MEPS HC-191: 2016 Person Round Plan Public Use File
August 2018
Agency for Healthcare Research and Quality
Center for Financing, Access, and Cost Trends
5600 Fishers Lane
Rockville, MD 20857
(301) 427-1406
Table of Contents
A. Data Use Agreement
B. Background
1.0 Household Component
2.0 Medical Provider Component
3.0 Survey Management and Data Collection
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, Exchanges, 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 HMOs
3.5.2 Change in Plan Name
3.6 Links to Job Providing Insurance
4.0 Linking to Other Files
4.1 National Health Interview Survey
4.2 Longitudinal Analysis
5.0 Using MEPS Data for Trend Analysis
References
D. Variable-Source Crosswalk
Individual identifiers have been removed from the
micro-data contained in these files. 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; and
- 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. Furthermore, linkage of the Medical Expenditure Panel
Survey and the National Health Interview Survey may not occur
outside the AHRQ Data Center, NCHS Research Data Center (RDC) or
the U.S. Census RDC network.
By using these 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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The Medical Expenditure Panel Survey (MEPS) provides
nationally representative estimates of health care use, expenditures, sources of
payment, and health insurance coverage for the U.S. civilian
non-institutionalized population. The MEPS Household Component (HC) also
provides estimates of respondents’ health status, demographic and socio-economic
characteristics, employment, access to care, and satisfaction with health care.
Estimates can be produced for individuals, families, and selected population
subgroups. The panel design of the survey, which includes 5 Rounds of interviews
covering 2 full calendar years, provides data for examining person level changes
in selected variables such as expenditures, health insurance coverage, and
health status. Using computer assisted personal interviewing (CAPI) technology,
information about each household member is collected, and the survey builds on
this information from interview to interview. All data for a sampled household
are reported by a single household respondent.
The MEPS-HC was initiated in 1996. Each year a new
panel of sample households is selected. Because the data collected are
comparable to those from earlier medical expenditure surveys conducted in 1977
and 1987, it is possible to analyze long-term trends. Each annual MEPS-HC sample
size is about 15,000 households. Data can be analyzed at either the person or
event level. Data must be weighted to produce national
estimates.
The set of households selected for each panel of the
MEPS HC is a subsample of households participating in the previous year’s
National Health Interview Survey (NHIS) conducted by the National Center for
Health Statistics. The NHIS sampling frame provides a nationally representative
sample of the U.S. civilian non-institutionalized population and reflects an
oversample of Blacks and Hispanics. In 2006, the NHIS implemented a new sample
design, which included Asian persons in addition to households with Black and
Hispanic persons in the oversampling of minority populations. The linkage of the
MEPS to the previous year’s NHIS provides additional data for longitudinal
analytic purposes.
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Upon completion of the household CAPI interview and
obtaining permission from the household survey respondents, a sample of medical
providers are contacted by telephone to obtain information that household
respondents cannot accurately provide. This part of the MEPS is called the
Medical Provider Component (MPC) and information is collected on dates of visit,
diagnosis and procedure codes, charges and payments. The Pharmacy Component
(PC), a subcomponent of the MPC, does not collect charges or diagnosis and
procedure codes but does collect drug detail information, including National
Drug Code (NDC) and medicine name, as well as date filled and sources and
amounts of payment. The MPC is not designed to yield national estimates. It is
primarily used as an imputation source to supplement/replace household reported
expenditure information.
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MEPS HC and MPC data are collected under the authority
of the Public Health Service Act. Data are collected under contract with Westat,
Inc. (MEPS HC) and Research Triangle Institute (MEPS MPC). Data sets and summary
statistics are edited and published in accordance with the confidentiality
provisions of the Public Health Service Act and the Privacy Act. The National
Center for Health Statistics (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, micro data files, and tables via the
MEPS website.
Selected data can be analyzed through MEPSnet, an on-line interactive tool
designed to give data users the capability to statistically analyze MEPS data in
a menu-driven environment.
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,
5600 Fishers Lane, Rockville, MD 20857 (301-427-1406).
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This public use data file contains data for each
person with private health insurance reported in Rounds 3, 4, and 5 of Panel 20
and Rounds 1, 2, and 3 of Panel 21 (i.e., the rounds for the survey panels
covering calendar year 2016) of the Medical Expenditure Panel Survey Household
Component (MEPS HC). Released as an ASCII file (with related SAS, SPSS, and
Stata programming statements and data user information) and in SAS transport
format, this public use file (PUF) provides information collected on a
nationally representative sample of the civilian noninstitutionalized population
of the United States during the calendar year 2016. The HC-191 file
(Person-Round-Plan Public Use File) contains records for persons insured through
private establishments providing hospital/physician, Medigap, dental, vision, or
prescription medication coverage and includes variables pertaining to HMOs. The
file contains 68 variables and has a logical record length of 217 with an
additional 2-byte carriage return/line feed at the end of each record.
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The Person-Round-Plan (PRPL) file for 2016 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-177, the Point-in-Time
Public Use File, and HC-184, the Full-Year Population Characteristics File)
requires users to make 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 of the interview
- Interview Round
- Policyholder
- 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)1
- Out-of-pocket premiums and employee contributions
- Links to the job providing insurance (for employment-based
insurance only, HC-185, the JOBS Public Use File)
- Plan (for hospital/physician and Medicare supplemental
insurance coverage only)
- Household reports of health maintenance organizations (HMOs)
- High deductibles and Health Savings Accounts (HSAs) for
hospital/physician insurance coverage only
1 No effort has been made to
validate variables representing type of coverage with external sources.
FIGURE 1
CONCEPTUAL OVERVIEW OF PRPL
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 were asked in reference to the establishment providing insurance to
the policyholder. For example, the MEPS HC asked 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 HMO or self-insured company from which the 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 HMO characteristics as the hospital/physician plan.
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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 61,495 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
one job record in HC-185. 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.
- 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.
- 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.
- 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.
No Private Insurance
- Paul is uninsured. In this case, Paul does not have any PRPL
records.
- Mary has Medicaid instead of private coverage. In this case,
Mary does not have any PRPL records.
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-185.
- 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-185.
- 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-185.
Policyholders Not in the Household
- Edith is a widow and has retiree insurance from her deceased
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 deceased husband, where he is flagged as
the policyholder and flagged as deceased, but this record does
not link to any records on any other MEPS PUFs.
- 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 Reporting Unit (RU), but this PRPL record
does not link to any records on any other MEPS PUFs.
Changes in Insurance
- Bob changes jobs between January 1st, 2016 and
the date of his MEPS interview, and both jobs provide 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 21) but pays her
previous employer to continue her health insurance while she
looks for another job in Round 2. In this case, Julie’s Round 1
PRPL record flags her current main job as the source of her
insurance and links to a job record in PUF HC-185. 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 job variables from Round 1 are no longer current in
Round 2, but the link exists for users.
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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 establishment –
employer, union, insurance company, or other – i.e., the source of insurance
coverage on the record.
EPRSIDX is the concatenation of ESTBIDX, PHLDRIDX, and
RN and it uniquely identifies the insurance coverage that a policyholder obtains
from an individual establishment.
EPCPIDX is the concatenation of EPRSIDX and DUPERSID,
and it uniquely identifies each record.
JOBSIDX is the concatenation of the PHLDRIDX, a round
identifier (RN), and a job number, 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 if (1) they are covered (as a policyholder or a dependent) by
insurance policies from more than one establishment, or (2) they are covered in
more than one round. Within each round, establishment-policyholder pairs
(EPRSIDXs) can be listed more than once if the health plan a policyholder
obtains from a given establishment also covers his/her dependents. 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 |
RN |
EPRSIDX |
EPCPIDX |
JOBSIDX |
| 11 |
42 |
42 |
1 |
11421 |
1142142 |
42101 |
| 11 |
42 |
42 |
2 |
11422 |
1142242 |
42201 |
| 11 |
42 |
42 |
3 |
11423 |
1142342 |
42301 |
| 22 |
64 |
64 |
1 |
22641 |
2264164 |
64101 |
| 33 |
64 |
64 |
1 |
33641 |
3364164 |
-1 |
| 44 |
61 |
61 |
1 |
44611 |
4461161 |
61101 |
| 44 |
62 |
61 |
1 |
44611 |
4461162 |
61101 |
| 44 |
63 |
61 |
1 |
44611 |
4461163 |
61101 |
| 55 |
71 |
71 |
1 |
55711 |
5571171 |
71102 |
| 55 |
71 |
71 |
2 |
55712 |
5571271 |
71102 |
The first three rows of the table represent a
situation where a person (DUPERSID=42) is listed three times in the PRPL file
because she obtains insurance from the same establishment in all three rounds.
Since the person is the policyholder, her DUPERSID 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
within each round, EPRSIDX=44611). 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 2016. In Panel 21, 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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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).
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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 2016 (Panel 21 Round 1 or Panel 20 Round 3). Then you would select
PRPL records matching HC-177 (PITFLG=1) where the insurance is through a current
main job (CMJINS=1) and [(PANEL=21 and RN=1) or (PANEL=20 and RN=3)]. From
HC-177, 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-177 or
HC-184. These include deceased policyholders and policyholders residing outside
the RU. For these policyholders, PITFLG and FYFLG may be equal to 0, 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, when creating nationally representative estimates of
policies and policyholders, establishment-policyholder pairs where the
policyholder resides outside the RU should not be included in estimates. This is
because MEPS policyholders include policies covering dependents outside the RU,
and including RU members covered by a policyholder outside the RU will result in
double counting policies that span RUs. Alternatively, a researcher could create
nationally representative estimates of covered persons, regardless of whether
the policyholder was in the RU, using all the covered persons in the MEPS.
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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-177 or HC-184. 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 four research questions.
How many people were covered by two or more private
hospital/physician insurance plans at the end of 2016?
Select the Panel 21 Round 3 and Panel 20 Round 5
records with PRIVCAT>0 and
MSUPINSX 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-184 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 2016?
Select the Panel 21 Round 3 and Panel 20 Round 5
records with DENTLINS=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-184 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 21 Round 1 and Panel 20 Round 3
records with PRIVCAT in (2, 3, 6, 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-177 and use weights, strata, and PSUs to create
nationally representative estimates.
At the time of the first interview of 2016, 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 21 Round
1 or Panel 20 Round 3) and PHOLDER=1 and PRIVCAT=1 and EVALCOVR=1]. From the
2016 JOBS file, PUF HC-185, select the records with jobs from which the person
retired (SUBTYPE=6 or RETIRJOB=1 or YLEFT=2 or YNOBUSN=2 or WHY_LEFT=3). Persons
in Panel 20 may have reported retiring from a job in 2015, so, from the 2015
JOBS file, PUF HC-176, select the records with PANEL=20 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 RETIRJOB=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-184 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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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-191 PRPL file can be linked to other public use
files such as MEPS HC-177 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 person-level public use
files by using the PHLDRIDX to match the DUPERSID on the person-level 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, PHLDRIDX, and RN.
In a few cases, more than one EPRSIDX may identify a policyholder-source of
coverage pair. For example, when an RU splits, 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 may 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
EPRSIDXs (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, and it uniquely identifies the policyholder’s
job at the establishment that provided insurance (for employment-based
coverage). The round identifier embedded 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-185).
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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
PITFLG indicates whether the person has a record on HC-177, and FYFLG indicates
whether the person has a record on HC-184.
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 20 and
Rounds 1 and 2 of Panel 21) or on December 31 (Round 5 of Panel 20 and Round 3
of Panel 21). 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 21, STATUS1-STATUS12 represent coverage from
January 2016 through December 2016, and STATUS13-24 are inapplicable because
this information is in the year 2017. For Panel 20, STATUS13-STATUS24 represent
coverage from January 2016 through December 2016, and STATUS1-STATUS12 are
inapplicable because this information is in the year 2015. Coverage is reported
only for the interview reference period. For example, if a person from Panel 21
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
record for the second round will have STATUS3 through STATUS8 set to 1 and the
rest set to inapplicable.
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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 OUTPHLDR 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 the household, which should instead be obtained from the PSTATS
variables on the person-level files. (For example, policyholders who die between
Round 1 (Panel 21) or 3 (Panel 20) and the end of 2016 will have records on
HC-177 and HC-184, and PITFLG and FYFLG will be set to 1.)
Return To Table Of Contents
The values of establishment-level variables do not
vary across the records of the persons insured through the
policyholder-establishment pair.
Return To Table Of Contents
The type of establishment providing coverage
(TYPEFLAG) is on the record. This variable is the source for types of
establishments providing employer-based and non-employer-based, private
coverage. In this file, TYPEFLAG includes the answers to 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), for most cases, only the coverage record through
the employer establishment is retained. These cases are identifiable through the
PROVDINS variable on the JOBS File. In some cases, the union and employer may
provide different types of coverage. It is important for researchers to review
coverage type variables - HOSPINSX, MSUPINSX, PMEDINS, DENTLINS, VISIONIN, and
COBRA - to determine which establishment would be most helpful in answering
analytic questions.
As of Panel 14 Round 5 and Panel 15 Round 3, “High
Risk Pool” (TYPEFLAG = 20) was added to the list of sources of coverage at HX03
and HX23, where information is collected about purchased insurance associated
with a self-employed job and firm-size = 1, and privately purchased health
insurance not obtained through an employer.
Note that when TYPEFLAG has a value of 10, “spouse’s/deceased spouse’s
previous employer,” and the spouse resides in the RU, and the respondent selects the spouse as the
policyholder at HP11, then the policyholder’s ID is the spouse’s ID.
Beginning in 2014, the MEPS HC asks about State
Exchanges, so the PRPL File has four variables and one TYPEFLAG (HX03, HX23)
value related to State Exchanges. These variables and value pertain to sources
of health insurance coverage created as part of the 2010 Affordable Care Act.
The exchanges were launched in 2014 to simplify shopping for private health
insurance coverage. Note that the terms “marketplace” and “exchange” are
interchangeable.
Individuals may purchase care directly from a State
Exchange for themselves or family members. The Small Business Health Options
Program (SHOP) Marketplaces help small businesses offer health insurance to
their employees. For more information, please see the
Health Insurance Marketplaces page on
the CMS website on the CMS website.
The questions about State Exchanges and SHOPs are
asked of respondents in every state. The name of the exchange in the
respondent’s state is used in the questions, but states are not identified on
this file.
The variables are as follows:
Coverage through a State Exchange
STEXCH
In CAPI, STEXCH03, STEXCH23, and OESTEXCH indicate
whether insurance was obtained through an exchange. STEXCH03 provides this
information for insurance obtained by a self-employed person with firm size = 1
through that job; STEXCH23 is for all other cases. OESTEXCH was added to CAPI in
Panel 20 Round 3 and is asked where the plan name changed in the current round
and no State Exchange was reported through the establishment in the previous
round. All three variables are set to “inapplicable” (-1) for insurance obtained
through a current or former employer, union, school, high risk pool, or unknown
source. Applicable values exist only for insurance obtained through other
groups, insurance companies, insurance agents, HMOs, State Exchanges, or other
private sources. These variables are automatically set to “1,” indicating that
the source of coverage was from a State Exchange when State Exchange was
selected as the source of insurance at HX03 or HX23. Otherwise, these variables
are the responses to HP04A. In Round 3, for insurance reported in a prior round
that was not through an exchange, OESTEXCH contains responses to question OE28A.
After the interview, STEXCH03, STEXCH23, and OESTEXCH
were edited to “2,” indicating that the source of coverage is not from a State
Exchange, when either of the following was true:
- The respondent reported Medigap coverage (MSUPINSX = 1) was
obtained through the State Exchange, or
- For persons 65 years and older, the person had Medicare
(reported elsewhere in the health insurance section of the
survey).
Thus, these records are no longer included as State
Exchange coverage.
Beginning in 2015, instead of delivering these
individual State Exchange variables, the PRPL File creates one variable to
summarize whether coverage is through a State Exchange, using STEXCH03,
STEXCH23, and OESTEXCH. STEXCH is set to “inapplicable” (-1) for insurance
obtained through a current or former employer, union, school, high risk pool, or
unknown source. STEXCH is set to “Yes, Exchange Coverage” (1) if any of the
three following conditions are met:
- The respondent said a State Exchange is the source of
insurance through a self-insured firm with firm-size=1 (HX03)
- The respondent said a State Exchange is the source of
insurance not elsewhere reported (HX23)
- The respondents said the insurance was through a group,
association, insurance company, insurance agent, HMO, or other
private source and the respondent said yes to “Is this coverage
through STATE EXCHANGE NAME?” either in the interview the
insurance was first reported (HP04A) or in Round 3 for insurance
reported in an early round, reported as not through a State
Exchange when it was first reported (OE28A).
All others are set to “No, Not Exchange Coverage” (2).
PLANMETL
There are five levels or “tiers” of coverage available
through the Marketplace that identify how the policyholder and the insurance
plan will split costs. To assist consumers in selecting a level of coverage, the
tiers are named Catastrophic, Bronze, Silver, Gold, and Platinum, reflecting a
graduated level of cost to the consumer for deductibles, copayments,
coinsurance, and out-of-pocket maximums.
Persons are asked to identify the “metal” plan if
State Exchange coverage is indicated at HX03, HX23, or OE28A; the coverage
provides hospitalization and physician benefits; and the person is less than 65
years of age.
During editing, PLANMETL is set to “not ascertained”
if hospitalization/physician benefit coverage is “refused” (-7), “don’t know” (-8),
or “not ascertained” (-9).
PREMSUBZ
PREMSUBZ (HX62A and OE35AA2) indicates whether
insurance was subsidized based on family income. PREMSUBZ is set to inapplicable
(-1) for insurance obtained through a current or former employer, union, school,
high risk pool, or unknown source. Applicable values exist only for insurance
obtained through other groups, insurance companies, insurance agents, HMOs,
State Exchanges, or other private sources. For these sources of insurance,
respondents are asked each round whether the insurance is subsidized, with one
exception. The exception is that subsidy information is not collected in Round 5
for insurance first reported in a prior round.
Coverage through the Small Business Health Options
Program
STSHOP
STSHOP (HP14A and OE08B) indicates whether
employment-related health insurance coverage with a change in plan name is
related at all to a SHOP marketplace. This information is collected for
employment-related insurance through a current main job at a small employer. For
this part of the survey, a small business establishment is defined differently
for the self-employed and those working for others. For the self-employed, a
small business is defined as an establishment with more than one but fewer than
200 employees. For jobholders working for others, a small business is defined as
an establishment having only one location and fewer than 200 employees or the
respondent estimated the establishment had 100 or fewer employees.
It is important to note that a person may have SHOP
and State Exchange coverage in the same round; however, these are through
different establishments.
Return To Table Of Contents
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” (1)
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, 6, 99) |
| Medicare supplemental insurance |
MSUPINSX = 1 |
| Hospital and physician insurance |
PRIVCAT in (1, 2, 3, 4, 5, 6, 99) & MSUPINSX ne 1 |
| Dental insurance |
DENTLINS = 1 |
The variable COBRA is a flag for whether the
respondent reported that 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). 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/Was} (POLICYHOLDER)’s
(ESTABLISHMENT) insurance like that {on (END DATE)}?
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 = 1 (HX03)
- The respondent said COBRA is the source of insurance not
elsewhere reported (HX23)
COBRA is set to “no” (2) when the insurance was not
COBRA coverage. COBRA is set to “inapplicable” (-1) when the coverage was not
employment-based, and when the coverage was through a current job. COBRA is set
to “not ascertained” (-9) 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 21 Rounds 1 and 2, and Panel 20
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 21 Round 3 and Panel 20
Round 5, the number is as of December 31st. Beginning with the 2010
data, when coverage ceased before the end of the reference period for every
co-residing family member, COVTYPIN is set based on the number of persons ever
covered during the round. The variable COVROUT indicates whether out-of-RU
persons were covered by the plan.
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.
Return To Table Of Contents
In the 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 21 as
of Round 1 and Panel 20 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 20 Round 3 with missing out-of-pocket premiums, if coverage is through a
continuation job which was originally reported in Panel 20 Round 1 and type of
coverage (COVTYPIN) is the same as in Panel 20 Round 1, then OOPPREMX is set
equal to OOPPREMX from Panel 20 Round 1 times the growth rate in out-of-pocket
premiums from 2015 to 2016. The growth rate is assigned by type of coverage and
is based on private sector out-of-pocket premiums reported in the MEPS Insurance
Component in 2015 and 2016. For all other cases, imputed values were assigned by
one of several imputation methods – hot-deck imputation or MEANS substitution,
both of which consider the following person/plan characteristics: source of
insurance (private employer, state and local government, federal government,
Medigap, other non-group policy, State Exchanges), age of policyholder,
educational attainment of policyholder, number of persons covered by the policy,
if there is a high family deductible, size of employer, region and MSA, presence
of supplemental benefits such as drug, dental and vision, and active or retired
job. Missing premium amounts on coverage purchased through a State Exchange are
hot-deck imputed in a separate process.
Both OOPPREM and OOPPREMX are coded as zero for group
policyholders who reported paying none of their premium.
OOPPREM is created using the out-of-pocket amount
reported and the frequency of payments (HX61, HX62, and HX62OV1):
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.]
[Do include any contribution made to the plan
as part of a paycheck.]
How much {(do/does)/did} (POLICYHOLDER) pay for the
(ESTABLISHMENT) coverage?
{Is/Was} that per year, per month, per week, or what?
PREMLEVX shows whether OOPPREM was the full premium or
part of it. The PREMLEVL (HX61, OE35A) question is asked in all rounds for
insurance obtained through other groups, insurance companies, insurance agents,
HMOs, State Exchanges, or other private sources, but not insurance obtained
through a current or former employer, union, school, high risk pool, or unknown
source. Note that the premium amount is not collected in Rounds 2, 4, and 5.
For the entire set of 6 variables (OOPPREM, OOPPREMX,
OOPX12X, OOPELIG, OOPFLAG, PREMLEVX), 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.
Return To Table Of Contents
The values of plan-level variables do not vary across
the records of the persons insured through the policyholder-establishment pair.
The variables ANNDEDCT (HX63A/OE09B/OE23B/OE35B) and
HSAACCT (HX63B/OE09C/OE23C/OE35C) capture whether a private health plan has a
high deductible and whether that plan is associated with a Health Savings
Account (HSA) or a similar special fund/account. These questions are asked
during the first report and during the review of insurance in Rounds 1 and 3 for
all private plans except for individuals covered by disability, Workers’
Compensation, accident insurance, or any combination thereof, and/or individuals
covered by Medicare supplement/Medigap plans.
Return To Table Of Contents
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 insurance purchased directly
through an HMO (HX03, HX23)
- If the respondent identified the type of insurance company
as an HMO (HX49, HX51)
- If the respondent answered yes to the following question
(MC01):
{Is/Was} (POLICYHOLDER)’s {NAME OF INSURER BEING
LOOPED ON} an HMO {as of (END DATE)}? {When answering this question, do not
consider (POLICYHOLDER)’s insurance through Medicare.}
[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.]
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.
Return To Table Of Contents
The variable NAMECHNG indicates whether the name of
the plan obtained through the establishment changed from the prior round. For
Panel 21 Rounds 2 and 3 and Panel 20 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):
{Last time we recorded that (POLICYHOLDER) (were/was)
covered by {INSURER OF ESTAB-PERS-INSURER TRIPLE ON PREV RD INT DT}.}
{Since (START DATE), has there been/Between (START
DATE) and (END DATE), was there} any change in the plan name of the health insurance
(POLICYHOLDER) (have/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, 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 she or he obtains insurance.
Switches in EPRSIDs and ESTBIDs between rounds indicate those other types of
changes.
Return To Table Of Contents
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 insurance is through a previous job or
through self-employment and there is only one employee, then CMJINS is set to “no.”
When the insurance is not employment-based, CMJINS is set to “inapplicable.”
Generally, many edited and imputed variables describing policyholders’
current main jobs are available on HC-177 and HC-184. If CMJINS =1 and the policyholder
has a PUF record (PITFLG or FYFLG = 1), 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-185 and HC-176) 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-185, but for Panel
20, if the job ended before 2016, information about the job is contained in
HC-176. 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 was 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 answer 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, ESTBIDX, and PHLDRIDX to get the original
information.
Return To Table Of Contents
The set of households selected for MEPS is a subsample
of those participating in the National Health Interview Survey (NHIS), thus,
each MEPS panel can be linked back to the previous year’s NHIS public use data
files. For information on obtaining MEPS/NHIS link files please see the
Data File Types page
of the MEPS website.
Return To Table Of Contents
Panel-specific longitudinal files are available for
downloading in the data section of the MEPS Website. For each panel, the
longitudinal file comprises MEPS survey data obtained in Rounds 1 through 5 of
the panel and can be used to analyze changes over a two-year period. Variables
in the file pertaining to survey administration, demographics, employment,
health status, disability days, quality of care, patient satisfaction, health
insurance, and medical care use and expenditures were obtained from the MEPS
full-year Consolidated files from the two years covered by that panel.
For more details or to download the data files, please
see Longitudinal Weight Files on the
Data File Types page
of the MEPS website.
Return To Table Of Contents
MEPS began in 1996, and the utility of the survey for
analyzing health care trends expands with each additional year of data; however,
there are a variety of methodological and statistical considerations when
examining trends over time using MEPS. Tests of statistical significance should
be conducted to assess the likelihood that observed trends are not attributable
to sampling variation. The length of time being analyzed should also be
considered. In particular, large shifts in survey estimates over short periods
of time (e.g. from one year to the next) that are statistically significant
should be interpreted with caution unless they are attributable to known factors
such as changes in public policy, economic conditions, or MEPS survey methodology.
With respect to methodological considerations, in 2013
MEPS introduced an effort to obtain more complete information about health
care utilization from MEPS respondents with full implementation in 2014.
This effort likely resulted in improved data quality and a reduction in
underreporting starting in the 2014 full year files and have had some
impact on analyses involving trends in utilization across years.
There are also statistical factors to consider in
interpreting trend analyses. Looking at changes over longer periods of time can
provide a more complete picture of underlying trends. Analysts may wish to
consider using techniques to smooth or stabilize analyses of trends using MEPS
data such as comparing pooled time periods (e.g. 1996-97 versus 2011-2013),
working with moving averages or using modeling techniques with several
consecutive years of MEPS data to test the fit of specified patterns over time.
Finally, researchers should be aware of the impact of multiple comparisons on
Type I error. Without making appropriate allowance for multiple comparisons,
undertaking numerous statistical significance tests of trends increases the
likelihood of concluding that a change has taken place when one has not.
Return To Table Of Contents
U.S. Department of Labor. Employee Benefits Security Administration. 2006.
An Employee’s Guide to Health Benefits under COBRA, the Consolidated Omnibus Budget Reconciliation Act of 1986. Washington, DC.
Return To Table Of Contents
VARIABLE TO SOURCE CROSSWALK
FOR MEPS PUBLIC USE FILE HC-191: 2016 Person Round Plan
Health Insurance Variables
| Variable |
Description |
Source |
| EPCPIDX |
UNIQUE RECORD IDENTIFIER (EPRSIDX + DUPERSID) |
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+RN) |
CONSTRUCTED |
| PANEL |
PANEL NUMBER |
CONSTRUCTED |
| RN |
ROUND NUMBER |
CONSTRUCTED |
| JOBSIDX |
JOB IDENTIFIER |
CONSTRUCTED |
| JOBSINFR |
JOBSIDX INFERRED RATHER THAN REPORTED ID |
CONSTRUCTED |
| JOBSFILE |
PUF NUMBER WITH JOBSIDX |
CONSTRUCTED |
| PITFLG |
PERSON IN POINT-IN-TIME PUF |
CONSTRUCTED |
| FYFLG |
PERSON IN FY PUFS |
CONSTRUCTED |
| CMJINS |
CMJ AS THE SOURCE OF PLAN: 1 YES, 2 NO |
CONSTRUCTED |
| EMPLSTAT |
POLICYHOLDER EMPLOYMENT STATUS |
HP12 |
| PHOLDER |
POLICY HOLDER |
HP09, 11 |
| DEPNDNT |
DEPENDENT OF POLICY HOLDER |
CONSTRUCTED |
| EVALCOVR |
COVERED @ INTERVIEW OR 12/31 |
HQ01, 02 |
| STATUS1 – STATUS24 |
STATUS - MONTH 1 THROUGH STATUS - MONTH 24 |
HQ01, 02, 03, 04, 05 |
| DECPHLDR |
DECEASED POLICYHOLDER FLAG: 1 YES, 2 NO |
CONSTRUCTED |
| OUTPHLDR |
OUT-OF-RU POLICYHOLDER FLAG: 1 YES, 2 NO |
CONSTRUCTED |
| NOPUFLG |
PHLDR NOT IN FULL YEAR OR PIT PUFS |
CONSTRUCTED |
| COVROUT |
POLICY COVERS PERS NOT IN RU |
HP16, 17; OE08A, 22A, 32, 34A |
| TYPEFLAG |
TYPE OF ESTABLISHMENT |
HX03, 23; EM06, 08, 12, 14, 19, 22, 23, 28, 31, 32, 41, 44, 45, 57, 58, 71, 74, 75, 83, 86, 87, 118, 120 |
| STEXCH |
IS THIS EXCHANGE COVERAGE |
HX03, 23; OE28A |
| STSHOP |
SMALL BUSINESS ESTB RELATED HEALTH INS |
HP14A, OE08B |
| PRIVCAT |
CATEGORY OF PRIVATE COVERAGE |
CONSTRUCTED |
| 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 |
CONSTRUCTED |
| PLANMETL |
PLAN METAL LEVEL |
HX60A; OE38B |
| COVTYPIN |
COVERAGE @INTVW: 1=SINGLE, 2=FAMILY |
HP15, 16, 17 |
| OOPELIG |
FLAG: POLICYHOLDER ESTB HAS PREMIUM |
CONSTRUCTED |
| OOPPREM |
MONTHLY OUT-OF-POCKET PREMIUM |
HX61, 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) |
HX61, 62 |
| PREMSUBZ |
IS COST OF THE PREMIUM SUBSIDIZED |
HX62A, OE35AA2 |
| ANNDEDCT |
ANNUAL DEDUCTIBLE |
HX63A; OE09B, 23B, 35B |
| HSAACCT |
HSA W/THIS PLAN |
HX63B; OE09C, 23C, 35C |
| UPRHMO |
HMO COVERAGE (FROM PRPL) |
CONSTRUCTED |
| NAMECHNG |
HAS THERE BEEN A CHANGE IN PLAN NAME |
OE09, 23, 35 |
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