Following the death of the subscriber, some plan sponsors may offer survivors the opportunity to enroll as a subscriber for survivor coverage. Where the plan sponsors offers "survivor coverage," the surviving spouse or dependent electing such coverage may enroll as a new subscriber. In such cases, the association between the new enrollment for the survivor and the originating subscriber can be represented in a USEnrollment instance by setting the SubscriberTypeCode with a value "Survivorship" and using the Subscriber/OriginatingSubscriberDetails/SubscriberID to identify the associated deceased subscriber.

It is RECOMMENDED that complete family units be sent whenever there is a change to any member of the family. In other words, the unit of work for an update transaction is all members of the family regardless of who or what is actually changing. See also the section called “Data Management Approaches”