Private Health Insurance Detail (HP) Section
THROUGHOUT THE SPECIFICATIONS FOR THIS CAPI SECTION, FOR SCREENS THAT SPECIFY THE REFERENCE PERIOD {END DATE} AS PART OF THE CONTEXT HEADER, CAPI DISPLAYS THE {END DATE} ONLY FOR ROUND 5. IN ANY OTHER ROUND, CAPI DOES NOT DISPLAY THE {END DATE} IN THE CONTEXT HEADER. FOR MOST PERSONS, THE END DATE FOR ROUND 5 WILL BE DECEMBER 31 OF THE SECOND YEAR OF THE PANEL.
NOTE THAT ‘HEALTH INSURANCE PURCHASING ALLIANCE’ (CODE ‘4’ AT HX03 AND CODE ‘2’ AT HX23) WAS OMITTED IN PANEL 12 ROUND 2 AND WILL BE OMITTED IN ALL FUTURE ROUNDS.
NOTE THAT ESTABLISHMENT ADDRESS INFORMATION AND THE INFORMED CONSENT SCREENS WERE OMITTED STARTING IN PANEL 12 ROUND 3. THIS INFORMATION WAS IN PANEL 12 ROUNDS 1 AND 2. STARTING IN PANEL 13 THESE ITEMS WILL BE OMITTED IN ALL ROUNDS. BOX_00
CONTEXT HEADER DISPLAY INSTRUCTIONS: DISPLAY PERS.FULLNAME, ESTB.ESTBNAME, PRND.BEGREFMM, PRND.BEGREFDD, PRND.BEGREFYY, PRND.ENDREFMM, PRND.ENDREFDD, PRND.ENDREFYY, ‘INSURANCE SOURCE’. FOR ‘INSURANCE SOURCE’, DISPLAY THE CATEGORY TEXT FROM HX23. IF HX23=91, DISPLAY THE OTHER SPECIFY TEXT. BOX_01
IF LOOPING ON ANY ESTABLISHMENT FLAGGED IN THE EMPLOYMENT (EM) SECTION AS ‘PROVIDES HEALTH INSURANCE’ AND NOT FLAGGED AS ‘SELF-EMPLOYED’ WITH A FIRM-SIZE-1, GO TO LOOP_01
IF LOOPING ON AN HX03 CATEGORY OR IF LOOPING ON AN HX23 CATEGORY (EXCEPT CODE ‘3’ (DIRECTLY FROM A SCHOOL)), GO TO HP03
IF LOOPING ON CODE ‘3’ (DIRECTLY FROM A SCHOOL) AT HX23, CONTINUE WITH HP01 HP01 Does the insurance from the school cover only injuries
caused HP02 Would the insurance from the school cover health
services HP03 I’d like to talk about the insurance which is from
{CATEGORY
DISPLAY ‘through a self-employed business’ IF LOOPING ON AN HX03 CATEGORY. DISPLAY ‘someone in the family purchased or obtained directly from that source.’ IF LOOPING ON AN HX23 CATEGORY.
DISPLAY THE FOLLOWING FOR ‘CATEGORY NAME FROM HX03 OR HX23’: - ‘a professional association’ IF CODED ‘1’ AT HX03 - ‘a small business group’ IF CODED ‘2’ AT HX03 - ‘a union’ IF CODED ‘3’ AT HX03 - ‘an insurance agent’ IF CODED ‘5’ AT HX03 - ‘an insurance company’ IF CODED ‘6’ AT HX03 - ‘an HMO’ IF CODED ‘7’ AT HX03 - ‘a previous employer’ IF CODED ‘8’ AT HX03 - ‘a previous employer (COBRA)’ IF CODED ‘9’ AT HX03 - ‘a high risk pool {(e.g., {STATE NAME FOR HIGH RISK POOL})}’ IF CODED ‘10’ AT HX03 - ‘the {HX03OV OTHER SPECIFY TEXT}’ IF CODED ‘91’ AT HX03 - ‘{STATE EXCHANGE NAME}’ IF CODED ‘11’ AT HX03 - ‘source purchased for that business’ IF CODED ‘-7’ OR ‘-8’ AT HX03 - ‘a group or association’ IF CODED ‘1’ AT HX23 - ‘a school’ IF CODED ‘3’ AT HX23 - ‘an insurance agent’ IF CODED ‘4’ AT HX23 - ‘an insurance company’ IF CODED ‘5’ AT HX23 - ‘an HMO’ IF CODED ‘6’ AT HX23 - ‘a union’ IF CODED ‘7’ AT HX23 - ‘a previous employer (COBRA)’ IF CODED ‘8’ AT HX23 - ‘a previous employer (not COBRA)’ IF CODED ‘9’ AT HX23 - ‘a spouse’s (or deceased spouse’s) previous employer’ IF CODED ‘10’ AT HX23 - ‘some other employer’ IF CODED ‘11’ AT HX23 - ‘the plan of someone not living here’ IF CODED ‘12’ AT HX23 - ‘a high risk pool {(e.g., {STATE NAME FOR HIGH RISK POOL})}’ IF CODED ‘13’ AT HX23 - ‘{STATE EXCHANGE NAME-A}’ IF CODED ‘14’ AT HX23 - ‘the {HX23OV OTHER SPECIFY TEXT} IF CODED ‘91’ AT HX23 - ‘a source that provided directly purchased insurance’ IF CODED ‘-7’ OR ‘-8’
DISPLAY ‘(e.g., {STATE NAME FOR HIGH RISK POOL})’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED OFFERS A HIGH RISK POOL HEALTH INSURANCE PLAN. THIS INCLUDES ALL STATES EXCEPT: AZ, DE, DC, GA, HI, ME, MA, MI, NV, NJ, NY, OH, PA, RI, VT, VA. IF INTERVIEW STATE IS ONE OF THESE STATES, USE A NULL DISPLAY. FOR ‘STATE NAME FOR HIGH RISK POOL’ DISPLAY THE HIGH RISK POOL PLAN NAME ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED. FOR ‘STATE EXCHANGE NAME’, DISPLAY THE EXCHANGE NAME ‘A’ ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED.
IF CODED ‘2’ (INSURANCE REPORTED IN ERROR), FLAG ITEM FOR SOURCE CLEAN-UP. LOOP_01
For each of the following: ESTABLISHMENT 1 ESTABLISHMENT 2 ESTABLISHMENT 3 ESTABLISHMENT 4 ask BOX_01Aa-END_LP01
LOOP DEFINITION: LOOP-01 COLLECTS DETAILED INFORMATION ABOUT INSURANCE PROVIDED THROUGH AN EMPLOYER OR THE ESTABLISHMENT NAMES OF THE INSURANCE SOURCE COLLECTED IN EITHER HX03 OR HX23. IF LOOPING ON INSURANCE PROVIDED FROM AN EMPLOYER ONLY ONE LOOP CYCLE IS COMPLETED. IF LOOPING ON INSURANCE PROVIDED THROUGH AN INSURANCE SOURCE COLLECTED IN HX03 OR HX23, THE FIRST LOOP CYCLE COLLECTS THE MAIN ESTABLISHMENT NAME OF THE INSURANCE SOURCE. SUBSEQUENT CYCLES, IF ANY, ARE DETERMINED BY THE RESPONSE TO HP18. IF HP18 IS CODED ‘1’ (YES), THE LOOP CYCLES AGAIN TO COLLECT THE NEXT ESTABLISHMENT NAME. IF HP18 IS NOT ASKED OR IS CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), THE LOOP ENDS. BOX_01AA
IF LOOPING ON CODE ‘11’ (STATE EXCHANGE NAME) AT HX03 OR CODE ‘14’ (STATE EXCHANGE NAME) AT HX23, AUTOMATICALLY CODE HP04A AS ‘YES’ AND AUTOMATICALLY ADD THE ESTABLISHMENT NAME ‘{STATE EXCHANGE NAME}’ TO THE HP04/HP06 ESTABLISHMENT ROSTER. THEN GO TO BOX_02
IF LOOPING ON CODE ‘1’ (PROFESSIONAL ASSOCIATION), ‘2’ (SMALL BUSINESS GROUP), ‘5’ (INSURANCE AGENT), ‘6’ (INSURANCE COMPANY), ‘7’ (HMO), OR ‘91’ (OTHER) AT HX03 OR CODE ‘1’ (GROUP/ASSOCIATION), ‘4’ (INSURANCE AGENT), ‘5’ (INSURANCE COMPANY), ‘6’ (HMO), OR ‘91’ (OTHER) AT HX23, CONTINUE WITH HP04A
OTHERWISE, GO TO BOX_01A
NOTE: THE HP04/HP06 ESTABLISHMENT ROSTER HAS A CHARACTER LIMIT OF 30 CHARACTERS. IF AN ESTABLISHMENT IS AUTOMATICALLY ADDED TO THE ROSTER AT HP04/HP06 THAT IS OVER 30 CHARACTERS, THE ESTABLISHMENT NAME WILL BE TRUNCATED. AS OF P19R2/P18R4, THE FOLLOWING STATE EXCHANGE NAMES WERE TRUNCATED: ORIGINAL ‘the Health Insurance Marketplace’ ‘the Massachusetts Health Connector’ ‘Washington Health Benefit Exchange’ ‘Avenue H Health Insurance Marketplace’ TRUNCATED ‘Health Insurance Marketplace’ ‘Massachusetts Health Connector’ ‘WA Health Benefit Exchange’ ‘Avenue H Hlth Ins Marketplace’ HP04A Is this coverage through {STATE EXCHANGE NAME-A}{,
[which may also
DISPLAY ‘, [which may also be known as {ALIAS B} {or {ALIAS C}}]’ IF THERE IS MORE THAN ONE EXCHANGE NAME ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED.
DISPLAY ‘or {ALIAS C}’ IF THERE ARE THREE EXCHANGE NAMES ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED.
FOR ‘STATE EXCHANGE NAME-A’, ‘ALIAS B’, AND ‘ALIAS C’, DISPLAY THE EXCHANGE NAME(S) ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED. BOX_01A
IF LOOPING ON ANY ESTABLISHMENT FLAGGED IN EMPLOYMENT AS ‘PROVIDES HEALTH INSURANCE’ AND NOT FLAGGED AS ‘SELF-EMPLOYED’ WITH A FIRM-SIZE-1, GO TO HP09
OTHERWISE, CONTINUE WITH HP04 HP04 {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
ESTABLISHMENT}
ROSTER. ESTABLISHMENT 1. Establishment Name-30 2. Establishment Name-30 3. Establishment Name-30
DISPLAY ‘Please give … an agent.’ IF NOT
LOOPING ON HX23 CODE ‘12’ (UNDER PLAN OF SOMEONE NOT LIVING HERE). DISPLAY ‘You mentioned...this insurance?’ IF LOOPING ON HX23 CODE ‘12’ (UNDER PLAN OF SOMEONE NOT LIVING HERE). DISPLAY ‘professional association’ IF LOOPING ON HX03 CODE ‘1’ (FROM A PROFESSIONAL ASSOCIATION). DISPLAY ‘small business group’ IF LOOPING ON HX03 CODE ‘2’ (FROM A SMALL BUSINESS GROUP). DISPLAY ‘union’ IF LOOPING ON HX03 CODE ‘3’ (FROM A UNION) OR LOOPING ON HX23 CODE ‘7’ (FROM A UNION). DISPLAY ‘insurance company’ IF LOOPING ON HX03 CODE ‘5’ (DIRECTLY FROM AN INSURANCE AGENT) OR ‘6’ (DIRECTLY FROM INSURANCE COMPANY) OR LOOPING ON HX23 CODE ‘4’ (DIRECTLY FROM AN INSURANCE AGENT) OR ‘5’ (DIRECTLY FROM INSURANCE COMPANY). DISPLAY ‘HMO’ IF LOOPING ON HX03 CODE ‘7’ (DIRECTLY FROM AN HMO) OR LOOPING ON HX23 CODE ‘6’ (DIRECTLY FROM AN HMO). DISPLAY ‘previous employer’ IF LOOPING ON HX03 CODE ‘8’ (FROM A PREVIOUS EMPLOYER) OR LOOPING ON HX23 CODE ‘9’ (FROM ANYONE’S PREVIOUS EMPLOYER). DISPLAY ‘previous employer (using COBRA)’ IF LOOPING ON HX03 CODE ‘9’ (FROM A PREVIOUS EMPLOYER (COBRA)) OR LOOPING ON HX23 CODE ‘8’ (FROM ANYONE’S PREVIOUS EMPLOYER (COBRA)). DISPLAY ‘group or association’ IF LOOPING ON HX23 CODE ‘1’ (FROM A GROUP OR ASSOCIATION). DISPLAY ‘school’ IF LOOPING ON HX23 CODE ‘3’ (DIRECTLY THROUGH A SCHOOL). DISPLAY ‘spouse’s (or deceased spouse’s) previous employer’ IF LOOPING ON HX23 CODE ‘10’ (FROM SPOUSE’S/DECEASED SPOUSE’S PREVIOUS EMPLOYER). DISPLAY ‘employer’ IF LOOPING ON HX23 CODE ‘11’ (FROM SOME OTHER EMPLOYER). DISPLAY ‘high risk pool {(e.g., {STATE NAME FOR HIGH RISK POOL})}’ IF LOOPING ON HX03 CODE ‘10’ (DIRECTLY FROM A HIGH RISK POOL) OR LOOPING ON HX23 CODE ‘13’ (DIRECTLY FROM A HIGH RISK POOL). DISPLAY ‘{HX03OV/HX23OV OTHER SPECIFY}’ IF LOOPING ON HX03 CODE ‘91’ (OTHER) OR LOOPING ON HX23 CODE ‘91’ (OTHER SOURCE). FOR ‘HX03OV/HX23OV OTHER SPECIFY’ DISPLAY THE TEXT ENTERED AT EITHER HX03OV OR HX23OV. DISPLAY ‘source’ IF LOOPING ON HX03 OR HX23 CODES ‘-7’ (REF) OR ‘-8’ (DK). DISPLAY ‘from which someone in the family {purchased/obtained} this insurance’ IF NOT LOOPING ON HX03 CODE ‘5’ (DIRECTLY FROM AN INSURANCE AGENT) OR HX23 CODE ‘4’ (DIRECTLY FROM AN INSURANCE AGENT) IF LOOPING ON HX03 CODE ‘5’ OR HX23 CODE ‘4’, DISPLAY, ‘for the insurance purchased from an agent’. DISPLAY ‘purchased’ IF LOOPING ON HX03 CODES ‘1’, ‘2’, ‘3’, ‘6’, ‘7’, ‘10’, ‘-7,’ OR ‘-8’ OR IF LOOPING ON HX23 CODES ‘1’, ‘3’, ‘5’, ‘6’, ‘7’, ‘13’, ‘-7,’ OR ‘-8’. DISPLAY ‘obtained’ IF LOOPING ON HX03 CODES ‘8’, ‘9’, OR ‘91’ OR IF LOOPING ON HX23 CODES ‘8’, ‘9’, ‘10’, ‘11’, OR ’91’.
DISPLAY ‘(e.g., {STATE NAME FOR HIGH RISK POOL})’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED OFFERS A HIGH RISK POOL HEALTH INSURANCE PLAN. THIS INCLUDES ALL STATES EXCEPT: AZ, DE, DC, GA, HI, ME, MA, MI, NV, NJ, NY, OH, PA, RI, VT, VA. IF INTERVIEW STATE IS ONE OF THESE STATES, USE A NULL DISPLAY. FOR ‘STATE NAME FOR HIGH RISK POOL’ DISPLAY THE HIGH RISK POOL PLAN NAME ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED.
THE CONTEXT HEADER DISPLAYED ON SCREENS HP04 - HP08 DEPENDS ON THE PATH THAT LEADS TO THE SCREEN. IF ASKING ABOUT A SPECIFIC PERSON (I.E., JOBHOLDER WHEN COMING FROM AN HX03 CATEGORY), CAPI DISPLAYS THE PERSON AND START DATE. IF ASKING ABOUT A SPECIFIC ESTABLISHMENT, CAPI DISPLAYS THE ESTABLISHMENT AND START DATE. OTHERWISE, CAPI DISPLAYS THE START DATE. FOR ROUND 5, CAPI ALSO DISPLAYS THE END DATE OF THE REFERENCE PERIOD.
DISPLAY AN “ADD ESTABLISHMENT” OPTION ON THIS SCREEN.
IF ‘ADD ESTABLISHMENT’ OPTION IS SELECTED, CONTINUE WITH BOX_01B
OTHERWISE (ESTABLISHMENT WAS SELECTED FROM THE LIST), GO TO BOX_02
ROSTER DETAILS: TITLE: RU_ESTB_3 COL # 1 HEADER: ESTABLISHMENT INSTRUCTIONS: DISPLAY ESTABLISHMENT NAME (ESTB.ESTBNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENTS-ROSTERS FOR DISPLAY OF PRIVATE INSURANCE ESTABLISHMENTS.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ESTABLISHMENTS THAT ARE SOURCES OF PRIVATE INSURANCE. THIS DOES NOT INCLUDE ESTABLISHMENTS FLAGGED AS ‘EMPLOYER’ AND ‘SELF-EMPLOYED’ WITH A FIRM-SIZE-1 THAT ARE COMING FROM THE HX03 SERIES. BOX_01B
IF LOOPING ON CODE ‘12’ (UNDER PLAN OF SOMEONE NOT LIVING HERE) AT HX23 AND IF ‘ADD ESTABLISHMENT’ IS SELECTED, GO TO HP07. (NOTE THAT HP07 IS NOT A SEPARATE SCREEN; IT REPRESENTS A POPUP ON HP04.)
IF ‘ADD ESTABLISHMENT’ IS SELECTED AND IF NOT LOOPING ON CODE ‘12’ (UNDER PLAN OF SOMEONE NOT LIVING HERE) AT HX23, CONTINUE WITH HP06 (NOTE THAT HP06 IS NOT A SEPARATE SCREEN; IT REPRESENTS A POPUP ON HP04.) HP06 {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
DISPLAY THE FOLLOWING FOR ‘CATEGORY NAME FROM HX03 OR HX23’: - ‘PROFESSIONAL ASSOCIATION’ IF CODED ‘1’ AT HX03 - ‘SMALL BUSINESS GROUP’ IF CODED ‘2’ AT HX03 - ‘UNION’ IF CODED ‘3’ AT HX03 - ‘INSURANCE AGENT’ IF CODED ‘5’ AT HX03 - ‘INSURANCE COMPANY’ IF CODED ‘6’ AT HX03 - ‘HMO’ IF CODED ‘7’ AT HX03 - ‘PREVIOUS EMPLOYER’ IF CODED ‘8’ AT HX03 - ‘PREVIOUS EMPLOYER [COBRA]’ IF CODED ‘9’ AT HX03 - ‘HIGH RISK POOL’ IF CODED ‘10’ AT HX03 - THE TEXT ENTERED AT HX03OV IF CODED ‘91’ AT HX03 - ‘SOURCE PURCHASED FROM FOR THAT BUSINESS’ IF CODED ‘-7’ OR ‘-8’ AT HX03 - ‘GROUP OR ASSOCIATION’ IF CODED ‘1’ AT HX23 - ‘SCHOOL’ IF CODED ‘3’ AT HX23 - ‘INSURANCE AGENT’ IF CODED ‘4’ AT HX23 - ‘INSURANCE COMPANY’ IF CODED ‘5’ AT HX23 - ‘HMO’ IF CODED ‘6’ AT HX23 - ‘UNION’ IF CODED ‘7’ AT HX23 - ‘PREVIOUS EMPLOYER [COBRA]’ IF CODED ‘8’ AT HX23 - ‘PREVIOUS EMPLOYER [NOT COBRA]’ IF CODED ‘9’ AT HX23 - ‘SPOUSE’S/DECEASED SPOUSE’S PREVIOUS EMPLOYER’ IF CODED ‘10’ AT HX23 - ‘SOME OTHER EMPLOYER’ IF CODED ‘11’ AT HX23 - ‘PLAN OF SOMEONE NOT LIVING HERE’ IF CODED ‘12’ AT HX23 - ‘HIGH RISK POOL’ IF CODED ‘13’ AT HX23 - THE TEXT ENTERED AT HX23OV IF CODED ‘91’ AT HX23 - ‘SOURCE THAT PROVIDED DIRECTLY PURCHASED INSURANCE’ IF CODED ‘-7’ OR ‘-8’
WRITE ESTABLISHMENT TO THE RU-Establishments- ROSTER. HP07 {STR-DT}
ONLY CATEGORY ‘12’ (UNDER PLAN OF SOMEONE NOT LIVING HERE) OF HX23 IS ASKED HP07.
WRITE ESTABLISHMENT TO THE RU-Establishments- ROSTER. BOX_02
IF HX03 IS CODED ‘1’ OR ‘2’ FLAG ESTABLISHMENT AS ‘GROUP’. IF HX03 IS CODED ‘3’, FLAG ESTABLISHMENT AS ‘UNION’. IF HX03 IS CODED ‘5’, FLAG ESTABLISHMENT AS ‘INSURANCE COMPANY-FROM AN AGENT’. IF HX03 IS CODED ‘6’, FLAG ESTABLISHMENT AS ‘INSURANCE COMPANY’. IF HX03 IS CODED ‘7’, FLAG ESTABLISHMENT AS ‘HMO’. IF HX03 IS CODED ‘8’, FLAG ESTABLISHMENT AS ‘PREVIOUS EMPLOYER, NOT COBRA’. IF HX03 IS CODED ‘9’, FLAG ESTABLISHMENT AS ‘COBRA’. IF HX03 IS CODED ‘10’, FLAG ESTABLISHMENT AS ‘HIGH RISK POOL’. IF HX03 IS CODED ‘11’, FLAG ESTABLISHMENT AS ‘EXCHANGE COVERAGE’. IF HX03 IS CODED ‘91’, FLAG ESTABLISHMENT AS ‘UNKNOWN TYPE-COLLECTED AT OTHER’. IF HX23 IS CODED ‘1’, FLAG ESTABLISHMENT AS ‘GROUP’. IF HX23 IS CODED ‘3’, FLAG ESTABLISHMENT AS ‘SCHOOL’. IF HX23 IS CODED ‘4’, FLAG ESTABLISHMENT AS ‘INSURANCE COMPANY-FROM AN AGENT’. IF HX23 IS CODED ‘5’, FLAG ESTABLISHMENT AS ‘INSURANCE COMPANY’. IF HX23 IS CODED ‘6’, FLAG ESTABLISHMENT AS ‘HMO’. IF HX23 IS CODED ‘7’, FLAG ESTABLISHMENT AS ‘UNION’. IF HX23 IS CODED ‘8’, FLAG ESTABLISHMENT AS ‘COBRA’. IF HX23 IS CODED ‘9’, FLAG ESTABLISHMENT AS ‘PREVIOUS EMPLOYER, NOT COBRA’. IF HX23 IS CODED ‘10’, FLAG ESTABLISHMENT AS ‘SPOUSE PREVIOUS EMPLOYER’. IF HX23 IS CODED ‘11’, FLAG ESTABLISHMENT AS ‘EMPLOYER’. IF HX23 IS CODED ‘12’, FLAG ESTABLISHMENT AS ‘UNKNOWN TYPE-OUTSIDE RU’. IF HX23 IS CODED ‘13’, FLAG ESTABLISHMENT AS ‘HIGH RISK POOL’. IF HX23 IS CODED ‘14’, FLAG ESTABLISHMENT AS ‘EXCHANGE COVERAGE’. IF HX23 IS CODED ‘91’, FLAG ESTABLISHMENT AS ‘UNKNOWN TYPE - COLLECTED AT OTHER’.
NOTE THAT ‘HEALTH INSURANCE PURCHASING ALLIANCE’ (CODE ‘4’ AT HX03 AND CODE ‘2’ AT HX23) WAS OMITTED IN PANEL 12 ROUND 2 AND WILL BE OMITTED IN ALL FUTURE ROUNDS. BOX_03
IF LOOPING ON AN HX23 CATEGORY, GO TO HP11
OTHERWISE, CONTINUE WITH HP09 HP09
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
DISPLAY ‘{Are/Is}’ IF NOT ROUND 5. DISPLAY ‘As of {END DATE}, {were/was}’ IF ROUND 5.
PERSON REFERS TO JOBHOLDER.
IF CODED ‘1’ (YES), FLAG JOBHOLDER AS ‘POLICYHOLDER’. HP10
{NAME OF ESTABLISHMENT} {STR-DT}
DISPLAY ‘is’ IF NOT ROUND 5. DISPLAY ‘was’ IF ROUND 5. DISPLAY ‘on {END DATE}’ IF ROUND 5. OTHERWISE, USE NULL DISPLAY.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), FLAG FOR EVENT CLEANUP.
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_2 COL # 1 HEADER: JOBHOLDER/EMPLOYER PAIR INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAME/ESTABLISHMENT NAME (PERS.FULLNAME/ ESTB.ESTBNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF EMPLOYER/JOBHOLDER PAIRS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL PAIRS ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER THAT MEET BOTH OF THE FOLLOWING CONDITIONS: 1. ESTABLISHMENT IS FLAGGED AS AN ‘EMPLOYER’ THAT IS ALSO FLAGGED AS ‘PROVIDES HEALTH INSURANCE’ AND 2. PERSON IS A JOBHOLDER AT THE JOB PROVIDED BY ESTABLISHMENT HP11
{NAME OF ESTABLISHMENT} {STR-DT}
DISPLAY ‘Please tell me the names of everyone who is a primary insured person or policyholder of the’ IF HX23 IS CODED ‘14’ (DIRECTLY FROM {STATE EXCHANGE NAME}). OTHERWISE, DISPLAY ‘Who {is/was} the primary insured person or policyholder of the’. DISPLAY ‘CODE ALL THAT APPLY’ IF HX23 IS CODED ‘14’ (DIRECTLY FROM {STATE EXCHANGE NAME}). OTHERWISE, USE A NULL DISPLAY.
DISPLAY ‘is’ IF NOT ROUND 5. DISPLAY ‘was’ IF ROUND 5. DISPLAY ‘on {END DATE}’ IF ROUND 5. OTHERWISE, USE NULL DISPLAY. DISPLAY A “POLICYHOLDER NOT LISTED IN DU” AND “POLICYHOLDER DECEASED” OPTION ON THIS SCREEN.
IF BOTH ‘POLICYHOLDER NOT LISTED IN DU’; AND ‘POLICYHOLDER DECEASED’ ARE NOT SELECTED, GO TO LOOP_02
IF ‘POLICYHOLDER DECEASED’ SELECTED, ALONE OR IN COMBINATION WITH OTHER NAMES EXCEPT ‘POLICYHOLDER NOT LISTED IN DU’, GO TO HP11B
IF ‘POLICYHOLDER NOT LISTED IN DU’ SELECTED, ALONE OR IN COMBINATION WITH OTHER NAMES AND/OR ‘POLICYHOLDER DECEASED’, CONTINUE WITH HP11A
ROSTER DETAILS: TITLE: DU_MEMBERS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY DU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS DU-MEMBERS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: NO FILTER; DISPLAY ALL DU MEMBERS. HP11A
{NAME OF ESTABLISHMENT} {STR-DT}
whenever this policyholder is being asked ABOUT IN THE REMAINDER OF HP, HQ, HX, AND OE, THE POLICYHOLDER NAME IN THE CONTEXT HEADER WILL BE DISPLAYED AS ‘PLCYHLDR NOT IN DU-’ FOLLOWED BY THE 15 CHARACTER ENTRY AT HP11A.
IF ‘POLICYHOLDER DECEASED’ SELECTED AT HP11, CONTINUE WITH HP11B
OTHERWISE, GO TO LOOP_02 HP11B
{NAME OF ESTABLISHMENT} {STR-DT}
FLAG POLICYHOLDER AS ‘DECEASED’.
WHENEVER THE POLICYHOLDER IS BEING ASKED ABOUT IN THE REMAINDER OF HP, HQ, HX, AND OE, THE POLICYHOLDER NAME IN THE CONTEXT HEADER WILL BE DISPLAYED AS ‘PLCYHLDR DECEASED-’ FOLLOWED BY THE FIRST 15 CHARACTERS OF THE ENTRY AT HP11B. LOOP_02
FOR EACH ELEMENT ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK BOX_04 - END_LP02
LOOP DEFINITION: LOOP_02 COLLECTS INFORMATION ABOUT THE POLICYHOLDER AND DEPENDENTS FOR EACH ESTABLISHMENT-PERSON. THIS LOOP CYCLES ON EACH ESTABLISHMENT-PERSON-PAIR CREATED AT HP09 AND HP11 DURING THE CURRENT ROUND FOR THE ESTABLISHMENT BEING CYCLED ON IN LOOP_01. BOX_04
IF LOOPING ON AN ESTABLISHMENT FLAGGED IN EMPLOYMENT AS ‘PROVIDES HEALTH INSURANCE’, GO TO BOX_07
OTHERWISE, CONTINUE WITH BOX_05 BOX_05
IF HX23 IS CODED ‘8’ (PREVIOUS EMPLOYER-COBRA), ‘9’ (PREVIOUS EMPLOYER-NOT COBRA), ‘10’ (SPOUSE PREVIOUS EMPLOYER), OR ‘11’ (OTHER EMPLOYER) CONTINUE WITH BOX_06
OTHERWISE, GO TO BOX_07 BOX_06
IF POLICYHOLDER WAS FLAGGED AT HP11 AS ‘DECEASED’, CODE HP12 AS ‘4’ (DECEASED) AUTOMATICALLY BY CAPI AND GO TO HP13
IF POLICYHOLDER IS NOT A CURRENT RU MEMBER, GO TO BOX_07
OTHERWISE, CONTINUE WITH HP12 HP12
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
IF CODED ‘4’ (DECEASED), FLAG POLICYHOLDER AS ‘DECEASED’.
HARD CHECK: CODE ‘4’ (DECEASED) CANNOT BE SELECTED FOR A POLICYHOLDER WHO IS A CURRENT RU MEMBER. HP12OV
SPECIFY: HP13
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘{Are/Is}’ IF HP12 IS CODED ‘1’ (CURRENTLY EMPLOYED). OTHERWISE, DISPLAY ‘{Were/Was}’. BOX_07
IF ESTABLISHMENT THAT PROVIDES INSURANCE IS FLAGGED AS: ‘EMPLOYER’ AND JOB SUBTYPE IS NOT ‘CURRENT MAIN’, ‘CURRENT MISCELLANEOUS JOB WITHIN REFERENCE PERIOD’, OR ‘RETIREMENT JOB’ OR ‘EMPLOYER’ AND [JOB SUBTYPE IS ‘FORMER MAIN’, ‘FORMER MISCELLANEOUS’ OR ‘LAST JOB OUTSIDE REFERENCE PERIOD’] AND JOB IS ALSO FLAGGED AS ‘NOT RETIRED FROM’ OR ‘PREVIOUS EMPLOYER, NOT COBRA’ (I.E., HX03-CODE ‘8’; HX23-CODE ‘9’) OR ‘EMPLOYER’ (I.E., HX23-CODE ‘11’) AND HP12 IS NOT CODED ‘1’ (CURRENTLY EMPLOYED) OR ‘SPOUSE PREVIOUS EMPLOYER’ (I.E., HX23-CODE ‘10’) OR ‘UNKNOWN TYPE-OUTSIDE RU’ (I.E., HX23-CODE ‘12’) OR ‘UNKNOWN TYPE-COLLECTED AT OTHER’ (I.E., HX23- CODE ‘91’), CONTINUE WITH HP14
OTHERWISE, GO TO BOX_07A HP14 {POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Is’ IF NOT ROUND 5. DISPLAY ‘Was’ IF ROUND 5. DISPLAY ‘on {END DATE}’ IF ROUND 5. OTHERWISE, USE NULL DISPLAY. BOX_07A
SMALL BUSINESS DETERMINATION IF ESTABLISHMENT-PERSON-PAIR BEING ASKED ABOUT MEETS THE FOLLOWING CONDITIONS: - PERSON WAS A JOBHOLDER AT ESTABLISHMENT, AND - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND - ESTABLISHMENT IS AN EMPLOYER FLAGGED AS ‘PROVIDES HEALTH INSURANCE’, AND - ESTABLISHMENT FLAGGED AS A CURRENT-MAIN-JOB, AND - JOB IS FLAGGED AS ‘SELF-EMPLOYED’, AND - EM124 IS GREATER THAN 1 BUT LESS THAN 200, CONTINUE WITH HP14A
SMALL BUSINESS DETERMINATION IF ESTABLISHMENT-PERSON-PAIR BEING ASKED ABOUT MEETS THE FOLLOWING CONDITIONS: - PERSON WAS A JOBHOLDER AT ESTABLISHMENT, AND - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND - ESTABLISHMENT IS AN EMPLOYER FLAGGED AS ‘PROVIDES HEALTH INSURANCE’, AND - ESTABLISHMENT FLAGGED AS A CURRENT-MAIN-JOB, AND - JOB IS FLAGGED AS ‘NOT SELF-EMPLOYED’, AND - FIRM SIZE IS SMALL (SEE DETERMINATION BELOW) - EM91 IS LESS THAN 200 OR - EM92 IS CODED ‘1’ (LESS THAN 10), ‘2’ (10 TO 25), ‘3’ (26 TO 49) OR ‘4’ (50 TO 100), AND - EM93 IS CODED ‘2’ (NO), CONTINUE WITH HP14A
OTHERWISE, GO TO HP15 HP14A {POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
FOR ‘RU STATE’, DISPLAY THE FULL STATE NAME ASSOCIATED WITH THIS RU’S ADDRESS. DISPLAY ‘, [which may also be known as {ALIAS B} {or {ALIAS C}}],’ IF THERE IS MORE THAN ONE SHOP NAME ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED. DISPLAY ‘or {ALIAS C}’ IF THERE ARE THREE SHOP NAMES ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED. FOR ‘STATE SHOP NAME-A’ ‘ALIAS B’, AND ‘ALIAS C’, DISPLAY THE SMALL BUSINESS HEALTH OPTIONS PROGRAM NAME ASSOCIATED WITH THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED. DISPLAY ‘new’ IF PANEL 17 ROUND 5, PANEL 18 ROUNDS 3-5, PANEL 19 ROUNDS 1-5 OR PANEL 20 ROUNDS 1-3 (YEARS 2014 AND 2015). OTHERWISE, USE A NULL DISPLAY. HP15
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘living here’ IF LOOPING ON CODE ‘12’ (OUTSIDE RU) AT HX23. DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5. HP16
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF ‘PERSON NOT LISTED IN RU’ IS SELECTED, FLAG INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT LISTED IN RU’.
GO TO BOX_08
ROSTER DETAILS: TITLE: RU_MEMBERS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL PERSONS ON THE RU-MEMBERS-ROSTER EXCLUDING THE PERSON WHO IS THE POLICYHOLDER FOR THIS INSURANCE; THAT IS, DO NOT DISPLAY THE NAME OF PERSON IN THE ESTABLISHMENT-PERSON-PAIR BEING ASKED ABOUT.
DISPLAY ‘PERSON NOT LISTED IN RU’ AS LAST ITEM ON ROSTER. HP17 {POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Does’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}, did’ IF ROUND 5.
IF CODED ‘1’ (YES), FLAG INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT LISTED IN RU’ IN HP16. BOX_08
IF THERE ARE NO POLICYHOLDERS OR DEPENDENTS WHO ARE CURRENT RU MEMBERS, THAT IS, POLICYHOLDER IS A DU MEMBER BUT NOT A CURRENT RU MEMBER, OR IS FLAGGED AS ‘NOT LISTED IN DU’ OR ‘POLICYHOLDER DECEASED’ AND INSURANCE ALSO FLAGGED ONLY AS ‘COVERING PERSON NOT IN RU’, GO TO END_LP02
OTHERWISE, CONTINUE WITH LOOP_03 LOOP_03
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_HP03 - END_LP03
LOOP DEFINITION: LOOP_03 COLLECTS TIME PERIOD COVERAGE FOR ALL CURRENT RU MEMBERS COVERED BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON CURRENT RU MEMBERS WHO ARE SELECTED AS DEPENDENTS AT HP16 AND THE RU MEMBER WHO IS FLAGGED AS THE POLICYHOLDER FOR THIS INSURANCE.
NAVIGATOR DETAILS: LOOP_03 USES NAV_HP03 TO CONTROL THE FLOW OF THE LOOP. NAV_HP03
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Self-Employed RU Member’s Insurance Coverage’ IF LOOPING ON AN HX03 CATEGORY. OTHERWISE, DISPLAY ‘Insurance Coverage Duration during Reference Period.’
ROSTER DETAILS: COL # 1 HEADER: QUESTION SERIES INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME) COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH RU MEMBER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS SELECTED AT HP16.
CONTINUE WITH BOX_09 FOR SELECTED RU MEMBER. BOX_09
ASK THE TIME PERIOD COVERED DETAIL (HQ) SECTION. AT COMPLETION OF TIME PERIOD COVERED DETAIL (HQ) SECTION, CONTINUE WITH END_LP03 END_LP03
CYCLE ON NEXT PERSON IN THE RU-ESTB-PLCYHLDR- COVRD-PERS-TRPLS-ROSTER WHO MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_03 AND CONTINUE WITH END_LP02 END_LP02
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER WHO MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_02 AND CONTINUE WITH BOX_10 BOX_10
IF LOOPING ON AN ESTABLISHMENT FLAGGED IN EMPLOYMENT AS ‘PROVIDES HEALTH INSURANCE’ AND NOT FLAGGED AS ‘SELF-EMPLOYED’ WITH A FIRM-SIZE-1, OR IF LOOPING ON AN ESTABLISHMENT FLAGGED AS ‘EXCHANGE COVERAGE’ (I.E., LOOPING ON HX03 CATEGORY ‘11’ OR HX23 CATEGORY ‘14’), GO TO END_LP01
OTHERWISE, CONTINUE WITH HP18 HP18
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY THE FOLLOWING FOR ‘CATEGORY NAME FROM HX03 OR HX23’: - ‘a professional association’ IF CODED ‘1’ AT HX03 - ‘a small business group’ IF CODED ‘2’ AT HX03 - ‘a union’ IF CODED ‘3’ AT HX03 - ‘an insurance agent’ IF CODED ‘5’ AT HX03 - ‘an insurance company’ IF CODED ‘6’ AT HX03 - ‘an HMO’ IF CODED ‘7’ AT HX03 - ‘a previous employer’ IF CODED ‘8’ AT HX03 - ‘a previous employer (COBRA)’ IF CODED ‘9’ AT HX03 - ‘a high risk pool’ IF CODED ‘10’ AT HX03 - ‘the {HX03OV OTHER SPECIFY TEXT}’ IF CODED ‘91’ AT HX03 - ‘source purchased for that business’ IF CODED ‘-7’ OR ‘-8’ AT HX03 - ‘a group or association’ IF CODED ‘1’ AT HX23 - ‘a school’ IF CODED ‘3’ AT HX23 - ‘an insurance agent’ IF CODED ‘4’ AT HX23 - ‘an insurance company’ IF CODED ‘5’ AT HX23 - ‘an HMO’ IF CODED ‘6’ AT HX23 - ‘a union’ IF CODED ‘7’ AT HX23 - ‘a previous employer (COBRA)’ IF CODED ‘8’ AT HX23 - ‘a previous employer (not COBRA)’ IF CODED ‘9’ AT HX23 - ‘a spouse’s (or deceased spouse’s) previous employer’ IF CODED ‘10’ AT HX23 - ‘some other employer’ IF CODED ‘11’ AT HX23 - ‘the plan of someone not living here’ IF CODED ‘12’ AT HX23 - ‘a high risk pool’ IF CODED ‘13’ AT HX23 - ‘the {HX23OV OTHER SPECIFY TEXT} IF CODED ‘91’ AT HX23 - ‘a source that provided directly purchased insurance’ IF CODED ‘-7’ OR ‘-8’ END_LP01
IF HP18 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT ESTABLISHMENT NAME.
IF HP18 IS NOT ASKED OR IS CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), END LOOP_01 AND CONTINUE WITH BOX_11 BOX_11
RETURN TO THE HEALTH INSURANCE (HX) SECTION.
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