Time Period Covered Detail (HQ) Section

BOX_00 (HQ1000)

Route Details: 01 Box = BOX_00, BOX_10, BOX_20, BOX 25, BOX_30

05 Single Select with Display Roster = HQ10_01, HQ10_02, HQ10_03, HQ10_04, HQ10_05



BOX_10 (HQ1002)

Route Details: General Display Instructions for Question Text:

For ‘{START DATE}’, display the RU level reference period start date (typically-but not always Jan 1 if Round 1 or the previous round interview date if Rds 2-5). Display as full month, xx, YYYY - e.g., "January 1, 2016". Use variable BegRefDt.

For ‘{END DATE}’, display the RU level reference period end date (typically but not always current round interview date if Rds 1-4 or Dec 31 if Round 5). Display as full month, xx, YYYY - e.g., "January 1, 2016". Use variable EndRefDt.

For ‘{PERSON’S START DATE}’, display the person level reference period start date. Display as full month, xx, YYYY - e.g., "January 1, 2016". Use variables Person.BegRefM, Person.BegRefD, Person.BegRefY.

For ‘{PERSON’S END DATE}’, display the person level reference period end date.

Display as full month, xx, YYYY - e.g., "January 1, 2016". Use variables Person.EndRefM, Person.EndRefD, Person.EndRefY.



BOX_20 (HQ1003)

Route Details: Context header display instructions:

Display Person.FullName, Insurance.Plcyhldr , Insurance.HISrcName

Display the first part of the context header ‘{POLICYHOLDER’S FIRST MIDDLE LAST NAME} INSURANCE THROUGH’ only when the HQ section was launched for private insurance (Insurance.HIPubPriv=Private).



HQ10_01 (HQ1005)

BLAISE NAME: CovdWholeTime

Context Header: {{POLICYHOLDER’S FIRST MIDDLE LAST NAME} INSURANCE THROUGH} {NAME OF INSURANCE SOURCE}

Question Text:

{Were/Was} {you/ {PERSON}} covered the whole time from {PERSON’S START DATE} until {today/ {PERSON’S END DATE}}, or only part of the time?

NAVIGATION: Complete the grid in order of respondent’s answers.

Responses: WHOLE TIME 1

PART OF THE TIME 2

REFUSED RF

DON'T KNOW DK

Programmer Instructions: Preloaded Grid Type 2 (flexible navigation) including question HQ10_01, HQ10_02, HQ10_03, HQ10_04, HQ10_05, and BOX 25.

If Round 1 and coded ‘1’ (WHOLE TIME), set SimplePerson.CovdJan1=Yes.

Display Instructions: Display 'today' if (not round 5) and (Person level reference period end date = RU level reference period end date). Otherwise, display '{PERSON’S END DATE}'.

Roster 1 - Report

Roster definition:

See the originating section for the grid roster definition and roster filter instructions. (The HQ section is called from multiple items within the HX, HP, and PR sections. The grid will be preloaded based on where the section is called from.)

Format form pane in columns with headers:

RU Member

Insurance Source Name

Covd Whole Time? (HQ10_01)

Covd Now? (HQ10_02)

Covd {INTV MONTH}? (HQ10_03)

Covd at all {INTV MONTH}? (HQ10_04)

Covd {MONTH_1}? (HQ10_05)

Covd {MONTH_2}? (HQ10_06)

Covd {MONTH_3}? (HQ10_07)

Covd {MONTH_4}? (HQ10_08)

Covd {MONTH_5}? (HQ10_09)

Covd {MONTH_N}? (HQ10_N)

For RU Member:

Display the RU member's first, middle, and last names (Person.FullName) from the covered person array that is linked to this instance of HQ. This column is protected. No changes are allowed.

For Insurance Source Name:

Display the name of the insurance linked to this instance of HQ (Insurance.HISrcName). This column is protected. No changes are allowed.

For {INTV MONTH}, display the interview month using three letter abbreviation.

For {MONTH_1} … {MONTH_N}, display the months between the RU reference period start date and the RU reference period end date, excluding the interview month if not round 5. In Round 5, display all the months of the RU reference period, including December. Use the three letter abbreviation for each month. However, for each row person, the only months that are active for that person are the ones that are part of that person’s reference period, excluding the interview month.

January = JAN July= JUL

February = FEB August= AUG

March= MAR September= SEP

April= APR October= OCT

May= MAY November= NOV

June= JUN December= DEC

Display the interviewer instruction ‘NAVIGATION': Complete the grid in order of respondent’s answers. ’ In red text.


HQ10_02 (HQ1010)

BLAISE NAME: CovdNow

Context Header: {{POLICYHOLDER’S FIRST MIDDLE LAST NAME} INSURANCE THROUGH} {NAME OF INSURANCE SOURCE}

Question Text:

{Are/Is} {you/{PERSON}} covered now?

NAVIGATION: Complete the grid in order of respondent’s answers.

Responses: YES 1

NO 2

REFUSED RF

DON'T KNOW DK

Programmer Instructions: Display HQ10_02 as an active cell for the person’s row, if it is (rounds 1 -4) and (HQ10_01 is coded ‘2’ (PART OF THE TIME)) and (person's reference period end date includes the interview month).

Otherwise, HQ10_02 is an inactive cell for the person’s row.

Display Instructions: Display the interviewer instruction ‘NAVIGATION': Complete the grid in order of respondent’s answers. ’ In red text.


HQ10_03 (HQ1015)

BLAISE NAME: CovdContin

Context Header: {{POLICYHOLDER’S FIRST MIDDLE LAST NAME} INSURANCE THROUGH} {NAME OF INSURANCE SOURCE}

Question Text:

{Have/Has} {you/{PERSON}} been covered continuously, since the first of {INTERVIEW MONTH} through today?

NAVIGATION: Complete the grid in order of respondent’s answers.

Responses: YES 1

NO 2

REFUSED RF

DON'T KNOW DK

Programmer Instructions: Display HQ10_03 as an active cell for the person’s row, if it is rounds 1 -4 and HQ10_02 is coded ‘1’ (YES) (YES, covered now).

Otherwise, HQ10_03 is an inactive cell for the person’s row.

If Round 1 and interview month=January and coded ‘1’ (YES), set SimplePerson.CovdJan1=Yes.

Display Instructions: Display name of month in which interview is being conducted (month in which interview first started) for ‘INTERVIEW MONTH’. (Use month from EndRefDt)

Display the interviewer instruction ‘NAVIGATION': Complete the grid in order of respondent’s answers. ’ In red text.


HQ10_04 (HQ1020)

BLAISE NAME: CovdIntvMth

Context Header: {{POLICYHOLDER’S FIRST MIDDLE LAST NAME} INSURANCE THROUGH} {NAME OF INSURANCE SOURCE}

Question Text:

{Were/Was} {you/{PERSON}} covered at all during {INTERVIEW MONTH}?

NAVIGATION: Complete the grid in order of respondent’s answers.

Responses: YES 1

NO 2

REFUSED RF

DON'T KNOW DK

Programmer Instructions: Display HQ10_04 as an active cell for the person’s row, if it is rounds 1- 4 and HQ10_02 is coded ‘2’ (NO), ‘RF’ (REFUSED), or ‘DK’ (DON’T KNOW) (NO/DK/RF if covered now).

Otherwise, HQ10_04 is an inactive cell for the person’s row.

Display Instructions: Display name of month in which interview is being conducted (i.e., month in which interview first started) for ‘INTERVIEW MONTH’. (Use month from EndRefDt)

Display the interviewer instruction ‘NAVIGATION': Complete the grid in order of respondent’s answers. ’ In red text.


HQ10_05 (HQ1025)

BLAISE NAME: CovdMth

Context Header: {{POLICYHOLDER’S FIRST MIDDLE LAST NAME} INSURANCE THROUGH} {NAME OF INSURANCE SOURCE}

Question Text:

{VARIABLE TEXT [a-e]}

HQ10_05[1] a. In {MONTH{, YEAR}}, {were/was} {you/{PERSON}} covered the whole month, part of the month, or not at all during the month?

HQ10_06[2] b. How about in {MONTH{, YEAR}}? {Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?

HQ10_07[3] c. What about in {MONTH{, YEAR}}? [{Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?]

HQ10_08[4] d. What about in {MONTH{, YEAR}}? [{Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?]

HQ10_09[5] e. What about in {MONTH{, YEAR}}? {Were/Was} {you/{PERSON}} covered the whole month, part of the month, or not at all during the month?

For items HQ10_07[3] c. and HQ10_08[4] d., display the text [{Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?] in brackets and in grayed out text.

NAVIGATION: Complete the grid in order of respondent’s answers.

Responses: WHOLE MONTH 1 BOX_30 (HQ1040)

PART OF MONTH (INCLUDING FIRST OF MONTH) 2 BOX_30 (HQ1040)

PART OF MONTH (NOT INCLUDING FIRST OF MONTH) 3 BOX_30 (HQ1040)

NOT COVERED 4 BOX_30 (HQ1040)

REFUSED RF BOX_30 (HQ1040)

DON'T KNOW DK BOX_30 (HQ1040)

Programmer Instructions: HQ10_05 also includes HQ10_06, HQ10_07, HQ10_08, HQ10_09, … HQ10_N.

Display HQ10_05… HQ10_N as active cells for the person’s row if HQ10_01 is coded ‘2’ (PART OF THE TIME). Otherwise, HQ10_05…HQ10_N are inactive cells for the person’s row.

Note: The number and names of the months listed in the full grid are determined by the number of months between the month prior to the month of the interview and the month of the reference date. For example, if the reference date is January 1 and the interview date is April 10, 'January', 'February', and 'March' are displayed. 'April' would not be asked about in HQ10_05 because questions HQ10_03 and HQ10_04 determined the coverage during the interview month. However, not all RU members will be eligible for every month. The cells for the months that are not applicable for that RU member should not be active. The only month cells that should be active for a specific row are the ones that apply to that person's individual reference period.

For round 5, the end date is not the interview date. It is either 12/31/{YEAR} or the date the person left the RU, died, was institutionalized, moved, etc.

The screen layout should accommodate all the months in the person’s reference period. Horizontal scrolling may be necessary in the grid.

Hard Check:

Edit: If Rounds 1-4, person must be covered at least one month during the reference period. If person does not have coverage during the interview month (HQ10_02=2 or HQ10_04=2) and does not have coverage for any of the months displayed at HQ10_05 (all months displayed at HQ10_05 are coded '4' (NOT COVERED)), display the following message: "MUST BE COVERED AT LEAST PART OF ONE MONTH. IF NOT, BACK UP AND DELETE PERSON AS A COVERED PERSON (DEPENDENT) FOR THIS INSURANCE."

Edit: If Round 5, all months displayed at HQ10_05 cannot be coded '4' (NOT COVERED). If all are, display the following message: "MUST BE COVERED AT LEAST PART OF ONE MONTH. IF NOT, BACK UP AND DELETE PERSON AS A COVERED PERSON (DEPENDENT) FOR THIS INSURANCE."

For each person (row), if Round 1 and if January is coded ‘1’ (WHOLE MONTH) or ‘2’ (PART OF MONTH (INCLUDING FIRST OF MONTH), set SimplePerson.CovdJan1=Yes.

Display Instructions: Display ‘, YEAR’ as a 4-digit year only if Round 3. Otherwise, use a null display for ‘YEAR’.

Array responses and variable text columns in the panel. Display "variable text" in the a-e sequence until all rows have been displayed. Variable question text displays for each month in the reference period. If more than 5 months to display, repeat, the question wording, beginning from “a” for other months in the reference period eligible to be displayed. As the cursor moves from one month row to the next, display the other rows in grayed out text.

The wording for each row is as follows:

HQ10_05[1] a. In {MONTH{, YEAR}}, {were/was} {you/{PERSON}} covered the whole month, part of the month, or not at all during the month?

HQ10_06[2] b. How about in {MONTH{, YEAR}}? {Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?

HQ10_07[3] c. What about in {MONTH{, YEAR}}? [{Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?]

HQ10_08[4] d. What about in {MONTH{, YEAR}}? [{Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?]

HQ10_09[5] e. What about in {MONTH{, YEAR}}? {Were/Was} {you/{PERSON}} covered the whole month, part of the month, or not at all during the month?

For items HQ10_07[3] c. and HQ10_08[4] d., display the text [{Were/Was} {you/he/she} covered the whole month, part of the month, or not at all during the month?] in brackets and in grayed out text.

Display the interviewer instruction ‘NAVIGATION': Complete the grid in order of respondent’s answers. ’ In red text.


BOX 25 (HQ1026)

Route Details: Continue with BOX_30

CAPI should verify that all eligible fields per row of the grid have a valid answer entered. If not, display error message “ONE OR MORE QUESTIONS HAVE NOT BEEN ANSWERED. PRESS <ENTER> TO GO TO THE FIRST UNANSWERED QUESTION.” CAPI will move to the first unanswered item/field, starting from the top left of the grid and moving to the next unanswered item, left to right by row, until all are complete. If coded ‘2’ (NO), CAPI should return to the first unanswered item/field, starting from the top left of the grid and moving to the next unanswered item, left to right by row, until all are complete.



BOX_30 (HQ1040)

Route Details: Return to the HX, HP, or PR section.

Programmer Instructions: CovdPers.LRndCovd

MHOP will need to set a flag on the Covered Person Array to determine if an RU member is considered covered for the following round. This flag will be called CovdPers.LRndCovd and will be used in the OE and PR sections to determine whether coverage is asked about for each eligible RU member. This setting will need to be made prior to rounds 2-5. The value of the Flag will be the current round. If the RU member was considered covered in Round 1, for review in Round 2, the flag will be set to ‘1’. If the RU member was considered covered in Round 2, for review in Round 3, the flag will be set to ‘2’, etc.

  1. Public Insurance (Medicare) [Insurance.HIPubPriv=Public, Insurance.HISrc= Medicare] – once an RU member is added as having Medicare coverage, CAPI collects an effective date for coverage in the HX section. An effective end date is never collected and it is assumed that Medicare coverage never ends for that RU member. In cases of Medicare coverage, LRndCovd is not necessary.

  2. Public Insurance (except Medicare) [Insurance.HIPubPriv=Public, Insurance.HISrc <> Medicare] – The HQ section determines what months each RU member is covered by each source of public insurance. To be eligible for to be reviewed for public coverage, the RU member must have been covered at least one day in the previous round (not necessarily on the interview date).
    Set CovdPers.LRndCovd = <current round> for this RU member for this insurance if:
    HQ10_01 = ‘1’ (WHOLE TIME) or
    HQ10_02 = ‘1’ (YES) or
    HQ10_04 = ‘1’ (YES) or
    HQ10_05 = ‘1’ (WHOLE MONTH), ‘2’ (PART OF MONTH (INCLUDING FIRST OF MONTH)), or ‘3’ (PART OF MONTH (NOT INCLUDING FIRST OF MONTH)) for at least one month in the grid.

  3. Private Insurance [Insurance.HIPubPriv=Private, Insurance.OrigRnd=current round] – The HQ section determines what months each RU member is covered by each source of private insurance that was created in the current round. (The specifications for this flag for private insurance that was reviewed during the current round is included in the OE section.) To be eligible to be reviewed for private coverage, the RU member must have been covered on the interview date of the previous round.
    Set CovdPers.LRndCovd = <current round> for this RU member for this insurance if:
    HQ10_01 = ‘1’ (WHOLE TIME) or
    HQ10_02 = ‘1’ (YES)

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