Design Comments: For ELIGIBILITY, yes/no is derived from the use cases below, based on the requested date and policy: [1] NO: If policy exists, but no longer in effect:. . . . negationInd = F statusCode = completed, aborted effectiveTime = time policy was in effect reasonCode = reasons why policy was terminated [2] YES: If policy exists and in effect:. . . . . . . . . . . .negationInd = F statusCode = active effectiveTime = time policy in effect reasonCode = null [3] NO: If policy exists, but is in effect in the future:.negationInd = F statusCode = new effectiveTime = time policy will be in effect reasonCode = null [4] NO: If policy does not exist:. . . . . . . . . . . . . . . . negationInd = T statusCode = null effectiveTime = null reasonCode = [optional] other policies that may be known id: = Coverage Identifier, extension = Policy.Plan.Group.Contract. Division.Section.Version (or similar). Carrier noted in author participation, and may not be same namespace as OID of id