SBI Specific Benefit Information
To specify specifc benefit scenarios
Position
Element
Name
Type
Requirement
Min
Max
Repeat
Code identifying eligibility or benefit information
Code specifying periods
Total number of periods
C0302: If SBI-03 is present, then SBI-02 is required
Percentage expressed as a decimal (e.g., 0.0 through 1.0 represents 0% through 100%)
Monetary amount
SBI05 represents a single benefit amount or minimum benefit amount dependent upon the code sent in SBI01.
Monetary amount
SBI06 represents a remaining benefit amount or maximum benefit amount dependent upon the code sent in SBI01.
Number identifying the level to which the benefits are assigned or limited
A description or number that identifies the plan or coverage
Code indicating a Yes or No condition or response
SBI09 is the triggering event indicator. A "Y" indicates that a triggering event has occurred, an "N" indicates no triggering event has occurred, a "U" indicates it cannot be determined if a triggering event occurred.
Code indicating a Yes or No condition or response
SBI10 is the single use benefit indicator. A "Y" indicates that the benefit is a single use per period (one time use), an "N" indicates an exhaustive benefit (used until benefit or benefit amount is '0') a "U" indicates it's unknown if the benefit is of single use or exhaustive type.