MEPS HC-047: 2000 Person Round Plan Public Use File
March 2003
Agency for Healthcare Research and Quality
Center for Cost and Financing Studies
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) (formerly
the Agency for Health Care Policy and Research (AHCPR)) 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.
- A Bureau of the Census list frame of private sector
business establishments.
- The Census of Governments from Bureau of the Census.
- An Internal Revenue Service list of the self-employed.
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 followup 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
web site (www.meps.ahrq.gov).
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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 4 and
rounds 1, 2, and 3 of Panel 5 (i.e., the rounds for the survey panels covering
calendar year 2000) 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 2000. The HC-047 file contains
records for persons insured through establishments providing hospital/physician,
medigap, dental, vision, prescription medication, or long-term care coverage and
includes variables pertaining to managed care and satisfaction with plan
coverage.
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2.0 Data File Description
The Person-Round-Plan (PRPL) file for 2000
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-022 and HC-039) 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
- Interview Round
- Policyholder
- Establishment providing insurance
- Type of establishment (employer, union, insurance
agent, etc.)
- Types of coverage (hospital/physician, medigap,
dental, vision, prescription medication, long-term care, COBRA, single or
family)1
- Out-of-pocket premium (only for Panel 5 round 1 and
only when either the plan is not through a current employer or
union, or the plan is from a previous employer)
- Plan (for hospital/physician and Medicare supplemental
insurance coverage only)
- Household reports of managed care
- Family satisfaction with plan (collected for rounds 2
and 4)
- Links to the job providing insurance (for
employment-based insurance only, HC-040)
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 A 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.
1 No 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 54,427 total records. The PRPL file contains
records for persons insured through establishments providing hospital/physician,
medigap, dental, vision, prescription medication, or long-term care 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-040. However, other cases are more complex,
and some hypothetical examples follow.
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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 Public Use File
(PUF) HC-040.
- 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-040.
- Fred has hospital/physician insurance through his
employer, and he buys long-term care 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-040.
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.
- 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.
Changes in Insurance
- Bob changes jobs between January 1st, 2000
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 5) but pays her
previous employer to continue her health insurance while she looks for
another job in round 2. In this case, Jane's round 1 PRPL record flags her
current main job as the source of his insurance and links to a job record in
PUF HC-040. 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
establishmentB employer, union, insurance company or otherB that 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 |
53 |
53 |
2253 |
1 |
2253153 |
53101 |
33 |
53 |
53 |
3353 |
1 |
3353153 |
-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 |
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=53) 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 2000. In Panel 5, 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)
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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 2000 (Panel 5 round 1 or Panel 4 round 3).
Then you would select PRPL records matching HC-022 (PUF22FLG=1) where the
insurance is through a current main job (CMJINS=1) and [(PANEL00=2 and RN=1) or
(PANEL00=1 and RN=3)]. From HC-022, 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-022 or HC-039. These include deceased policyholders and policyholders
residing outside the RU. For these policyholders, PUF22FLG and PUF39FLG 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-022 or HC-039.
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 three research
questions.
How many people were covered by two or
more private hospital/physician insurance plans at the end of 2000?
Select the Panel 5 round 3 and Panel 4
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-039 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 2000?
Select the Panel 5 round 3 and Panel 4
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-039 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 5 round 1 and Panel 4
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-022 and use weights, strata, and PSUs to
create nationally representative estimates.
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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-022: Combined Panel 4, Round
3/Panel 5, Round 1 2000 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).
ESTIBIDX 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-040).
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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
PUF22FLG indicates whether the person has a record on HC-022, and PUF39FLG
indicates whether the person has a record on HC-039.
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 4, and 5 of
Panel 4 and rounds 1, and 2 of Panel 5) or on December 31 (round 3 of Panel 5
and round 5 of Panel 4). 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 5, STATUS1-STATUS12 represent
coverage from January 2000 through December 2000, and STATUS13-24 are
inapplicable, because this information is in year 2001. For Panel 4,
STATUS13-STATUS24 represent coverage from January 2000 through December 2000,
and STATUS1-STATUS12 are inapplicable, because this information is in the year
1999. Coverage is reported only for the interview reference period. For example,
if a person from Panel 5 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 5) or 3 (Panel 4) and the end of 2000 will have records on HC-022 and
HC-039, and PUF22FLG and PUF39FLG will be set to 1.)
Return To Table Of Contents
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. 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, prescription medication, or long-term
care 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, PMEDINS, and LTCINS flags indicate the
establishment provides coverage for dental care, vision care, prescription
medications, and long-term care, 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 Consolidated Omnibus Budget Reconciliation Act (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 5 rounds 1 and 2,
and Panel 4 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 5 round 3 and
Panel 4 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
The variable OOPPREM is the edited monthly
out-of-pocket premium paid by the policyholder for coverage through the
establishment for Panel 5 as of round 1 (out-of-pocket premiums for Panel 4
round 1 appear on the 1999 PRPL file), when the establishment was not a current
employer or union, coverage was through a self-employed job with firm size 1, or
COBRA coverage. OOPELIG flags these covered-person-policyholder-establishment
triples. 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?
OOPPREM is coded as zero for those who
reported paying none of their premium, which often happened with
out-of-household coverage. OOPPREM is coded "inapplicable" when the
establishment was a current employer or union, coverage was not through a
self-employed job with firm size 1, and not COBRA coverage. Premiums were
reported only in round 1 for any given Panel, and in all other rounds OOPPREM is
coded "inapplicable". Because information about out-of-pocket premiums
was collected only in Panel 5, nationally representative estimates of premiums
for this population in 2000 cannot be made using the weights (nor, of course,
without the weights).
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 all nine variables (PREMLEVX OOPPREM
BYFED BYSTATE BYLOCAL BYSOMGOV BYEMPL BYUNION BYOTHER), the same values are
reported on the records of each person covered through the establishment, but
the policyholder paid only once per establishment-policyholder.
Users should note that a few respondents
reported zero, very low, or very high premiums, and some respondents said they
paid all or some of their premium but reported an amount of zero. There was no
attempt to resolve these inconsistencies, because it is not clear what could be
done.
Return To Table Of Contents
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
satisfaction variables for hospital/physician and Medicare supplemental plans.
For all other plans, these variables are set to "inapplicable".
Return To Table Of Contents
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. The respondent was asked MC03:
Is there a book or list of doctors associated with the plan?
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)
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.
With gatekeepers and lists of doctors, the
variable VISTPAYX identifies records for plans that the household respondent
said paid for out-of-network visits. The household respondent has not identified
the plan as an PPO or a Point of Service (POS) plan but has identified a plan
characteristic associated with PPO and POS plans. VISTPAYX 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 both the following conditions are met:
- If the person did not say the plan is an HMO (HX03,
HX23, HX49, HX51, HX54, MC01)
If the respondent answered "yes"
to the gatekeeper question (MC02) or answered "yes" to the list of
doctors question (MC03)
VISTPAYX 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 does not require a gatekeeper and does not have a list of doctors.
An additional managed care question (MC05)
was asked to differentiate between HMOs and POS plans, but due to an error in
the skip logic of the questionnaire, the data were not collected for all
relevant plans, and this variable will not be publicly released.
Return To Table Of Contents
3.5.2 Family Satisfaction with Plan
Satisfaction with Plan questions were
asked at rounds 2 (Panel 5) and 4 (Panel 4) 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
Satisfaction with Plan questions. Respondents were eligible for the Satisfaction
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.
The Satisfaction with Plan variables are
APPT, CHANPROV, COSTQUAL, CUSTSRV, DIFFREF, PAIDLESS, PLANREF, PLANSAT, RECPLAN,
SATAMT, SATCHOIC, SATCOVH, SATCOVMH, SATCOVP, SATCOVPM, SATCS, SATPAPER.
When multiple RU members were covered by
the same private plan, the respondent answered the questions once and described
satisfaction for the policyholder and family members. These family-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.
Return To Table Of Contents
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 5 rounds 2 and 3 and Panel 4 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.
Return To Table Of Contents
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-022 and HC-039. If CMJINS =1 and the policyholder has a PUF
record (PUF22FLG or PUF39FLG), 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-040 and HC-032) 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-040, but for Panel 4, if the job ended before 2000, information about the job
is contained in HC-032. 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.
Return To Table Of Contents
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
]
Return To Table Of Contents
D. Variable Source Crosswalk
VARIABLE TO SOURCE CROSSWALK
FOR MEPS PUBLIC USE FILE HC-047: 2000 FILE
HEALTH INSURANCE VARIABLES - SOURCE
Variable |
Label |
Source |
PHOLDER |
POLICY HOLDER |
HP 9, 11 |
DEPENDNT |
DEPENDENT OF POLICY HOLDER |
PRIVCAT, PHOLDER |
CMJINS |
CMJ AS THE SOURCE OF PLAN: 1 YES, 2 NO |
PRIVCAT, RJ01A, RJ0189A, EM08, EM14 |
EVALCOVR |
COVERED @ INTERVIEW OR 12/31 |
HQ1, 2 |
STATUS1 – STATUS24 |
STATUS -MONTH 1 through
STATUS -MONTH 24 |
HQ1, 2, 3, 4, 5 |
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 |
LTCINS |
TYPE OF HI GOTTEN: LTC-NURSING HOME |
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, R1 (ED) |
HX 61, 62 |
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 |
VISITPYX |
PLAN PAY FOR NON-HMO, NON-REFER DR VISIT (ED) |
MC 4 |
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 |
CUSTSRV |
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 |
EMPLSTAT |
POLICYHOLDER EMPLOYMENT STATUS |
HP 12 |
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