diff --git a/src/lib/fhir/__tests__/build-bundle.test.ts b/src/lib/fhir/__tests__/build-bundle.test.ts
index 62c840260..c3aa8a1b7 100644
--- a/src/lib/fhir/__tests__/build-bundle.test.ts
+++ b/src/lib/fhir/__tests__/build-bundle.test.ts
@@ -241,7 +241,7 @@ describe("buildFhirDocumentBundle", () => {
     expect(coverage?.contained?.[0].identifier?.[0].value).toBe("101234567");
   });
 
-  it("omits the Coverage entirely when neither insurer name nor IKNR is present", () => {
+  it("omits the Coverage entirely when there is no payor signal at all", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         patient: {
@@ -253,17 +253,57 @@ describe("buildFhirDocumentBundle", () => {
           // neither insurerName nor insurerIkNumber
         },
       }),
-      { insuranceNumber: "A123456780" },
+      // ...and no KVNR.
+      { insuranceNumber: null },
       FIXED_NOW,
     );
     expect(coverageOf(bundle)).toBeUndefined();
-    // KVNR still rides on Patient.identifier.
+  });
+
+  it("emits a KVNR-only Coverage (no insurer) to align with the iOS exporter", () => {
+    const bundle = buildFhirDocumentBundle(
+      makeData({
+        patient: {
+          username: "sample-user",
+          dateOfBirth: null,
+          gender: null,
+          heightCm: null,
+          fullName: "Sample Patient",
+          // neither insurerName nor insurerIkNumber — just a bare KVNR.
+        },
+      }),
+      { insuranceNumber: "A123456780" },
+      FIXED_NOW,
+    );
+    const coverage = coverageOf(bundle);
+    expect(coverage).toBeDefined();
+    expect(coverage?.status).toBe("active");
+    expect(coverage?.beneficiary.reference).toBe("Patient/patient-1");
+    expect(coverage?.subscriberId).toBe("A123456780");
+    // No insurer known → no contained payor Organization, no payor[].
+    expect(coverage?.contained).toBeUndefined();
+    expect(coverage?.payor).toBeUndefined();
+    // KVNR still rides on Patient.identifier too.
     const patient = bundle.entry.find(
       (e) => e.resource.resourceType === "Patient",
     )?.resource as FhirPatient;
     expect(patient.identifier?.[0].value).toBe("A123456780");
   });
 
+  it("emits a top-level Composition.text narrative", () => {
+    const bundle = buildFhirDocumentBundle(
+      makeData(),
+      { insuranceNumber: null },
+      FIXED_NOW,
+    );
+    const composition = bundle.entry[0].resource;
+    expect(composition.resourceType).toBe("Composition");
+    if (composition.resourceType === "Composition") {
+      expect(composition.text?.status).toBe("generated");
+      expect(composition.text?.div).toContain("Health record for");
+    }
+  });
+
   it("maps weight to LOINC 29463-7 / UCUM kg with the latest reading", () => {
     const bundle = buildFhirDocumentBundle(
       makeData(),
diff --git a/src/lib/fhir/build-bundle.ts b/src/lib/fhir/build-bundle.ts
index 7227ba4d5..2578c6912 100644
--- a/src/lib/fhir/build-bundle.ts
+++ b/src/lib/fhir/build-bundle.ts
@@ -226,33 +226,36 @@ export function buildFhirDocumentBundle(
   entries.push({ fullUrl: `urn:uuid:${patientId}`, resource: patient });
 
   // --- Coverage (insurer; sits right after the Patient) ------------------
-  // Emitted whenever ANY payor info is present (insurer name and/or IKNR).
-  // The payor is a CONTAINED Organization referenced by a local `#`-ref.
-  // The KVNR stays on `Patient.identifier`; here it doubles as the
-  // Coverage `subscriberId` (the member id) when present. When neither an
-  // insurer name nor an IKNR is known, omit Coverage entirely rather than
-  // emit an empty payor.
+  // v1.9.0 — emitted whenever ANY payor signal is present: an insurer
+  // name, an IKNR, OR a bare KVNR. The KVNR-only case aligns the server
+  // with the iOS exporter (which emits a Coverage on a bare member id);
+  // it carries the `subscriberId` with no contained payor Organization.
+  // When an insurer name and/or IKNR is known, the payor is a CONTAINED
+  // Organization referenced by a local `#`-ref. The KVNR stays on
+  // `Patient.identifier` and doubles as the `subscriberId` (member id).
   const insurerName = data.patient.insurerName ?? null;
   const insurerIkNumber = data.patient.insurerIkNumber ?? null;
-  if (insurerName || insurerIkNumber) {
-    const orgId = "insurer-org-1";
-    const payorOrg: FhirOrganization = {
-      resourceType: "Organization",
-      id: orgId,
-    };
-    if (insurerIkNumber) {
-      payorOrg.identifier = [{ system: IKNR_SYSTEM, value: insurerIkNumber }];
-    }
-    if (insurerName) payorOrg.name = insurerName;
-
+  const hasPayorOrg = Boolean(insurerName || insurerIkNumber);
+  if (hasPayorOrg || identity.insuranceNumber) {
     const coverage: FhirCoverage = {
       resourceType: "Coverage",
       id: "coverage-1",
       status: "active",
-      contained: [payorOrg],
       beneficiary: patientRef,
-      payor: [{ reference: `#${orgId}` }],
     };
+    if (hasPayorOrg) {
+      const orgId = "insurer-org-1";
+      const payorOrg: FhirOrganization = {
+        resourceType: "Organization",
+        id: orgId,
+      };
+      if (insurerIkNumber) {
+        payorOrg.identifier = [{ system: IKNR_SYSTEM, value: insurerIkNumber }];
+      }
+      if (insurerName) payorOrg.name = insurerName;
+      coverage.contained = [payorOrg];
+      coverage.payor = [{ reference: `#${orgId}` }];
+    }
     if (identity.insuranceNumber) {
       coverage.subscriberId = identity.insuranceNumber;
     }
@@ -555,6 +558,13 @@ export function buildFhirDocumentBundle(
     date: now.toISOString(),
     author: [{ reference: "Device/healthlog", display: "HealthLog" }],
     title: "Health Record",
+    // v1.9.0 — top-level document narrative (Coverage nit 2). Reuses the
+    // same escaped plain-text summary the Vital-signs section carries, so
+    // a strict US-Core-style validator sees a `Composition.text`.
+    text: {
+      status: "generated",
+      div: `<div xmlns="http://www.w3.org/1999/xhtml">${escapeXml(narrativeText)}</div>`,
+    },
     section: [
       {
         // Vital-signs section carries the narrative + every Observation ref,
diff --git a/src/lib/fhir/types.ts b/src/lib/fhir/types.ts
index 55a375235..649e6f54f 100644
--- a/src/lib/fhir/types.ts
+++ b/src/lib/fhir/types.ts
@@ -175,6 +175,12 @@ export interface FhirComposition {
   date: string;
   author: FhirReference[];
   title: string;
+  /**
+   * v1.9.0 — top-level document narrative. Section narrative is already
+   * present; a strict US-Core-style validator additionally expects a
+   * `Composition.text`. Reuses the same escaped plain-text summary.
+   */
+  text?: FhirNarrative;
   section?: FhirCompositionSection[];
 }