HL7 Terminology (THO)
4.0.0 - Publication International flag

This page is part of the HL7 Terminology (v4.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions

ValueSet: UnderwriterParticipationFunction

Official URL: http://terminology.hl7.org/ValueSet/v3-UnderwriterParticipationFunction Version: 2.0.0
Active as of 2014-03-26 Computable Name: UnderwriterParticipationFunction
Other Identifiers: : urn:oid:2.16.840.1.113883.1.11.19904

Definition: Set of codes indicating the manner in which underwriters participate in a policy or program.


This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)



This value set contains 5 concepts

Expansion based on ParticipationFunction v2.1.0 (CodeSystem)

1  _UnderwriterParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionUnderwriterParticipationFunction

Definition: Set of codes indicating the manner in which underwriters participate in a policy or program.

2    PAYORCNTRhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionpayor contracting

Definition: Contracting for the provision and administration of health services to payors while retaining the risk for coverage. Contracting may be for all provision and administration; or for provision of certain types of services; for provision of services by region; and by types of administration, e.g., claims adjudication, enrollment, provider management, and utilization management. Typically done by underwriters for sponsors who need coverage provided to covered parties in multiple regions. The underwriter may act as the payor in some, but not all of the regions in which coverage is provided.

2    REINShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionreinsures

Definition: Underwriting reinsurance for another underwriter for the policy or program.

2    RETROCEShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionretrocessionaires

Definition: Underwriting reinsurance for another reinsurer.

2    SUBCTRThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionsubcontracting risk

Definition: Delegating risk for a policy or program to one or more subcontracting underwriters, e.g., a major health insurer may delegate risk for provision of coverage under a national health plan to other underwriters by region .

2    UNDERWRTNGhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionunderwriting

Definition: Provision of underwriting analysis for another underwriter without assumption of risk.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code


2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26reviseVocabulary (Woody Beeler) (no record of original request)2014T1_2014-03-26_001283 (RIM release ID)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26