Old Employment and Private Related Insurance (OE) SectionNovember 14, 2017 MEPS P21R5/P22R3/P23R1 NOTE: The MEPS instrument design changed beginning in Spring of 2018, affecting Panel 23 Round 1, Panel 22 Round 3, and Panel 21 Round 5, and affected the 2017 MEPS data files. The MEPS website releases the consolidated CAPI survey instruments each year for the Rounds 1 through 3 for the first year panel and Rounds 3 through 5 for the second year panel to accompany data releases. For the Full-Year 2017 PUFs, the Panel 22 Round 3 and Panel 21 Round 5 data were transformed to the degree possible to conform to the previous year (2016) design. For this reason, we are releasing 2016 CAPI survey instruments, updated to reflect 2017 dates, and users should note that not all changes to the instrument administered in the Spring of 2018 will be reflected in these documents.
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} FOR ROUNDS 2-5. FOR MOST PERSONS, THE END DATE FOR ROUNDS 2-4 WILL BE THE INTERVIEW DATE. FOR MOST PERSONS, THE END FOR ROUND 5 WILL BE DECEMBER 31 OF THE SECOND YEAR OF THE PANEL. BOX_00
CONTEXT HEADER DISPLAY INSTRUCTIONS: DISPLAY PERS.FULLNAME, ESTB.ESTBNAME, PRND.BEGREFMM, PRND.BEGREFDD, PRND.BEGREFYY, PRND.ENDREFMM, PRND.ENDREFDD, PRND.ENDREFYY BOX_01
IF ONE OR MORE RU MEMBERS STILL HOLDS A ‘CURRENT MAIN’ OR ‘CURRENT MISCELLANEOUS’ JOB THIS ROUND THAT WAS REPORTED DURING THE PREVIOUS ROUND AS PROVIDING HEALTH INSURANCE ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW, THAT IS: IF ONE OR MORE ESTABLISHMENT-PERSON-PAIRS IN THE RU MEET THE FOLLOWING CONDITIONS: - RJ01 OR RJ06 WAS CODED ‘1’ (YES) DURING THIS ROUND FOR THIS PAIR, AND - PERSON IS A JOBHOLDER AT ESTABLISHMENT, AND - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND - ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’ AND, - THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW (HQ01 WAS CODED ‘1’ (WHOLE TIME) OR HQ02 WAS CODED ‘1’ (YES) IN THE PREVIOUS ROUND), AND - JOB AT ESTABLISHMENT IS NOT FLAGGED AS ‘SELF- EMPLOYED’ WITH A FIRM-SIZE-1, CONTINUE WITH LOOP_01
NOTE: IF POLICYHOLDER WAS NOT PHYSICALLY PRESENT IN THE RU ON THE PREVIOUS ROUND’S INTERVIEW DATE, THE FIFTH CONDITION ABOVE CAN BE MET IF AT LEAST ONE DEPENDENT WAS COVERED BY POLICYHOLDER’S INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW DATE. THE LOOP WILL CYCLE ON THE POLICYHOLDER’S NAME.
OTHERWISE, GO TO BOX_10
NOTE: ESTABLISHMENT-PERSON-PAIRS WHERE THE POLICYHOLDER IS OUT-OF-SCOPE (E.G., DECEASED, INSTITUTIONALIZED, OUT OF COUNTRY) ON THE CURRENT ROUND’S INTERVIEW DATE, BUT WHERE THE ESTABLISHMENT-PERSON-PAIR COVERED DEPENDENTS WHO ARE STILL RU MEMBERS MAY STILL QUALIFY FOR LOOP_01. LOOP_01
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_OE01A - END_LP01
LOOP DEFINITION: LOOP_01 COLLECTS INFORMATION ABOUT THE CONTINUATION OF INSURANCE COVERAGE THROUGH A ‘CURRENT MAIN’ OR ‘CURRENT MISCELLANEOUS’ JOB THAT WAS COLLECTED IN THE PREVIOUS ROUND. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET THE FOLLOWING CONDITIONS: - RJ01 OR RJ06 WAS CODED ‘1’ (YES) DURING THIS ROUND FOR THIS PAIR, AND - PERSON IS A JOBHOLDER AT ESTABLISHMENT, AND - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND - ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’ AND, - THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW (HQ01 WAS CODED ‘1’ (WHOLE TIME) OR HQ02 WAS CODED ‘1’ (YES) IN THE PREVIOUS ROUND), AND - JOB AT ESTABLISHMENT IS NOT FLAGGED AS ‘SELF- EMPLOYED’ WITH A FIRM-SIZE-1
NAVIGATOR DETAILS: LOOP_01 USES BOTH NAV_OE01A AND OE01B TO CONTROL THE FLOW OF THE LOOP. NAV_OE01A
SERIES: Confirming Insurance from a Previous Round
through a
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET THE CONDITIONS STATED AT THE LOOP_01 DEFINITION.
CONTINUE WITH NAV_OE01B FOR SELECTED RU MEMBER. NAV_OE01B
SERIES: Confirming Insurance from a Previous Round
through a
ROSTER DETAILS: COL # 1 HEADER: POLICYHOLDER...EMPLOYER PROVIDING INSURANCE INSTRUCTIONS: DISPLAY RU-ESTABLISHMENT-PERSON- PAIR COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH PAIR EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL EMPLOYERS THAT MEET THE CONDITIONS STATED AT THE LOOP_01 DEFINITION.
CONTINUE WITH OE01 FOR SELECTED PAIR.
OE01
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘{Are/Is}’ IF NOT ROUND 5. DISPLAY ‘{Were/Was}’ IF ROUND 5. DISPLAY ‘today,’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY. OE02
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘IF INSURANCE ENDED... SELECT ‘YES’.’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE02OV
OTHERWISE, GO TO BOX_02
OE02OV
Can you just tell me if {you/he/she} {were/was}
covered under that BOX_02
IF THE POLICYHOLDER IS THE ONLY PERSON COVERED AT THE PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, AUTOMATICALLY CODE OE03 AS ‘1’ (YES) AND GO TO BOX_03
OTHERWISE, CONTINUE WITH OE03 OE03
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Are’ IF OE01 IS CODED ‘1’ (YES). DISPLAY ‘Were’ IF OE01 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE02 DATE}’ IF OE01 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE01 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE02 FOR ‘OE02 DATE’. IF THE MONTH OR YEAR FIELD AT OE02 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE02 DATE’.
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER FOR DISPLAY.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, INCLUDING THE POLICYHOLDER 2. PERSON IS AN RU MEMBER BOX_03
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO THE END DATE OF THE CURRENT ROUND, THAT IS: IF OE01 IS CODED ‘1’ (YES) AND OE03 IS CODED ‘1’ (YES), FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS ‘CONTINUOUS COVERAGE’ THROUGH THE REFERENCE PERIOD END DATE AND GO TO BOX_05
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO PART OF THE CURRENT ROUND, THAT IS: IF OE01 IS CODED ‘2’ (NO) AND OE03 IS CODED ‘1’ (YES), FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS ‘CONTINUOUS COVERAGE’ THROUGH THE DATE RECORDED AT OE02 AND GO TO BOX_05
OTHERWISE (I.E., OE03 CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)), CONTINUE WITH OE04 OE04
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘is’ IF OE01 IS CODED ‘1’ (YES). DISPLAY ‘was’ IF OE01 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE02 DATE}’ IF OE01 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE01 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE02 FOR ‘OE02 DATE’. IF THE MONTH OR YEAR FIELD AT OE02 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE02 DATE’.
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE01 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE04 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE01 IS CODED ‘2’ (NO), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE04 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL DATE RECORDED AT OE02.
GO TO LOOP_02
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, INCLUDING THE POLICYHOLDER 2. PERSON IS AN RU MEMBER LOOP_02
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE02 - END_LP02
LOOP DEFINITION: LOOP_02 COLLECTS THE DATE ON WHICH THE INSURANCE COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER WHOSE COVERAGE ENDED EITHER PRIOR TO THE REFERENCE PERIOD END DATE OR THE DATE REPORTED IN OE02. THIS LOOP CYCLES ON PERSONS SELECTED AT OE04.
NAVIGATOR DETAILS: LOOP_02 USES NAV_OE02 TO CONTROL THE FLOW OF THE LOOP. NAV_OE02
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE04.
CONTINUE WITH OE05 FOR SELECTED RU MEMBER. OE05
{POLICYHOLDER’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE05OV
OTHERWISE, GO TO BOX_04 OE05OV
Can you just tell me if {you/he/she} {were/was} was
covered under that BOX_04
FLAG INSURANCE FOR PERSON AS ‘CONTINUOUS COVERAGE’ THROUGH THE COMPLETE DATE RECORDED AT OE05 AND OE05OV. END_LP02
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_02 AND CONTINUE WITH BOX_05 BOX_05
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE04), CONTINUE WITH OE06
OTHERWISE, GO TO OE08A OE06
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}’ IF ROUND 5. OE07
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘has been’ AND ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘was’ AND ‘between {START DATE} and {END DATE}’ IF ROUND 5.
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR- COVRD-PERS-TRPLS-ROSTER.
IF ‘PERSON NOT LISTED IN RU’ IS SELECTED, FLAG INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT LISTED IN RU’.
GO TO LOOP_03
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. INTERVIEWER MAY SELECT ONE OR MORE FROM THE LISTED MEMBERS. 2. ADD, DELETE, AND EDIT DISALLOWED. 3. DISPLAY ‘PERSON NOT LISTED IN RU’ AS LAST ENTRY ON THIS ROSTER.
ROSTER FILTER: DISPLAY PERSONS WHO WERE NOT COVERED BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ON THE PREVIOUS ROUND’S INTERVIEW DATE. LOOP_03
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE03 - END_LP03
LOOP DEFINITION: LOOP_03 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON PERSONS SELECTED AT OE07.
NAVIGATOR DETAILS: LOOP_03 USES NAV_OE03 TO CONTROL THE FLOW OF THE LOOP. NAV_OE03
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE07.
CONTINUE WITH OE08 FOR SELECTED RU MEMBER. OE08
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE08OV
OTHERWISE, GO TO BOX_06 OE08OV
Can you just tell me if {you/he/she} {were/was}
covered under that
HARD CHECK: COMPLETE DATE AT OE08 MUST BE < THAN COMPLETE DATE AT OE02 IF A DATE IS RECORDED AT OE02 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS RECORDED AT OE02. BOX_06
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE01 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE08 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH ESTABLISHMENT-PERSON-PAIR (OE01 IS CODED ‘2’ (NO)) FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE08 UNTIL DATE RECORDED AT OE02. END_LP03
CYCLE ON NEXT PERSON IN 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 GO TO BOX_07 OE08A
{POLICYHOLDER’S 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 OE07 BOX_07
IF ONE OR MORE RU MEMBERS ARE STILL COVERED BY THE INSURANCE THROUGH THE ESTABLISHMENT-PERSON- PAIR ON THE CURRENT ROUND’S INTERVIEW DATE, THAT IS, OE01 IS CODED ‘1’ (YES), CONTINUE WITH BOX_07A
OTHERWISE, GO TO END_LP01 BOX_07A
IF ROUND 3, CONTINUE WITH OE09A
OTHERWISE, GO TO OE09 OE09A
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
NOTE: THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE, NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY. OE09AA
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
NOTE: THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE, NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY.
CONTINUE WITH OE09AAOV1 OE09AAOV1 UNIT OF COVERAGE: OE09AAOV2
SPECIFY: BOX_08AA
IF INSURANCE BEING ASKED ABOUT PROVIDES MEDICARE SUPPLEMENT/MEDIGAP COVERAGE (I.E., HX48 OR OE10 OR OE24 OR OE37 WAS CODED ‘5’ (MEDICARE SUPPLEMENT /MEDIGAP) EITHER ALONE OR WITH ANY COMBINATION OF CODES IN THE PREVIOUS ROUND FOR THIS ESTABLISHMENT -PERSON-PAIR), GO TO OE09
OTHERWISE, CONTINUE WITH OE09B OE09B
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘$1,300 or $1,300’ IN THE QUESTION TEXT AND ‘$1,300’ IN THE RESPONSE CATEGORY OPTIONS IF THE POLICYHOLDER IS THE ONLY COVERED RU MEMBER AND THERE ARE NO DEPENDENTS OUTSIDE THE RU (OE08A IS CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)) FOR THE PAIR BEING ASKED ABOUT. OTHERWISE (E.G., AT LEAST ONE RU MEMBER, OTHER THAN THE POLICYHOLDER IS LISTED AS A COVERED PERSON FOR THIS PAIR OR OE08A IS CODED ‘1’ (YES) FOR THIS PAIR OR THE POLICYHOLDER IS NOT IN THE RU), DISPLAY ‘family’ and ‘$2,600 or $2,600’ IN THE QUESTION TEXT AND ‘$2,600’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER <= 2 AND OE08A IS CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), THEN DISPLAY ‘1,300 or 1,300’ IN THE QUESTION TEXT AND ‘1,300’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER <= 2 AND OE08A IS CODED ‘1’ (YES), THEN DISPLAY ‘family’ AND ‘2,600 or 2,600’ IN THE QUESTION TEXT AND ‘2,600’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER > 2, THEN DISPLAY ‘family’ AND ‘2,600 or 2,600’ IN THE QUESTION TEXT AND ‘2,600’ IN THE RESPONSE CATEGORY OPTIONS. OE09C
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF OE09
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY FIRST PARAGRAPH IF THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON- PAIR HAD ANY INSURERS FLAGGED AS PROVIDING MEDIGAP OR HOSPITAL/PHYSICIAN BENEFITS AT ANY TIME DURING THE PREVIOUS ROUND.
FOR ‘NAME OF INSURER BEING LOOPED ON’, DISPLAY THE NAME OF THIS POLICYHOLDER’S CURRENT ROUND’S PRIVATE OR MEDIGAP INSURER FOR PLAN NAME. THAT IS, DISPLAY THE NAME OF THE PLAN (PROVIDING MEDICARE SUPPLEMENT / MEDIGAP BENEFITS OR HOSPITAL/ PHYSICIAN BENEFITS) ENTERED AT HX49, HX51, OE11, OE25, OE36, OR OE38.
DISPLAY ‘Since {START DATE}, has there been’ AND ‘{have/has}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}, was there’ AND ‘had’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), FLAG PREVIOUS ROUND’S INSURER AS CURRENT ROUND’S INSURER FOR THIS ESTABLISHMENT-PERSON- PAIR. OE10
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘{do/does}’ IF NOT ROUND 5. DISPLAY ‘did’ IF ROUND 5. DISPLAY ‘now’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY. DISPLAY ‘as of {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) IN COMBINATION WITH ANY OTHER CODE.
IF CODED ‘91’ (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER CODES, CONTINUE WITH OE10OV
OTHERWISE, GO TO BOX_08 OE10OV
SPECIFY: BOX_08
NOTE: ALL ESTABLISHMENTS WHICH ARE BEING LOOPED ON HERE ARE EMPLOYERS. THEREFORE, IT IS NOT NECESSARY TO AUTOMATICALLY CODE OE11 IF THE ESTABLISHMENT IS AN INSURANCE COMPANY OR HMO.
IF OE10 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS) OR ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP), ALONE OR WITH ANY OTHER COMBINATION OF CODES, CONTINUE WITH OE11
OTHERWISE, GO TO BOX_07AA OE11
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘hospital and physician benefits’ AND ‘HOSPITAL AND PHYSICIAN’ IF OE10 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP). DISPLAY ‘Medicare supplement or Medigap benefits’ AND ‘MEDIGAP’ IF OE10 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP).
WRITE INSURER(S) TO THE RU-ESTAB-PERSON-INSURER- TRIPLES-ROSTER FOR THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR.
FLAG INSURER(S) COLLECTED AT OE11 AS CURRENT ROUND’S INSURER(S) FOR THIS ESTABLISHMENT-PERSON- PAIR.
IF OE10 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP) FLAG INSURANCE CO./HMO AS ‘SUPPLYING MEDICARE SUPPLEMENT/MEDIGAP BENEFITS (WHICH INCLUDES HOSPITAL/PHYSICIAN BENEFITS)’ FOR THE CURRENT ROUND.
IF OE10 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT ‘5’ (MEDICARE SUPPLEMENT/ MEDIGAP), FLAG INSURANCE CO./HMO AS ‘SUPPLYING HOSPITAL/PHYSICIAN BENEFITS’ FOR THE CURRENT ROUND. LOOP_04
FOR EACH ELEMENT ON THE RU-ESTAB-PERSON-INSURER- TRIPLES-ROSTER, ASK BOX_09A - END_LP04.
LOOP DEFINITION: LOOP_04 COLLECTS MANAGED CARE INFORMATION FOR INSURERS COLLECTED AT OE11. THIS LOOP CYCLES ON TRIPLES THAT MEET THE FOLLOWING CONDITIONS: - ESTABLISHMENT-PERSON-PAIR PROVIDES THE INSURANCE BEING ASKED ABOUT - INSURER IS ENTERED AT OE11 BOX_09A
IF INSURER BEING LOOPED ON IS CODED ‘2’ (HMO) IN OE11, GO TO END_LP04
OTHERWISE, CONTINUE WITH BOX_09 BOX_09
ASK THE MANAGED CARE (MC) SECTION FOR THIS INSURER AT COMPLETION OF MANAGED CARE (MC) SECTION, CONTINUE WITH END_LP04 END_LP04
CYCLE ON NEXT INSURER IN THE RU-ESTAB-PERSON- INSURER-TRIPLES-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER INSURERS MEET THE STATED CONDITIONS, END LOOP_04 AND CONTINUE WITH BOX_07AA BOX_07AA
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 OE08B
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 OE08B
OTHERWISE, GO TO END_LP01 OE08B
{POLICYHOLDER’S 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. END_LP01
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_01 AND CONTINUE WITH BOX_10 BOX_10
IF ONE OR MORE RU MEMBERS DOES NOT STILL HOLD A ‘CURRENT MAIN’ OR ‘CURRENT MISCELLANEOUS’ JOB THIS ROUND THAT WAS REPORTED DURING THE PREVIOUS ROUND AS PROVIDING HEALTH INSURANCE ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW, THAT IS: IF ONE OR MORE ESTABLISHMENT-PERSON-PAIRS IN THE RU MEET THE FOLLOWING CONDITIONS: - RJ01 OR RJ06 WAS CODED ‘2’ (NO), ‘-7’ (REFUSED), ‘-8’ (DON’T KNOW) DURING THIS ROUND FOR THIS PAIR, AND - PERSON WAS A JOBHOLDER AT ESTABLISHMENT, AND - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND - ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’ AND, - THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW (HQ01 WAS CODED ‘1’ (WHOLE TIME) OR HQ02 WAS CODED ‘1’ (YES) IN THE PREVIOUS ROUND), AND - JOB AT ESTABLISHMENT IS NOT FLAGGED AS ‘SELF- EMPLOYED’ WITH A FIRM-SIZE-1, CONTINUE WITH LOOP_05
OTHERWISE, GO TO BOX_19
NOTE: IF POLICYHOLDER WAS NOT PHYSICALLY PRESENT IN THE RU ON THE PREVIOUS ROUND’S INTERVIEW DATE, THE FIFTH CONDITION IN THE ABOVE BOX CAN BE MET IF AT LEAST ONE DEPENDENT WAS COVERED BY POLICYHOLDER’S INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW DATE. COVERAGE FOR THE POLICYHOLDER IS ASSUMED IN THAT CASE AND THE LOOP WILL CYCLE ON THE POLICYHOLDER’S NAME.
NOTE: ESTABLISHMENT-PERSON-PAIRS WHERE THE POLICYHOLDER IS OUT-OF-SCOPE (E.G., DECEASED, INSTITUTIONALIZED, OUT OF COUNTRY) ON THE CURRENT ROUND’S INTERVIEW DATE, BUT WHERE THE ESTABLISHMENT-PERSON-PAIR COVERED DEPENDENTS WHO ARE STILL RU MEMBERS MAY STILL QUALIFY FOR LOOP_05. LOOP_05
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_OE05A - END_LP05
LOOP DEFINITION: LOOP_05 COLLECTS INFORMATION ABOUT THE CONTINUATION OF INSURANCE COVERAGE THROUGH A NO LONGER HELD ‘CURRENT MAIN’ OR ‘CURRENT MISCELLANEOUS’ JOB THAT WAS COLLECTED IN THE PREVIOUS ROUND. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET THE FOLLOWING CONDITIONS: - RJ01 OR RJ06 WAS CODED ‘2’ (NO), ‘-7’ (REFUSED), ‘-8’ (DON’T KNOW) DURING THIS ROUND FOR THIS PAIR, AND - PERSON WAS A JOBHOLDER AT ESTABLISHMENT, AND - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND - ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’ AND, - THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW (HQ01 WAS CODED ‘1’ (WHOLE TIME) OR HQ02 WAS CODED ‘1’ (YES) IN THE PREVIOUS ROUND), AND - JOB AT ESTABLISHMENT IS NOT FLAGGED AS ‘SELF- EMPLOYED’ WITH A FIRM-SIZE-1.
NAVIGATOR DETAILS: LOOP_05 USES BOTH NAV_OE05A AND OE05B TO CONTROL THE FLOW OF THE LOOP. NAV_OE05A
SERIES: Confirming Insurance from a Previous Round
through a
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET THE CONDITIONS STATED AT THE LOOP_05 DEFINITION.
CONTINUE WITH NAV_OE05B FOR SELECTED RU MEMBER. NAV_OE05B
SERIES: Confirming Insurance from a Previous Round
through a
ROSTER DETAILS: COL # 1 HEADER: POLICYHOLDER...FORMER EMPLOYER PROVIDING INSURANCE INSTRUCTIONS: DISPLAY RU-ESTABLISHMENT-PERSON- PAIR COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH PAIR EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL EMPLOYERS THAT MEET THE CONDITIONS STATED AT THE LOOP_05 DEFINITION.
CONTINUE WITH OE12 FOR SELECTED PAIR. OE12
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘{Are/Is}’ IF NOT ROUND 5. DISPLAY ‘{Were/Was}’ IF ROUND 5. DISPLAY ‘today,’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY. OE13
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF OE14
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF OE15
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘IF INSURANCE ENDED... SELECT ‘YES’.’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE15OV
OTHERWISE, GO TO BOX_11 OE15OV
Can you just tell me if {you/he/she} {were/was}
covered under that OE16
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
IF THE POLICYHOLDER IS THE ONLY PERSON COVERED AT THE PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, AUTOMATICALLY CODE OE17 AS ‘1’ (YES) AND GO TO BOX_12
OTHERWISE, CONTINUE WITH OE17 OE17
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Are’ IF OE12 IS CODED ‘1’ (YES). DISPLAY ‘Were’ IF OE12 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE15 DATE}’ IF OE12 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE12 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE15 FOR ‘OE15 DATE’. IF THE MONTH OR YEAR FIELD AT OE15 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE15 DATE’.
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS PERSONS ON THE RU-ESTB- PLCYHLDR-COVRD-PERS-TRPLS-ROSTER FOR DISPLAY.
ROSTER BEHAVIOR: 1. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, INCLUDING THE POLICYHOLDER AND 2. PERSON IS AN RU MEMBER BOX_12
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO THE END DATE OF THE CURRENT ROUND, THAT IS: IF OE12 IS CODED ‘1’ (YES) AND OE17 IS CODED ‘1’ (YES), FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS ‘CONTINUOUS COVERAGE’ THROUGH THE REFERENCE PERIOD END DATE AND GO TO BOX_14
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO PART OF THE CURRENT ROUND, THAT IS: IF OE12 IS CODED ‘2’ (NO) AND OE17 IS CODED ‘1’ (YES), FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS ‘CONTINUOUS COVERAGE’ THROUGH THE DATE RECORDED AT OE15 AND GO TO BOX_14
OTHERWISE (I.E., OE17 CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)), CONTINUE WITH OE18 OE18
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘is’ IF OE12 IS CODED ‘1’ (YES). DISPLAY ‘was’ IF OE12 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE15 DATE}’ IF OE12 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE12 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE15 FOR ‘OE15 DATE’. IF THE MONTH OR YEAR FIELD AT OE15 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE15 DATE’.
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE12 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE18 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE12 IS CODED ‘2’, (NO)), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE18 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL DATE RECORDED AT OE15.
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT THE PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, INCLUDING THE POLICYHOLDER 2. PERSON IS AN RU MEMBER LOOP_06
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE06 - END_LP06
LOOP DEFINITION: LOOP_06 COLLECTS THE DATE ON WHICH THE INSURANCE COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER WHOSE COVERAGE ENDED PRIOR TO THE REFERENCE PERIOD END DATE OR THE DATE REPORTED IN OE15. THIS LOOP CYCLES ON PERSONS SELECTED AT OE18.
NAVIGATOR DETAILS: LOOP_06 USES NAV_OE06 TO CONTROL THE FLOW OF THE LOOP. NAV_OE06
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE18.
CONTINUE WITH OE19 FOR SELECTED RU MEMBER. OE19
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE19OV
OTHERWISE, GO TO BOX_13 OE19OV
Can you just tell me if {you/he/was} {were/was} was
covered under that BOX_13
FLAG INSURANCE FOR PERSON AS ‘CONTINUOUS COVERAGE’ THROUGH THE COMPLETE DATE RECORDED AT OE19 AND OE19OV. END_LP06
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_06 AND CONTINUE WITH BOX_14 BOX_14
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE18), CONTINUE WITH OE20
OTHERWISE, GO TO OE22A OE20
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}’ IF ROUND 5. OE21
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘has been’ AND ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘was’ AND ‘between {START DATE} and {END DATE}’ IF ROUND 5.
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR- COVRD-PERS-TRPLS-ROSTER.
IF ‘PERSON NOT LISTED IN RU’ IS SELECTED, FLAG INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT LISTED IN RU’.
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. INTERVIEWER MAY SELECT ONE OR MORE FROM THE LISTED MEMBERS. 2. ADD, DELETE, AND EDIT DISALLOWED. 3. DISPLAY ‘PERSON NOT LISTED IN RU’ AS LAST ENTRY ON THIS ROSTER.
ROSTER FILTER: DISPLAY PERSONS WHO WERE NOT COVERED BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ON THE PREVIOUS ROUND’S INTERVIEW DATE. LOOP_07
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE07 - END_LP07
LOOP DEFINITION: LOOP_07 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON PERSONS SELECTED AT OE21.
NAVIGATOR DETAILS: LOOP_07 USES NAV_OE07 TO CONTROL THE FLOW OF THE LOOP. NAV_OE07
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE21.
CONTINUE WITH OE22 FOR SELECTED RU MEMBER. OE22
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE22OV
OTHERWISE, GO TO BOX_15 OE22OV
Can you just tell me if {you/he/she} {were/was}
covered under that
HARD CHECK: COMPLETE DATE AT OE22 MUST BE < THAN COMPLETE DATE AT OE15 IF A DATE IS RECORDED AT OE15 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS RECORDED AT OE15. BOX_15
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE12 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE22 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE12 IS CODED ‘2’ (NO)), FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE22 UNTIL DATE RECORDED AT OE15. END_LP07
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_07 AND GO TO BOX_16 OE22A
{POLICYHOLDER’S 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 OE21 BOX_16
IF ONE OR MORE RU MEMBERS ARE STILL COVERED BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON- PAIR ON THE CURRENT ROUND’S INTERVIEW DATE, THAT IS, OE12 IS CODED ‘1’(YES), CONTINUE WITH BOX_16A
OTHERWISE, GO TO END_LP05 BOX_16A
IF ROUND 3, CONTINUE WITH OE23A
OTHERWISE, GO TO OE23 OE23A
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
NOTE: THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE, NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY. OE23AA
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
NOTE: THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE, NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY. OE23AAOV1
Is that per year, per month, per week, or what? OE23AAOV2
SPECIFY: BOX_17AA
IF INSURANCE BEING ASKED ABOUT PROVIDES MEDICARE SUPPLEMENT/MEDIGAP COVERAGE (I.E., HX48 OR OE10 OR OE24 OR OE37 WAS CODED ‘5’ (MEDICARE SUPPLEMENT /MEDIGAP) EITHER ALONE OR WITH ANY COMBINATION OF CODES IN THE PREVIOUS ROUND FOR THIS ESTABLISHMENT -PERSON-PAIR), GO TO OE23
OTHERWISE, CONTINUE WITH OE23B OE23B
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘$1,300 or $1,300’ IN THE QUESTION TEXT AND ‘$1,300’ IN THE RESPONSE CATEGORY OPTIONS IF THE POLICYHOLDER IS THE ONLY COVERED RU MEMBER AND THERE ARE NO DEPENDENTS OUTSIDE THE RU (OE22A IS CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)) FOR THE PAIR BEING ASKED ABOUT. OTHERWISE (E.G., AT LEAST ONE RU MEMBER, OTHER THAN THE POLICYHOLDER IS LISTED AS A COVERED PERSON FOR THIS PAIR OR OE22A IS CODED ‘1’ (YES) FOR THIS PAIR OR THE POLICYHOLDER IS NOT IN THE RU), DISPLAY ‘family’ and ‘$2,600 or $2,600’ IN THE QUESTION TEXT AND ‘$2,600’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER <= 2 AND OE22A IS CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), THEN DISPLAY ‘1,300 or 1,300’ IN THE QUESTION TEXT AND ‘1,300’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER <= 2 AND OE22A IS CODED ‘1’ (YES), THEN DISPLAY ‘family’ AND ‘2,600 or 2,600’ IN THE QUESTION TEXT AND ‘2,600’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER > 2, THEN DISPLAY ‘family’ AND ‘2,600 or 2,600’ IN THE QUESTION TEXT AND ‘2,600’ IN THE RESPONSE CATEGORY OPTIONS. OE23C
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF OE23
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY FIRST PARAGRAPH IF THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON- PAIR HAD ANY INSURERS FLAGGED AS PROVIDING MEDIGAP OR HOSPITAL/PHYSICIAN BENEFITS AT ANY TIME DURING THE PREVIOUS ROUND.
FOR ‘NAME OF INSURER BEING LOOPED ON’, DISPLAY
THE NAME OF THIS POLICYHOLDER’S CURRENT ROUND’S PRIVATE OR MEDIGAP INSURER FOR PLAN NAME. THAT IS, DISPLAY THE NAME OF THE PLAN (PROVIDING MEDICARE SUPPLEMENT / MEDIGAP BENEFITS OR HOSPITAL/ PHYSICIAN BENEFITS) ENTERED AT HX49, HX51, OE11, OE25, OE36, OR OE38.
DISPLAY ‘Since {START DATE}, has there been’ AND ‘{have/has}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}, ‘was there’ AND ‘had’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), FLAG PREVIOUS ROUND’S INSURER AS CURRENT ROUND’S INSURER FOR THIS ESTABLISHMENT-PERSON- PAIR. OE24
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘{do/does}’ IF NOT ROUND 5. DISPLAY ‘did’ IF ROUND 5. DISPLAY ‘now’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY. DISPLAY ‘as of {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) IN COMBINATION WITH ANY OTHER CODE.
IF CODED ‘91’ (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER CODES, CONTINUE WITH OE24OV
OTHERWISE, GO TO BOX_17 OE24OV
SPECIFY: BOX_17
IF OE24 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS) OR ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP), ALONE OR WITH ANY OTHER COMBINATION OF CODES, CONTINUE WITH OE25
OTHERWISE, GO TO END_LP05
NOTE: ALL ESTABLISHMENTS WHICH ARE BEING LOOPED ON HERE ARE EMPLOYERS. THEREFORE, IT IS NOT NECESSARY TO AUTOMATICALLY CODE OE25 IF THE ESTABLISHMENT IS AN INSURANCE CO. OR HMO. OE25
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘hospital and physician benefits’ AND ‘HOSPITAL AND PHYSICIAN’ IF OE24 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP). DISPLAY ‘Medicare supplement or Medigap benefits’ AND ‘MEDIGAP’ IF OE24 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP).
WRITE INSURER(S) TO THE RU-ESTB-PERSON-INSURER- TRIPLES-ROSTER FOR THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR.
FLAG INSURER(S) COLLECTED AT OE25 AS CURRENT ROUND’S INSURER(S) FOR THIS ESTABLISHMENT-PERSON- PAIR.
IF OE24 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP) FLAG INSURANCE CO./HMO AS ‘SUPPLYING MEDICARE SUPPLEMENT/MEDIGAP BENEFITS (WHICH INCLUDES HOSPITAL/PHYSICIAN BENEFITS)’ FOR THE CURRENT ROUND.
IF OE24 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT ‘5’ (MEDICARE SUPPLEMENT/ MEDIGAP), FLAG INSURANCE CO./HMO AS ‘SUPPLYING HOSPITAL/PHYSICIAN BENEFITS’ FOR THE CURRENT ROUND. LOOP_08
FOR EACH ELEMENT ON THE RU-ESTAB-PERSON-INSURER- TRIPLES-ROSTER, ASK BOX_18A - END_LP08.
LOOP DEFINITION: LOOP_08 COLLECTS MANAGED CARE INFORMATION FOR INSURERS COLLECTED AT OE25. THIS LOOP CYCLES ON TRIPLES THAT MEET THE FOLLOWING CONDITIONS: - ESTABLISH-PERSON-PAIR PROVIDES THE INSURANCE BEING ASKED ABOUT - INSURER IS ENTERED AT OE25 BOX_18A
IF INSURER BEING LOOPED ON IS CODED ‘2’ (HMO) IN OE25, GO TO END_LP08
OTHERWISE, CONTINUE WITH BOX_18 BOX_18
ASK THE MANAGED CARE (MC) SECTION FOR THIS INSURER AT COMPLETION OF MANAGED CARE (MC) SECTION, CONTINUE WITH END_LP08 END_LP08
CYCLE ON NEXT INSURER IN THE RU-ESTAB-PERSON- INSURER-TRIPLES-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER INSURERS MEET THE STATED CONDITIONS, END LOOP_08 AND CONTINUE WITH END_LP05 END_LP05
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_05 AND CONTINUE WITH BOX_19 BOX_19
IF ONE OR MORE OF RU MEMBERS WAS COVERED BY INSURANCE THROUGH A NON-CURRENT EMPLOYER FROM THE PREVIOUS ROUND, AN EMPLOYER FLAGGED AS ‘SELF- EMPLOYED’ WITH A FIRM-SIZE-1, OR A DIRECT PURCHASE SOURCE ON THE PREVIOUS ROUND’S INTERVIEW DATE, THAT IS: IF ONE OR MORE ESTABLISHMENT-PERSON-PAIRS IN THE RU MEETS THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS ONE OF THE FOLLOWING TYPES: - FLAGGED AS A DIRECT PURCHASE SOURCE - FLAGGED AS AN ‘EMPLOYER’ WITH FIRM-SIZE-1, FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’, OR - FLAGGED AS AN ‘EMPLOYER’ WITH FIRM-SIZE- GREATER-THAN-1, FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’, AND HAD ONE OF THE FOLLOWING JOB SUBTYPES DURING THE PREVIOUS ROUND: - ‘FORMER MAIN WITHIN REFERENCE PERIOD’ - ‘FORMER MISCELLANEOUS JOB WITHIN REFERENCE PERIOD’ - ‘LAST JOB OUTSIDE REFERENCE PERIOD’ - ‘RETIREMENT JOB’ - PERSON IS OR WAS A JOBHOLDER AT ESTABLISHMENT, IF THE ESTABLISHMENT IS ONE OF THE SECOND 2 TYPES NOTED ABOVE; - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE; - THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW (HQ WAS CODED ‘1’ (WHOLE TIME) OR HQ02 WAS CODED ‘1’ (YES) IN THE PREVIOUS ROUND); CONTINUE WITH LOOP_09
OTHERWISE, GO TO BOX_29
NOTE: IF POLICYHOLDER WAS NOT PHYSICALLY PRESENT IN THE RU ON THE PREVIOUS ROUND’S INTERVIEW DATE, THE LAST CONDITION IN THE ABOVE BOX CAN BE MET IF AT LEAST ONE DEPENDENT WAS COVERED BY POLICYHOLDER’S INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW DATE. THE LOOP WILL CYCLE ON THE POLICYHOLDER’S NAME.
NOTE: ESTABLISHMENT-PERSON-PAIRS WHERE THE POLICYHOLDER IS OUT-OF-SCOPE (E.G., DECEASED, INSTITUTIONALIZED, OUT OF COUNTRY) ON THE CURRENT ROUND’S INTERVIEW DATE, BUT WHERE THE ESTABLISHMENT-PERSON-PAIR COVERED DEPENDENTS WHO ARE STILL RU MEMBERS MAY STILL QUALIFY FOR LOOP_09.
NOTE: FOR DIRECT PURCHASE AND SELF-EMPLOYED-FIRM- SIZE-1, THE CONTEXT HEADER SHOULD DISPLAY THE NAME OF THE SOURCE PROVIDING THE INSURANCE RATHER THAN THE NAME OF THE DIRECT PURCHASE CATEGORY OR THE SELF-EMPLOYED-FIRM-SIZE-1 EMPLOYER NAME OR TYPE OF PURCHASE CATEGORY. FOR EMPLOYERS WHICH ARE NOT SELF-EMPLOYED WITH FIRM-SIZE-1, USE THE JOBHOLDER NAME AND EMPLOYER NAME IN THE CONTEXT HEADER. LOOP_09
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_OE09A - END_LP09
LOOP DEFINITION: LOOP_09 COLLECTS INFORMATION ABOUT THE CONTINUATION OF INSURANCE COVERAGE THROUGH A NON-CURRENT EMPLOYER FROM THE PREVIOUS ROUND, AN EMPLOYER FLAGGED AS ‘SELF-EMPLOYED’ WITH A FIRM-SIZE-1, OR A DIRECT PURCHASE SOURCE THAT WAS COLLECTED IN THE PREVIOUS ROUND. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS ONE OF THE FOLLOWING TYPES: - FLAGGED AS A DIRECT PURCHASE SOURCE - FLAGGED AS AN ‘EMPLOYER’ WITH FIRM-SIZE-1, FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’, OR - FLAGGED AS AN ‘EMPLOYER’ WITH FIRM-SIZE- GREATER-THAN-1, FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’, AND HAD ONE OF THE FOLLOWING JOB SUBTYPES DURING THE PREVIOUS ROUND: - ‘FORMER MAIN WITHIN REFERENCE PERIOD’ - ‘FORMER MISCELLANEOUS JOB WITHIN REFERENCE PERIOD’ - ‘LAST JOB OUTSIDE REFERENCE PERIOD’ - ‘RETIREMENT JOB’ - PERSON IS OR WAS A JOBHOLDER AT ESTABLISHMENT, IF THE ESTABLISHMENT IS ONE OF THE SECOND 2 TYPES NOTED ABOVE; - PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE; - THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW (HQ WAS CODED ‘1’ (WHOLE TIME) OR HQ02 WAS CODED ‘1’ (YES) IN THE PREVIOUS ROUND)
NAVIGATOR DETAILS: LOOP_09 USES BOTH NAV_OE09A AND OE09B TO CONTROL THE FLOW OF THE LOOP. NAV_OE09A
SERIES: Confirming Insurance Obtained by Someone in
the Family
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET THE CONDITIONS STATED AT THE LOOP_09 DEFINITION.
CONTINUE WITH NAV_OE09B FOR SELECTED RU MEMBER. NAV_OE09B
SERIES: Confirming Insurance Obtained by Someone in
the Family
ROSTER DETAILS: COL # 1 HEADER: POLICYHOLDER...ESTABLISHMENT PROVIDING INSURANCE INSTRUCTIONS: DISPLAY RU-ESTABLISHMENT-PERSON- PAIR COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH PAIR EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL ESTABLISHMENTS THAT MEET THE CONDITIONS STATED AT THE LOOP_09 DEFINITION.
CONTINUE WITH BOX_19A FOR SELECTED PAIR. BOX_19A
IF THE POLICYHOLDER OF THIS ESTABLISHMENT-PERSON- PAIR IS FLAGGED AS ‘POLICYHOLDER NOT LISTED IN RU (DU)’ OR ‘POLICYHOLDER DECEASED’, CONTINUE WITH OE25A
OTHERWISE, GO TO OE26
OE25A
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
IF A DU MEMBER’S NAME IS SELECTED FROM THE ROSTER, REPLACE THIS NAME AS THE CURRENT POLICYHOLDER OF THIS ESTABLISHMENT-PERSON-PAIR. IF ‘NAME NOT ON ROSTER’ SELECTED LEAVE THE POLICYHOLDER NAME OF THIS ESTABLISHMENT-PERSON- PAIR AS IS.
ROSTER DETAILS: TITLE: DU_MEMBERS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY DU MEMBERS’ FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS PERSONS ON THE DU-MEMBERS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED. 3. DISPLAY ‘NAME NOT ON ROSTER’ AS LAST ENTRY ON THIS ROSTER.
ROSTER FILTER: NO FILTER; DISPLAY ALL. OE26
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘{Are/Is}’ IF NOT ROUND 5. DISPLAY ‘{Were/Was}’ IF ROUND 5. DISPLAY ‘today,’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY.
IF CODED ‘1’ (YES) AND THIS ESTABLISHMENT-PERSON- PAIR IS AN ESTABLISHMENT FLAGGED AS ‘SELF- EMPLOYED’ WITH FIRM-SIZE-1, CONTINUE WITH OE27
OTHERWISE (I.E., IF CODED ‘1’ (YES) AND ESTABLISHMENT-PERSON-PAIR IS NOT AN ESTABLISHMENT WITH FIRM-SIZE-1), GO TO BOX_19B OE27
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF OE28
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘IF INSURANCE ENDED... SELECT ‘YES’.’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE28OV
OTHERWISE, GO TO BOX_20
OE28OV
Can you just tell me if {you/he/she} {were/was}
covered under that BOX_19B
IF ROUND 3, CONTINUE WITH BOX_19C
OTHERWISE, GO TO BOX_20 BOX_19C
IF HP04A WAS CODED ‘2’ (NO, PLAN IS NOT EXCHANGE), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) THE ROUND THE INSURANCE WAS CREATED OR OE28A WAS CODED ‘2’ (NO, PLAN IS NOT EXCHANGE), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) WHEN ESTABLISHMENT-PERSON-PAIR WAS REVIEWED (IN A PREVIOUS ROUND) AND IF ESTABLISHMENT ALREADY FLAGGED AS ‘INSURANCE CO’, ‘INSURANCE CO.-FROM AGENT’, OR ‘HMO’ [CODED ‘5’ (INSURANCE AGENT), ‘6’ (INSURANCE COMPANY) OR ‘7’ (HMO) AT HX03 OR ‘4’ (INSURANCE AGENT), ‘5’ (INSURANCE COMPANY) OR ‘6’ (HMO) AT HX23] AND POLICYHOLDER OF THIS PAIR IS 64 YEARS OF AGE OR YOUNGER OR IN AGE CATEGORIES 1-8 CONTINUE WITH OE28A
OTHERWISE, GO TO BOX_20
OE28A
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
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_20
IF THE POLICYHOLDER IS THE ONLY PERSON COVERED AT THE PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, AUTOMATICALLY CODE OE29 AS ‘1’ (YES) AND GO TO BOX_21
OTHERWISE, CONTINUE WITH OE29
OE29
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Are’ IF OE26 IS CODED ‘1’ (YES). DISPLAY ‘Were’ IF OE26 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE28 DATE}’ IF OE26 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE26 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE28 FOR ‘OE28 DATE’. IF THE MONTH OR YEAR FIELD AT OE28 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE28 DATE’.
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER FOR DISPLAY.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, INCLUDING THE POLICYHOLDER 2. PERSON IS AN RU MEMBER BOX_21
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO THE END DATE OF THE CURRENT ROUND, THAT IS: IF OE26 IS CODED ‘1’ (YES) AND OE29 IS CODED ‘1’ (YES), FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS ‘CONTINUOUS COVERAGE’ THROUGH THE REFERENCE PERIOD END DATE AND GO TO BOX_23
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO PART OF THE CURRENT ROUND, THAT IS: IF OE26 IS CODED ‘2’ (NO) AND OE29 IS CODED ‘1’ (YES). FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS ‘CONTINUOUS COVERAGE’ THROUGH THE DATE RECORDED AT OE28 AND GO TO BOX_23
OTHERWISE (I.E., OE29 CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)), CONTINUE WITH OE30 OE30
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘is’ IF OE26 IS CODED ‘1’ (YES). DISPLAY ‘was’ IF OE26 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE28 DATE}’ IF OE26 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE26 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE28 FOR ‘OE28 DATE’. IF THE MONTH OR YEAR FIELD AT OE28 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE28 DATE’.
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE26 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE30 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE26 IS CODED ‘2’ (NO)), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE30 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL DATE RECORDED AT OE28
GO TO LOOP_10
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, INCLUDING THE POLICYHOLDER 2. PERSON IS AN RU MEMBER LOOP_10
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE10 - END_LP10
LOOP DEFINITION: LOOP_10 COLLECTS THE DATE ON WHICH THE INSURANCE COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER WHOSE COVERAGE ENDED EITHER PRIOR TO THE REFERENCE PERIOD END DATE OR THE DATE REPORTED IN OE28. THIS LOOP CYCLES ON PERSONS SELECTED AT OE30.
NAVIGATOR DETAILS: LOOP_10 USES NAV_OE10 TO CONTROL THE FLOW OF THE LOOP. NAV_OE10
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE30.
CONTINUE WITH OE31 FOR SELECTED RU MEMBER. OE31
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE31OV
OTHERWISE, GO TO BOX_22
OE31OV
Can you just tell me if {you/he/she} {were/was}
covered under that BOX_22
FLAG INSURANCE FOR PERSON AS ‘CONTINUOUS COVERAGE’ THROUGH THE COMPLETE DATE RECORDED AT OE31 AND OE31OV. END_LP10
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_10 AND CONTINUE WITH BOX_23 BOX_23
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE30), CONTINUE WITH OE32
OTHERWISE, GO TO OE34A OE32
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}’ IF ROUND 5. OE33
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘has been’ AND ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘was’ AND ‘between {START DATE} and {END DATE}’ IF ROUND 5.
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR- COVRD-PERS-TRPLS-ROSTER.
IF ‘PERSON NOT LISTED IN RU’ IS SELECTED, FLAG INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT LISTED IN RU’.
GO TO LOOP_11
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. INTERVIEWER MAY SELECT ONE OR MORE FROM THE LISTED MEMBERS. 2. ADD, DELETE, AND EDIT DISALLOWED. 3. DISPLAY ‘PERSON NOT LISTED IN RU’ AS LAST ENTRY ON THIS ROSTER.
ROSTER FILTER: DISPLAY PERSONS WHO WERE NOT COVERED BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ON THE PREVIOUS ROUND’S INTERVIEW DATE. LOOP_11
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE11 - END_LP11
LOOP DEFINITION: LOOP_11 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON PERSONS SELECTED AT OE33.
NAVIGATOR DETAILS: LOOP_11 USES NAV_OE11 TO CONTROL THE FLOW OF THE LOOP. NAV_OE11
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE33.
CONTINUE WITH OE34 FOR SELECTED RU MEMBER. OE34
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE34OV
OTHERWISE, GO TO BOX_24 OE34OV
Can you just tell me if {you/he/she} {were/was}
covered under that
HARD CHECK: COMPLETE DATE AT OE34 MUST BE < THAN COMPLETE DATE AT OE28 IF A DATE IS RECORDED AT OE28 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS RECORDED AT OE28. BOX_24
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE26 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE34 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE26 IS CODED ‘2’ (NO)), FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE34 UNTIL DATE RECORDED AT OE28. END_LP11
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_11 AND CONTINUE WITH BOX_25 OE34A
{POLICYHOLDER’S 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 OE33 BOX_25
IF ONE OR MORE RU MEMBERS ARE STILL COVERED BY THE INSURANCE THROUGH THE ESTABLISHMENT-PERSON- PAIR ON THE CURRENT ROUND’S INTERVIEW DATE, THAT IS, OE26 IS CODED ‘1’(YES), CONTINUE WITH BOX_25A
OTHERWISE, GO TO END_LP09 BOX_25A
IF ROUND 2 OR ROUND 4, CONTINUE WITH BOX_25AA
IF ROUND 3, GO TO OE35A
IF ROUND 5, GO TO OE35 BOX_25AA
IF THIS ESTABLISHMENT-PERSON-PAIR: - WAS FLAGGED AS ‘GROUP’ (HX03=1 OR 2 OR HX23=1) OR ‘INSURANCE COMPANY-FROM AN AGENT’ (HX03=5 OR HX23=4) OR ‘INSURANCE COMPANY’ (HX03=6 OR HX23=5) OR ‘HMO’ (HX03=7 OR HX23=6) OR ‘EXCHANGE COVERAGE’ (HX03=11 OR HX23=14) OR ‘UNKNOWN TYPE-COLLECTED AT OTHER’ (HX03=91 OR HX23=91) IN THE ROUND THE PAIR WAS FIRST CREATED AND - WAS FLAGGED AS ‘SUPPLYING HOSPITAL AND PHYSICIAN BENEFITS’ BUT NOT ‘5’ (MEDIGAP) IN THE PREVIOUS ROUND AND - POLICYHOLDER OF THIS PAIR IS 64 YEARS OF AGE OR YOUNGER OR IN AGE CATEGORIES 1-8 CONTINUE WITH OE35A
OTHERWISE, GO TO OE35 OE35A
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
NOTE: THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE, NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY. BOX_25AAA
IF ROUND 3, CONTINUE WITH OE35AA
OTHERWISE, GO TO OE35AA2 OE35AA
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
NOTE: THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE, NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY. OE35AAOV1
Is that per year, per month, per week, or what? OE35AAOV2
SPECIFY: BOX_25B
IF THIS ESTABLISHMENT-PERSON-PAIR: - WAS FLAGGED AS ‘GROUP’ (HX03=1 OR 2 OR HX23=1) OR ‘INSURANCE COMPANY-FROM AN AGENT’ (HX03=5 OR HX23=4) OR ’INSURANCE COMPANY’ (HX03=6 OR HX23=5) OR ’HMO’ (HX03=7 OR HX23=6) OR ‘EXCHANGE COVERAGE’ (HX03=11 OR HX23=14) OR ‘UNKNOWN TYPE- COLLECTED AT OTHER’ (HX03=91 OR HX23=91) IN THE ROUND THE PAIR WAS FIRST CREATED AND - WAS FLAGGED AS ‘SUPPLYING HOSPITAL AND PHYSICIAN BENEFITS’ BUT NOT ‘5’ (MEDIGAP) IN THE PREVIOUS ROUND AND - POLICYHOLDER OF THIS PAIR IS 64 YEARS OF AGE OR YOUNGER OR IN AGE CATEGORIES 1-8 CONTINUE WITH OE35AA2
OTHERWISE, GO TO BOX_26A OE35AA2
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF BOX_26A
IF ROUND 3, CONTINUE WITH BOX_26AA
OTHERWISE, GO TO OE35 BOX_26AA
IF INSURANCE BEING ASKED ABOUT PROVIDES MEDICARE SUPPLEMENT/MEDIGAP COVERAGE (I.E., HX48 OR OE10 OR OE24 OR OE37 WAS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP) EITHER ALONE OR WITH ANY COMBINATION OF CODES IN THE PREVIOUS ROUND FOR THIS ESTABLISHMENT-PERSON-PAIR), GO TO OE35
OTHERWISE, CONTINUE WITH OE35B OE35B
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘$1,300 or $1,300’ IN THE QUESTION TEXT AND ‘$1,300’ IN THE RESPONSE CATEGORY OPTIONS IF THE POLICYHOLDER IS THE ONLY COVERED RU MEMBER AND THERE ARE NO DEPENDENTS OUTSIDE THE RU (OE34A IS CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)) FOR THE PAIR BEING ASKED ABOUT. OTHERWISE (E.G., AT LEAST ONE RU MEMBER, OTHER THAN THE POLICYHOLDER IS LISTED AS A COVERED PERSON FOR THIS PAIR OR OE34A IS CODED ‘1’ (YES) FOR THIS PAIR OR THE POLICYHOLDER IS NOT IN THE RU), DISPLAY ‘family’ and ‘$2,600 or $2,600’ IN THE QUESTION TEXT AND ‘$2,600’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER <= 2 AND OE34A IS CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), THEN DISPLAY ‘1,300 or 1,300’ IN THE QUESTION TEXT AND ‘1,300’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER <= 2 AND OE34A IS CODED ‘1’ (YES), THEN DISPLAY ‘family’ AND ‘2,600 or 2,600’ IN THE QUESTION TEXT AND ‘2,600’ IN THE RESPONSE CATEGORY OPTIONS. IF POLICYHOLDER IS FLAGGED AS ‘DECEASED’ AND THE NUMBER OF COVERED PERSONS ON RU-ESTB-PLCYHLDR- CVRD-PERS-TRPLS-ROSTER > 2, THEN DISPLAY ‘family’ AND ‘2,600 or 2,600’ IN THE QUESTION TEXT AND ‘2,600’ IN THE RESPONSE CATEGORY OPTIONS. OE35C
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF OE35
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY FIRST PARAGRAPH IF THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR HAD ANY INSURERS FLAGGED AS PROVIDING MEDIGAP OR HOSPITAL/ PHYSICIAN BENEFITS AT ANY TIME DURING THE PREVIOUS ROUND.
FOR ‘NAME OF INSURER BEING LOOPED ON’, DISPLAY THE NAME OF THIS POLICYHOLDER’S CURRENT ROUND’S PRIVATE OR MEDIGAP INSURER FOR PLAN NAME. THAT IS, DISPLAY THE NAME OF THE PLAN (PROVIDING MEDICARE SUPPLEMENT / MEDIGAP BENEFITS OR HOSPITAL/ PHYSICIAN BENEFITS) ENTERED AT HX49, HX51, OE11, OE25, OE36, OR OE38.
DISPLAY ‘Since {START DATE}, has there been’ AND ‘{have/has}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}, was there’ AND ‘had’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), FLAG PREVIOUS ROUND’S INSURER AS CURRENT ROUND’S INSURER FOR THIS ESTABLISHMENT-PERSON- PAIR.
IF CODED ‘1’ (YES) AND ESTABLISHMENT IS FLAGGED AS AN ‘INSURANCE CO.’, ‘INSURANCE CO.-FROM AGENT’, OR ‘HMO’, CONTINUE WITH OE36
IF CODED ‘1’ (YES) AND ESTABLISHMENT IS NOT FLAGGED AS AN ‘INSURANCE CO.’, ‘INSURANCE CO.- FROM AGENT’, OR ‘HMO’, GO TO OE37 OE36
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
WRITE ESTABLISHMENT NAME CORRECTION TO THE RU- ESTABLISHMENT-PERSONS-PAIRS-ROSTER. THIS IS THE CORRECTED ESTABLISHMENT NAME.
FLAG INSURER ENTERED ABOVE AS CURRENT ROUND’S INSURER FOR THIS POLICYHOLDER-ESTABLISHMENT PAIR.
NOTE: IF A SOURCE OF INSURANCE WAS DIRECTLY PURCHASED FROM AN HMO, INSURANCE COMPANY, OR FROM AN INSURANCE AGENT, THE ESTABLISHMENT NAME IS THE SAME AS THE INSURER NAME. THEREFORE, ANY CHANGE IN PLAN NAME AUTOMATICALLY DICTATES A CHANGE IN THE ESTABLISHMENT NAME. OE37
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘{do/does}’ IF NOT ROUND 5. DISPLAY ‘did’ IF ROUND 5. DISPLAY ‘now’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY. DISPLAY ‘as of {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) IN COMBINATION WITH ANY OTHER CODE.
IF CODED ‘91’ (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER CODES, CONTINUE WITH OE37OV
OTHERWISE, GO TO BOX_26 OE37OV
SPECIFY: BOX_26
IF OE37 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS) OR ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP), ALONE OR WITH ANY OTHER COMBINATION OF CODES, CONTINUE WITH BOX_27
OTHERWISE, GO TO END_LP09 BOX_27
IF ESTABLISHMENT ALREADY FLAGGED AS ‘INSURANCE CO’, ‘INSURANCE CO.-FROM AGENT’, OR ‘HMO’, AUTOMATICALLY CODE OE38 WITH APPROPRIATE RESPONSES AND GO TO LOOP_12
OTHERWISE, CONTINUE WITH OE38 OE38
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘hospital and physician benefits’ AND ‘HOSPITAL AND PHYSICIAN’ IF OE37 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP). DISPLAY ‘Medicare supplement or Medigap benefits’ AND ‘MEDIGAP’ IF OE37 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP).
WRITE INSURER(S) TO THE RU-ESTAB-PERSON-INSURER- TRIPLES-ROSTER FOR THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR
FLAG INSURER(S) COLLECTED AT OE38 AS CURRENT ROUND’S INSURER(S) FOR THIS ESTABLISHMENT-PERSON- PAIR.
IF OE37 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP) FLAG INSURANCE CO./HMO AS ‘SUPPLYING MEDICARE SUPPLEMENT/MEDIGAP BENEFITS (WHICH INCLUDES HOSPITAL/PHYSICIAN BENEFITS)’ FOR THE CURRENT ROUND.
IF OE37 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT ‘5’ (MEDICARE SUPPLEMENT/ MEDIGAP), FLAG INSURANCE CO./HMO AS ‘SUPPLYING HOSPITAL/PHYSICIAN BENEFITS’ FOR THE CURRENT ROUND. LOOP_12
FOR EACH ELEMENT ON THE RU-ESTAB-PERSON-INSURER- TRIPLES-ROSTER, ASK BOX_28A - END_LP12.
LOOP DEFINITION: LOOP_12 COLLECTS MANAGED CARE INFORMATION FOR INSURERS COLLECTED AT OE38. THIS LOOP CYCLES ON TRIPLES THAT MEET THE FOLLOWING CONDITIONS: - ESTABLISHMENT-PERSON-PAIR PROVIDES THE INSURANCE BEING ASKED ABOUT - INSURER IS ENTERED AT OE38 BOX_28A
IF INSURER BEING LOOPED ON IS CODED ‘2’ (HMO) IN OE38, GO TO END_LP12
OTHERWISE, CONTINUE WITH BOX_28 BOX_28
ASK THE MANAGED CARE (MC) SECTION FOR THIS INSURER AT COMPLETION OF MANAGED CARE (MC) SECTION, CONTINUE WITH END_LP12 END_LP12
CYCLE ON NEXT INSURER IN THE RU-ESTAB-PERSON- INSURER-TRIPLES-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER INSURERS MEET THE STATED CONDITIONS, END LOOP_12 AND CONTINUE WITH BOX_28B BOX_28B
IF HP04A WAS CODED ‘1’ (YES, PLAN IS EXCHANGE) OR IF THIS ESTABLISHMENT-PERSON-PAIR WAS FLAGGED AS ‘EXCHANGE COVERAGE’ (HX03=11 OR HX23=14) THE ROUND THE INSURANCE WAS CREATED OR OE28A WAS CODED ‘1’ (YES, PLAN IS EXCHANGE) WHEN ESTABLISHMENT-PERSON- PAIR WAS REVIEWED (IN A CURRENT OR PREVIOUS ROUND) AND IS FLAGGED AS ‘SUPPLYING HOSPITAL AND PHYSICIAN BENEFITS’ (OE37 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS, INCLUDING COVERAGE THROUGH AN HMO) BUT NOT ‘5’ (MEDIGAP)) AND POLICYHOLDER OF THIS PAIR IS 64 YEARS OF AGE OR YOUNGER OR IN AGE CATEGORIES 1-8 CONTINUE WITH OE38B
OTHERWISE, GO TO END_LP09 OE38B
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY THE ACTUAL PLAN NAME ENTERED AT OE38 FOR ‘{INSURER RECORDED AT OE38}’ IF A PLAN NAME WAS ENTERED. OTHERWISE, USE A NULL DISPLAY END_LP09
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_09 AND CONTINUE WITH BOX_29 BOX_29
IF ONE OR MORE RU MEMBERS WAS A COVERED PERSON BY AN ESTABLISHMENT-PERSON-PAIR ON THE PREVIOUS ROUND’S INTERVIEW DATE WHERE THE ESTABLISHMENT IS A PRIVATE SOURCE OF INSURANCE AND THE POLICYHOLDER IS FLAGGED AS ‘POLICYHOLDER/ DEPENDENT IN DIFFERENT RUS’ AT THE CURRENT ROUND’S INTERVIEW DATE, CONTINUE WITH LOOP_13
OTHERWISE, GO TO BOX_33
NOTE: WHEN A POLICYHOLDER LEAVES AN RU, WE WILL NEVER ASK RJ AND THAT POLICYHOLDER WILL NEVER QUALIFY FOR LOOPS 01, 05, OR 09. WE CREATED A NEW LOOP, LOOP_13 THAT WILL HANDLE THE SITUATIONS WHERE THE POLICYHOLDER HAS LEFT THE RU AND LEFT DEPENDENTS BEHIND, OR THE SITUATION WHERE THE DEPENDENTS HAVE LEFT THE RU (WITHOUT THE POLICYHOLDER). THIS SITUATION WILL BE FLAGGED AS ‘POLICYHOLDER/DEPENDENT IN DIFFERENT RUs’. THIS FLAG CAN BE ASSOCIATED WITH ANY ESTABLISHMENT- PERSON-PAIR IN A PARTICULAR RU WHERE THEY ARE COVERED PERSONS, BUT THE POLICYHOLDER IS IN ANOTHER RU. THIS FLAG SHOULD NEVER EXIST ON A PAIR IN AN RU WHERE THE POLICYHOLDER OF THE PAIR IS IN THE SAME RU AS ALL OF THE DEPENDENTS OR WHERE THE POLICYHOLDER OF THE PAIR WAS ORIGINALLY CREATED AS ‘POLICYHOLDER NOT IN RU/DU’ OR ‘POLICYHOLDER DECEASED’. LOOP_13
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_OE13A - END_LP13
LOOP DEFINITION: LOOP_13 COLLECTS INFORMATION ABOUT THE CONTINUATION OF INSURANCE COVERAGE THROUGH AN ESTABLISHMENT-PERSON-PAIR WHERE THE POLICYHOLDER OR THE ELIGIBLE DEPENDENT(S) HAVE MOVED FROM THE RU. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET THE FOLLOWING CONDITIONS: - THE ESTABLISHMENT IS A PRIVATE SOURCE OF INSURANCE - THE ESTABLISHMENT-PERSON-PAIR IS FLAGGED AS ‘POLICYHOLDER/DEPENDENT MOVED’ AT THE CURRENT ROUND’S INTERVIEW DATE FOR THIS RU - AT LEAST ONE RU MEMBER WAS A COVERED PERSON FOR THIS ESTABLISHMENT-PERSON-PAIR ON THE PREVIOUS ROUND’S INTERVIEW DATE - POLICYHOLDER IS NOT A CURRENT RU MEMBER
NAVIGATOR DETAILS: LOOP_13 USES BOTH NAV_OE13A AND OE13B TO CONTROL THE FLOW OF THE LOOP. NAV_OE13A
SERIES: Confirming all of the RU Member’s Insurance
from a
ROSTER DETAILS: COL # 1 HEADER: POLICYHOLDER INSTRUCTIONS: DISPLAY POLICYHOLDER’S FIRST, MIDDLE, AND LAST NAMES COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH POLICYHOLDER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL POLICYHOLDERS WHO MEET THE CONDITIONS STATED AT THE LOOP_13 DEFINITION.
CONTINUE WITH NAV_OE13B FOR SELECTED POLICYHOLDER. NAV_OE13B
{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ROSTER DETAILS: COL # 1 HEADER: POLICYHOLDER...ESTABLISHMENT INSTRUCTIONS: DISPLAY RU-ESTABLISHMENT-PERSON- PAIR COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH PAIR EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL ESTABLISHMENTS THAT MEET THE CONDITIONS STATED AT THE LOOP_13 DEFINITION.
CONTINUE WITH OE39 FOR SELECTED PAIR. OE39
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Is’ IF NOT ROUND 5. DISPLAY ‘Was’ IF ROUND 5. DISPLAY ‘today,’ AND ‘ now’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY.
IF CODED ‘3’ (INSURANCE ALREADY DISCUSSED), FLAG ITEM FOR SOURCE CLEAN-UP.
IF YES AND ONLY ONE PERSON IS FLAGGED AS COVERED AT THE END OF THE PREVIOUS ROUND, AUTOMATICALLY CODE OE41 AS ‘1’ (YES) AND GO TO BOX_31. IF YES AND MORE THAN ONE PERSON FLAGGED AS COVERED AT THE END OF THE PREVIOUS ROUND, GO TO OE41. OE40
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘IF INSURANCE ENDED... SELECT ‘YES’.’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE40OV
IF ONLY ONE PERSON COVERED AT THE END OF THE PREVIOUS ROUND, GO TO LOOP_14
OTHERWISE, CONTINUE WITH OE41 OE40OV
Can you just tell me if {you/he/she} {were/was}
covered under that
IF ONLY ONE PERSON COVERED AT END OF PREVIOUS ROUND, GO TO LOOP_14
OTHERWISE, CONTINUE WITH OE41 OE41
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Are’ IF OE39 IS CODED ‘1’ (YES). DISPLAY ‘Were’ IF OE39 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE40 DATE}’ IF OE39 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE39 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE40 FOR ‘OE40 DATE’. IF THE MONTH AND DAY FIELD AT OE40 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE40 DATE’.
IF OE39 IS CODED ‘1’ (YES) AND OE41 IS CODED ‘1’ (YES), FLAG INSURANCE FOR ALL COVERED PERSONS AS ‘CONTINUOUS COVERAGE’ THROUGH THE REFERENCE PERIOD END DATE.
IF OE39 IS CODED ‘2’ (NO) AND OE41 IS CODED ‘1’ (YES), FLAG INSURANCE FOR ALL COVERED PERSONS AS ‘CONTINUOUS COVERAGE’ THROUGH THE DATE RECORDED AT OE40.
IF OE41 IS CODED ‘1’ (YES) AND OE39 IS CODED ‘1’ (YES) OR ‘2’ (NO), GO TO BOX_31
OTHERWISE (I.E., OE41 CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)), CONTINUE WITH OE42
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS PERSONS ON THE RU-ESTB- PLCYHLDR-COVRD-PERS-TRPLS-ROSTER FOR DISPLAY.
ROSTER BEHAVIOR: 1. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT THE PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR AND 2. PERSON IS AN RU MEMBER OE42
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘is’ IF OE39 IS CODED ‘1’ (YES). DISPLAY ‘was’ IF OE39 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS ROUND 5. DISPLAY ‘until {OE40 DATE}’ IF OE39 IS CODED ‘2’ (NO). DISPLAY ‘on {END DATE}’ IF OE39 IS CODED ‘1’ (YES). DISPLAY THE DATE RECORDED AT OE40 FOR ‘OE40 DATE’. IF THE MONTH AND DAY FIELD AT OE40 IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE40 DATE’.
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE39 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE42 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE39 IS CODED ‘2’ (NO), FLAG INSURANCE FOR ALL PERSONS NOT SELECTED AT OE42 AS ‘CONTINUOUS COVERAGE’ FROM THE REFERENCE PERIOD START DATE UNTIL DATE RECORDED AT OE40.
ROSTER DETAILS: TITLE: RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY COVERED PERSONS’ NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. PERSON WAS COVERED AT PREVIOUS ROUND’S INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR AND 2. PERSON IS AN RU MEMBER LOOP_14
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE14 - END_LP14
LOOP DEFINITION: LOOP_14 COLLECTS THE DATE ON WHICH THE INSURANCE COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER WHOSE COVERAGE ENDED EITHER PRIOR TO THE REFERENCE PERIOD END DATE OR THE DATE REPORTED IN OE40. THIS LOOP CYCLES ON PERSONS SELECTED AT OE42.
NAVIGATOR DETAILS: LOOP_14 USES NAV_OE14 TO CONTROL THE FLOW OF THE LOOP. NAV_OE14
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE42.
CONTINUE WITH OE43 FOR SELECTED RU MEMBER. OE43
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE43OV
OTHERWISE, GO TO BOX_30 OE43OV
Can you just tell me if {you/he/she} {were/was}
covered under that BOX_30
FLAG INSURANCE FOR PERSON AS ‘CONTINUOUS COVERAGE’ THROUGH THE COMPLETE DATE RECORDED AT OE43 AND OE43OV. END_LP14
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_14 AND CONTINUE WITH BOX_31 BOX_31
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE42), CONTINUE WITH OE44
OTHERWISE, GO TO OE47 OE44
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘Since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}’ IF ROUND 5. OE45
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
DISPLAY ‘has been’ AND ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘was’ AND ‘between {START DATE} and {END DATE}’ IF ROUND 5.
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR- COVRD-PERS-TRPLS-ROSTER.
IF ‘PERSON NOT LISTED IN RU’ IS SELECTED, FLAG INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT LISTED IN RU’.
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. INTERVIEWER MAY SELECT ONE OR MORE FROM THE LISTED MEMBERS. 2. ADD, DELETE, AND EDIT DISALLOWED. 3. DISPLAY ‘PERSON NOT LISTED IN RU’ AS LAST ENTRY ON THIS ROSTER.
ROSTER FILTER: DISPLAY PERSONS WHO WERE NOT COVERED BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ON THE PREVIOUS ROUND’S INTERVIEW DATE. LOOP_15
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD- PERS-TRPLS-ROSTER, ASK NAV_OE15 - END_LP15
LOOP DEFINITION: LOOP_15 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON PERSONS SELECTED AT OE45.
NAVIGATOR DETAILS: LOOP_15 USES NAV_OE15 TO CONTROL THE FLOW OF THE LOOP. NAV_OE15
{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER 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 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 OE45.
CONTINUE WITH OE46 FOR SELECTED RU MEMBER OE46
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF
IF DAY FIELD IS CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND MONTH FIELD IS NOT CODED ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW), CONTINUE WITH OE46OV
OTHERWISE, GO TO BOX_32 OE46OV
Can you just tell me if {you/he/she} {were/was}
covered under that
HARD CHECK: EDIT: COMPLETE DATE AT OE46 MUST BE < THAN COMPLETE DATE AT OE40 IF A DATE IS RECORDED AT OE40 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS RECORDED AT OE40. BOX_32
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE39 IS CODED ‘1’ (YES)), FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE46 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH ESTABLISHMENT-PERSON-PAIR (OE39 IS CODED ‘2’ (NO)) FLAG INSURANCE FOR THIS PERSON AS ‘CONTINUOUS COVERAGE’ FROM DATE RECORDED AT OE46 UNTIL DATE RECORDED AT OE40. END_LP15
CYCLE ON NEXT PERSON IN 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_15 AND GO TO END_LP13 OE47
{POLICYHOLDER’S 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 OE45 END_LP13
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_13 AND CONTINUE WITH BOX_33 BOX_33
RETURN TO ORIGINAL QUESTIONNAIRE SECTION IN HX |