MEPS HC-076: 2003 Person Round Plan Public Use File
Agency for Healthcare Research and Quality
Center for Financing, Access, and Cost Trends
540 Gaither Road
Rockville, MD 20850
(301) 427-1406
TABLE OF CONTENTS
A. Data Use Agreement
B. Background
1.0 Household Component
2.0 Medical Provider Component
3.0 Insurance Component
4.0 Survey Management
C. Technical and Programming Information
1.0 General Information
2.0 Data File Description
2.1 Complex File Structure With Examples
2.2 Identifiers
2.3 Adding the Characteristics of Covered Persons
2.4 Adding the Policyholder’s Characteristics
2.5 Choosing PRPL Records for Your Research Question
3.0 Data File Contents
3.1 ID Variables
3.2 Person Variables
3.3 Policyholder Variables
3.4 Establishment Variables
3.4.1 Employers and Other Establishments
3.4.2 Types of Coverage through the Establishment
3.4.3 Out-of-Pocket Premiums
3.5 Plan Variables
3.5.1 Household Reports of Managed Care
3.5.2 Family Satisfaction with Plan
3.5.3 Change in Plan Name
3.6 Links to Job Providing Insurance
References
D. Variable Source Crosswalk
A. Data Use Agreement
Individual identifiers have been removed from the
micro-data contained in the files that are part of this Public Use Release.
Nevertheless, under sections 308 (d) and 903 (c) of the Public Health Service
Act (42 U.S.C. 242m and 42 U.S.C. 299 a-1), data collected by the Agency for
Healthcare Research and Quality (AHRQ) and /or the National Center for Health
Statistics (NCHS) may not be used for any purpose other than for the purpose for
which they were supplied; any effort to determine the identity of any reported
cases, is prohibited by law.
Therefore in accordance with the above referenced Federal
Statute, it is understood that:
No one is to use the data in this data set in any way
except for statistical reporting and analysis; and
If the identity of any person or establishment should be
discovered inadvertently, then (a) no use will be made of this knowledge, (b)
The Director Office of Management AHRQ will be advised of this incident, (c) the
information that would identify any individual or establishment will be
safeguarded or destroyed, as requested by AHRQ, and (d) no one else will be
informed of the discovered identity.
No one will attempt to link this data set with
individually identifiable records from any data sets other than the Medical
Expenditure Panel Survey or the National Health Interview Survey.
By using this data you signify your agreement to comply
with the above stated statutorily based requirements with the knowledge that
deliberately making a false statement in any matter within the jurisdiction of
any department or agency of the Federal Government violates Title 18 Part 1
Chapter 47 Section 1001 and is punishable by a fine of up to $10,000 or up to 5
years in prison.
The Agency for Healthcare Research and Quality requests
that users cite AHRQ and the Medical Expenditure Panel Survey as the data source
in any publications or research based upon these data.
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B. Background
This documentation describes one in a series of public use
files from the Medical Expenditure Panel Survey (MEPS). The survey provides a
new and extensive data set on the use of health services and health care in the
United States.
MEPS is conducted to provide nationally representative estimates of health care
use, expenditures, sources of payment, and insurance coverage for the U.S.
civilian non-institutionalized population. MEPS is cosponsored by the Agency for
Healthcare Research and Quality (AHRQ) and the National Center for Health
Statistics (NCHS).
MEPS comprises three component surveys: the Household Component (HC), the
Medical Provider Component (MPC), and the Insurance Component (IC). The HC is
the core survey, and it forms the basis for the MPC sample and part of the IC
sample. Together these surveys yield comprehensive data that provide national
estimates of the level and distribution of health care use and expenditures,
support health services research, and can be used to assess health care policy
implications.
MEPS is the third in a series of national probability surveys conducted by AHRQ
on the financing and use of medical care in the United States. The National
Medical Care Expenditure Survey (NMCES, also known as NMES-1) was conducted in
1977, the National Medical Expenditure Survey (NMES-2) in 1987. Beginning in
1996, MEPS continues this series with design enhancements and efficiencies that
provide a more current data resource to capture the changing dynamics of the
health care delivery and insurance system.
The design efficiencies incorporated into MEPS are in accordance with the
Department of Health and Human Services (DHHS) Survey Integration Plan of June
1995, which focused on consolidating DHHS surveys, achieving cost efficiencies,
reducing respondent burden, and enhancing analytical capacities. To accommodate
these goals, new MEPS design features include linkage with the National Health
Interview Survey (NHIS), from which the sampled households for the MEPS HC are
drawn, and continuous longitudinal data collection for core survey components.
The MEPS HC augments NHIS by selecting a sample of NHIS respondents, collecting
additional data on their health care expenditures, and linking these data with
additional information collected from the respondents’ medical providers,
employers, and insurance providers.
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1.0 Household Component
The MEPS HC, a nationally representative survey of the
U.S. civilian non-institutionalized population, collects medical expenditure
data at both the person and household levels. The HC collects detailed data on
demographic characteristics, health conditions, health status, use of medical
care services, charges and payments, access to care, satisfaction with care,
health insurance coverage, income, and employment.
The HC uses an overlapping panel design in which data are collected through a
preliminary contact followed by a series of five rounds of interviews over a 2½
- year period. Using computer-assisted personal interviewing (CAPI) technology,
data on medical expenditures and use for two calendar years are collected from
each household. This series of data collection rounds is launched each year on a
new sample of households to provide overlapping panels of survey data and, when
combined with other ongoing panels, will provide continuous and current
estimates of health care expenditures.
The sample of households selected for the MEPS HC is drawn from among
respondents to the NHIS, conducted by NCHS. The NHIS provides a nationally
representative sample of the U.S. civilian non-institutionalized population,
with oversampling of Hispanics and blacks.
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2.0 Medical Provider Component
The MEPS MPC supplements and/or replaces information on
medical care events reported in the MEPS HC by contacting medical providers and
pharmacies identified by household respondents. The MPC sample includes all home
health agencies and pharmacies reported by HC respondents. Office-based
physicians, hospitals, and hospital physicians are also included in the MPC but
may be subsampled at various rates, depending on burden and resources, in
certain years.
Data are collected on medical and financial characteristics of medical and
pharmacy events reported by HC respondents. The MPC is conducted through
telephone interviews and record abstraction.
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3.0 Insurance Component
The MEPS IC collects data on health insurance plans
obtained through employers, unions, and other sources of private health
insurance. Data obtained in the IC include the number and types of private
insurance plans offered, benefits associated with these plans, premiums,
contributions by employers and employees, eligibility requirements, and employer
characteristics.
Establishments participating in the MEPS IC are selected through four sampling
frames:
- A list of employers or other insurance providers
identified by MEPS HC respondents who report having private health insurance
at the Round 1 interview.
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- A Bureau of the Census list frame of private sector
business establishments.
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- The Census of Governments from Bureau of the Census.
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- An Internal Revenue Service list of the self-employed.
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To provide an integrated picture of health insurance, data
collected from the first sampling frame (employers and insurance providers) are
linked back to data provided by the MEPS HC respondents. Data from the other
three sampling frames are collected to provide annual national and State
estimates of the supply of private health insurance available to American
workers and to evaluate policy issues pertaining to health insurance.
The MEPS IC is an annual panel survey. Data are collected from the selected
organizations through a prescreening telephone interview, a mailed
questionnaire, and a telephone follow-up for nonrespondents.
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4.0 Survey Management
MEPS data are collected under the authority of the Public
Health Service Act. They are edited and published in accordance with the
confidentiality provisions of this act and the Privacy Act. NCHS provides
consultation and technical assistance.
As soon as data collection and editing are completed, the MEPS survey data are
released to the public in staged releases of summary reports and microdata
files. Summary reports are released as printed documents and/or electronic files
on the MEPS web site (www.meps.ahrq.gov).
All microdata files are available for download from the MEPS web site in
compressed formats (zip and self-extracting executable files.) Selected data
files are available on CD-ROM from the MEPS Clearinghouse.
For printed documents and CD-ROMs that are available through the AHRQ
Publications Clearinghouse, write or call:
AHRQ Publications Clearinghouse
Attn: (publication number)
P.O. Box 8547
Silver Spring, MD 20907
800/358-9295
410/381-3150 (callers outside the United States only)
888/586-6340 (toll-free TDD service; hearing impaired only)
Be sure to specify the AHRQ number of the document or CD-ROM you are requesting.
Additional information on MEPS is available from the MEPS project manager or the
MEPS public use data manager at the Center for Financing, Access and Cost
Trends, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville,
MD 20850 (301/427-1406).
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C. Technical and Programming
Information
1.0 General Information
This public use data file contains data for each person
with private health insurance reported in rounds 3, 4, and 5 of Panel 7 and
rounds 1, 2, and 3 of Panel 8 (i.e., the rounds for the survey panels covering
calendar year 2003) of the Medical Expenditure Panel Survey Household Component
(MEPS HC). Released as an ASCII file with SAS format statements and in SAS
transport format, this public use file provides information collected on a
nationally representative sample of the civilian noninstitutionalized population
of the United States during the calendar year 2003. The HC-076 file contains
records for persons insured through private establishments providing
hospital/physician, medigap, dental, vision, or prescription medication coverage
and includes variables pertaining to managed care and experiences with plans.
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2.0 Data File Description
The Person-Round-Plan (PRPL) file for 2003 is a complex
file of privately insured persons and their private health insurance plans and
links to the jobs providing insurance. The PRPL file is designed to facilitate
research on the sometimes complex and dynamic relationships between consumers
and their private insurance. It is not a person-level file, and linking the PRPL
file to a person-level file (such as HC-064 and HC-073) requires users making
analytic decisions based on understanding the complexity of the PRPL file.
Records contain the following types of information (Figure 1):
- Covered person
- Flags for whether the person is the policyholder or a
dependent
- Whether enrolled at time of interview
- Months enrolled during the reference period for the
interview
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|
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- Establishment providing insurance
- Type of establishment (employer, union, insurance
agent, etc.)
- Types of coverage (hospital/physician, medigap,
dental, vision, prescription medication, Consolidated Omnibus Budget
Reconciliation Act (COBRA), single or
family)
- Out-of-pocket premiums and employee contributions
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- Plan (for hospital/physician and Medicare supplemental
insurance coverage only)
- Household reports of managed care
- Family experience with plan (collected for rounds 2
and 4)
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- Links to the job providing insurance (for
employment-based insurance only, HC-074)
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FIGURE 1
CONCEPTUAL OVERVIEW OF PRPL |
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Covered Person:
Policyholder or Dependent
Enrollment at Time of Interview or End of Year |
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|
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Interview Round |
| |
| |
|
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Policyholder |
| |
| |
|
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Links to policyholder’s Job at Establishment
(Employment-Based Insurance Only) |
| |
| |
|
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Establishment Providing Insurance::
Type of Establishment
Types Coverage
Out-of-Pocket Premiums |
| |
| |
|
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Plan
(Hospital/Physician and Medigap Only):
Managed Care
Family Experience with Plan (rounds 2 & 4) |
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On the records for dependents, variables link to the
policyholder’s job providing insurance, rather than the dependent’s job.
“Establishment” refers to the organization through which the policyholder
obtains private insurance. The establishment may be an employer, a union, an
insurance agent, an insurance company, a
professional association, or another type of organization. Many questions in the
MEPS HC instrument are asked in reference to the establishment providing
insurance to the policyholder. For example, the MEPS HC asks about the “types of
health insurance” or covered services, such as hospital/physician and dental
coverage, the policyholder gets through the establishment.
For each establishment, a “plan” is “the insurance company or Health Maintenance
Organization (HMO)” or self-insured company “from which (POLICYHOLDER) receives”
hospital/physician or Medicare supplemental (Medigap) coverage. For some focused
analyses, it may be important to recognize that information collected at the
establishment level does not necessarily pertain to the plan level. For example,
if a policyholder obtains from the establishment two separate plans, a
hospital/physician plan and a dental plan, then the dental plan may not have the
same managed care characteristics as the hospital/physician plan.
1No effort has been made to validate
variables representing type of coverage with external sources.
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2.1 Complex File Structure With
Examples
The PRPL file is designed to reflect the sometimes complex
and dynamic relationships between people and their private insurance. It allows
maximum flexibility for researchers, but it also requires that they make
analytical decisions in their research.
The PRPL file is a person-round-policyholder-establishment-level file. There is
one unique record for each unique combination of establishment (source of
private insurance), policyholder, interview round, and covered person
(policyholder or dependent). Thus, the PRPL file contains at least one record
for each person in each round with private health insurance, or 62,736 total
records. The PRPL file contains records for persons insured through
establishments providing hospital/physician, medigap, dental, vision, or
prescription medication coverage.
In most cases in this file, one person in the family has insurance from his or
her employer, and this insurance covers everyone in the family. In this case,
there is one record for each family member in each round, and each record flags
the policyholder’s current main job and links to the one job record in HC-074.
However, other cases are more complex, and some hypothetical examples follow.
Multiple Establishments
- Juan and Maria are both employed parents, both have
health insurance through their employers, and both parents choose family
coverage. In this case, there are two PRPL records for each family member in
each round.
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- John and Jane are both employed parents. John has
single coverage from his employer. Jane has family coverage from her employer.
In this case, Jane and the children each have one PRPL record for each round.
John has two records for each round.
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- Jamie has Medicare and Medicare supplemental insurance.
In this case, Jamie has one PRPL record in each round for the Medicare
supplemental insurance. There is no record for Medicare, because it is public
insurance.
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- Arlene is a child living with her mother. Both have
Medicaid. Arlene=s father, who does not live with them, has private insurance
that covers Arlene. Arlene has one PRPL record in each round for the private
insurance. There is no record for Medicaid, because it is public insurance.
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No Private Insurance
- Paul is uninsured. In this case, Paul does not have any
PRPL records.
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- Mary has Medicaid instead of private coverage. In this
case, Mary does not have any PRPL records.
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Sources of Insurance: Employers and Other
Establishments
- Dexter is an employed parent with family coverage
through his current main job. In this case, each family member’s PRPL record
flags Dexter’s current main job as the source of insurance, and each family
member’s PRPL record links to that job record in PUF HC-074.
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- Claire is employed, but she does not have insurance
through her job. Instead she buys a plan directly from an HMO. In this case,
Claire’s PRPL records do not flag her current main job, nor do they link to
any job records in PUF HC-074.
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- Fred has hospital/physician insurance through his
employer, and he buys dental insurance through an insurance agent. In this
case, Fred has two PRPL records, and only the employment-based insurance flags
his current main job and links to a job record in PUF HC-074.
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Policyholders Not in the Household
- Edith is a widow and has retiree insurance from her
former husband=s former job. In this case, Edith’s PRPL record does not link
to any employment information in the MEPS. There is also a PRPL record for
Edith’s former husband, where he is flagged as the policyholder and flagged as
deceased, but this record does not link to any records on any PUFs.
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- Matilda’s parents are divorced. She lives with her
father, but her insurance is through her mother’s job. In this case, Matilda’s
PRPL record does not link to any employment information in the MEPS. There is
also a PRPL record for Matilda’s mother, where she is flagged as the
policyholder and not residing in the Respondent Unit (RU), but this PRPL
record does not link to any records on any PUFs.
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Changes in Insurance
| Bob changes jobs between January 1st, 2003 and the date
of his MEPS interview, and both jobs provided health insurance. In this case,
Bob has two PRPL records for the round. EVALCOVR shows whether one or both
plans covered Bob on the interview date. |
| Bob changes jobs between January 1st, 2003 and the date
of his MEPS interview, and both jobs provided health insurance. In this case,
Bob has two PRPL records for the round. EVALCOVR shows whether one or both
plans covered Bob on the interview date. |
| Julie quits her job in round 1 (Panel 8) but pays her
previous employer to continue her health insurance while she looks for another
job in round 2. In this case, Julie’ round 1 PRPL record flags her current
main job as the source of her insurance and links to a job record in PUF
HC-074. Julie’s round 2 PRPL record does not flag her current main job as the
source of her insurance, but it links to the same job record from round 1.
Thus, the jobs variables from round 1 are no longer current in round 2, but
the link exists for users. |
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2.2 Identifiers
Each record contains the following ID variables:
DUPERSID is the person identifier (either a dependent or a policyholder).
RN is the round of the interview in which the enrollment data were collected
PHLDRIDX is the person identifier of the policyholder
ESTBIDX is an ID number for the establishmentBemployer, union, insurance company
or otherBthat is the source of insurance coverage on the record.
EPRSIDX is a combination of ESTBIDX and the PHLDRIDX, and it uniquely identifies
the insurance coverage that a policyholder obtains from an individual
establishment.
EPCPIDX is a combination of DUPERSID, RN, and EPRSIDX, and it uniquely
identifies each record.
JOBSIDX is a combination of the PHLDRIDX, a round identifier (RN), and a job
number (JOBSN), and it uniquely identifies the policyholder’s job at the
establishment that provided insurance (for employment-based coverage)
For each person covered by a policyholder-establishment combination, the
PHLDRIDX, ESTBIDX, and EPRSIDX appear on each plan record for that coverage.
A person (DUPERSID) can be listed more than once on this file (1) if they are
covered (as a policyholder or a dependent) by insurance policies from more than
one establishment, or (2) if they are covered in more than one round.
Establishment-policyholder pairs (EPRSIDXs) can be listed more than once (1) if
the health plan a policyholder obtains from a given establishment also covers
his/her dependents, or (2) if the health plan a policyholder obtains from a
given establishment provides coverage in more than one interview round. As noted
above, there is a PRPL record for each unique combination of establishment
(source of insurance), round, and covered person (policyholder or dependent).
The following table presents a hypothetical example that illustrates the
relationship between the ID variables on this file.
ESTBIDX |
DUPERSID |
PHLDRIDX |
EPRSIDX |
RN |
EPCPIDX |
JOBSIDX |
11 |
42 |
42 |
1142 |
1 |
1142142 |
42101 |
11 |
42 |
42 |
1142 |
2 |
1142242 |
42201 |
11 |
42 |
42 |
1142 |
3 |
1142342 |
42301 |
22 |
64 |
64 |
2264 |
1 |
2264164 |
64101 |
33 |
64 |
64 |
3364 |
1 |
3364164 |
-1 |
44 |
61 |
61 |
4461 |
1 |
4461161 |
61101 |
44 |
62 |
61 |
4461 |
1 |
4461162 |
61101 |
44 |
63 |
61 |
4461 |
1 |
4461163 |
61101 |
55 |
71 |
71 |
5571 |
1 |
5571171 |
71102 |
55 |
71 |
71 |
5571 |
2 |
5571271 |
71102 |
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The first three rows of the table represent a situation
where a person (DUPERSID=42) is listed thrice in the PRPL file because she
obtains insurance from the same establishment in all three rounds. Since the
person is the policyholder, her DUPERSIDX is the same as the PHLDRIDX, which is
repeated in the EPRSIDX, EPCPIDX, and JOBSIDX.
The fourth and fifth rows of the table represent a situation where a person (DUPERSID=64)
is listed twice in the PRPL file because she obtains insurance from more than
one establishment. In this example, the second establishment is not an employer
or union, so JOBSIDX is inapplicable (-1).
The sixth, seventh, and eighth rows of the table represent a situation where a
policyholder and two dependents obtain coverage through the policyholder’s
employer (a unique establishment-policyholder pair, EPRSIDX=4461). The
policyholder’s PHLDRIDX appears in the EPRSIDX and the JOBSIDX for all three
covered persons.
The last two rows of the table represent a situation where a person is retired
and has retiree insurance through a job that ended prior to 2003. In Panel 8,
round 1, the respondent reported the job from which the sample member retired,
and MEPS does not ask about that job again. However, in each round we ask about
the health insurance. So in round 2 the JOBSIDX contains round number 1, when
the jobs data were last collected.
Finally, note that EPCPIDX uniquely identifies each record on the file.
In order to conduct person-level analyses, it is necessary to identify all
policies that cover each individual either as a policyholder or as a dependent.
Since each person in the PRPL file is uniquely identified by the variable
DUPERSID, person-level analyses can be conducted by examining all PRPL records
containing each DUPERSID.
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2.3 Adding the Characteristics of
Covered Persons
The DUPERSID allows you to link on the age, sex, race,
health status, or other person-level variables from the other HC files. However,
this will result in multiple records per person, and estimates will not be
nationally representative unless you use one PRPL record per person or summarize
PRPL records to the person level (and use weights).
2.4 Adding the Policyholder’s
Characteristics
The PHLDRIDX allows you to link characteristics of the
policyholder onto the records of every person covered by the plan. For example,
suppose you wanted to study persons whose private employment-based insurance is
through an employee working full time at a current main job as of the first
interview of 2003 (Panel 8 round 1 or Panel 7 round 3). Then you would select
PRPL records matching HC-064 (PUF64FLG=1) where the insurance is through a
current main job (CMJINS=1) and [(PANEL=8 and RN=1) or (PANEL=7 and RN=3)]. From
HC-064, select the DUPERSID and HOUR13 variables and rename DUPERSID to PHLDRIDX.
Merge HOUR13 onto the PRPL file by PHLDRIDX.
Some policyholders do not have records on HC-064 or HC-073. These include
deceased policyholders and policyholders residing outside the RU. For these
policyholders, PUF64FLG and PUF73FLG may be equal to 2, depending on when the
policyholder left the RU. All of the covered person records for these
establishment-policyholder pairs are flagged with DECPHLDR, OUTPHLDR, or NOPUFLG
equal to 1. Deceased policyholders complicate the estimation of nationally
representative statistics on active policies. For these
establishment-policyholder pairs, users must choose a covered person with a
positive weight. However, establishment-policyholder pairs where the
policyholder resides outside the RU should not be included in estimates, because
this will result in double counting, as RU members covering those outside the RU
are already included.
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2.5 Choosing PRPL Records for Your
Research Question
In order to produce estimates from the data in this file,
researchers must use the person (or family) level weights released in either of
two previously released PUFs, HC-064 or HC-073. Researchers must consult the
documentation for these PUFs for guidance on creating nationally representative
estimates for different time periods.
Note that if there are multiple records per person (DUPERSID) when you merge on
weights, you will double count some people, and your estimates will not be
nationally representative. There are two solutions: select only one record per
person, or aggregate information across PRPL records.
How you develop your analytical file depends on your research question. The PRPL
file is designed to help answer a wide variety of research questions. AHRQ
cannot anticipate all these questions, so this section provides examples of how
to use the PRPL file for five research questions.
How many people were covered by two or more private hospital/physician insurance
plans at the end of 2003?
Select the Panel 8 round 3 and Panel 7 round 5 records with PRIVCAT>0 and
MSUPINS ne 1 and EVALCOVR=1. Count the number of records for each person (DUPERSID).
Create one person-level record for each DUPERSID that has the number of plans (PRPL
records). Merge the count variable onto PUF HC-073 and use weights, strata, and
PSUs to create nationally representative estimates.
How many people reported private dental coverage from an
employer at the end of 2003?
Select the Panel 8 round 3 and Panel 7 round 5 records with DNTLINS=1 and
PRIVCAT in (1,4,5) and EVALCOVR=1. Among these records, select one record for
each person (DUPERSID). Merge each record onto PUF HC-073 and use weights,
strata, and PSUs to create nationally representative estimates.
At the time of the first interview, how many private insurance policies for
hospital/physician were not employment-based?
Select the Panel 8 round 1 and Panel 7 round 3 records with PRIVCAT in (2, 3,
99) and EVALCOVR=1. Select one record for each policyholder-establishment pair (EPRSIDX).
To have a positive weight for the final count, we recommend choosing the covered
person record of the policyholder (PHOLDER=1), unless the policyholder is
deceased (DECPHLDR=1), in which case then the researcher should choose a
different covered person=s record. Merge each record onto PUF HC-064 and use
weights, strata, and PSUs to create nationally representative estimates.
How many people were in families that gave the highest rating for at least
one of their private health plans?
Select the Panel 8 round 2 and Panel 7 round 4 records with SATELIG=1 and
RATEPLAN=10. Select one record for each DUPERSID. Merge each record onto PUF
HC-073 and use weights, strata, and PSUs to create nationally representative
estimates.
At the time of the first interview of 2003, how many people had insurance
from jobs from which they retired?
Select the PRPL records for policyholders of employment-related insurance at the
time of the first interview [(Panel 8 round 1 or Panel 7 round 3) and PHOLDER=1
and PRIVCAT=1 and EVALCOVR=1]. From the 2003 JOBS file, PUF HC-074, select the
records with for jobs from which the person retired (SUBTYPE=6 or RETIRJOB=1 or
YLEFT=2 or YNOBUSN=2 or WHY_LEFT=3). Persons in Panel 6 may have reported
retiring from a job in 2001, so, from the 2002 JOBS file, PUF HC-063, select the
records with PANEL=6 and (SUBTYPE=6 or RETIRJOB=1 or YLEFT=2 or YNOBUSN=2 or
WHY_LEFT=3). Combine the records from the two JOBS files, keeping only one
record per JOBSIDX. Using the JOBSIDX, merge the selected JOBS records onto the
selected PRPL records. Select the PRPL records with SUBTYPE=6 or RETIREJOB=1 or
YLEFT=2 or YNOBUSN=2 or WHY_LEFT=3 or EMPLSTAT=2. Select one record for each
DUPERSID. Merge each record onto PUF HC-073 and use weights, strata, and PSUs to
create nationally representative estimates of the number of people with one of
these PRPL records.
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3.0 Data File Contents
3.1 ID Variables
In the MEPS Household Component, the definitions of
Dwelling Units (DUs) and Group Quarters are generally consistent with the
definitions employed for the National Health Interview Survey. The dwelling unit
ID (DUID) is a five-digit random ID number assigned after the case was sampled
for MEPS. The person number (PID) uniquely identifies all persons within the
dwelling unit. The variable DUPERSID is the combination of the variables DUID
and PID. The MEPS - HC - PRPL file can be linked to other person-level public
use files such as MEPS HC-064: Combined Panel 7, Round 3/Panel 8, Round 1 2003
Population Characteristics by using the DUPERSID.
PHLDRIDX is the person identifier (DUID + PID) of the policyholder of the
private health insurance plan. Generally, the characteristics of the
policyholder can be linked from other person-level public use files by using the
PHLDRIDX to match the DUPERSID on the other files. However, when the
policyholder is deceased or resides outside the RU, then there are no
person-level variables on public use files (unless the policyholder was alive
and resided in the household at some point during the time periods covered by
the interviews).
ESTBIDX is an ID number assigned to place of employment and to sources of
insurance.
EPRSIDX is a combination of ESTBIDX and PHLDRIDX. In a few cases, more than one
EPRSIDX may identify a policyholder-source of coverage pair, because when an RU
splits, for example, through divorce or because a child goes to college, each
new RU separately reports insurance information, and hence MEPS cannot determine
with certainty whether members in both RUs have the same policy. Although both
RUs may report coverage through the same policyholder, the RUs will have
different EPRSIDXs and ESTBIDXs. (The RU letter is embedded in the ESTBIDX and
EPRSIDX.) For each RU (EPRSIDX), there is a PRPL record for the policyholder as
a covered person, but for only one of the EPRSIDX’s (the one in which the
policyholder resides) is the policyholder coded as having coverage in the STATUS
or EVALCOVR variables.
JOBSIDX is a combination of the PHLDRIDX, a round identifier (RN), and a job
number (JOBSN), and it uniquely identifies the policyholder’s job at the
establishment that provided insurance (for employment-based coverage). The round
identifier imbedded in JOBSIDX is the round in which the job was last reported,
which is not necessarily the round in which the insurance was last reported (for
example, when the job ended but the insurance continued). JOBSIDX can be used to
link on characteristics of the policyholder’s job providing insurance from the
Jobs public use file (HC-074).
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3.2 Person Variables
There are four person-level variables. Binary variables
indicate whether the person is the policy holder (PHOLDER) or a dependent (DEPNDNT)
on the coverage through the establishment. The variable PUF64FLG indicates
whether the person has a record on HC-064, and PUF73FLG indicates whether the
person has a record on HC-073.
There are 25 person-round-level variables. EVALCOVR is a binary variable
indicating whether the person was covered by insurance from the establishment at
the time of interview (rounds 3, and 4 of Panel 7 and rounds 1, and 2 of Panel
8) or on December 31 (round 3 of Panel 8 and round 5 of Panel 7). The variables
STATUS1-STATUS24 indicate whether the respondent reported the person was covered
by insurance from the establishment for at least one day during the month. For
Panel 8, STATUS1-STATUS12 represent coverage from January 2003 through December
2003, and STATUS13-24 are inapplicable, because this information is in year
2004. For Panel 7, STATUS13-STATUS24 represent coverage from January 2003
through December 2003, and STATUS1-STATUS12 are inapplicable, because this
information is in the year 2002. Coverage is reported only for the interview
reference period. For example, if a person from Panel 8 was first interviewed in
February and reported she was covered in January and February, and then in the
second interview in August she reported she was covered from March through
August, then the PRPL record for the first round will have STATUS1 and STATUS2
set to 1 and the rest set to inapplicable, and the PRPL for the second round
will have STATUS3 through STATUS8 set to 1 and the rest set to inapplicable.
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3.3 Policyholder Variables
The values of three variables describing the policyholder
do not vary across the records of the persons covered by the plan, regardless of
whether the covered person is the policyholder. The variable DECPHLDR indicates
the policyholder is deceased. The variable OUTHLDR indicates the policyholder
resides outside the RU. In each case, there are no person-level records on a
person-level PUF, even though the PRPL file has a record for the policyholder as
a covered-person (that is, a record where PHOLDER=1). The variable NOPUFLG
indicates there is another reason the policyholder does not have a record on a
person-level PUF. The purpose of these flags is to explain any difficulty users
may have linking policyholder information onto the PRPL file. These variables do
not, however, measure mortality or policyholders’ leaving household, which
should instead be obtained from the PSTATUS variables on the person-level files.
(For example, policyholders who die between rounds 1 (Panel 8) or 3 (Panel 7)
and the end of 2003 will have records on HC-064 and HC-073, and PUF64FLG and
PUF73FLG will be set to 1.)
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3.4 Establishment Variables
The values of establishment-level variables do not vary
across the records of the persons insured through the policyholder-establishment
pair.
3.4.1 Employers and Other
Establishments
The type of establishment providing coverage (TYPEFLAG) is
on the record. This variable is the source for types of establishments providing
coverage that is not through an employer (HX03 and HX23). TYPEFLAG reflects the
type of establishment when the establishment was first reported, but it is not
necessarily updated. For example, users must link to the jobs file to obtain
information on employees who left their job since the interview in which the
employer was first reported (see section 3.6). For employment-based coverage
through both an employer and a union (such as insurance through a
labor-management committee), information about only one of the establishments,
usually the employer, is on the record. (These cases are identifiable through
the PROVDINS variable on the JOBS file.)
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3.4.2 Types of Coverage through the
Establishment
The establishments in the PRPL file provide private health
insurance covering hospital/physician, Medicare supplemental insurance, dental,
vision, or prescription medication insurance. The variable PRIVCAT identifies
the type of source for hospital and physician or Medicare supplemental
insurance. HOSPINSX and MSUPINSX are edited establishment-policyholder flags for
whether the policyholder has physician/hospital and medigap coverage,
respectively, through the establishment. However, even when PRIVCAT indicates
there is either hospital/physician or medigap coverage, both HOSPINSX and
MSUPINSX may have missing values. Note also that both HOSPINSX and MSUPINSX may
be coded “yes’ on the same record. DENTLINS, VISIONIN, and PMEDINS flags
indicate the establishment provides coverage for dental care, vision care, and
prescription medications, respectively. Below are examples of how to use these
variables to identify types of insurance:
Identifying Types of Insurance |
Variable and Values |
| Hospital and physician or Medicare
supplemental insurance |
PRIVCAT in (1,2,3,4,5,99) |
| Medicare supplemental insurance |
MSUPINSX = 1 |
| Hospital and physician insurance |
PRIVCAT in (1,2,3,4,5,99) & MSUPINSX
ne 1 |
| Dental insurance |
DNTLINS = 1 |
The variable COBRA is a flag for whether the respondent
reported the coverage was obtained through the requirements of the COBRA of
1986. This act requires that certain employers allow some former employees to
continue their employment-based coverage by paying the employer the premium
(U.S. Department of Labor 1999). This flag does not, however, indicate all the
coverage through former employers, which can be determined using TYPEFLAG and
links to former jobs in the JOBS file. COBRA is set to “yes” if any of the three
following conditions are met:
- The respondent said insurance from a previous job is
the source of coverage and the respondent answered yes to either HP14 or OE14
(depending on when the job ended):
|
Some employer insurance can be continued after leaving the company by
continuing to pay the premium. This is sometimes referred to as a COBRA plan.
Is (POLICYHOLDER)’ s (ESTABLISHMENT) insurance like that?
|
Or
Did that health insurance continue through COBRA?
- The respondent said COBRA is the source of insurance
through a self-insured firm with firm-size one (HX03)
|
- The respondent said COBRA is the source of insurance
not elsewhere reported (HX23)
|
COBRA is set to “no” when the insurance was not COBRA coverage. COBRA is set to
“inapplicable” when the coverage was not employment-based, and when the coverage
was through a current job. COBRA is set to “not ascertained” for retirement jobs
first reported in the employment section in round 1 (EM80), retirement jobs
first reported in the employment section for new RU members (EM80), and
insurance through unions reported in the insurance section (HX23).2 In a few cases, self-employed persons with firm size = 1 reported buying
coverage through a previous job, and these cases are coded as yes or no, while
other insurance through self-employment with firm size = 1 is coded
“inapplicable.”
The variable COVTYPIN flags whether coverage was single or family, based on the
number of persons covered in the RU, whether the establishment’s insurance
covers someone outside the household, and whether the policyholder is outside
the household. For Panel 8 rounds 1 and 2, and Panel 7 rounds 3 and 4, the
number of covered persons was measured at the time of the interview (or end of
the reference period). For Panel 8 round 3 and Panel 7 round 5 the number is as
of December 31st.
2 In these three cases, the
survey was not designed to ascertain whether the coverage was COBRA or not, but
the variable is coded as “not ascertained” to help analysts.
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3.4.3 Out-of-Pocket Premiums
In the 2003 MEPS, questions on out of pocket premiums were
asked of all policyholders with private insurance coverage, for all
establishments. The variable OOPPREM provides the monthly out-of-pocket premium
paid by the policyholder for coverage through the establishment for Panel 8 as
of round 1 and Panel 7 as of round 3. OOPELIG flags these
covered-person-policyholder-establishment triples. OOPPREMX provides an edited
version of OOPPREM and the variable OOPFLAG identifies which records were
edited. OOPX12X is provided as a convenience to researchers and contains the
edited monthly out-of-pocket premium amount multiplied by 12, representing the
annual amount.
The edited variable OOPPREMX includes imputed values for records which contained
missing values as well as for a limited number of records with values that were
implausibly low or high.
For policyholders in Panel 7 Round 3 with missing out-of-pocket premiums, if
coverage is through a continuation job which was originally reported in Panel 7
Round 1 and type of coverage, (COVTYPIN) is the same as in Panel 7 Round 1, then
OOPPREMX is set equal to OOPPREMX from Panel 7 Round 1 times the growth rate in
out-of-pocket premiums from 2002 to 2003. The growth rate is assigned by type of
coverage and is based on private sector out-of-pocket premiums reported in
MEPS-Insurance Component in 2002 and 2003. For all other cases, imputed values
were assigned by a hotdeck imputation procedure which accounted for source of
insurance (private employer, state and local government, federal government,
medigap, other non-group policy), age of policyholder, number of persons covered
by the policy, size of employer, region and MSA, presence of supplemental
benefits such as drug, dental and vision, and active or retired job.
Both OOPPREM and OOPREMX are coded as zero for those who reported paying none of
their premium.
OOPPREM was created using the out-of-pocket amount reported and the frequency of
payments (HX61, HX62, and HX620V1):
For the coverage through (ESTABLISHMENT), does anyone in
the family pay all of the premium or cost, some of the premium or cost, or none
of the premium or cost?
[Do not include the cost of any co-payments, coinsurance or deductibles anyone
in the family may have had to pay.]
How much {(do/does)/did} (POLICYHOLDER) pay for the (ESTABLISHMENT) coverage?
PROBE: {Is/Was} that per year, per month, per week, or what?
PREMLEVX shows whether OOPPREM was the full premium or
part of it. When the respondent reported they paid some or none of the premium,
the variables BYFED BYSTATE BYLOCAL BYSOMGOV BYEMPL BYUNION BYOTHER indicate who
paid the rest of the premium.
For the entire set of 13 variables (OOPPREM OOPREMX OOPX12X OOPELIG OOPFLAG
PREMLEVX BYFED BYSTATE BYLOCAL BYSOMGOV BYEMPL BYUNION BYOTHER), the same values
are reported on the records of each dependent person covered through the
policyholder’s establishment, but the policyholder paid only once per
establishment-policyholder.
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3.5 Plan Variables
The values of plan-level variables do not vary across the
records of the persons insured through the policyholder-establishment pair. The
PRPL file contains managed care and experience with plan variables for
hospital/physician and Medicare supplemental plans. For all other plans, these
variables are set to “inapplicable.”
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3.5.1 Household Reports of
Managed Care
The variable UPRHMO identifies records for HMO coverage
when the household respondent reported that the insurance was purchased through
an HMO, reported the insurance company was an HMO, or described the plan as an
HMO. In all cases the respondent answered a question using the term “HMO.”
UPRHMO is set to “yes” if any of the three following conditions are met:
- If the respondent reported purchasing the insurance
directly through an HMO (HX03, HX23)
|
- If the respondent identified the type of insurance
company as an HMO (HX49, HX51, HX54)
|
- If the respondent answered yes to the following
question (MC01):
|
Now I will ask you a few questions about how (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) works for non-emergency care.
We are interested in knowing if (POLICYHOLDER)’s (ESTABLISHMENT) plan is an
HMO, that is, a Health Maintenance Organization. With an HMO, you must
generally receive care from HMO physicians. For other doctors, the expense is
not covered unless you were referred by the HMO or there was a medical
emergency. Is (POLICYHOLDER)’s (INSURER NAME) an HMO?
UPRHMO is set to “no” when the plan was not an HMO. UPRHMO
is set to inapplicable when the plan was not hospital/physician or Medicare
supplemental coverage.
The variable UPRMNC identifies records for gatekeeper plans. The household
respondent has not identified the plan as an HMO but has identified a
characteristic of the plan that requires plan members to sign up with a
gatekeeper for all routine care (the exact question is given below). In 1998,
this gatekeeper feature was associated with HMO plans and with some Preferred
Provider Organization (PPO) plans. Users of the data can decide how to classify
these persons. UPRMNC is set to “yes” if the following condition is met:
If the respondent answered “no” to the HMO question (MC01)
and “yes” to the following question (MC02):
(Do/Does) (POLICYHOLDER)’s insurance plan require
(POLICYHOLDER) to sign up with a certain primary care doctor, group of doctors,
or a certain clinic which (POLICYHOLDER) must go to for all of (POLICYHOLDER)’s
routine care?
Probe: Do not include emergency care or care from a specialist you were referred
to.
UPRMNC is set to “no” when the plan does not require a
gatekeeper and when the plan is an HMO. UPRMNC is set to “inapplicable” when the
plan is not hospital/physician or Medicare supplemental coverage.
For plans other than HMOs and those with gatekeepers, the variable DRLIST
identifies records for plans that the household respondent said had a book or
list of doctors. The household respondent has not identified the plan as a PPO
but has identified a plan characteristic associated with PPO plans. If both the
following conditions were met:
- If the person did not say the plan is an HMO (HX03,
HX23, HX49, HX51, HX54, MC01)
|
- If the respondent answered “no” to the gatekeeper
question (MC02)
|
then the respondent was asked MC03:
Is there a book or list of doctors associated with the
plan?
DRLIST is set to “inapplicable” when the plan is not
hospital/physician or Medicare supplemental coverage, when the plan is an HMO,
or when the plan requires a gatekeeper.
For HMOs and for plans with gatekeepers and lists of doctors, the variable
VISITPAY identifies records for plans that the household respondent said paid
for out-of-network visits. The household respondent has not identified the plan
as a PPO or a Point of Service (POS) plan but has identified a plan
characteristic associated with PPO and POS plans. When the respondent answered
“yes” to the gatekeeper question (MC02), or answered “yes” to the list of
doctors question (MC03), then VISITPAY has the responses to MC04:
Will (POLICYHOLDER)’s plan pay for any of the costs of
visits to doctors who are not associated with (POLICYHOLDER)’s plan, even
if (POLICYHOLDER) (do/does) not have a referral?
When the respondent said the plan is an HMO (HX03, HX23,
HX49, HX51, HX54, MC01), then VISITPAY has the responses to MC05, HX60A, OE11B,
OE25B, and OE38B:
Will (POLICYHOLDER)’s plan pay for any of the costs of
visits to doctors who are not part of (POLICYHOLDER)’s HMO, even if
(POLICYHOLDER) (do/does) not have a referral?
VISITPAY is set to “inapplicable” when the plan is not
hospital/physician or Medicare supplemental coverage, or when the plan does not
require a gatekeeper and does not have a list of doctors.
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3.5.2 Family Experience with Plan
Experience with plan questions were asked at rounds 2
(Panel 8) and 4 (Panel 7) for families where at least one member was covered by
the plan at the time of the interview. The variable SATELIG indicates whether
the policyholder-establishment was eligible for the experience with plan
questions. Respondents were eligible for the experience with plan questions if
someone in the RU was covered by the plan on the date of the interview and the
insurance was hospital/physician or Medicare supplemental coverage. Question
wording is based on questions in the Consumer Assessment of Health Plans (CAHPS®),
an AHRQ-sponsored family of survey instruments designed to measure quality from
the consumer’s perspective.
The variables address the following topics: difficulty getting a personal doctor
or nurse (GTDOCPRB), delays waiting for plan approval for care (APRVTRET,
APRVDLAY), problems finding or understanding plan information (LOOKINF, PRBFDINF),
problems getting help from customer service (CUSTSERV, PRBCSTSV), problems with
paperwork (PAPRWRK, PRBPPRWK), and rating of experience with plan (RATEPLAN).
When multiple RU members were covered by the same private plan, the respondent
answered the questions once and described experiences for the policyholder and
family members. These family (RU)-level responses are on each round 2 or 4
covered person-policyholder-establishment record for the
policyholder-establishment and do not vary across covered persons.
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3.5.3 Change in Plan Name
The variable NAMECHNG indicates whether the name of the
plan obtained through the establishment changed from the prior round. For Panel
8 rounds 2 and 3 and Panel 7 rounds 3, 4 and 5, NAMECHNG is set to “yes” if
someone in the RU had coverage through the establishment in the prior round and
still had coverage at the time of the interview, and the respondent answered yes
to the following question (OE09, OE23, OE35):
Since (START DATE), has there been any change in the plan name of the health
insurance (POLICYHOLDER) has through (ESTABLISHMENT)?
If the respondent answered no, then NAMECHNG is coded no. If no one in the RU
had coverage through the establishment in the prior round, no one had coverage
at the time of the interview, or it is a round 1 record, then NAMECHNG is set to
“inapplicable.”
When the respondent answered yes, then MEPS HC asked about types of benefits and
managed care, which are updated on the PRPL file.
There are two important caveats to this variable. First, changes in plan name do
not necessarily imply the plan itself changed. For example, the plan may have
merely changed its name for marketing purposes. Second, the variable NAMECHNG
pertains only to changes in plan names at the same establishment; a policyholder
may switch plans if she or he switches the establishment (including employer)
through which he or she obtains insurance. Switches in EPRSIDs and ESTBIDs
between rounds indicate those other types of changes.
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3.6 Links to Job Providing Insurance
For employment-based insurance, there are two variables
linking the insurance to details about the jobs through which the insurance was
obtained, CMJINS and JOBSIDX.
Most people with employment-based insurance have it through current main jobs.
The variable CMJINS indicates whether the insurance is through a current main
job. When the insurance is not employment-based, then CMJINS is set to
“inapplicable.” Generally, many edited and imputed variables describing
policyholders’ current main jobs are available on HC-064 and HC-073. If CMJINS
=1 and the policyholder has a PUF record (PUF64FLG or PUF73FLG), then edited and
imputed current main jobs variables are available on the indicated PUF.
For other types of jobs (for example, former jobs), the JOBS files (HC-074 and
HC-063) contain edited variables describing the job. JOBSFILE indicates which
jobs file contains information about the source of coverage. In most cases,
information about the job is in HC-074, but for Panel 7, if the job ended before
2003, information about the job is contained in HC-063. JOBSIDX is the link to
the record for the job in the JOBS file that is the source of coverage. This
link is slightly complicated, because the variable JOBSINFR indicates links that
were inferred, rather than obtained directly from the respondent. Links were
inferred because when persons reported employment-based health insurance at the
end of the insurance section (HX23), the plan is not always easily linked to a
specific job. Most of these cases were directly linked by establishment IDs, but
others required inferences based on whether the insurance was through a current
or former job (EMPLSTAT), and some could not be linked at all.
The variable EMPLSTAT contains the answers to question HP12, which is asked only
about the policyholders of employment-related insurance first mentioned at the
end of the insurance section of the interview (HX23), and it is asked only in
the interview round where the insurance was first reported. Thus, it is useful
only for the cases where links to jobs could not be inferred. Because it does
not contain updated information about the policyholder’s employment at each
interview, the value is set to -2 in subsequent rounds, and users can link back
to the PRPL record from the prior rounds, using the DUPERSID and EPRSIDX, to get
the original information.
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References
U.S. Department of Labor. Pension and Welfare Benefits
Administration. 1999. Health Benefits under the Consolidated Omnibus Budget
Reconciliation Act (COBRA). Washington, DC. [Available on-line at: http://www.dol.gov/ebsa/pdf/cobra99.pdf]
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D. Variable Source Crosswalk
VARIABLE TO SOURCE CROSSWALK
FOR MEPS PUBLIC USE FILE HC-076
HEALTH INSURANCE VARIABLES - SOURCE
Variable |
Label |
Source |
| EPCPIDX |
UNIQUE RECORD IDENTIFIER
(DUPERSID+RN+EPRSIDX) |
CONSTRUCTED |
| DUPERSID |
PERSON IDENTIFIER
(EITHER DEPENDENT OR POLICYHOLDER) |
CONSTRUCTED |
| PHLDRIDX |
PERSON IDENTIFIER OF THE POLICYHOLDER |
CONSTRUCTED |
| ESTBIDX |
ESTABLISHMENT ID |
CONSTRUCTED |
| EPRSIDX |
UNIQUELY IDENTIFIES INSURANCE COVERAGE THAT A POLICYHOLDER OBTAINS FROM ESTABLISHMENT (ESTBIDX+PHLDRIDX) |
CONSTRUCTED |
| PANEL |
PANEL NUMBER |
CONSTRUCTED |
| RN |
ROUND NUMBER |
CONSTRUCTED |
| JOBSIDX |
UNIQUELY IDENTIFIES POLICYHOLDER’S JOB AT THE ESTABLISHMENT THAT PROVIDED INSURANCE |
CONSTRUCTED |
| JOBSINFR |
JOBSIDX INFERRED RATHER THAN REPORTED ID |
CONSTRUCTED |
| PUF34FLG |
INDICATOR IF PERSON IS IN PUF 34 |
CONSTRUCTED |
| PUF55FLG |
INDICATOR IF PERSON IS IN PUF 55 |
CONSTRUCTED |
| CMJINS |
CMJ AS THE SOURCE OF PLAN: 1 YES, 2 NO |
PRIVCAT, RJ01A,
RJ0189A, EM08, EM14 |
| EMPLSTAT |
POLICYHOLDER EMPLOYMENT STATUS |
HP 12 |
| PHOLDER |
POLICY HOLDER |
HP 9, 11 |
| DEPENDNT |
DEPENDENT OF POLICY HOLDER |
PRIVCAT, PHOLDER |
| EVALCOVR |
COVERED @ INTERVIEW OR 12/31 |
HQ1, 2 |
| STATUS1 – STATUS24 |
STATUS ‑MONTH 1 THROUGH STATUS ‑MONTH 24 |
HQ1, 2, 3, 4, 5 |
| >DECPHLDR |
DECEASED POLICYHOLDER FLAG |
CONSTRUCTED |
| OUTPHLDR |
OUT-OF-RU POLICYHOLDER FLAG |
CONSTRUCTED |
| NOPUFLG |
PHLDR NOT IN HC034 OR HC055 |
CONSTRUCTED |
| TYPEFLAG |
TYPE OF ESTABLISHMENT |
HX 3, 23; EM 6, 8, 12, 14,
19, 22, 23, 28, 31, 32, 41,
44, 45, 54, 57, 58, 71, 74,
75, 83, 86, 87, 118, 120 |
| PRIVCAT |
CATEGORY OF PRIVATE COVERAGE |
HX 2, 3, 23, 48, 61, 63;
HP 1, 2, 9, 11, 15, 16;
EM 17, 18, 26, 27, 39, 40, 52, 53, 69,
70, 81, 82, 91,
92, 117 |
| HOSPINSX |
TYPE OF HI GOTTEN: HOSPITAL/HMO (EDITED) |
HX48 |
| MSUPINSX |
TYPE OF HI GOTTEN: MEDIGAP (EDITED) |
HX48 |
| DENTLINS |
TYPE OF HI GOTTEN: DENTAL |
HX48 |
| VISIONIN |
TYPE OF HI GOTTEN: VISION |
HX48 |
| PMEDINS |
TYPE OF HI GOTTEN: PRESCRIPTION DRUG |
HX48 |
| COBRA |
COBRA COVERAGE: 1=YES, 2=NO |
HX 3, 23; HP12, 14 ; OE14;
EM 8, 9, 14, 15, 22, 23, 24,
31, 32, 33, 44, 46, 57, 58,
74, 75, 76, 80, 85A, 86, 87, 88; RJ 1A, 189A; PRIVCAT |
| COVTYPIN |
COVERAGE @INTVW: 1=SINGLE, 2=FAMILY |
HP 15, 16, 17 |
| OOPELIG |
FLAG: POLICYHOLDER ESTB HAS PREMIUM |
RN; TYPEFLAG; HX 3, 23;
HP14 |
| OOPPREM |
MONTHLY OUT‑OF‑POCKET PREMIUM |
HX 61, 62 |
| OOPPREMX |
MONTHLY OUT‑OF‑POCKET PREMIUM (ED/IMP) |
CONSTRUCTED |
| OOPX12X |
ANNUAL OUT-OF-POCKET PREMIUM (ED/IMP) |
CONSTRUCTED |
| OOPFLAG |
OOPPREMX EDIT/IMPUTATION FLAG |
CONSTRUCTED |
| PREMLEVX |
HOW MUCH OF PREMIUM PAID BY FAM (ED) |
HX 61, 62 |
| BYFED |
FEDERAL GOVT PAID FOR PRIV PLAN PREMIUM |
HX63 |
| BYSTATE |
STATE GOVT PAID FOR PRIV PLAN PREMIUM |
HX63 |
| BYLOCAL |
LOCAL GOVT PAID FOR PRIV PLAN PREMIUM |
HX63 |
| BYSOMGOV |
SOME GOVT PAID FOR PRIV PLAN PREMIUM |
HX63 |
| BYEMPL |
EMPLOYER PAID FOR PRIV PLAN PREMIUM |
HX63 |
| BYUNION |
UNION PAID FOR PRIV PLAN PREMIUM |
HX63 |
| BYOTHER |
OTHER PAID FOR PRIV PLAN PREMIUM |
HX63 |
| UPRHMO |
HMO COVERAGE (FROM PRPL) |
HX 3, 23, 49_02.TYPE, 50_02.TYPE,
54_02.TYPE; MC 1 |
| UPRMNC |
PLAN REQRD COVRD PERS USE GATEKEEPER |
MC 2 |
| DRLIST |
DOES PLAN HAVE A BOOK/LIST OF DOCTORS? |
MC 3 |
| VISITPAY |
PLAN PAY FOR NON‑REFER DR VISIT |
MC 4, 5,
HX60A,
OE11B, 25B, 38B |
| NAMECHNG |
HAS THERE BEEN A CHANGE IN PLAN NAME |
OE 9, 23, 35 |
| SATELIG |
ELIG. FOR SATIS. PLAN QUEST: 1=YES, 2=NO |
PRIVCAT, RN,
EVALCOVR |
| APPT |
HOW DIFFICULT TO GET SPECIALIST APPT? |
SP 7 |
| CHANPROV |
DID HAVE TO CHANGE PRIMARY CARE PROVIDER |
SP 5 |
| COSTQUAL |
IMPORTANCE COST/QUALITY IN CHOOSING PLAN |
SP 15 |
| CUSTSERV |
HAS CALLED CUSTOMER SERVICE/ADMIN OFFICE |
SP 11 |
| DIFFREF |
HOW DIFFICULT TO GET SPECIALIST REFERRAL |
SP 6 |
| PAIDLESS |
HAS PLAN PAID LESS THAN EXPECTED? |
SP 10 |
| PLANREF |
PLAN REFUSED TO PAY FOR OR APPROVE CARE |
SP 9 |
| PLANSAT |
SATISFACTION WITH INSURANCE PLAN |
SP 2 |
| RECPLAN |
LIKELY TO RECOMMEND PLAN? |
SP 3 |
| SATAMT |
SATISFIED WITH AMOUNT PAID |
SP 14 |
| SATCHOIC |
HOW SATISFIED WITH CHOICE OF PROVIDER |
SP 4 |
| SATCOVH |
HOW SATISFIED WITH HOSPITALIZATION? |
SP 8_02 |
| SATCOVMH |
HOW SATISFIED WITH MENTAL HEALTH SERVICE |
SP 8_04 |
| SATCOVP |
HOW SATISFIED W/ PREVENTIVE HEALTH CARE? |
SP 8_01 |
| SATCOVPM |
HOW SATISFIED WITH PRESCRIPTION MEDS? |
SP 8_03 |
| SATCS |
HAS CALLED CUSTOMER SERVICE/ADMIN OFFICE |
SP 12 |
| SATPAPER |
SATISFIED W/ AMOUNT/DIFFICULTY PAPERWORK |
SP 13 |
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