<?xml version=“1.0” encoding=“UTF-8”?><Coverage xmlns=“hl7.org/fhir”>

<id value="9876B1"/>

<text>
   <status value="generated"/>
   <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the coverage</div>
</text>

<identifier>
  <system value="http://benefitsinc.com/certificate"/>
  <value value="12345"/>
</identifier>

<status value="active"/>

<type>
 <coding>
  <system value="http://hl7.org/fhir/v3/ActCode"/>
  <code value="EHCPOL"/>
  <display value="extended healthcare"/>
 </coding>
</type>

<policyHolder>
  <reference value="http://benefitsinc.com/FHIR/Organization/CBI35"/>
</policyHolder>

<subscriber>
  <reference value="Patient/4"/>
</subscriber>

<beneficiary>
  <reference value="Patient/4"/>
</beneficiary>

<relationship>
 <coding>
  <code value="self"/>
 </coding>
</relationship>

<period> 
  <start value="2011-05-23"/>
  <end value="2012-05-23"/>
</period>

<payor>
  <reference value="Organization/2"/>
</payor>

<grouping>
  <group value="CBI35"/>
  <groupDisplay value="Corporate Baker&#39;s Inc. Local #35"/>
  <subGroup value="123"/>
  <subGroupDisplay value="Trainee Part-time Benefits"/>
  <plan value="B37FC"/>
  <planDisplay value="Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"/>
  <subPlan value="P7"/>
  <subPlanDisplay value="Includes afterlife benefits"/>
  <class value="SILVER"/>
  <classDisplay value="Silver: Family Plan spouse only"/>
  <subClass value="Tier2"/>
  <subClassDisplay value="Low deductable, max $20 copay"/>
</grouping>

<dependent value="0"/>
<sequence value="9"/>

</Coverage>