<xsd:schema xmlns="http://ns.hr-xml.org/2007-04-15" xmlns:xsd="http://www.w3.org/2001/XMLSchema" targetNamespace="http://ns.hr-xml.org/2007-04-15" elementFormDefault="qualified" version="2007-04-15">
<xsd:annotation>
<xsd:documentation>
"Copyright The HR-XML Consortium. All Rights Reserved. http://www.hr-xml.org"
Name: USTierCoverage.xsd
Status: Recommendation
Date this version: 2007-04-15
Purpose:
Author(s):
Documentation: Enrollment.html
</xsd:documentation>
</xsd:annotation>
<xsd:import namespace="http://www.w3.org/XML/1998/namespace" schemaLocation="../../../W3C/xml.xsd"/>
<xsd:include schemaLocation="../../CPO/PersonName.xsd"/>
<xsd:include schemaLocation="../../CPO/PostalAddress.xsd"/>
<xsd:include schemaLocation="../../CPO/DateTimeDataTypes.xsd"/>
<xsd:include schemaLocation="../../CPO/ContactMethod.xsd"/>
<xsd:include schemaLocation="../../CPO/TelcomNumber.xsd"/>
<xsd:include schemaLocation="../../CPO/OnlineAddress.xsd"/>
<xsd:include schemaLocation="../../CPO/EntityIdType.xsd"/>
<xsd:include schemaLocation="../../CPO/UserArea.xsd"/>
<xsd:include schemaLocation="../../CPO/ISOUtilities.xsd"/>
<xsd:include schemaLocation="../../Enrollment/EnrollmentTypes.xsd"/>
<xsd:complexType name="USTierCoverage">
<xsd:sequence>
<xsd:element name="TransactionCode" minOccurs="0">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="Add"/>
<xsd:enumeration value="Audit"/>
<xsd:enumeration value="Change"/>
<xsd:enumeration value="Correction"/>
<xsd:enumeration value="Delete"/>
<xsd:enumeration value="Employee Information Not Available"/>
<xsd:enumeration value="Reinstatement"/>
<xsd:enumeration value="Termination"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:element>
<xsd:element name="ElectedPlanCode" type="xsd:string" minOccurs="0"/>
<xsd:element name="GroupNumber" type="xsd:string" minOccurs="0"/>
<xsd:element name="COBRAStatus">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="COBRA"/>
<xsd:enumeration value="non-COBRA"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:element>
<xsd:element name="StartDate" type="LocalDateType"/>
<xsd:element name="COBRAInformation" minOccurs="0">
<xsd:complexType>
<xsd:sequence>
<xsd:element name="COBRAStartDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="COBRAEndDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="PaidThroughDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="QualifyingEventDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="QualifyingEventCode" minOccurs="0">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="Bankruptcy of a Retired Employee"/>
<xsd:enumeration value="Death"/>
<xsd:enumeration value="Divorce"/>
<xsd:enumeration value="Ineligible Child"/>
<xsd:enumeration value="Medicare"/>
<xsd:enumeration value="Reduction of work hours"/>
<xsd:enumeration value="Separation"/>
<xsd:enumeration value="Termination of Employment"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:element>
<xsd:element name="AdditionalQualifyingEventData" type="xsd:string" minOccurs="0"/>
</xsd:sequence>
</xsd:complexType>
</xsd:element>
<xsd:element name="EndDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="CoverageLevel" maxOccurs="unbounded">
<xsd:complexType>
<xsd:sequence>
<xsd:element name="CoverageLevelCode">
<xsd:simpleType>
<xsd:union memberTypes="CoverageLevelCodeType xStringPatternExtensionType"/>
</xsd:simpleType>
</xsd:element>
<xsd:element name="StartDate" type="LocalDateType"/>
</xsd:sequence>
</xsd:complexType>
</xsd:element>
<xsd:element name="Provider" minOccurs="0" maxOccurs="unbounded">
<xsd:complexType>
<xsd:sequence>
<xsd:element name="StartDate" type="LocalDateType" minOccurs="0"/>
<xsd:choice minOccurs="0">
<xsd:element name="OrganizationName" type="xsd:string" minOccurs="0"/>
<xsd:element name="PersonName" type="PersonNameType" minOccurs="0"/>
</xsd:choice>
<xsd:element name="ContactInformation" type="ContactMethodType" minOccurs="0" maxOccurs="unbounded"/>
<xsd:element name="ProviderId" minOccurs="0">
<xsd:complexType>
<xsd:simpleContent>
<xsd:extension base="xsd:string">
<xsd:attribute name="providerIdQualifier" use="required">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="Social Security Number"/>
<xsd:enumeration value="Federal Taxpayer Identification Number"/>
<xsd:enumeration value="HCFA National Provider Identifier"/>
<xsd:enumeration value="Mutually Defined"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:attribute>
</xsd:extension>
</xsd:simpleContent>
</xsd:complexType>
</xsd:element>
<xsd:element name="ProviderRelationshipCode" minOccurs="0">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="Established Patient"/>
<xsd:enumeration value="Not Established Patient"/>
<xsd:enumeration value="Not Known"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:element>
<xsd:element name="ProviderChangeReason" minOccurs="0">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="Appointment Times Not Met in a Timely Manner"/>
<xsd:enumeration value="Current Customer Information File in Error"/>
<xsd:enumeration value="Dissatisfaction with Medical Care/Services Rendered">
<xsd:annotation>
<xsd:documentation>This enumeration has been deprecated and replaced with an enumeration without the "/".</xsd:documentation>
</xsd:annotation>
</xsd:enumeration>
<xsd:enumeration value="Dissatisfaction with Office Staff"/>
<xsd:enumeration value="Dissatisfaction with Physician's Referral Policy">
<xsd:annotation>
<xsd:documentation>This enumeration has been deprecated and replaced with an enumeration without the apostrophe.</xsd:documentation>
</xsd:annotation>
</xsd:enumeration>
<xsd:enumeration value="Dissatisfied with Office Hours"/>
<xsd:enumeration value="Inconvenient Office Location"/>
<xsd:enumeration value="Less Respect/Attention/Time Given Than to Other Patients">
<xsd:annotation>
<xsd:documentation>This enumeration has been deprecated and replaced with an enumeration without the "/".</xsd:documentation>
</xsd:annotation>
</xsd:enumeration>
<xsd:enumeration value="No Reason Given"/>
<xsd:enumeration value="Patient Moved to a New Location"/>
<xsd:enumeration value="Plan Change"/>
<xsd:enumeration value="Unable to Scheduled Appointments in a Timely Manner"/>
<xsd:enumeration value="Voluntary Withdrawal"/>
<xsd:enumeration value="Dissatisfaction with Medical Care or Services Rendered"/>
<xsd:enumeration value="Dissatisfaction with Physician Referral Policy"/>
<xsd:enumeration value="Less Respect or Attention or Time Given Than to Other Patients"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:element>
</xsd:sequence>
<xsd:attribute name="providerType">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="Obstetrics and Gynecology Facility"/>
<xsd:enumeration value="Doctor of Optometry"/>
<xsd:enumeration value="Primary Care Provider"/>
<xsd:enumeration value="Pharmacy"/>
<xsd:enumeration value="Dentist"/>
<xsd:enumeration value="Managed Care Organization"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:attribute>
<xsd:attribute name="providerTypeQualifier">
<xsd:simpleType>
<xsd:restriction base="xsd:string">
<xsd:enumeration value="Person"/>
<xsd:enumeration value="Non Person Entity"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:attribute>
</xsd:complexType>
</xsd:element>
<xsd:element name="PlanParticipationSuspensionDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="EnrollmentSignatureDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="Carrier" type="CarrierData" minOccurs="0"/>
<xsd:element name="HSAVendor" type="HSAVendorType" minOccurs="0"/>
<xsd:element name="EligibilityPostalCode" type="xsd:string" minOccurs="0"/>
<xsd:element name="IdCard" type="IdCardData" minOccurs="0"/>
<xsd:element name="EligibilityRegion" type="xsd:string" minOccurs="0"/>
<xsd:element name="OriginalEffectiveDate" type="LocalDateType" minOccurs="0"/>
<xsd:element name="LateEntrantIndicator" type="xsd:boolean" minOccurs="0"/>
</xsd:sequence>
<xsd:attribute name="type" type="USTierCoveragePlanType" use="required"/>
</xsd:complexType>
<xsd:simpleType name="USTierCoveragePlanType">
<xsd:restriction base="xsd:string">
<xsd:enumeration value="24 Care"/>
<xsd:enumeration value="Dental"/>
<xsd:enumeration value="Dental Capitation"/>
<xsd:enumeration value="Exclusive Provider Organization"/>
<xsd:enumeration value="Health"/>
<xsd:enumeration value="Health Maintenance Organization"/>
<xsd:enumeration value="Hearing"/>
<xsd:enumeration value="Long Term Care"/>
<xsd:enumeration value="Long Term Disability"/>
<xsd:enumeration value="Mail Order Drug"/>
<xsd:enumeration value="Major Medical"/>
<xsd:enumeration value="Medicare Risk"/>
<xsd:enumeration value="Mental Health"/>
<xsd:enumeration value="Point of Service"/>
<xsd:enumeration value="Preferred Provider Organization"/>
<xsd:enumeration value="Prescription Drug"/>
<xsd:enumeration value="Preventative Care"/>
<xsd:enumeration value="Short Term Disability"/>
<xsd:enumeration value="Utilization Review"/>
<xsd:enumeration value="Vision"/>
</xsd:restriction>
</xsd:simpleType>
</xsd:schema>
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XSD Schema Code: