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Domain: EnrollEligCOB — EnrollEligCOB
HealthcarePolicy

HealthcarePolicy

EnrollEligCOB::HealthcarePolicy
An Insurance Policy is a contract between an benefits provider (e.g. an insurance company or a government agency) and an individual or his/her sponsor (e.g. an employer or union). A Payer will generally offer one or more pre-defined sets of benefits, to which we assigned the generic term, "Health Plan". An Insurance Policy is an instance of a Health Plan. For example, Payer A might offer a Gold Plan and a Silver Plan. John Smith may have a Gold Plan Policy number 123, and Jane Doe may have Gold Plan Policy number 456. ABC Motors may purchase the Silver Plan (Policy number 789) for their employees. Claims for reimbursement will cite the Insurance Policy number, and sometimes a Group Number, if applicable. In the above example, ABC Motors' Insurance Policy is a Group Policy, so individual employees will cite the Group Number.
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