example1.xml

<Coverage xmlns="http://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>

  <!-- <issuerIdentifier>
    <system value="http://benefitsinc.com/certificate"/>
    <value value="12345"/>
  </issuerIdentifier> -->

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

  <period>
    <start value="2014-05-23"/>
    <end value="2012-05-23"/>
  </period>

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

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

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

  <relationship>
    <system value="http://example.org/codesystem/example-1"/>
    <code value="self"/>
  </relationship>

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

  <plan value="CBI35"/>

  <subPlan value="123"/>

  <dependent value="1"/>

  <sequence value="1"/>

  <network value="test"/>

  <contract>
    <reference value="Contract/4"/>
    <display value="Contract no 4"/>
  </contract>

</Coverage>