsd:complexType name="SubscriberDetailsType">
<xsd:annotation>
<xsd:documentation>The Subscriber element is a required element containing information about the individual with an ability to enroll in the benefits program(s) based on a relationship with the Organization sponsoring the benefit program(s).</xsd:documentation>
</xsd:annotation>
<xsd:sequence>
<xsd:element ref="ID" minOccurs="0"/>
<xsd:element ref="SubscriberPerson" minOccurs="0"/>
<xsd:element ref="SubscriberEmployee" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="SubscriberEmployment" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="SubscriberDeployment" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="USHealthCoverage" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="USRateBasedCoverage" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="SpendingAccountCoverage" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="HIPAA" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="Medicare" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="Medicaid" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="SubscriberDependent" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
<xsd:attributeGroup ref="EffectiveDateAttributeGroup"/>
</xsd:complexType>
<xsd:element name="HIPAA" type="HIPAAType">
<xsd:annotation>
<xsd:documentation>Contain information relevant to compliance under the U.S. Health Insurance Portability </xsd:documentation>
</xsd:annotation>
</xsd:element>
<xsd:element name="Medicaid" type="MedicaidType"/>
<xsd:element name="Medicare" type="MedicareType"/>
<xsd:complexType name="HIPAAType">
<xsd:annotation>
<xsd:documentation>Contains details relavent to compliance with provisions under the
U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA). Reports the
number of prior months during which the person had medical coverage.
HIPAA Title I limits restrictions that a group health plan can place on benefits for
preexisting conditions. Group health plans may refuse to provide benefits relating
to preexisting conditions for a period of 12 months after enrollment in the plan or 18
months in the case of late enrollment. However, individuals may reduce this exclusion
period if they had group health plan coverage or health insurance prior to enrolling in
the plan. Title I allows individuals to reduce the exclusion period by the amount of
time that they had "creditable coverage" prior to enrolling in the plan and after any
"significant breaks" in coverage.</xsd:documentation>
</xsd:annotation>
<xsd:sequence>
<xsd:element ref="PriorCoverageMonths"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
<xsd:attributeGroup ref="EffectiveDateAttributeGroup"/>
</xsd:complexType>
<xsd:complexType name="MedicaidType">
<xsd:sequence>
<xsd:element ref="StartDate"/>
<xsd:element ref="EndDate" minOccurs="0"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
<xsd:attributeGroup ref="EffectiveDateAttributeGroup"/>
</xsd:complexType>
<xsd:complexType name="MedicareType">
<xsd:sequence>
<xsd:element ref="MedicareEntitlementDetails" minOccurs="0">
<xsd:annotation>
<xsd:documentation>Contains U.S. Medicare information for a subcriber or dependent.</xsd:documentation>
</xsd:annotation>
</xsd:element>
<xsd:element ref="HealthInsuranceClaimNumberID" minOccurs="0"/>
<xsd:element ref="MedicarePartA" minOccurs="0"/>
<xsd:element ref="MedicarePartB" minOccurs="0"/>
<xsd:element ref="MedicarePartD" minOccurs="0"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
<xsd:attributeGroup ref="EffectiveDateAttributeGroup"/>
</xsd:complexType>
<xsd:element name="MedicareEntitlementDetails" type="MedicareEntitlementDetailsType"/>
<xsd:complexType name="MedicareEntitlementDetailsType">
<xsd:annotation>
<xsd:documentation>Contains information indicating whether the individual is entitled to the U.S. Medicare program and relevant effective dating.</xsd:documentation>
</xsd:annotation>
<xsd:sequence>
<xsd:element ref="MedicareEligibleCode" minOccurs="0"/>
<xsd:element ref="MedicareEntitlementReasonCode" minOccurs="0"/>
<xsd:element ref="StartDate" minOccurs="0"/>
<xsd:element ref="EndDate" minOccurs="0"/>
</xsd:sequence>
</xsd:complexType>
<xsd:element name="MedicareEntitlementReasonCode" type="MedicareEntitlementReasonCodeType"/>
<xsd:complexType name="MedicareEntitlementReasonCodeType">
<xsd:annotation>
<xsd:documentation>Codes classifying the reason for entitlement under the U.S. Medicare program.</xsd:documentation>
</xsd:annotation>
<xsd:simpleContent>
<xsd:extension base="MedicareEntitlementReasonCodeContentType">
<xsd:attributeGroup ref="oa:CodeListAttributeGroup"/>
</xsd:extension>
</xsd:simpleContent>
</xsd:complexType>
<xsd:element name="DrugPlanCoverageCode" type="DrugPlanCoverageCodeType"/>
<xsd:complexType name="DrugPlanCoverageCodeType">
<xsd:annotation>
<xsd:documentation>Codes classifying the type of drug plan coverage under U.S. Medicare Part D.</xsd:documentation>
</xsd:annotation>
<xsd:simpleContent>
<xsd:extension base="DrugPlanCoverageCodeContentType">
<xsd:attributeGroup ref="oa:CodeListAttributeGroup"/>
</xsd:extension>
</xsd:simpleContent>
</xsd:complexType>
<xsd:element name="MedicareEligibleCode" type="MedicareEligibleCodeType"/>
<xsd:complexType name="MedicareEligibleCodeType">
<xsd:annotation>
<xsd:documentation>Codes classifying a person's eligibility under the U.S. Medicare program. Medicare eligibility is determined by whether an individual meets the legal requirements for Medicare coverage.</xsd:documentation>
</xsd:annotation>
<xsd:simpleContent>
<xsd:extension base="MedicareEligibleCodeContentType">
<xsd:attributeGroup ref="oa:CodeListAttributeGroup"/>
</xsd:extension>
</xsd:simpleContent>
</xsd:complexType>
<xsd:element name="MedicarePartA" type="MedicarePartAType"/>
<xsd:complexType name="MedicarePartAType">
<xsd:complexContent>
<xsd:extension base="MedicareEnrollmentBaseType"/>
</xsd:complexContent>
</xsd:complexType>
<xsd:element name="MedicarePartB" type="MedicarePartBType"/>
<xsd:complexType name="MedicarePartBType">
<xsd:complexContent>
<xsd:extension base="MedicareEnrollmentBaseType"/>
</xsd:complexContent>
</xsd:complexType>
<xsd:element name="MedicarePartD" type="MedicarePartDType"/>
<xsd:complexType name="MedicarePartDType">
<xsd:annotation>
<xsd:documentation>Pertains to the U.S. Medicare project. Contains information about the individual's Medicare Part D program enrollment as well as details about the specific drug plan in which the individual is enrolled.</xsd:documentation>
</xsd:annotation>
<xsd:sequence>
<xsd:element ref="EnrollmentIndicator"/>
<xsd:element ref="StartDate" minOccurs="0"/>
<xsd:element ref="EndDate" minOccurs="0"/>
<xsd:element ref="UniqueBenefitOptionID"/>
<xsd:element ref="DrugPlanCoverageCode" minOccurs="0"/>
<xsd:element ref="StartDate" minOccurs="0"/>
<xsd:element ref="EndDate" minOccurs="0"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
</xsd:complexType>
<xsd:complexType name="MedicareEnrollmentBaseType">
<xsd:sequence>
<xsd:element ref="EnrollmentIndicator"/>
<xsd:element ref="StartDate" minOccurs="0"/>
<xsd:element ref="EndDate" minOccurs="0"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
</xsd:complexType>
<xsd:element name="SubscriberDependent" type="SubscriberDependentType"/>
<xsd:complexType name="SubscriberDependentType">
<xsd:complexContent>
<xsd:extension base="DependentPersonDossierBaseType">
<xsd:sequence>
<xsd:element ref="CustodialParent" minOccurs="0"/>
<xsd:element ref="ResponsiblePerson" minOccurs="0"/>
<xsd:element ref="USHealthCoverage" minOccurs="0"/>
<xsd:element ref="SpendingAccountCoverage" minOccurs="0"/>
<xsd:element ref="HIPAA" minOccurs="0"/>
<xsd:element ref="Medicare" minOccurs="0"/>
<xsd:element ref="Medicaid" minOccurs="0"/>
<xsd:element ref="EducationOrganization" minOccurs="0"/>
<xsd:element ref="UserArea" minOccurs="0"/>
</xsd:sequence>
<xsd:attributeGroup ref="EffectiveDateAttributeGroup"/>
</xsd:extension>
</xsd:complexContent>
</xsd:complexType>
</xsd:schema>
|
XSD Schema Code: