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Release Notes

This page provides high-level summaries for each published version of the Benefit Plan Standard.
For a detailed, chronological record of all technical changes, see the Changelog.

v1.0.0 — Foundational Release (Draft)

Release Date: June 2025
Status: Draft (public preview)

The v1.0.0 release represents the foundational publication of the Benefit Plan Standard, defining the structural, semantic, and operational elements for a unified benefit-plan representation. This release establishes the baseline for interoperability across carriers and for downstream applications that consume normalized health plan data.

🎯 Goals of v1.0.0​

  • Establish a stable, long-term JSON schema for representing all major components of medical benefit plans.
  • Provide a repeatable normalization model capable of absorbing the diversity found in carrier SBCs, EOCs, and benefit booklets.
  • Create a transparent governance and versioning framework to support future expansion.
  • Deliver a developer-friendly documentation site and onboarding pathway.
  • Ensure this standard is practical and deployable for real ingestion pipelines.

📐 Schema & Specification​

✔ Initial Schema Backbone​

A formal schema backbone was created, defining the core structural domains:

  • Plan metadata (plan identifiers, market, carrier, year, type)
  • Network tiers and structurally consistent cost-sharing layers
  • Accumulator model (deductibles, out-of-pocket limits)
  • Benefits model (services, categories, cost shares)
  • Limits structure (quantity limits, time periods)
  • Conditions model (prior auth, referral requirements, execution notes)
  • Source referencing (page and text excerpt mapping for ingestion traceability)

This structure supports both commercial health plans and Medicare Advantage mappings.

🧩 Module Definitions​

Version 1.0.0 introduces the modular architecture, allowing future expansions without breaking earlier versions.
The initial modules include:

  • Core Plan Metadata Module
  • Network Cost-Share Module
  • Accumulator Module
  • Benefit Definitions Module
  • Limits & Conditions Module
  • Source Mapping Module

These modules form the minimum required set for end-to-end plan normalization.

🗂 Field Definition Matrix​

A comprehensive, machine-aligned definition matrix was added, listing:

  • Every normalized field
  • Field type
  • Required/optional status
  • Semantic meaning
  • Examples
  • Alignment with carrier terminology
  • Future expansion notes

This matrix strengthens interoperability and ensures consistent ingestion rules across carriers.

🔄 Carrier Crosswalk Framework​

The initial crosswalk framework was introduced, with support for:

  • Blue Cross Blue Shield
  • GatorCare
  • SCAN
  • Aetna
  • UnitedHealthcare
  • Cigna
  • Humana

The crosswalk provides:

  • Vocabulary harmonization
  • Mapping rules
  • Exception handling patterns
  • Notes on ambiguous carrier language
  • Placeholders for additional carriers (Kaiser, Molina, Oscar, Ambetter)

A publicly accessible live Google Sheet now serves as the canonical crosswalk reference.

📚 Documentation Framework​

Version 1.0.0 includes a full documentation site built using Docusaurus:

Included Sections​

  • Getting Started (installation, ingestion guidelines, examples)
  • Specification (schema overview, modules, crosswalk, field definitions)
  • Governance (mission, overview, roadmap, FAQ, contribution process, versioning policy)
  • Project Index and Changelog

Developer-Friendly Enhancements​

  • MDX React components
  • Embedded crosswalk viewer
  • Logical sidebar hierarchy
  • Clear versioning metadata

🔧 Tooling & Infrastructure​

  • Integration of a structured GitHub repository layout for schema and documentation
  • Foundation for future:
    • CI validation of schema updates
    • Automated build & publishing
    • Example normalization pipelines

🧭 What’s Next (v1.1.0 Preview)​

Planned enhancements include:

  • New carriers in the crosswalk (Kaiser, Molina, Oscar, Ambetter)
  • Pharmacy benefit module (preliminary)
  • Formal plan “Variants” support (SBC variations under one parent ID)
  • Machine-executable ingestion rules (YAML-based rule system)
  • Example benefit-plan JSON library
  • API specification for parsing & normalization services

Summary

The v1.0.0 release establishes the Benefit Plan Standard as a credible, extensible, and production-ready framework for benefit-plan normalization.
This foundation enables:

  • predictable ingestion pipelines
  • unified data structures
  • improved interoperability across carriers
  • future schema and module expansions

The work delivered here forms the core of all future releases.