MEPS-HC Survey Instrument

13 - er (beta).pdf

Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC through 2009)

MEPS-HC Survey Instrument

OMB: 0935-0118

Document [pdf]
Download: pdf | pdf
Old Empl/Priv Related Ins (OE) Section
Beta
Throughout the specifications for this CAPI section, for screens that
specify the reference period {END DATE} as part of the context header,
CAPI displays the {END DATE} only for Round 5. In any other round, CAPI
does not display the {END DATE} in the context header. For most
persons, the end date for Round 5 will be December 31 of the second
year of the panel.

BOX_01
IF ONE OR MORE RU MEMBERS STILL HOLDS A 'CURRENT MAIN' OR 'CURRENT
MISCELLANEOUS' JOB THIS ROUND THAT WAS REPORTED DURING THE PREVIOUS ROUND
AS PROVIDING HEALTH INSURANCE ON THE DATE OF THE PREVIOUS ROUND'S
INTERVIEW, THAT IS:
IF ONE OR MORE ESTABLISHMENT-PERSON-PAIRS IN THE RU MEET THE FOLLOWING
CONDITIONS:
- RJ01 OR RJ06 WAS CODED '1' (YES) DURING THIS ROUND FOR THIS PAIR, AND
- PERSON IS A JOBHOLDER AT ESTABLISHMENT, AND
- PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND
- ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS ROUND AS
'PROVIDES HEALTH INSURANCE' AND,
- THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON
THE DATE OF THE PREVIOUS ROUND'S INTERVIEW (HQ01 WAS CODED '1'
(WHOLE TIME) OR HQ02 WAS CODED '1' (YES) IN THE PREVIOUS ROUND), AND
- JOB AT ESTABLISHMENT IS NOT FLAGGED AS 'SELF- EMPLOYED' WITH A
FIRM-SIZE-1,
CONTINUE WITH LOOP_01.
NOTE: IF POLICYHOLDER WAS
PREVIOUS ROUND’S INTERVIEW
AT LEAST ONE DEPENDENT WAS
PREVIOUS ROUND’S INTERVIEW
POLICYHOLDER’S NAME.

NOT PHYSICALLY PRESENT IN THE RU ON THE
DATE, THE FIFTH CONDITION ABOVE CAN BE MET IF
COVERED BY POLICYHOLDER’S INSURANCE ON THE
DATE. THE LOOP WILL CYCLE ON THE

OTHERWISE, GO TO BOX_10
NOTE: ESTABLISHMENT-PERSON-PAIRS WHERE THE POLICYHOLDER IS OUT-OF-SCOPE
(E.G, DECEASED, INSTITUTIONALIZED, OUT OF COUNTRY) ON THE CURRENT ROUND'S
INTERVIEW DATE, BUT WHERE THE ESTABLISHMENT-PERSON-PAIR COVERED DEPENDENTS
WHO ARE STILL RU MEMBERS MAY STILL QUALIFY FOR LOOP_01.

1

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Beta

LOOP_01
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK OE01 END_LP01.
LOOP DEFINITION:
LOOP_01 COLLECTS INFORMATION ABOUT THE CONTINUATION OF INSURANCE COVERAGE
THROUGH A 'CURRENT MAIN' OR 'CURRENT MISCELLANEOUS' JOB THAT WAS COLLECTED
IN THE PREVIOUS ROUND. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS
THAT MEET THE FOLLOWING CONDITIONS:
-

RJ01 OR RJ06 WAS CODED '1' (YES) DURING THIS ROUND FOR THIS PAIR, AND
PERSON IS A JOBHOLDER AT ESTABLISHMENT, AND
PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND
ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS ROUND AS
'PROVIDES HEALTH INSURANCE' AND,
- THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON
ON THE DATE OF THE PREVIOUS ROUND'S INTERVIEW (HQ01 WAS CODED
'1' (WHOLE TIME) OR HQ02 WAS CODED '1' (YES) IN THE PREVIOUS ROUND),
AND
- JOB AT ESTABLISHMENT IS NOT FLAGGED AS 'SELF-EMPLOYED' WITH A
FIRM-SIZE-1

2

Old Empl/Priv Related Ins (OE) Section
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OE01

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPCP.EPCPID

EPCP ID KEY: EPRSID + PERSID

Label

Size
28

EPCP.EPCPRURN
EPCP.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPRS.CONFPLCY
EPRS.PLCYHOLD

CONFIRM SOMEONE STILL COVRD POLCY/MEDCAR
IS PERSON PRIMARY INSURED PERSON

2
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
During the last interview, we recorded that someone in the family was covered
by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {(Are/Is)/
(Were/Was)} (POLICYHOLDER) or anyone in the family covered by
(POLICYHOLDER)'s health insurance through (ESTABLISHMENT) as of
{today,} (END DATE)?
YES
NO

1
2

{BOX_02}
{OE02}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP01}
{END_LP01}

DISPLAY INSTRUCTIONS:
DISPLAY ‘(Are/Is)’ IF NOT ROUND 5. DISPLAY ‘(Was/Were)’ IF
ROUND 5.
DISPLAY ‘today,’ IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY.

3

Old Empl/Priv Related Ins (OE) Section
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OE02

Help Enabled

Comment Enabled

Variable Name
EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

Jump Back Enabled

Label

Size
2
2
4

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
On what date did (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT) end?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_02}
{BOX_02}

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE02OV
OTHERWISE, GO TO BOX_02

Hard CHECK:
FOR ROUND 5 ONLY: COMPLETE DATE ENTERED CANNOT BE AFTER 12/31/{YEAR}, WHERE
'YEAR' IS THE SECOND CALENDAR YEAR OF THE PANEL. IF A DATE AFTER
12/31/{YEAR} IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: ‘DATE CANNOT BE
AFTER 12/31/{YEAR}. IF INSURANCE ENDED AFTER 12/31/{YEAR}, JUMPBACK AND
CHANGE RESPONSE TO OE01.

4

Old Empl/Priv Related Ins (OE) Section
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OE02OV

Help Enabled
Variable Name
EPCP.ENDMONTH

Comment Enabled

Jump Back Enabled

Label
END COVERAGE: COVER WHOLE/PART OF MONTH

Size
2

Can you just tell me if (POLICYHOLDER) was covered under that insurance
the whole month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_02}
{BOX_02}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_02}
{BOX_02}

BOX_02
IF THE POLICYHOLDER IS THE ONLY PERSON COVERED AT THE PREVIOUS ROUND'S
INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR,
AUTOMATICALLY CODE OE03 AS '1' (YES) AND GO TO BOX_03.
OTHERWISE, CONTINUE WITH OE03.

5

Old Empl/Priv Related Ins (OE) Section
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OE03

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.ALLCOVR

ALL PERSONS ARE STILL COVERED

Label

Size
2

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
During the last interview, we recorded that (READ NAME(S) BELOW)
(were/was) covered by (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT).
{Are/Were} they all covered by this health insurance {until {{OE02 DATE}/it
ended}/on (END-DT)}?
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
YES

1

{BOX_03}

NO

2

{BOX_03}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

6

{BOX_03}
{BOX_03}

Old Empl/Priv Related Ins (OE) Section
Beta
DISPLAY INSTRUCTIONS:
DISPLAY 'Are' IF OE01 IS CODED ‘1’ (YES).
DISPLAY 'Were' IF OE01 IS CODED ‘2’ (NO) OR IF CURRENT ROUND
IS ROUND 5.
DISPLAY 'until {OE02 DATE}' IF OE01 IS CODED ‘2’ (NO).
DISPLAY 'on (END-DT)' IF OE01 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE02 FOR ‘OE02 DATE’. IF THE
MONTH OR YEAR FIELD AT OE02 IS CODED ‘RF’ (REFUSED) OR ‘DK’
(DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE02 DATE’.

Roster Details
Title:

RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1

Col #

Header

Instructions

NAME

Display covered persons’ names
PERS.FULLNAME

1

Roster Definition:
This item displays the RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLSROSTER for display.
Roster Behavior:
1. Display only.
2. Select, add, delete, and edit disallowed.
Roster Filter:
1. Person was covered at the previous round’s interview
date by the insurance from this establishment-person-pair,
including the policyholder
2. Person is an RU member

7

Old Empl/Priv Related Ins (OE) Section
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BOX_03
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO THE END DATE OF THE
CURRENT ROUND, THAT IS:
IF OE01 IS CODED '1' (YES) AND OE03 IS CODED '1' (YES), FLAG INSURANCE FOR
ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS 'CONTINUOUS COVERAGE'
THROUGH THE REFERENCE PERIOD END DATE AND GO TO BOX_05.
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO PART OF THE CURRENT
ROUND, THAT IS: IF OE01 IS CODED '2' (NO) AND OE03 IS CODED '1' (YES),
FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS
'CONTINUOUS COVERAGE' THROUGH THE DATE RECORDED AT OE02 AND GO TO BOX_05.
OTHERWISE (I.E., OE03 CODED '2' (NO), 'RF' (REFUSED), OR 'DK' (DON'T
KNOW)), CONTINUE WITH OE04.

8

Old Empl/Priv Related Ins (OE) Section
Beta

OE04

Help Enabled

Comment Enabled

Variable Name
EPCP.bw_OE04

Jump Back Enabled

Label

Size

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {is/was} no longer covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {until {{OE02 DATE}/it ended}/on (END-DT)}?

[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]

{LOOP_02}

DISPLAY INSTRUCTIONS:
DISPLAY 'is' IF OE01 IS CODED ‘1’ (YES).
DISPLAY 'was' IF OE01 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS
ROUND 5.
DISPLAY 'until {OE02 DATE}' IF OE01 IS CODED ‘2’ (NO).
DISPLAY 'on (END-DT)' IF OE01 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE02 FOR ‘OE02 DATE’. IF THE
MONTH OR YEAR FIELD AT OE02 IS CODED ‘RF’ (REFUSED) OR ‘DK’
(DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE02 DATE’.

9

Old Empl/Priv Related Ins (OE) Section
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PROGRAMMER NOTES:
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR (OE01 IS CODED '1' (YES)), FLAG INSURANCE FOR ALL
PERSONS NOT SELECTED AT OE04 AS CONTINUOUS COVERAGE FROM THE
REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END
DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR (OE01 IS CODED '2' (NO)), FLAG
INSURANCE FOR ALL PERSONS NOT SELECTED AT OE04 AS 'CONTINUOUS
COVERAGE' FROM THE REFERENCE PERIOD START DATE UNTIL DATE
RECORDED AT OE02.

Roster Details
Title:

RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1

Col #

Header

Instructions

NAME

Display covered persons’ names
PERS.FULLNAME

1

Roster Definition:
This item displays the RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLSROSTER for selection.
Roster Behavior:
1. Multiple select allowed.
2. Add, delete, and edit disallowed.
Roster Filter:
1. Person was covered at the previous round’s interview date
by the insurance from this Establishment-Person-Pair,
including the policyholder
2. Person is an RU member

LOOP_02
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE05 - END_LP02.
LOOP DEFINITION: LOOP_02 COLLECTS THE DATE ON WHICH THE INSURANCE
COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER
WHOSE COVERAGE ENDED EITHER PRIOR TO THE REFERENCE PERIOD END DATE OR THE
DATE REPORTED IN OE02. THIS LOOP CYCLES ON PERSONS SELECTED AT OE04.

10

Old Empl/Priv Related Ins (OE) Section
Beta

OE05

Help Enabled

Comment Enabled

Variable Name
EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

Jump Back Enabled

Label

Size
2
2
4

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
On what date did the health insurance through (ESTABLISHMENT) end for
(PERSON)?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_04}
{BOX_04}

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE05OV.
OTHERWISE, GO TO BOX_04.

11

Old Empl/Priv Related Ins (OE) Section
Beta

OE05OV

Help Enabled
Variable Name
EPCP.ENDMONTH

Comment Enabled

Jump Back Enabled

Label
END COVERAGE: COVER WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_04}
{BOX_04}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_04}
{BOX_04}

BOX_04
FLAG INSURANCE FOR PERSON AS 'CONTINUOUS COVERAGE' THROUGH THE COMPLETE
DATE RECORDED AT OE05 AND OE05OV.

END_LP02
CYCLE ON NEXT PERSON IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_02 AND CONTINUE
WITH BOX_05.

BOX_05
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS
ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS
RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND'S INTERVIEW
DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE04),
CONTINUE WITH OE06.
OTHERWISE, GO TO OE08A.

12

Old Empl/Priv Related Ins (OE) Section
Beta

OE06

Help Enabled (DEPENDENT)
Variable Name
EPRS.COVRPERS

Comment Enabled

Jump Back Enabled

Label

Size
2

ANYONE COVERED AS DEPENDENT

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, have any
persons living here, we have not yet mentioned, been covered by
(POLICYHOLDER)’s health insurance through (ESTABLISHMENT)?
YES
NO

1
2

{OE07}
{OE08A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE08A}
{OE08A}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT.
DISPLAY INSTRUCTIONS:
DISPLAY ‘Since (START DATE)’ IF NOT ROUND 5.
DISPLAY ‘Between (START DATE) and (END DATE)’ IF ROUND
5.

13

Old Empl/Priv Related Ins (OE) Section
Beta

OE07

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.COVROUT

Label
HP16/HP17: POLICY COVERS PERS NOT IN RU

Size
2

EPCP.bw_OE07
EPCP.EPCPID

EPCP ID KEY: EPRSID + PERSID

28

EPCP.EPCPRURN
EPCP.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPCP.COVRSTOP

PERSON IS NO LONGER COVERD THRU END DATE

2

EPCP.COVREMM
EPCP.COVREDD

MONTH HEALTH INSURANCE ENDED
DAY HEALTH INSURANCE ENDED

2
2

EPCP.COVREYY

YEAR HEALTH INSURANCE ENDED

4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {has been/was} covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {since (START DATE)/between (START DATE)
and (END DATE)} that we have not yet mentioned?
PROBE: Who else {has been/was} covered by (POLICYHOLDER)’s health
insurance through (ESTABLISHMENT) {since (START DATE)/between
(START DATE) and (END DATE)} that we have not yet mentioned?
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]

{LOOP_03}

DISPLAY INSTRUCTIONS:
DISPLAY ‘has been’ AND ‘since (START DATE)’ IF NOT ROUND 5.
DISPLAY ‘was’ AND ‘between (START DATE) and (END DATE)’ IF
ROUND 5.
PROGRAMMER NOTES:
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR-COVRD-PERSTRPLS-ROSTER.
IF ‘PERSON NOT LISTED IN RU’ IS SELECTED, FLAG INSURANCE
THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT
LISTED IN RU’.

14

Old Empl/Priv Related Ins (OE) Section
Beta

Roster Details
Title:

RU_Members_1

Col #

Header

Instructions

NAME

Display RU member's first, middle, and last names
PERS.FULLNAME

1

Roster Definition:
This item displays RU-MEMBERS-ROSTER for selection of RUmembers.
Roster Behavior:
1. Multiple select allowed. Interviewer may select one or
more from the listed members.
2. Add, delete, and edit disallowed.
3. Display ‘PERSON NOT LISTED IN RU’ as last entry on
this roster.
Roster Filter:
Display persons who were not covered by the insurance
through this establishment-person-pair on the previous
round’s interview date.

LOOP_03
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE08 - END_LP03.
LOOP DEFINITION: LOOP_03 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS
NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON PERSONS SELECTED AT OE07.

15

Old Empl/Priv Related Ins (OE) Section
Beta

OE08

Help Enabled

Comment Enabled

Variable Name
EPCP.COVRBMM

MONTH HEALTH INSURANCE BEGAN

EPCP.COVRBDD
EPCP.COVRBYY

DAY HEALTH INSURANCE BEGAN
YEAR HEALTH INSURANCE BEGAN

Jump Back Enabled

Label

Size
2
2
4

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
On what date did the health insurance through (ESTABLISHMENT) begin for
(PERSON)?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_06}
{BOX_06}

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE08OV
OTHERWISE, GO TO BOX_06

16

Old Empl/Priv Related Ins (OE) Section
Beta

OE08OV

Help Enabled
Variable Name
EPCP.BEGMONTH

Comment Enabled

Jump Back Enabled

Label
BEGIN COVERAGE: COV WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_06}
{BOX_06}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_06}
{BOX_06}

Hard CHECK:
COMPLETE DATE AT OE08 MUST BE < THAN COMPLETE DATE AT OE02 IF A DATE IS
RECORDED AT OE02 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS RECORDED
AT OE02.

BOX_06
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE01
IS CODED '1' (YES)), FLAG INSURANCE FOR THIS PERSON AS 'CONTINUOUS
COVERAGE' FROM DATE RECORDED AT OE08 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH ESTABLISHMENT-PERSON-PAIR
(OE01 IS CODED '2' (NO)) FLAG INSURANCE FOR THIS PERSON AS 'CONTINUOUS
COVERAGE' FROM DATE RECORDED AT OE08 UNTIL DATE RECORDED AT OE02.

END_LP03
CYCLE ON NEXT PERSON IN RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO MEETS
THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_03 AND GO TO
BOX_07.

17

Old Empl/Priv Related Ins (OE) Section
Beta

OE08A

Help Enabled (DEPENDENT)
Variable Name
EPRS.COVROUT

Comment Enabled

Jump Back Enabled

Label
HP16/HP17: POLICY COVERS PERS NOT IN RU

Size
2

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
{Does/Between (START DATE) and (END DATE), did} (POLICYHOLDER)'s
health coverage through (ESTABLISHMENT) cover as dependents any
persons who do not live here?
YES
NO

1
2

{BOX_07}
{BOX_07}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_07}
{BOX_07}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT.
DISPLAY INSTRUCTIONS:
DISPLAY ‘Does’ IF NOT ROUND 5.
DISPLAY ‘Between (START DATE) and (END DATE), did’ IF ROUND 5.
PROGRAMMER NOTES:
IF CODED '1' (YES), FLAG INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR AS 'COVERING PERSON NOT LISTED IN RU' IN OE07.

BOX_07
IF ONE OR MORE RU MEMBERS ARE STILL COVERED BY THE INSURANCE THROUGH THE
ESTABLISHMENT-PERSON-PAIR ON THE CURRENT ROUND'S INTERVIEW DATE, THAT IS,
OE01 IS CODED '1' (YES), CONTINUE WITH BOX_07A.
OTHERWISE, GO TO END_LP01.

18

Old Empl/Priv Related Ins (OE) Section
Beta

BOX_07A
IF ROUND 3, CONTINUE WITH OE09A.
OTHERWISE, GO TO OE09.

19

Old Empl/Priv Related Ins (OE) Section
Beta

OE09A

Help Enabled
Variable Name
EPRS.PREMLEVL

Comment Enabled

Jump Back Enabled

Label
HOW MUCH OF PREMIUM PAID BY FAM

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
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 copayments, 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.]
YES, PAY ALL OF PREMIUM/COST
YES, PAY SOME OF PREMIUM/COST

1
2

{OE09AA}
{OE09AA}

YES, BUT DON'T KNOW IF PAY ALL OR
SOME OF PREMIUM/COST
NO, DO NOT PAY

3

{OE09AA}

4

{OE09AAA}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE09}
{OE09}

HELP AVAILABLE FOR DEFINITION OF
PREMIUM/COPAYMENT/COINSURANCE/DEDUCTIBLE.
PROGRAMMER NOTES:
THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE
INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM
DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE,
NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY.

20

Old Empl/Priv Related Ins (OE) Section
Beta

OE09AA

Help Enabled
Variable Name
EPRS.COVRAMT

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID FOR COVERAGE-AMT

Size
12

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
How much (do/does) (POLICYHOLDER) pay for the (ESTABLISHMENT)
coverage?

AMOUNT:$ _______

{OE09AAOV1}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_08A}
{BOX_08A}

PROGRAMMER NOTES:
THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE
INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM
DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE,
NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY.

21

Old Empl/Priv Related Ins (OE) Section
Beta

OE09AAOV1

Help Enabled
Variable Name
EPRS.COVRUNIT

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID FORCOVERAGE-UNIT

Size
2

UNIT OF COVERAGE:
Is that per year, per month, per week, or what?
PER YEAR

1

{BOX_08A}

QUARTERLY/EVERY 3 MONTHS
BIMONTHLY/EVERY 2 MONTHS

2
3

{BOX_08A}
{BOX_08A}

PER MONTH
PER WEEK

4
5

{BOX_08A}
{BOX_08A}

BIWEEKLY/EVERY 2 WEEKS

6

{BOX_08A}

SEMI-ANNUALLY/2 TIMES PER YEAR
SEMI-MONTHLY/2 TIMES PER MONTH

7
8

{BOX_08A}
{BOX_08A}

OTHER

91

{OE09AAOV2}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

22

{BOX_08A}
{BOX_08A}

Old Empl/Priv Related Ins (OE) Section
Beta

OE09AAOV2

Help Enabled
Variable Name
EPRS.COVRUNOS

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID: COV UNIT OTH SPEC

Size
25

OTHER SPECIFY: _______________________

{BOX_08A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_08A}
{BOX_08A}

BOX_08A
IF OE09A IS CODED ‘1’ (YES, PAY ALL OF PREMIUM/ COST), GO TO OE09.
OTHERWISE, CONTINUE WITH OE09AAA.

23

Old Empl/Priv Related Ins (OE) Section
Beta

OE09AAA

Help Enabled

Comment Enabled

Variable Name
EPRS.bw_OE09AAA

Jump Back Enabled

Label

Size

EPRS.BYFED
EPRS.BYSTATE

FEDERAL GOVT PAID FOR PRIV PLAN PREMIUM
STATE GOVT PAID FOR PRIV PLAN PREMIUM

2
2

EPRS.BYLOCAL
EPRS.BYSOMGOV

LOCAL GOVT PAID FOR PRIV PLAN PREMIUM
SOME GOVT PAID FOR PRIV PLAN PREMIUM

2
2

EPRS.BYEMPL

EMPLOYER PAID FOR PRIV PLAN PREMIUM

2

EPRS.BYUNION
EPRS.BYOTHER

UNION PAID FOR PRIV PLAN PREMIUM
OTHER PAID FOR PRIV PLAN PREMIUM

2
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {else} pays {some of/for} the premium or cost of this insurance?
CHECK ALL THAT APPLY.
FEDERAL GOVERNMENT
STATE GOVERNMENT

1
2

LOCAL GOVERNMENT

3

SOME GOVERNMENT
EMPLOYER
UNION
OTHER

4
5
6
91

{OE09AAAOV}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE09}
{OE09}

DISPLAY INSTRUCTIONS:
DISPLAY ‘else’ IF OE09A IS CODED ‘2’ (YES, PAY SOME OF
PREMIUM/COST) OR ‘3’ (YES, BUT DON'T KNOW IF PAY ALL OR SOME
OF PREMIUM/COST). OTHERWISE, USE A NULL DISPLAY.
DISPLAY ‘some of’ IF OE09A IS CODED ‘2’ (YES, PAY SOME OF
PREMIUM/COST) OR ‘3’ (YES, BUT DON'T KNOW IF PAY ALL OR SOME
OF PREMIUM/COST). DISPLAY ‘for’ IF OE09A IS CODED ‘4’ (NO, DO
NOT PAY).

24

Old Empl/Priv Related Ins (OE) Section
Beta
PROGRAMMER NOTES:
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW 'RF' OR
'DK' IN COMBINATION WITH ANY OTHER CODE.
ROUTING INSTRUCTION:
IF CODED ‘91’ (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER
CODE, CONTINUE WITH OE09AAAOV.
OTHERWISE, GO TO OE09.

OE09AAAOV

Help Enabled
Variable Name
EPRS.BYOTHOS

Comment Enabled

Jump Back Enabled

Label
OTHER SPECIFY OF WHO PAID PRIV PLAN PREM

Size
25

OTHER SPECIFY: _______________________

{OE09}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

25

{OE09}
{OE09}

Old Empl/Priv Related Ins (OE) Section
Beta

OE09

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.NAMECHNG

Label
HAS THERE BEEN A CHANGE IN PLAN NAME

EPRS.HOSPINS
EPRS.DENTLINS

TYPE OF HI GOTTEN: HOSPITAL/HMO
TYPE OF HI GOTTEN: DENTAL

2
2

EPRS.PMEDINS
EPRS.VISIONIN

TYPE OF HI GOTTEN: PRESCRIPTION DRUG
TYPE OF HI GOTTEN: VISION

2
2

EPRS.MSUPINS

TYPE OF HI GOTTEN: MEDIGAP

2

EPRS.LTCINS
EPRS.CASHINS

TYPE OF HI GOTTEN: LTC-NURSING HOME
TYPE OF HI GOTTEN: EXTRA CASH

2
2

EPRS.DREADINS

TYPE OF HI GOTTEN: DREAD DISEASE

2

EPRS.DISABINS
EPRS.WCOMPINS

TYPE OF HI GOTTEN: DISABILITY
TYPE OF HI GOTTEN: WORKER'S COMP

2
2

EPRS.ACCDINS
EPRS.OTHINS

TYPE OF HI GOTTEN: ACCIDENT
TYPE OF HI GOTTEN: OTHER

2
2

EPRS.OTHINSOS

TYPE OF HI GOTTEN: OTH SPECIFY

25

EPRS.MCAREHMO
EPRS.MCARELET

MEDICARE: PERSON SIGNED WITH HMO
PLAN LETTER OF MEDICARE INSURANCE

2
4

EPRS.MCARELST

MEDICARE INSUR LISTED ON THIS CARD

2

EPRS.MCARENAM
EPRS.PROGDR

NAME OF MEDICARE HMO
PRIV PLAN REQUIRES SIGNING W/PHYS,GROUP

25
2

EPIN.EPINID
EPIN.EPINRURN

EPIN ID KEY: EPRSID + COUNTER(2)
ROUND STAMP: RU LETTER + ROUND NUMBER

22
2

EPIN.CREATEQ

CREATION STAMP

2

EPIN.DRLIST
EPIN.HMOPLAN

DOES PLAN HAVE A BOOK/LIST OF DOCTORS?
IS POLICYHOLDERS PLAN AN HMO PLAN?

2
2

EPIN.INSNAME

HX41/43/46 NAME OF INSURANCE CO OR HMO

25

EPIN.INSTYPE
EPIN.MAJORMED

HX41/43/46 TYPE OF INSURER
FLAG EPIN AS PROVIDING MAJOR MEDICAL COV

2
2

EPIN.MSUPFLG
EPIN.OTHNAME

FLAG-PROVIDE MEDICARE SUPPLEMENT/MEDIGAP
HX42/44/47 ANOTHER NAME FOR POLICY

2
2

EPIN.OTHNAMOS

HX42/44/47 OTH NAME FOR INSURANCE POLICY

25

EPIN.PROGDR
EPIN.VISITPAY

PRIV PLAN REQUIRES SIGNING W/PHYS,GROUP
PLAN PAY FOR NON-HMO, NON-REFER DR VISIT

2
2

HOME.PLANFLAG

RU PLAN FLAG-HOSP/PHYS INSR + HMO STATUS

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}

26

Size
2

Old Empl/Priv Related Ins (OE) Section
Beta

{Last time we recorded that (POLICYHOLDER) (were/was) covered by (READ
INSURER NAME(S) BELOW).}
{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) {has/had} through (ESTABLISHMENT)?
{INSURER OF ESTAB-PERS-INSURER TRIPLE ON PREV RD INT DT}

YES

1

{OE10}

NO

2

{END_LP01}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP01}
{END_LP01}

DISPLAY INSTRUCTIONS:
DISPLAY FIRST PARAGRAPH AND THE INSURER NAME IF THE INSURANCE
THROUGH THIS ESTABLISHMENT-PERSON-PAIR HAD ANY INSURERS
FLAGGED AS PROVIDING MEDIGAP OR HOSPITAL/PHYSICIAN BENEFITS AT
ANY TIME DURING THE PREVIOUS ROUND.
DISPLAY ‘Since (START DATE), has there been’ and ‘has’ IF NOT
ROUND 5.
DISPLAY ‘Between (START DATE) and (END DATE), was there’ and
‘had’ IF ROUND 5.
PROGRAMMER NOTES:
IF CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), FLAG
PREVIOUS ROUND’S INSURER AS CURRENT ROUND’S INSURER FOR THIS
ESTABLISHMENT-PERSON-PAIR.

Roster Details
Title:

RU_ESTB_PERS_INSURER_TRPLS_1

Col #

Header

Instructions

PREV RND INSURER
WITH MEDIGAP OR
HOSP/PHYS

Display establishment name
ESTB.ESTBNAME

1

27

Old Empl/Priv Related Ins (OE) Section
Beta

OE10

Help Enabled (TYPEINS)

Comment Enabled

Variable Name
EPRS.OE10BLSWVS

Jump Back Enabled

Label

Size

EPRS.HOSPINS
EPRS.DENTLINS

TYPE OF HI GOTTEN: HOSPITAL/HMO
TYPE OF HI GOTTEN: DENTAL

2
2

EPRS.PMEDINS
EPRS.VISIONIN

TYPE OF HI GOTTEN: PRESCRIPTION DRUG
TYPE OF HI GOTTEN: VISION

2
2

EPRS.MSUPINS

TYPE OF HI GOTTEN: MEDIGAP

2

EPRS.LTCINS
EPRS.CASHINS

TYPE OF HI GOTTEN: LTC-NURSING HOME
TYPE OF HI GOTTEN: EXTRA CASH

2
2

EPRS.DREADINS

TYPE OF HI GOTTEN: DREAD DISEASE

2

EPRS.DISABINS
EPRS.WCOMPINS

TYPE OF HI GOTTEN: DISABILITY
TYPE OF HI GOTTEN: WORKER'S COMP

2
2

EPRS.ACCDINS
EPRS.OTHINS

TYPE OF HI GOTTEN: ACCIDENT
TYPE OF HI GOTTEN: OTHER

2
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
SHOW CARD OE-1.
What type of health insurance {(do/does)/did} (POLICYHOLDER) {now} have
through (ESTABLISHMENT)'s new plan {on (END DATE)}?
CHECK ALL THAT APPLY.
HOSPITAL AND PHYSICIAN BENEFITS,
INCLUDING COVERAGE THROUGH AN
HMO

1

DENTAL
PRESCRIPTION DRUGS

2
3

VISION
MEDICARE SUPPLEMENT/MEDIGAP

4
5

LONG TERM CARE IN A NURSING HOME 6
EXTRA CASH FOR HOSPITAL STAYS
7
SERIOUS DISEASE OR DREAD DISEASE 8
DISABILITY
WORKER'S COMPENSATION

9
10

ACCIDENT

11

OTHER

91
28

{OE10OV}

Old Empl/Priv Related Ins (OE) Section
Beta
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_08}
{BOX_08}

HELP AVAILABLE FOR DEFINITION OF ANSWER CATEGORIES.
[NOTE: 'DISABILITY', 'WORKER'S COMPENSATION', AND 'ACCIDENT'
WILL NOT APPEAR ON THE SHOW CARD.]
DISPLAY INSTRUCTIONS:
DISPLAY ‘(do/does)’IF NOT ROUND 5. DISPLAY ‘did’ IF ROUND
5.
DISPLAY ‘now’ IF NOT ROUND 5. OTHERWISE, USE A NULL
DISPLAY.
DISPLAY ‘on (END DATE)’ IF ROUND 5. OTHERWISE, USE A NULL
DISPLAY.
PROGRAMMER NOTES:
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW 'RF' OR
'DK' IN COMBINATION WITH ANY OTHER CODE.
ROUTING INSTRUCTION:
IF CODED '91' (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER
CODES, CONTINUE WITH OE10OV.
OTHERWISE, GO TO BOX_08.

29

Old Empl/Priv Related Ins (OE) Section
Beta

OE10OV

Help Enabled
Variable Name
EPRS.OTHINSOS

Comment Enabled

Jump Back Enabled

Label

Size
25

TYPE OF HI GOTTEN: OTH SPECIFY

OTHER SPECIFY: _______________________

{BOX_08}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_08}
{BOX_08}

HELP AVAILABLE FOR DEFINITION OF ANSWER CATEGORIES.
[NOTE: 'DISABILITY', 'WORKER'S COMPENSATION', AND 'ACCIDENT'
WILL NOT APPEAR ON THE SHOW CARD.]

BOX_08
NOTE: ALL ESTABLISHMENTS WHICH ARE BEING LOOPED ON HERE ARE EMPLOYERS.
THEREFORE, IT IS NOT NECESSARY TO AUTOMATICALLY CODE OE11 IF THE
ESTABLISHMENT IS AN INSURANCE CO. OR HMO.
IF OE10 IS CODED '1' (HOSPITAL AND PHYSICIAN BENEFITS) OR '5' (MEDICARE
SUPPLEMENT/MEDIGAP), ALONE OR WITH ANY OTHER COMBINATION OF CODES,
CONTINUE WITH OE11.
OTHERWISE, GO TO END_LP01.

30

Old Empl/Priv Related Ins (OE) Section
Beta

OE11

Help Enabled (INSHMO)

Comment Enabled

Jump Back Enabled

Variable Name
EPIN.EPINID

EPIN ID KEY: EPRSID + COUNTER(2)

Label

Size
22

EPIN.EPINRURN
EPIN.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPIN.INSNAME
EPIN.INSTYPE

HX41/43/46 NAME OF INSURANCE CO OR HMO
HX41/43/46 TYPE OF INSURER

25
2

EPIN.MAJORMED

FLAG EPIN AS PROVIDING MAJOR MEDICAL COV

2

EPIN.MSUPFLG

FLAG-PROVIDE MEDICARE SUPPLEMENT/MEDIGAP

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
What is the new plan name for (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT) which provides the {hospital and physician
benefits/Medicare Supplement or Medigap benefit}?
IF MORE THAN ONE NAME, PROBE: What is the main new plan name?
RECORD THE NAME OF THE MAIN INSURER THAT PROVIDES THE
{HOSPITAL AND PHYSICIAN/MEDIGAP} BENEFITS FOR THIS PAIR.
IF RESPONDENT SAYS BOTH INSURANCE COMPANY AND HMO, CODE
2 (HMO).

NAME OF INSURER:
----------------------------------------------TYPE:
INSURANCE COMPANY

1

HMO
COMPANY IS SELF-INSURED

2
3

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

HELP AVAILABLE FOR DEFINITION OF INSURANCE CO/HMO/SELFINSURED CO.

31

Old Empl/Priv Related Ins (OE) Section
Beta
DISPLAY INSTRUCTIONS:
DISPLAY 'hospital and physician benefits' IF OE10 IS CODED ‘1’
(HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT CODED ‘5’ (MEDICARE
SUPPLEMENT/MEDIGAP). DISPLAY 'Medicare supplement or Medigap
benefits' IF OE10 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP).
PROGRAMMER NOTES:
WRITE INSURER(S) TO THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER
FOR THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR.
FLAG INSURER(S) COLLECTED AT OE11 AS CURRENT ROUND’S
INSURER(S) FOR THIS ESTABLISHMENT-PERSON-PAIR.
IF OE10 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP) FLAG
INSURANCE CO./HMO AS 'SUPPLYING MEDICARE SUPPLEMENT/MEDIGAP
BENEFITS (WHICH INCLUDES HOSPITAL/PHYSICIAN BENEFITS)’ FOR THE
CURRENT ROUND.
IF OE10 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT
NOT ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP), FLAG INSURANCE CO./HMO
AS 'SUPPLYING HOSPITAL/PHYSICIAN BENEFITS' FOR THE CURRENT
ROUND.

LOOP_04
FOR EACH ELEMENT ON THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER, ASK
OE11A - END_LP04.
LOOP DEFINITION: LOOP_04 COLLECTS OTHER POLICY NAMES AND MANAGED CARE
INFORMATION FOR INSURERS COLLECTED AT OE11. THIS LOOP CYCLES ON TRIPLES
THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT-PERSON-PAIR PROVIDES THE INSURANCE BEING ASKED ABOUT
- INSURER IS ENTERED AT OE11

32

Old Empl/Priv Related Ins (OE) Section
Beta

OE11A

Help Enabled
Variable Name
EPIN.OTHNAME

Comment Enabled

Jump Back Enabled

Label
HX42/44/47 ANOTHER NAME FOR POLICY

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Is there any other name for the {INSURANCE COMPANY OR HMO NAME}
policy, such as Option A, $100 Deductible Plan, 90/80 Plan, Gold Plan, or
High Option Plan?
YES, ANOTHER NAME
NO OTHER NAME

1
2

{OE11AOV}
{BOX_09A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_09A}
{BOX_09A}

HELP AVAILABLE FOR DEFINITION OF LOW OPTION/HIGH OPTION.
DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE INSURANCE CO/HMO RECORDED IN OE11
WHICH IS BEING LOOPED ON FOR ‘INSURANCE.... NAME’

33

Old Empl/Priv Related Ins (OE) Section
Beta

OE11AOV

Help Enabled
Variable Name
EPIN.OTHNAMOS

Comment Enabled

Jump Back Enabled

Label
HX42/44/47 OTH NAME FOR INSURANCE POLICY

Size
25

OTHER NAME: _______________________

{BOX_09A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_09A}
{BOX_09A}

HELP AVAILABLE FOR DEFINITION OF ANSWER CATEGORIES.

BOX_09A
IF INSURER BEING LOOPED ON IS CODED '2' (HMO) IN OE11 CONTINUE WITH OE11B.
OTHERWISE, GO TO BOX_09.

34

Old Empl/Priv Related Ins (OE) Section
Beta

OE11B

Help Enabled
Variable Name
EPIN.VISITPAY

Comment Enabled

Jump Back Enabled

Label
PLAN PAY FOR NON-HMO, NON-REFER DR VISIT

Size
2

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
INSURER NAME: {NAME OF INSURER BEING LOOPED ON}
Will (POLICYHOLDER)’s plan pay for any of the costs of visits to doctors who
are not part of (POLICYHOLDER)’s HMO, even if (POLICYHOLDER)
(do/does) not have a referral?
YES
NO

1
2

{END_LP04}
{END_LP04}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP04}
{END_LP04}

BOX_09
ASK THE MANAGED CARE (MC) SECTION FOR THIS INSURER.
AT COMPLETION OF MANAGED CARE (MC) SECTION, CONTINUE WITH END_LP04.

END_LP04
CYCLE ON NEXT INSURER IN THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER THAT
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER INSURERS MEET THE STATED CONDITIONS, END LOOP_04 AND CONTINUE
WITH END_LP01.

35

Old Empl/Priv Related Ins (OE) Section
Beta

END_LP01
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEETS
THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_01 AND CONTINUE
WITH BOX_10.

BOX_10
IF ONE OR MORE RU MEMBERS DOES NOT STILL HOLD A 'CURRENT MAIN' OR 'CURRENT
MISCELLANEOUS' JOB THIS ROUND THAT WAS REPORTED DURING THE PREVIOUS ROUND
AS PROVIDING HEALTH INSURANCE ON THE DATE OF THE PREVIOUS ROUND'S
INTERVIEW, THAT IS:
IF ONE OR MORE ESTABLISHMENT-PERSON-PAIRS IN THE RU MEET THE FOLLOWING
CONDITIONS:
- RJ01 OR RJ06 WAS CODED '2' (NO), 'RF' (REFUSED), 'DK' (DON'T KNOW)
DURING THIS ROUND FOR THIS PAIR, AND
- PERSON WAS A JOBHOLDER AT ESTABLISHMENT, AND
- PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND
- ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS
ROUND AS 'PROVIDES HEALTH INSURANCE' AND,
- THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED
PERSON ON THE DATE OF THE PREVIOUS ROUND'S INTERVIEW
(HQ01 WAS CODED '1' (WHOLE TIME) OR HQ02 WAS CODED '1'
(YES) IN THE PREVIOUS ROUND), AND
- JOB AT ESTABLISHMENT IS NOT FLAGGED AS 'SELF- EMPLOYED'
WITH A FIRM-SIZE-1,
CONTINUE WITH LOOP_05.
OTHERWISE, GO TO BOX_19.
NOTE: IF POLICYHOLDER WAS NOT PHYSICALLY PRESENT IN THE RU ON THE PREVIOUS
ROUND’S INTERVIEW DATE, THE FIFTH CONDITION IN THE ABOVE BOX CAN BE MET IF
AT LEAST ONE DEPENDENT WAS COVERED BY POLICYHOLDER’S INSURANCE ON THE
PREVIOUS ROUND’S INTERVIEW DATE. COVERAGE FOR THE POLICYHOLDER IS ASSUMED
IN THAT CASE AND THE LOOP WILL CYCLE ON THE POLICYHOLDER’S NAME.
NOTE: ESTABLISHMENT-PERSON-PAIRS WHERE THE POLICYHOLDER IS OUT-OF-SCOPE
(E.G., DECEASED, INSTITUTIONALIZED, OUT OF COUNTRY) ON THE CURRENT ROUND'S
INTERVIEW DATE, BUT WHERE THE ESTABLISHMENT-PERSON-PAIR COVERED DEPENDENTS
WHO ARE STILL RU MEMBERS MAY STILL QUALIFY FOR LOOP_05.

36

Old Empl/Priv Related Ins (OE) Section
Beta

LOOP_05
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER, ASK OE12END_LP05.
LOOP DEFINITION:
LOOP_05 COLLECTS INFORMATION ABOUT THE CONTINUATION OF INSURANCE COVERAGE
THROUGH A NO LONGER HELD 'CURRENT MAIN' OR 'CURRENT MISCELLANEOUS' JOB
THAT WAS COLLECTED IN THE PREVIOUS ROUND. THIS LOOP CYCLES ON
ESTABLISHMENT-PERSON-PAIRS THAT MEET THE FOLLOWING CONDITIONS:
- RJ01 OR RJ06 WAS CODED '2' (NO), 'RF' (REFUSED), 'DK' (DON'T KNOW)
DURING THIS ROUND FOR THIS PAIR, AND
- PERSON WAS A JOBHOLDER AT ESTABLISHMENT, AND
- PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE, AND
- ESTABLISHMENT IS AN EMPLOYER FLAGGED DURING THE PREVIOUS
ROUND AS 'PROVIDES HEALTH INSURANCE' AND,
- THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON
ON THE DATE OF THE PREVIOUS ROUND'S INTERVIEW (HQ01 WAS CODED
'1' (WHOLE TIME) OR HQ02 WAS CODED '1' (YES) IN THE PREVIOUS ROUND),
AND
- JOB AT ESTABLISHMENT IS NOT FLAGGED AS 'SELF-EMPLOYED' WITH A
FIRM-SIZE-1.

37

Old Empl/Priv Related Ins (OE) Section
Beta

OE12

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPCP.EPCPID

EPCP ID KEY: EPRSID + PERSID

Label

Size
28

EPIN.EPINRURN
EPIN.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPRS.PLCYHOLD
EPRS.CONFPLCY

IS PERSON PRIMARY INSURED PERSON
CONFIRM SOMEONE STILL COVRD POLCY/MEDCAR

2
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
During the last interview, we recorded that someone in the family was covered
by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {(Are/Is)
(Were/Was)} (POLICYHOLDER) or anyone in the family covered by
(POLICYHOLDER)'s health insurance through (ESTABLISHMENT) as of
{today,} (END DATE)?
YES

1

{OE16}

NO

2

{OE13}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP05}
{END_LP05}

DISPLAY INSTRUCTIONS:
DISPLAY '(Are/Is)' IF NOT ROUND 5. DISPLAY '(Was/Were)' if
round 5.
DISPLAY 'today,' IF NOT ROUND 5. OTHERWISE, USE A NULL DISPLAY.

38

Old Empl/Priv Related Ins (OE) Section
Beta

OE13

Help Enabled
Variable Name
EPRS.INSCONT

Comment Enabled

Jump Back Enabled

Label
DID INSURANCE CONTINUE AFTER JOB END

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Did the health insurance (POLICYHOLDER) had through (ESTABLISHMENT)
continue for any period of time after (POLICYHOLDER) stopped working at
(ESTABLISHMENT)?
YES
NO

1
2

{OE14}
{OE15}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

39

{OE15}
{OE15}

Old Empl/Priv Related Ins (OE) Section
Beta

OE14

Help Enabled (COBRA)
Variable Name
EPRS.COBRACON

Comment Enabled

Jump Back Enabled

Label
DID INSURANCE CONTINUE THRU COBRA

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Did that health insurance continue through COBRA?
YES

1

{OE15}

NO

2

{OE15}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE15}
{OE15}

HELP AVAILABLE FOR DEFINITION OF COBRA.

40

Old Empl/Priv Related Ins (OE) Section
Beta

OE15

Help Enabled

Comment Enabled

Variable Name
EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

Jump Back Enabled

Label

Size
2
2
4

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
On what date did (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT) end?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE15OV.
OTHERWISE, GO TO BOX_11.

Hard CHECK:
(FOR ROUND 5 ONLY): COMPLETE DATE ENTERED CANNOT BE AFTER 12/31/{YEAR},
WHERE 'YEAR' IS THE SECOND CALENDAR YEAR OF THE PANEL. IF A DATE AFTER
12/31/{YEAR) IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'DATE CANNOT BE
AFTER 12/31/{YEAR.' IF INSURANCE ENDED AFTER 12/31/{YEAR}, JUMPBACK TO
CHANGE RESPONSE TO OE12.

41

Old Empl/Priv Related Ins (OE) Section
Beta

OE15OV

Help Enabled
Variable Name
EPCP.ENDMONTH

Comment Enabled

Jump Back Enabled

Label
END COVERAGE: COVER WHOLE/PART OF MONTH

Size
2

Can you just tell me if (POLICYHOLDER) was covered under that insurance
the whole month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_11}
{BOX_11}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

42

{BOX_11}
{BOX_11}

Old Empl/Priv Related Ins (OE) Section
Beta

OE16

Help Enabled (COBRA)
Variable Name
EPRS.COBRACON

Comment Enabled

Jump Back Enabled

Label
DID INSURANCE CONTINUE THRU COBRA

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Is (POLICYHOLDER)’s health insurance through (ESTABLISHMENT) now
extended through COBRA?
YES
NO

1
2

{BOX_11}
{BOX_11}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_11}
{BOX_11}

HELP AVAILABLE FOR DEFINITION OF COBRA.

BOX_11
IF THE POLICYHOLDER IS THE ONLY PERSON COVERED AT THE PREVIOUS ROUND'S
INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR,
AUTOMATICALLY CODE OE17 AS '1' (YES) AND GO TO BOX_12
OTHERWISE, CONTINUE WITH OE17

43

Old Empl/Priv Related Ins (OE) Section
Beta

OE17

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.ALLCOVR

ALL PERSONS ARE STILL COVERED

Label

Size
2

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
During the last interview, we recorded that (READ NAME(S) BELOW)
(were/was) covered by (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT).
{Are/Were} they all covered by this health insurance {until {{OE15 DATE}/it
ended}/on (END-DT)}?
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
YES

1

{BOX_12}

NO

2

{BOX_12}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

44

{BOX_12}
{BOX_12}

Old Empl/Priv Related Ins (OE) Section
Beta
DISPLAY INSTRUCTIONS:
DISPLAY 'Are' IF OE12 IS CODED ‘1’ (YES).
DISPLAY 'Were' IF OE12 IS CODED ‘2’ (NO) OR IF CURRENT ROUND
IS ROUND 5.
DISPLAY 'until {OE15 DATE}' IF OE12 IS CODED ‘2’ (NO). DISPLAY
'on (END-DT)' IF OE12 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE15 FOR ‘OE15 DATE’. IF THE
MONTH OR YEAR FIELD AT OE15 IS CODED ‘RF’ (REFUSED) OR ‘DK’
(DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE15 DATE’.

Roster Details
Title:

RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1

Col #

Header

Instructions

NAME

Display covered persons’ names
PERS.FULLNAME

1

Roster Definition:
This item displays persons on the RU-ESTB-PLCYHLDR-CVRD-PERSTRPLS-ROSTER for display.
Roster Behavior:
1. Select, add, delete, and edit disallowed.
Roster Filter:
1. Person was covered at the previous round’s interview date
by the insurance from this ESTABLISHMENT-PERSON-PAIR,
including the policyholder and
2. Person is an RU member.

45

Old Empl/Priv Related Ins (OE) Section
Beta

BOX_12
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO THE END DATE OF THE
CURRENT ROUND, THAT IS:
IF OE12 IS CODED '1' (YES) AND OE17 IS CODED '1' (YES),
FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS
'CONTINUOUS COVERAGE' THROUGH THE REFERENCE PERIOD END DATE AND
GO TO BOX_14
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO PART OF THE CURRENT
ROUND, THAT IS:
IF OE12 IS CODED '2' (NO) AND OE17 IS CODED '1' (YES),
FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS
'CONTINUOUS COVERAGE' THROUGH THE DATE RECORDED AT OE15
AND GO TO BOX_14
OTHERWISE (I.E., OE17 CODED '2' (NO), 'RF' (REFUSED), OR 'DK' (DON'T
KNOW)), CONTINUE WITH OE18

46

Old Empl/Priv Related Ins (OE) Section
Beta

OE18

Help Enabled

Comment Enabled

Variable Name
EPCP.bw_OE18

Jump Back Enabled

Label

Size

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {is/was} no longer covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {until {{OE15 DATE}/it ended}/on (END-DT)}?
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
DISPLAY INSTRUCTIONS:
DISPLAY 'is' IF OE12 IS CODED ‘1’ (YES).
DISPLAY 'was' IF OE12 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS
ROUND 5.
DISPLAY 'until {OE15 DATE}' IF OE12 IS CODED ‘2’ (NO).
DISPLAY 'on (END-DT)' IF OE12 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE15 FOR ‘OE15 DATE’. IF THE
MONTH OR YEAR FIELD AT OE15 IS CODED ‘RF’ (REFUSED) OR ‘DK’
(DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE15 DATE’.

47

Old Empl/Priv Related Ins (OE) Section
Beta
PROGRAMMER NOTES:
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR (OE12 IS CODED '1' (YES)), FLAG INSURANCE FOR ALL
PERSONS NOT SELECTED AT OE18 AS 'CONTINUOUS COVERAGE' FROM THE
REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END
DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR (OE12 IS CODED '2', (NO)), FLAG
INSURANCE FOR ALL PERSONS NOT SELECTED AT OE18 AS CONTINUOUS
COVERAGE FROM THE REFERENCE PERIOD START DATE UNTIL DATE
RECORDED AT OE15.

Roster Details
Title:

RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1

Col #

Header

Instructions

NAME

Display covered persons’ names
PERS.FULLNAME

1

Roster Definition:
This item displays the RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLSROSTER for selection.
Roster Behavior:
1. Multiple select allowed.
2. Add, delete, and edit disallowed.
Roster Filter:
1. Person was covered at the previous round’s interview date
by the insurance from this establishment-person-pair,
including the policyholder
2. Person is an RU member

LOOP_06
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE19 - END_LP06.
LOOP DEFINITION: LOOP_06 COLLECTS THE DATE ON WHICH THE INSURANCE
COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER
WHOSE COVERAGE ENDED PRIOR TO THE REFERENCE PERIOD END DATE OR THE DATE
REPORTED IN OE15. THIS LOOP CYCLES ON PERSONS SELECTED AT OE18.

48

Old Empl/Priv Related Ins (OE) Section
Beta

OE19

Help Enabled

Comment Enabled

Variable Name
EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

Jump Back Enabled

Label

Size
2
2
4

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
On what date did the health insurance through (ESTABLISHMENT) end for
(PERSON)?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_13}
{BOX_13}

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE19OV
OTHERWISE, GO TO BOX_13

49

Old Empl/Priv Related Ins (OE) Section
Beta

OE19OV

Help Enabled
Variable Name
EPCP.ENDMONTH

Comment Enabled

Jump Back Enabled

Label
END COVERAGE: COVER WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_13}
{BOX_13}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_13}
{BOX_13}

BOX_13
FLAG INSURANCE FOR PERSON AS 'CONTINUOUS COVERAGE' THROUGH THE COMPLETE
DATE RECORDED AT OE19 AND OE19OV.

END_LP06
CYCLE ON NEXT PERSON IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_06 AND CONTINUE
WITH BOX_14

BOX_14
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS
ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS
RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND'S INTERVIEW
DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE18),
CONTINUE WITH OE20.
OTHERWISE, GO TO OE22A.

50

Old Empl/Priv Related Ins (OE) Section
Beta

OE20

Help Enabled (DEPENDENT)
Variable Name
EPRS.COVRPERS

Comment Enabled

Jump Back Enabled

Label

Size
2

ANYONE COVERED AS DEPENDENT

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, have any
persons living here, that we have not yet mentioned, been covered by
(POLICYHOLDER)’s health insurance through (ESTABLISHMENT)?
YES
NO

1
2

{OE21}
{OE22A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE22A}
{OE22A}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

51

Old Empl/Priv Related Ins (OE) Section
Beta

OE21

Help Enabled

Comment Enabled

Variable Name
EPCP.bw_OE21

Jump Back Enabled

Label

Size

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {has been/was} covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {since (START DATE)/between (START DATE)
and (END DATE)} that we have not yet mentioned?
PROBE: Who else {has been/was} covered by (POLICYHOLDER)’s health
insurance through (ESTABLISHMENT) {since (START DATE)/between
(START DATE) and (END DATE)} that we have not yet mentioned?
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
DISPLAY INSTRUCTIONS:
DISPLAY 'has been' AND 'since (START DATE)' IF NOT ROUND 5.
DISPLAY 'was' AND 'between (START DATE) and (END DATE)' IF
ROUND 5.
PROGRAMMER NOTES:
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR-COVRD-PERSTRPLS-ROSTER.
IF 'PERSON NOT LISTED IN RU' IS SELECTED, FLAG INSURANCE
THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS 'COVERING PERSON NOT
LISTED IN RU'.

52

Old Empl/Priv Related Ins (OE) Section
Beta

Roster Details
Title:

RU_Members_1

Col #

Header

Instructions

NAME

Display RU member's first, middle, and last names
PERS.FULLNAME

1

Roster Definition:
This item displays RU-MEMBERS-ROSTER for selection of RUmembers.
Roster Behavior:
1. Multiple select allowed. Interviewer may select one or
more from the listed members.
2. Add, delete, and edit disallowed.
3. Display ‘PERSON NOT LISTED IN RU’ as last entry on
this roster.
Roster Filter:
Display persons who were not covered by the insurance
through this Establishment-Person-Pair on the previous
round’s interview date.

LOOP_07
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE22 - END_LP07.
LOOP DEFINITION: LOOP_07 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS
NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON PERSONS SELECTED AT OE21.

53

Old Empl/Priv Related Ins (OE) Section
Beta

OE22

Help Enabled

Comment Enabled

Variable Name
EPCP.COVRBMM

MONTH HEALTH INSURANCE BEGAN

EPCP.COVRBDD
EPCP.COVRBYY

DAY HEALTH INSURANCE BEGAN
YEAR HEALTH INSURANCE BEGAN

Jump Back Enabled

Label

Size
2
2
4

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
On what date did the health insurance through (ESTABLISHMENT) begin for
(PERSON)?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE22OV.
OTHERWISE, GO TO BOX_15.

54

Old Empl/Priv Related Ins (OE) Section
Beta

OE22OV

Help Enabled
Variable Name
EPCP.BEGMONTH

Comment Enabled

Jump Back Enabled

Label
BEGIN COVERAGE: COV WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_15}
{BOX_15}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_15}
{BOX_15}

Hard CHECK:
COMPLETE DATE AT OE22 MUST BE < THAN COMPLETE DATE AT OE15 IF A DATE IS
RECORDED AT OE15 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS RECORDED
AT OE15.

BOX_15
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE12
IS CODED '1' (YES)), FLAG INSURANCE FOR THIS PERSON AS 'CONTINUOUS
COVERAGE' FROM DATE RECORDED AT OE22 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSONPAIR (OE12 IS CODED '2' (NO)), FLAG INSURANCE FOR THIS PERSON AS
'CONTINUOUS COVERAGE' FROM DATE RECORDED AT OE22 UNTIL DATE RECORDED AT
OE15.

END_LP07
CYCLE ON NEXT PERSON IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_07 AND CONTINUE
WITH BOX_16.

55

Old Empl/Priv Related Ins (OE) Section
Beta

OE22A

Help Enabled (DEPENDENT)
Variable Name
EPRS.COVROUT

Comment Enabled

Jump Back Enabled

Label
HP16/HP17: POLICY COVERS PERS NOT IN RU

Size
2

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
{Does/Between (START DATE) and (END DATE), did} (POLICYHOLDER)'s
health coverage through (ESTABLISHMENT) cover as dependents any
persons who do not live here?
YES
NO

1
2

{BOX_16}
{BOX_16}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_16}
{BOX_16}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT.
DISPLAY INSTRUCTIONS:
DISPLAY 'Does' IF NOT ROUND 5. DISPLAY 'Between (START DATE)
and (END DATE), did' IF ROUND 5.
PROGRAMMER NOTES:
IF CODED '1' (YES), FLAG INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR AS 'COVERING PERSON NOT LISTED IN RU' IN OE21

BOX_16
IF ONE OR MORE RU MEMBERS ARE STILL COVERED BY THE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR ON THE CURRENT ROUND'S INTERVIEW DATE, THAT IS,
OE12 IS CODED '1'(YES), CONTINUE WITH BOX_16A.
OTHERWISE, GO TO END_LP05.

56

Old Empl/Priv Related Ins (OE) Section
Beta

BOX_16A
IF ROUND 3, CONTINUE WITH OE23A.
OTHERWISE, GO TO OE23.

57

Old Empl/Priv Related Ins (OE) Section
Beta

OE23A

Help Enabled
Variable Name
EPRS.PREMLEVL

Comment Enabled

Jump Back Enabled

Label
HOW MUCH OF PREMIUM PAID BY FAM

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
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 copayments, 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.]
YES, PAY ALL OF PREMIUM/COST
YES, PAY SOME OF PREMIUM/COST

1
2

YES, BUT DON'T KNOW IF PAY ALL OR
SOME OF PREMIUM/COST
NO, DO NOT PAY

3
4

{OE23AAA}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE23}
{OE23}

HELP AVAILABLE FOR DEFINITION OF
PREMIUM/COPAYMENT/COINSURANCE/DEDUCTIBLE.
PROGRAMMER NOTES:
THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE
INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM
DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE,
NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY.

58

Old Empl/Priv Related Ins (OE) Section
Beta

OE23AA

Help Enabled
Variable Name
EPRS.COVRAMT

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID FOR COVERAGE-AMT

Size
12

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
How much (do/does) (POLICYHOLDER) pay for the (ESTABLISHMENT)
coverage?

AMOUNT: $ _______

{OE23AAOV1}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_17A}
{BOX_17A}

PROGRAMMER NOTES:
THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE
INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM
DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE,
NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY.

59

Old Empl/Priv Related Ins (OE) Section
Beta

OE23AAOV1

Help Enabled
Variable Name
EPRS.COVRUNIT

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID FORCOVERAGE-UNIT

Size
2

Is that per year, per month, per week, or what?
UNIT OF COVERAGE:
PER YEAR

1

{BOX_17A}

QUARTERLY/EVERY 3 MONTHS
BIMONTHLY/EVERY 2 MONTHS

2
3

{BOX_17A}
{BOX_17A}

PER MONTH
PER WEEK

4
5

{BOX_17A}
{BOX_17A}

BIWEEKLY/EVERY 2 WEEKS
SEMI-ANNUALLY/2 TIMES PER YEAR
SEMI-MONTHLY/2 TIMES PER MONTH

6
7
8

{BOX_17A}
{BOX_17A}
{BOX_17A}

OTHER

91

{OE23AAOV2}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

60

{BOX_17A}
{BOX_17A}

Old Empl/Priv Related Ins (OE) Section
Beta

OE23AAOV2

Help Enabled
Variable Name
EPRS.COVRUNOS

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID: COV UNIT OTH SPEC

Size
25

OTHER SPECIFY: _______________________

{BOX_17A}

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Refused
Don't Know

RF
DK

{BOX_17A}
{BOX_17A}

BOX_17A
IF OE23A IS CODED ‘1’ (YES, PAY ALL OF PREMIUM/COST), GO TO OE23.
OTHERWISE, CONTINUE WITH OE23AAA.

61

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OE23AAA

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.BYFED

Label
FEDERAL GOVT PAID FOR PRIV PLAN PREMIUM

Size
2

EPRS.BYSTATE
EPRS.BYLOCAL

STATE GOVT PAID FOR PRIV PLAN PREMIUM
LOCAL GOVT PAID FOR PRIV PLAN PREMIUM

2
2

EPRS.BYSOMGOV
EPRS.BYEMPL

SOME GOVT PAID FOR PRIV PLAN PREMIUM
EMPLOYER PAID FOR PRIV PLAN PREMIUM

2
2

EPRS.BYUNION

UNION PAID FOR PRIV PLAN PREMIUM

2

EPRS.BYOTHER

OTHER PAID FOR PRIV PLAN PREMIUM

2

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
Who {else} pays {some of/for} the premium or cost of this insurance?
CHECK ALL THAT APPLY.
FEDERAL GOVERNMENT
STATE GOVERNMENT

1
2

LOCAL GOVERNMENT

3

SOME GOVERNMENT
EMPLOYER

4
5

UNION
OTHER

6
91

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Don't Know

RF
DK

{OE23}
{OE23}

DISPLAY INSTRUCTIONS:
DISPLAY ‘else’ IF OE23A IS CODED ‘2’ (YES, PAY SOME OF
PREMIUM/COST) OR ‘3’ (YES, BUT DON'T KNOW IF PAY ALL OR SOME
OF PREMIUM/COST). OTHERWISE, USE A NULL DISPLAY.
DISPLAY ‘some of’ IF OE23A IS CODED ‘2’ (YES, PAY SOME OF
PREMIUM/COST) OR ‘3’ (YES, BUT DON'T KNOW IF PAY ALL OR SOME
OF PREMIUM/COST). DISPLAY ‘for’ IF OE23A IS CODED ‘4’ (NO, DO
NOT PAY).

62

Old Empl/Priv Related Ins (OE) Section
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PROGRAMMER NOTES:
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW 'RF' OR
'DK' IN COMBINATION WITH ANY OTHER CODE.
ROUTING INSTRUCTION:
IF CODED ‘91’ (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER
CODE, CONTINUE WITH OE23AAAOV
OTHERWISE, GO TO OE23

OE23AAAOV

Help Enabled
Variable Name
EPRS.BYOTHOS

Comment Enabled

Jump Back Enabled

Label
OTHER SPECIFY OF WHO PAID PRIV PLAN PREM

Size
25

OTHER SPECIFY: _______________________

{OE23}

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Refused
Don't Know

RF
DK

63

{OE23}
{OE23}

Old Empl/Priv Related Ins (OE) Section
Beta

OE23

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.MCARELST

Label
MEDICARE INSUR LISTED ON THIS CARD

EPIN.DRLIST
EPIN.HMOPLAN

DOES PLAN HAVE A BOOK/LIST OF DOCTORS?
IS POLICYHOLDERS PLAN AN HMO PLAN?

2
2

EPIN.INSNAME
EPIN.INSTYPE

HX41/43/46 NAME OF INSURANCE CO OR HMO
HX41/43/46 TYPE OF INSURER

25
2

EPIN.MAJORMED

FLAG EPIN AS PROVIDING MAJOR MEDICAL COV

2

EPRS.MCARELET
EPRS.MCARENAM

PLAN LETTER OF MEDICARE INSURANCE
NAME OF MEDICARE HMO

4
25

EPIN.MSUPFLG

FLAG-PROVIDE MEDICARE SUPPLEMENT/MEDIGAP

2

EPIN.PROGDR
EPIN.VISITPAY

PRIV PLAN REQUIRES SIGNING W/PHYS,GROUP
PLAN PAY FOR NON-HMO, NON-REFER DR VISIT

2
2

EPRS.MCAREHMO
EPRS.PROGDR

MEDICARE: PERSON SIGNED WITH HMO
PRIV PLAN REQUIRES SIGNING W/PHYS,GROUP

2
2

EPIN.OTHNAMOS

HX42/44/47 OTH NAME FOR INSURANCE POLICY

25

EPIN.OTHNAME
EPRS.NAMECHNG

HX42/44/47 ANOTHER NAME FOR POLICY
HAS THERE BEEN A CHANGE IN PLAN NAME

2
2

EPRS.HOSPINS

TYPE OF HI GOTTEN: HOSPITAL/HMO

2

EPRS.DENTLINS
EPRS.PMEDINS

TYPE OF HI GOTTEN: DENTAL
TYPE OF HI GOTTEN: PRESCRIPTION DRUG

2
2

EPRS.VISIONIN
EPRS.MSUPINS

TYPE OF HI GOTTEN: VISION
TYPE OF HI GOTTEN: MEDIGAP

2
2

EPRS.LTCINS

TYPE OF HI GOTTEN: LTC-NURSING HOME

2

EPRS.CASHINS
EPRS.DREADINS

TYPE OF HI GOTTEN: EXTRA CASH
TYPE OF HI GOTTEN: DREAD DISEASE

2
2

EPRS.DISABINS

TYPE OF HI GOTTEN: DISABILITY

2

EPRS.WCOMPINS
EPRS.ACCDINS

TYPE OF HI GOTTEN: WORKER'S COMP
TYPE OF HI GOTTEN: ACCIDENT

2
2

EPRS.OTHINS
EPRS.OTHINSOS

TYPE OF HI GOTTEN: OTHER
TYPE OF HI GOTTEN: OTH SPECIFY

2
25

HOME.PLANFLAG

RU PLAN FLAG-HOSP/PHYS INSR + HMO STATUS

2

EPIN.EPINID
EPIN.EPINRURN

EPIN ID KEY: EPRSID + COUNTER(2)
ROUND STAMP: RU LETTER + ROUND NUMBER

22
2

EPIN.CREATEQ

CREATION STAMP

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}

64

Size
2

Old Empl/Priv Related Ins (OE) Section
Beta

{Last time we recorded that (POLICYHOLDER) (were/was) covered by (READ
INSURER NAME BELOW).}
{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) { has/had} through (ESTABLISHMENT)?
{INSURER OF ESTAB-PERS-INSURER TRIPLE ON PREV RD INT DT}

YES

1

{OE24}

NO

2

{END_LP05}

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RF
DK

{END_LP05}
{END_LP05}

DISPLAY INSTRUCTIONS:
DISPLAY FIRST PARAGRAPH AND THE INSURER NAME IF THE INSURANCE
THROUGH THIS ESTABLISHMENT-PERSON-PAIR HAD ANY INSURERS
FLAGGED AS PROVIDING MEDIGAP OR HOSPITAL/PHYSICIAN BENEFITS AT
ANY TIME DURING THE PREVIOUS ROUND.
DISPLAY 'Since (START DATE), has there been' AND 'has' IF NOT
ROUND 5. DISPLAY 'Between (START DATE) and (END DATE), was
there' AND 'had' IF ROUND 5.
PROGRAMMER NOTES:
IF CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), FLAG
PREVIOUS ROUND’S INSURER AS CURRENT ROUND’S INSURER FOR THIS
ESTABLISHMENT-PERSON-PAIR.

Roster Details
Title:

RU_ESTB_PERS_INSURER_TRPLS_1

Col #

Header

Instructions

PREV RND INSURER
WITH MEDIGAP OR
HOSP/PHYS

Display establishment name
ESTB.ESTBNAME

1

65

Old Empl/Priv Related Ins (OE) Section
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OE24

Help Enabled (TYPEINS)

Comment Enabled

Variable Name
EPRS.OE24BLSWVS

Jump Back Enabled

Label

Size

EPRS.HOSPINS
EPRS.DENTLINS

TYPE OF HI GOTTEN: HOSPITAL/HMO
TYPE OF HI GOTTEN: DENTAL

2
2

EPRS.PMEDINS
EPRS.VISIONIN

TYPE OF HI GOTTEN: PRESCRIPTION DRUG
TYPE OF HI GOTTEN: VISION

2
2

EPRS.MSUPINS

TYPE OF HI GOTTEN: MEDIGAP

2

EPRS.LTCINS
EPRS.CASHINS

TYPE OF HI GOTTEN: LTC-NURSING HOME
TYPE OF HI GOTTEN: EXTRA CASH

2
2

EPRS.DREADINS

TYPE OF HI GOTTEN: DREAD DISEASE

2

EPRS.DISABINS
EPRS.WCOMPINS

TYPE OF HI GOTTEN: DISABILITY
TYPE OF HI GOTTEN: WORKER'S COMP

2
2

EPRS.ACCDINS

TYPE OF HI GOTTEN: ACCIDENT

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
SHOW CARD OE-1.
What type of health insurance {(do/does)/did} (POLICYHOLDER) {now} have
through (ESTABLISHMENT)'s new plan {on (END DATE)}?
CHECK ALL THAT APPLY.
HOSPITAL AND PHYSICIAN BENEFITS,
INCLUDING COVERAGE THROUGH AN
HMO

1

DENTAL
PRESCRIPTION DRUGS

2
3

VISION
4
MEDICARE SUPPLEMENT/MEDIGAP
5
LONG TERM CARE IN A NURSING HOME 6
EXTRA CASH FOR HOSPITAL STAYS
7
SERIOUS DISEASE OR DREAD DISEASE 8
DISABILITY
WORKER'S COMPENSATION

9
10

ACCIDENT

11

OTHER

91
66

Old Empl/Priv Related Ins (OE) Section
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RF
DK

{BOX_17}
{BOX_17}

HELP AVAILABLE FOR DEFINITION OF ANSWER CATEGORIES.
[NOTE: 'DISABILITY', 'WORKER'S COMPENSATION', AND 'ACCIDENT'
WILL NOT APPEAR ON THE SHOW CARD.]
DISPLAY INSTRUCTIONS:
DISPLAY '(do/does)' IF NOT ROUND 5.
DISPLAY 'now' IF NOT ROUND 5.

DISPLAY 'did' IF ROUND 5.

OTHERWISE, USE A NULL DISPLAY.

DISPLAY 'on (END DATE)' IF ROUND 5.
DISPLAY.

OTHERWISE, USE A NULL

PROGRAMMER NOTES:
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW 'RF' OR
'DK' IN COMBINATION WITH ANY OTHER CODE.
ROUTING INSTRUCTION:
IF CODED '91' (OTHER), ALONE OR IN COMBINATION
CODES, CONTINUE WITH OE24OV.
OTHERWISE, GO TO BOX_17.

67

WITH ANY OTHER

Old Empl/Priv Related Ins (OE) Section
Beta

OE24OV

Help Enabled
Variable Name
EPRS.OTHINSOS

Comment Enabled

Jump Back Enabled

Label

Size
25

TYPE OF HI GOTTEN: OTH SPECIFY

OTHER SPECIFY: _______________________

{BOX_17}

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Don't Know

RF
DK

{BOX_17}
{BOX_17}

HELP AVAILABLE FOR DEFINITION OF ANSWER CATEGORIES.
[NOTE: 'DISABILITY', 'WORKER'S COMPENSATION', AND 'ACCIDENT'
WILL NOT APPEAR ON THE SHOW CARD.]

BOX_17
IF OE24 IS CODED '1' (HOSPITAL AND PHYSICIAN BENEFITS) OR '5' (MEDICARE
SUPPLEMENT/MEDIGAP), ALONE OR WITH ANY OTHER COMBINATION OF CODES,
CONTINUE WITH OE25
OTHERWISE, GO TO END_LP05.
NOTE: ALL ESTABLISHMENTS WHICH ARE BEING LOOPED ON HERE ARE EMPLOYERS.
THEREFORE, IT IS NOT NECESSARY TO AUTOMATICALLY CODE OE25 IF THE
ESTABLISHMENT IS AN INSURANCE CO. OR HMO.

68

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Beta

OE25

Help Enabled (INSHMO)

Comment Enabled

Jump Back Enabled

Variable Name
EPIN.EPINID

EPIN ID KEY: EPRSID + COUNTER(2)

Label

Size
22

EPIN.EPINRURN
EPIN.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPIN.INSNAME
EPIN.INSTYPE

HX41/43/46 NAME OF INSURANCE CO OR HMO
HX41/43/46 TYPE OF INSURER

25
2

EPIN.MAJORMED

FLAG EPIN AS PROVIDING MAJOR MEDICAL COV

2

EPIN.MSUPFLG

FLAG-PROVIDE MEDICARE SUPPLEMENT/MEDIGAP

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
What is the new plan name for (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT) which provides the {hospital and physician
benefits/Medicare supplement or Medigap benefit}?
IF MORE THAN ONE NAME, PROBE: What is the main new plan name?
RECORD THE NAME OF THE MAIN INSURER THAT PROVIDES THE
{HOSPITAL AND PHYSICIAN/MEDIGAP} BENEFITS FOR THIS PAIR.
IF RESPONDENT SAYS BOTH INSURANCE COMPANY AND HMO,
SELECT 'HMO'.
NAME OF INSURER:
----------------------------------------------TYPE:
INSURANCE COMPANY

1

{LOOP_08}

HMO

2

{LOOP_08}

COMPANY IS SELF-INSURED

3

{LOOP_08}

HELP AVAILABLE FOR DEFINITION OF INSURANCE CO/HMO/SELFINSURED CO.
DISPLAY INSTRUCTIONS:
DISPLAY 'hospital and physician benefits' IF OE24 IS CODED ‘1’
(HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT CODED ‘5’ (MEDICARE
SUPPLEMENT/MEDIGAP). DISPLAY 'Medicare supplement or Medigap
benefits' and 'MEDIGAP' IF OE24 IS CODED ‘5’ (MEDICARE
SUPPLEMENT/MEDIGAP)

69

Old Empl/Priv Related Ins (OE) Section
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PROGRAMMER NOTES:
WRITE INSURER(S) TO THE RU-ESTB-PERSON-INSURER-TRIPLES-ROSTER
FOR THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR.
FLAG INSURER(S) COLLECTED AT OE25 AS CURRENT ROUND’S
INSURER(S) FOR THIS ESTABLISHMENT-PERSON-PAIR.
IF OE24 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP) FLAG
INSURANCE CO./HMO AS 'SUPPLYING MEDICARE SUPPLEMENT/MEDIGAP
BENEFITS (WHICH INCLUDES HOSPITAL/PHYSICIAN BENEFITS)’ FOR THE
CURRENT ROUND.
IF OE24 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT
NOT ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP), FLAG INSURANCE CO./HMO
AS 'SUPPLYING HOSPITAL/PHYSICIAN BENEFITS' FOR THE CURRENT
ROUND.

LOOP_08
FOR EACH ELEMENT ON THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER, ASK
OE25AA - END_LP08.
LOOP DEFINITION: LOOP_08 COLLECTS OTHER POLICY NAMES AND MANAGED CARE
INFORMATION FOR INSURERS COLLECTED AT OE25. THIS LOOP CYCLES ON TRIPLES
THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISH-PERSON PAIR PROVIDES THE INSURANCE BEING ASKED ABOUT
- INSURER IS ENTERED AT OE25

70

Old Empl/Priv Related Ins (OE) Section
Beta

OE25AA

Help Enabled
Variable Name
EPIN.OTHNAME

Comment Enabled

Jump Back Enabled

Label
HX42/44/47 ANOTHER NAME FOR POLICY

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Is there any other name for the {INSURANCE COMPANY OR HMO NAME}
policy, such as Option A, $100 Deductible, 90/80 Plan, Gold, or High Option?
YES, ANOTHER NAME
NO OTHER NAME

1
2

{OE25AAOV}
{BOX_18A}

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RF
DK

{BOX_18A}
{BOX_18A}

HELP AVAILABLE FOR DEFINITION OF LOW OPTION/HIGH OPTION.
DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE INSURANCE CO/HMO RECORDED IN OE25
WHICH IS BEING LOOPED ON FOR ‘INSURANCE.... NAME’

71

Old Empl/Priv Related Ins (OE) Section
Beta

OE25AAOV

Help Enabled
Variable Name
EPIN.OTHNAMOS

Comment Enabled

Jump Back Enabled

Label
HX42/44/47 OTH NAME FOR INSURANCE POLICY

Size
25

OTHER NAME: _______________________

{BOX_18A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_18A}
{BOX_18A}

BOX_18A
IF INSURER BEING LOOPED ON IS CODED '2' (HMO) IN OE25, GO TO END_LP08
OTHERWISE, CONTINUE WITH BOX_18

72

Old Empl/Priv Related Ins (OE) Section
Beta

OE25B

Help Enabled
Variable Name
EPIN.VISITPAY

Comment Enabled

Jump Back Enabled

Label
PLAN PAY FOR NON-HMO, NON-REFER DR VISIT

Size
2

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
INSURER NAME: {NAME OF INSURER BEING LOOPED ON}
Will (POLICYHOLDER)’s plan pay for any of the costs of visits to doctors who
are not part of (POLICYHOLDER)’s HMO, even if (POLICYHOLDER)
(do/does) not have a referral?

YES
NO

1
2

{END_LP08}
{END_LP08}

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Refused
Don't Know

RF
DK

{END_LP08}
{END_LP08}

BOX_18
ASK THE MANAGED CARE (MC) SECTION FOR THIS INSURER.
AT COMPLETION OF MANAGED CARE (MC) SECTION, CONTINUE WITH END_LP08.

END_LP08
CYCLE ON NEXT INSURER IN THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER THAT
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER INSURERS MEET THE STATED CONDITIONS, END LOOP_08 AND CONTINUE
WITH END_LP05.

73

Old Empl/Priv Related Ins (OE) Section
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END_LP05
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEETS
THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_05 AND CONTINUE
WITH BOX_19.

BOX_19
IF ONE OR MORE OR RU MEMBERS WAS COVERED BY INSURANCE THROUGH A NONCURRENT EMPLOYER FROM THE PREVIOUS ROUND, AN EMPLOYER FLAGGED AS 'SELFEMPLOYED' WITH A FIRM-SIZE-1, OR A DIRECT PURCHASE SOURCE ON THE PREVIOUS
ROUND'S INTERVIEW DATE, THAT IS:
IF ONE OR MORE ESTABLISHMENT-PERSON-PAIRS IN THE RU MEETS THE FOLLOWING
CONDITIONS:
- ESTABLISHMENT IS ONE OF THE FOLLOWING TYPES:
- FLAGGED AS A DIRECT PURCHASE SOURCE
- FLAGGED AS AN 'EMPLOYER' WITH FIRM-SIZE-1, FLAGGED DURING THE
PREVIOUS ROUND AS 'PROVIDES HEALTH INSURANCE', OR
- FLAGGED AS AN 'EMPLOYER' WITH FIRM-SIZE-GREATER-THAN-1,
FLAGGED DURING THE PREVIOUS ROUND AS 'PROVIDES HEALTH
INSURANCE', AND HAD ONE OF THE FOLLOWING JOB SUBTYPES
DURING THE PREVIOUS ROUND:
- 'FORMER MAIN WITHIN REFERENCE PERIOD'
- 'FORMER MISCELLANEOUS JOB WITHIN REFERENCE PERIOD'
- 'LAST JOB OUTSIDE REFERENCE PERIOD'
- 'RETIREMENT JOB'
- PERSON IS OR WAS A JOBHOLDER AT ESTABLISHMENT, IF THE ESTABLISHMENT
IS ONE OF THE SECOND 2 TYPES NOTED ABOVE;
- PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE;
- THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON ON
THE DATE OF THE PREVIOUS ROUND'S INTERVIEW (HQ WAS CODED '1'
(WHOLE TIME) OR HQ02 WAS CODED '1' (YES) IN THE PREVIOUS ROUND);
CONTINUE WITH LOOP_09.
OTHERWISE, GO TO BOX_29.
NOTE: IF POLICYHOLDER WAS NOT PHYSICALLY PRESENT IN THE RU ON THE
PREVIOUS ROUND’S INTERVIEW DATE,THE LAST CONDITION IN THE ABOVE BOX CAN BE
MET IF AT LEAST ONE DEPENDENT WAS COVERED BY POLICYHOLDER’S INSURANCE ON
THE PREVIOUS ROUND’S INTERVIEW DATE. THE LOOP WILL CYCLE ON THE
POLICYHOLDER’S NAME.
NOTE: ESTABLISHMENT-PERSON-PAIRS WHERE THE POLICYHOLDER IS OUT-OF-SCOPE
(E.G., DECEASED, INSTITUTIONALIZED, OUT OF COUNTRY) ON THE CURRENT ROUND'S
INTERVIEW DATE, BUT WHERE THE ESTABLISHMENT-PERSON-PAIR COVERED DEPENDENTS
WHO ARE STILL RU MEMBERS MAY STILL QUALIFY FOR LOOP_09.
NOTE: FOR DIRECT PURCHASE AND SELF-EMPLOYED-FIRM-SIZE-1, THE CONTEXT
HEADER SHOULD DISPLAY THE NAME OF THE SOURCE PROVIDING THE INSURANCE
RATHER THAN THE NAME OF THE DIRECT PURCHASE CATEGORY OR THE SELF-EMPLOYEDFIRM-SIZE-1 EMPLOYER NAME OR TYPE OF PURCHASE CATEGORY. FOR EMPLOYERS
WHICH ARE NOT SELF-EMPLOYED WITH FIRM-SIZE-1, USE THE JOBHOLDER NAME AND
EMPLOYER NAME IN THE CONTEXT HEADER.

74

Old Empl/Priv Related Ins (OE) Section
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LOOP_09
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER, ASK
BOX_19A - END_LP09
LOOP DEFINITION: LOOP_09 COLLECTS INFORMATION ABOUT THE CONTINUATION OF
INSURANCE COVERAGE THROUGH A NON-CURRENT EMPLOYER FROM THE PREVIOUS ROUND,
AN EMPLOYER FLAGGED AS ‘SELF-EMPLOYED’ WITH A FIRM-SIZE-1, OR A DIRECT
PURCHASE SOURCE THAT WAS COLLECTED IN THE PREVIOUS ROUND. THIS LOOP
CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS ONE OF THE FOLLOWING TYPES:
- FLAGGED AS A DIRECT PURCHASE SOURCE
- FLAGGED AS AN ‘EMPLOYER’ WITH FIRM-SIZE-1, FLAGGED DURING
THE PREVIOUS ROUND AS ‘PROVIDES HEALTH INSURANCE’, OR
- FLAGGED AS AN ‘EMPLOYER’ WITH FIRM-SIZE-GREATER-THAN-1,
FLAGGED DURING THE PREVIOUS ROUND AS ‘PROVIDES HEALTH
INSURANCE’, AND HAD ONE OF THE FOLLOWING JOB SUBTYPES
DURING THE PREVIOUS ROUND:
- ‘FORMER MAIN WITHIN REFERENCE PERIOD’
- ‘FORMER MISCELLANEOUS JOB WITHIN REFERENCE PERIOD’
- ‘LAST JOB OUTSIDE REFERENCE PERIOD’
- ‘RETIREMENT JOB’
- PERSON IS OR WAS A JOBHOLDER AT ESTABLISHMENT, IF THE ESTABLISHMENT
IS ONE OF THE SECOND 2 TYPES NOTED ABOVE;
- PERSON IS FLAGGED AS THE POLICYHOLDER OF THIS INSURANCE;
- THE HEALTH INSURANCE PROVIDED BY ESTABLISHMENT COVERED PERSON
ON THE DATE OF THE PREVIOUS ROUND’S INTERVIEW (HQ WAS CODED ‘1’
(WHOLE TIME) OR HQ02 WAS CODED ‘1’ (YES) IN THE PREVIOUS ROUND)

BOX_19A
IF THE POLICYHOLDER OF THIS ESTABLISHMENT-PERSON-PAIR IS FLAGGED AS
‘POLICYHOLDER NOT LISTED IN RU (DU)’ OR ‘POLICYHOLDER DECEASED’, CONTINUE
WITH OE25A.
OTHERWISE, GO TO OE26.

75

Old Empl/Priv Related Ins (OE) Section
Beta

OE25A

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.EPRSID

Label
EPRS ID KEY: ESTBID + PERSID + ROUND NUM

Size
20

EPRS.EPRSRURN
EPRS.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
QUESTION THAT CREATED EPRS RECORD

2
6

EPRS.DUPERSID
EPRS.DECEANAM

PERSID FOR WHO IS THE ACTUAL PLCYHOLDER
ENER NAME/DESCR OF DECEASED PLCY HOLDER

8
40

EPRS.NONRUNAM

SPECIFY NAME/DESCR OF NON-RU PLCY HOLDER

15

EPRS.PLCYHOLD
EPRS.PURCHTYP

IS PERSON PRIMARY INSURED PERSON
MAIN CATEGORY OF PURCHASING INSURANCE

2
2

EPRS.PURCHOS

GET INS FROM OTHER SOURCE-SPECIFIED

25

EPRS.PRIVINS
EPRS.PRIVINOS

PURCHASE SOURCE FOR HEALTH INSURANCE
PURCHASE SOURCE FOR HEALTH INSURANCE OS

2
25

EPCP.EPCPID
EPCP.CREATEQ

EPCP ID KEY: EPRSID + PERSID
CREATION STAMP

28
2

EPCP.EPCPRURN

ROUND STAMP: RU LETTER + ROUND NUMBER

2

TRNS.TRNSID
TRNS.TRNSRURN

TRNS ID KEY: RUNTID + TRANSACTION NUMBER
ROUND STAMP: RU LETTER + ROUND NUMBER

12
2

TRNS.TRNSDATE

TRANSACTION DATE

8

TRNS.TRNSKEY
TRNS.TRNSSEG

KEY OF RECORD BEING UPDATED
SEGMENT NAME OF RECORD BEING UPDATED

40
4

TRNS.TRNSVAR
TRNS.WHOTRNS

NAME OF VARIABLE BEING UPDATED
ID OF INTERVIEWER INITIATING TRANSACTION

8
4

TRNS.OLDTRNS

OLD VALUE OF VARIABLE BEING UPDATED

45

TRNS.NEWTRNS

NEW VALUE OF VARIABLE BEING UPDATED

45

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

{NAME OF

INTERVIEWER: IF (POLICYHOLDER)’S NAME IS LISTED ON THE
ROSTER BELOW, SELECT IT. IF NOT, SELECT ‘NAME NOT ON ROSTER’
AND CONTINUE.

[First Name, [Middle name], Last name]
[First Name, [Middle name], Last name]
[First Name, [Middle name], Last name]

76

Old Empl/Priv Related Ins (OE) Section
Beta
PROGRAMMER NOTES:
IF A DU MEMBER’S NAME IS SELECTED FROM THE ROSTER, REPLACE
THIS NAME AS THE CURRENT POLICYHOLDER OF THIS ESTABLISHMENTPERSON-PAIR. IF ‘NAME NOT ON ROSTER’ SELECTED LEAVE THE
POLICYHOLDER NAME OF THIS ESTABLISHMNT-PERSON-PAIR AS IS.

Roster Details
Title:

DU_MEMBERS_1

Col #

Header

Instructions

NAME

Display DU members’ first, middle, and last names
PERS.FULLNAME

1

Roster Definition:
This item displays persons in the DU-Members-Roster for
selection.
Roster Behavior:
1. Select allowed
2. Multiple Select, add, delete, and edit disallowed.
3. Display ‘NAME NOT ON ROSTER’ as last entry on this roster.
Roster Filter:
No filter; display all.

77

Old Empl/Priv Related Ins (OE) Section
Beta

OE26

Help Enabled

Comment Enabled

Variable Name
EPRS.CONFPLCY

Label
CONFIRM SOMEONE STILL COVRD POLCY/MEDCAR

EPRS.DUPERSID

PERSID FOR WHO IS THE ACTUAL PLCYHOLDER

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

Jump Back Enabled
Size
2
8

{NAME OF

During the last interview, we recorded that someone in the family was covered
by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {(Are/Is)/
(Were/Was)}(POLICYHOLDER) or anyone in the family covered by
(POLICYHOLDER)'s health insurance through (ESTABLISHMENT) as of
{today,} (END DATE)?
YES

1

NO

2

{OE28}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

DISPLAY INSTRUCTIONS:
DISPLAY ‘(Are/Is)’ IF NOT ROUND 5.
ROUND 5.
DISPLAY ‘today,’ IF NOT ROUND 5.
DISPLAY.

{END_LP09}
{END_LP09}

DISPLAY ‘(Was/Were)’ IF
OTHERWISE, USE A NULL

ROUTING INSTRUCTION:
IF CODED '1' (YES) AND THIS ESTABLISHMENT-PERSON- PAIR IS AN
ESTABLISHMENT FLAGGED AS 'SELF-EMPLOYED' WITH FIRM-SIZE-1,
CONTINUE WITH OE27
OTHERWISE (I.E., IF CODED ‘1’ (YES) AND ESTABLISHMENT-PERSONPAIR IS NOT AN ESTABLISHMENT WITH FIRM-SIZE-1), GO TO BOX_20

78

Old Empl/Priv Related Ins (OE) Section
Beta

OE27

Help Enabled (SELFEMPL)
Variable Name
EPRS.THRUBUSI

Comment Enabled

Jump Back Enabled

Label
IS INSR STILL THRU SELF-EMP BUSINESS

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

Size
2

{NAME OF

Is this insurance still through (POLICYHOLDER)’s self-employed business?
YES

1

{BOX_20}

NO

2

{BOX_20}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_20}
{BOX_20}

HELP AVAILABLE FOR DEFINITION OF SELF-EMPLOYED.

79

Old Empl/Priv Related Ins (OE) Section
Beta

OE28

Help Enabled

Comment Enabled

Variable Name
EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

Jump Back Enabled

Label

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

Size
2
2
4

{NAME OF

On what date did (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT) end?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_20}
{BOX_20}

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE28OV
OTHERWISE, GO TO BOX_20

Hard CHECK:
FOR ROUND 5 ONLY: COMPLETE DATE ENTERED CANNOT BE AFTER 12/31/{YEAR}, WHERE
'YEAR' IS THE SECOND CALENDAR YEAR OF THE PANEL. IF A DATE AFTER 12/31/2008
IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'DATE CANNOT BE AFTER
12/31/{YEAR}. IF INSURANCE ENDED AFTER 12/31/{YEAR}, JUMPBACK AND CHANGE
RESPONSE TO OE26.

80

Old Empl/Priv Related Ins (OE) Section
Beta

OE28OV

Help Enabled
Variable Name
EPCP.ENDMONTH

Comment Enabled

Jump Back Enabled

Label
END COVERAGE: COVER WHOLE/PART OF MONTH

Size
2

Can you just tell me if (POLICYHOLDER) was covered under that insurance
the whole month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_20}
{BOX_20}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_20}
{BOX_20}

BOX_20
IF THE POLICYHOLDER IS THE ONLY PERSON COVERED AT THE PREVIOUS ROUND'S
INTERVIEW DATE BY THE INSURANCE FROM THIS ESTABLISHMENT-PERSON-PAIR,
AUTOMATICALLY CODE OE29 AS '1' (YES) AND GO TO BOX_21.
OTHERWISE, CONTINUE WITH OE29.

81

Old Empl/Priv Related Ins (OE) Section
Beta

OE29

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.ALLCOVR

ALL PERSONS ARE STILL COVERED

Label

Size
2

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
During the last interview, we recorded that (READ NAMES BELOW)
(were/was) covered by (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT).
{Are/Were} they all covered by this health insurance {until {{OE28 DATE}/it
ended}/on (END-DT)}?
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
YES
NO

1
2

{BOX_21}
{BOX_21}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

82

{BOX_21}
{BOX_21}

Old Empl/Priv Related Ins (OE) Section
Beta
DISPLAY INSTRUCTIONS:
DISPLAY 'Are' IF OE26 IS CODED ‘1’ (YES).
DISPLAY 'Were' IF OE26 IS CODED ‘2’ (NO) OR IF CURRENT ROUND
IS ROUND 5.
DISPLAY 'until {OE28 DATE}' IF OE26 IS CODED ‘2’ (NO).
DISPLAY 'on (END-DT)' IF OE26 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE28 FOR ‘OE28 DATE’. IF THE
MONTH OR YEAR FIELD AT OE28 IS CODED ‘RF’ (REFUSED) OR ‘DK’
(DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE28 DATE’.

BOX_21
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO THE END DATE OF THE
CURRENT ROUND, THAT IS:
IF OE26 IS CODED '1' (YES) AND OE29 IS CODED '1' (YES),
FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS
'CONTINUOUS COVERAGE' THROUGH THE REFERENCE PERIOD END DATE AND
GO TO BOX_23 .
IF COVERAGE IS CONTINUOUS FROM THE PREVIOUS ROUND TO PART OF THE CURRENT
ROUND, THAT IS:
IF OE26 IS CODED '2' (NO) AND OE29 IS CODED '1' (YES),
FLAG INSURANCE FOR ALL COVERED PERSONS (INCLUDING THE POLICYHOLDER) AS
'CONTINUOUS COVERAGE' THROUGH THE DATE RECORDED AT OE28 AND
GO TO BOX_23.
OTHERWISE (I.E., OE29 CODED '2' (NO), 'RF' (REFUSED), OR 'DK' (DON'T
KNOW)), CONTINUE WITH OE30.

83

Old Empl/Priv Related Ins (OE) Section
Beta

OE30

Help Enabled

Comment Enabled

Variable Name
EPCP.bw_OE30

Jump Back Enabled

Label

Size

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {is/was} no longer covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {{until {OE28 DATE}/it ended}/on (END-DT)}?

[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]

{LOOP_10}

DISPLAY INSTRUCTIONS:
DISPLAY 'is' IF OE26 IS CODED ‘1’ (YES).
DISPLAY 'was' IF OE26 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS
ROUND 5.
DISPLAY 'until {OE28 DATE}' IF OE26 IS CODED ‘2’ (NO).
DISPLAY 'on (END-DT)' IF OE26 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE28 FOR ‘OE28 DATE’. IF THE
MONTH OR YEAR FIELD AT OE28 IS CODED ‘RF’ (REFUSED) OR ‘DK’
(DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE28 DATE’.

84

Old Empl/Priv Related Ins (OE) Section
Beta
PROGRAMMER NOTES:
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR (OE26 IS CODED '1' (YES)), FLAG INSURANCE FOR ALL
PERSONS NOT SELECTED AT OE30 AS 'CONTINUOUS COVERAGE' FROM THE
REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END
DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR (OE26 IS CODED '2' (NO)), FLAG
INSURANCE FOR ALL PERSONS NOT SELECTED AT OE30 AS CONTINUOUS
COVERAGE FROM THE REFERENCE PERIOD START DATE UNTIL DATE
RECORDED AT OE28

Roster Details
Title:

RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1

Col #

Header

Instructions

NAME

Display covered persons’ names
PERS.FULLNAME

1

Roster Definition:
This item displays the RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLSROSTER for selection.
Roster Behavior:
1. Multiple select allowed.
2. Add, delete, and edit disallowed.
Roster Filter:
1. Person was covered at the previous round’s interview date
by the insurance from this Establishment-Person-Pair,
including the policyholder
2. Person is an RU member

LOOP_10
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE31 - END_LP10.
LOOP DEFINITION: LOOP_10 COLLECTS THE DATE ON WHICH THE INSURANCE
COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER
WHOSE COVERAGE ENDED EITHER PRIOR TO THE REFERENCE PERIOD END DATE OR THE
DATE REPORTED IN OE28. THIS LOOP CYCLES ON PERSONS SELECTED AT OE30.

85

Old Empl/Priv Related Ins (OE) Section
Beta

OE31

Help Enabled

Comment Enabled

Variable Name
EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

Jump Back Enabled

Label

{PERSON’S FIRST MIDDLE AND LAST NAME}
{STR-DT} {END-DT}

Size
2
2
4

{NAME OF ESTABLISHMENT}

On what date did the health insurance through (ESTABLISHMENT) end for
(PERSON)?
_____/______/__________
MM DD YYYY

{OE31OV}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_22}
{BOX_22}

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE31OV.
OTHERWISE, GO TO BOX_22.

86

Old Empl/Priv Related Ins (OE) Section
Beta

OE31OV

Help Enabled
Variable Name
EPCP.ENDMONTH

Comment Enabled

Jump Back Enabled

Label
END COVERAGE: COVER WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_22}
{BOX_22}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_22}
{BOX_22}

BOX_22
FLAG INSURANCE FOR PERSON AS 'CONTINUOUS COVERAGE' THROUGH THE COMPLETE
DATE RECORDED AT OE31 AND OE31OV.

END_LP10
CYCLE ON NEXT PERSON IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_10 AND CONTINUE
WITH BOX_23.

BOX_23
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS
ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS
RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND'S INTERVIEW
DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE30),
CONTINUE WITH OE32.
OTHERWISE, GO TO OE34A.

87

Old Empl/Priv Related Ins (OE) Section
Beta

OE32

Help Enabled (DEPENDENT)

Comment Enabled

Variable Name
EPRS.COVRPERS

ANYONE COVERED AS DEPENDENT

EPRS.COVROUT

HP16/HP17: POLICY COVERS PERS NOT IN RU

Jump Back Enabled

Label

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

Size
2
2

{NAME OF

{Since (START DATE)/Between (START DATE) and (END DATE)}, have any
persons living here, we have not yet mentioned, been covered by
(POLICYHOLDER)’s health insurance through (ESTABLISHMENT)?
YES
NO

1
2

{OE33}
{OE34A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE34A}
{OE34A}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT
DISPLAY INSTRUCTIONS:
DISPLAY ‘Since (START DATE)’ IF NOT ROUND 5.
DISPLAY ‘Between (START DATE) and (END DATE)’ IF ROUND 5.

88

Old Empl/Priv Related Ins (OE) Section
Beta

OE33

Help Enabled

Comment Enabled

Variable Name
EPCP.bw_OE33

Jump Back Enabled

Label

Size

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

{NAME OF

Who {has been/was} covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {since (START DATE)/between (START DATE)
and (END DATE)} that we have not yet mentioned?
PROBE: Who else {has been/was} covered by (POLICYHOLDER)’s health
insurance through (ESTABLISHMENT) {since (START DATE)/between
(START DATE) and (END DATE)} that we have not yet mentioned?
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]

{LOOP_11}

DISPLAY INSTRUCTIONS:
DISPLAY ‘has been’ AND ‘since (START DATE)’ IF NOT ROUND 5.
DISPLAY ‘was’ AND ‘between (START DATE) and (END DATE)’ IF
ROUND 5.
PROGRAMMER NOTES:
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR-COVRD-PERSTRPLS-ROSTER.
IF 'PERSON NOT LISTED IN RU' IS SELECTED, FLAG INSURANCE
THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS 'COVERING PERSON NOT
LISTED IN RU'.

89

Old Empl/Priv Related Ins (OE) Section
Beta

Roster Details
Title:

RU_Members_1

Col #

Header

Instructions

NAME

Display RU member's first, middle, and last names
PERS.FULLNAME

1

Roster Definition:
This item displays RU-MEMBERS-ROSTER for selection of RUmembers.
Roster Behavior:
1. Multiple select allowed. Interviewer may select one or
more from the listed members.
2. Add, delete, and edit disallowed.
3. Display ‘PERSON NOT LISTED IN RU’ as last entry on
this roster.
Roster Filter:
Display persons who were not covered by the insurance
through this Establishment-Person-Pair on the previous
round’s interview date..

LOOP_11
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE34 - END_LP11.
LOOP DEFINITION: LOOP_11 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS
NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR.
THIS LOOP CYCLES ON PERSONS SELECTED AT OE33.

90

Old Empl/Priv Related Ins (OE) Section
Beta

OE34

Help Enabled

Comment Enabled

Variable Name
EPCP.COVRBMM

MONTH HEALTH INSURANCE BEGAN

EPCP.COVRBDD
EPCP.COVRBYY

DAY HEALTH INSURANCE BEGAN
YEAR HEALTH INSURANCE BEGAN

Jump Back Enabled

Label

Size
2
2
4

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
On what date did the health insurance through (ESTABLISHMENT) begin for
(PERSON)?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_24}
{BOX_24}

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE34OV.
OTHERWISE, GO TO BOX_24.

91

Old Empl/Priv Related Ins (OE) Section
Beta

OE34OV

Help Enabled
Variable Name
EPCP.BEGMONTH

Comment Enabled

Jump Back Enabled

Label
BEGIN COVERAGE: COV WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_24}
{BOX_24}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_24}
{BOX_24}

Hard CHECK:
COMPLETE DATE AT OE34 MUST BE < THAN COMPLETE DATE AT OE28 IF A DATE IS
RECORDED AT OE28 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS RECORDED
AT OE28.

BOX_24
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE26
IS CODED '1' (YES)), FLAG INSURANCE FOR THIS PERSON AS 'CONTINUOUS
COVERAGE' FROM DATE RECORDED AT OE34 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS ESTABLISHMENT-PERSONPAIR (OE26 IS CODED '2' (NO), FLAG INSURANCE FOR THIS PERSON AS
'CONTINUOUS COVERAGE' FROM DATE RECORDED AT OE34 UNTIL DATE RECORDED AT
OE28.

END_LP11
CYCLE ON NEXT PERSON IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_11 AND CONTINUE
WITH BOX_25.

92

Old Empl/Priv Related Ins (OE) Section
Beta

OE34A

Help Enabled (DEPENDENT)
Variable Name
EPRS.COVROUT

Comment Enabled

Jump Back Enabled

Label
HP16/HP17: POLICY COVERS PERS NOT IN RU

Size
2

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
{Does/Between (START DATE) and (END DATE), did} (POLICYHOLDER)'s
health coverage through (ESTABLISHMENT) cover as dependents any
persons who do not live here?
YES
NO

1
2

{BOX_25}
{BOX_25}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_25}
{BOX_25}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT.
DISPLAY INSTRUCTIONS:
DISPLAY 'Does' IF NOT ROUND 5. DISPLAY 'Between (START DATE)
AND (END DATE), did' IF ROUND 5.
PROGRAMMER NOTES:
IF CODED '1' (YES), FLAG INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR AS 'COVERING PERSON NOT LISTED IN RU' IN OE33.

BOX_25
IF ONE OR MORE RU MEMBERS ARE STILL COVERED BY THE INSURANCE THROUGH THE
ESTABLISHMENT-PERSON-PAIR ON THE CURRENT ROUND'S INTERVIEW DATE, THAT IS,
OE26 IS CODED '1'(YES), CONTINUE WITH BOX_25A.
OTHERWISE, GO TO END_LP09.

93

Old Empl/Priv Related Ins (OE) Section
Beta

BOX_25A
IF ROUND 3, CONTINUE WITH OE35A.
OTHERWISE, GO TO OE35.

94

Old Empl/Priv Related Ins (OE) Section
Beta

OE35A

Help Enabled
Variable Name
EPRS.PREMLEVL

Comment Enabled

Jump Back Enabled

Label
HOW MUCH OF PREMIUM PAID BY FAM

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
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 copayments, 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.]
YES, PAY ALL OF PREMIUM/COST
YES, PAY SOME OF PREMIUM/COST

1
2

{OE35AA}
{OE35AA}

YES, BUT DON'T KNOW IF PAY ALL OR
SOME OF PREMIUM/COST
NO, DO NOT PAY

3

{OE35AA}

4

{OE35AAA}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE35}
{OE35}

HELP AVAILABLE FOR DEFINITION OF
PREMIUM/COPAYMENT/COINSURANCE/DEDUCTIBLE.
PROGRAMMER NOTES:
THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE FOR THE
INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND INSURANCE FROM
DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME OF THE SOURCE,
NOT THE NAME OF THE EMPLOYER OR DIRECTLY PURCHASED CATEGORY.

95

Old Empl/Priv Related Ins (OE) Section
Beta

OE35AA

Help Enabled
Variable Name
EPRS.COVRAMT

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID FOR COVERAGE-AMT

Size
12

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
How much (do/does) (POLICYHOLDER) pay for the (ESTABLISHMENT)
coverage?

Amount: $ _______

{OE35AAOV1}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_26A}
{BOX_26A}

PROGRAMMER NOTES:
NOTE: THE ESTABLISHMENT NAME WHICH SHOULD BE DISPLAYED HERE
FOR THE INSURANCE FROM A SELF-EMPLOYED-FIRM-SIZE-1 AND
INSURANCE FROM DIRECTLY PURCHASED SOURCES, SHOULD BE THE NAME
OF THE SOURCE, NOT THE NAME OF THE EMPLOYER OR DIRECTLY
PURCHASED CATEGORY.

96

Old Empl/Priv Related Ins (OE) Section
Beta

OE35AAOV1

Help Enabled
Variable Name
EPRS.COVRUNIT

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID FORCOVERAGE-UNIT

Size
2

Is that per year, per month, per week, or what?
UNIT OF COVERAGE:
PER YEAR

1

{BOX_26A}

QUARTERLY/EVERY 3 MONTHS
BIMONTHLY/EVERY 2 MONTHS

2
3

{BOX_26A}
{BOX_26A}

PER MONTH
PER WEEK

4
5

{BOX_26A}
{BOX_26A}

BIWEEKLY/EVERY 2 WEEKS
SEMI-ANNUALLY/2 TIMES PER YEAR
SEMI-MONTHLY/2 TIMES PER MONTHS

6
7
8

{BOX_26A}
{BOX_26A}
{BOX_26A}

OTHER

91

{OE35AAOV2}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

97

{BOX_26A}
{BOX_26A}

Old Empl/Priv Related Ins (OE) Section
Beta

OE35AAOV2

Help Enabled
Variable Name
EPRS.COVRUNOS

Comment Enabled

Jump Back Enabled

Label
HOW MUCH PAID: COV UNIT OTH SPEC

Size
25

OTHER SPECIFY: _______________________

{BOX_26A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_26A}
{BOX_26A}

BOX_26A
IF OE35A IS CODED ‘1’ (YES, PAY ALL OF PREMIUM/COST), GO TO OE35.
OTHERWISE, CONTINUE WITH OE35AAA.

98

Old Empl/Priv Related Ins (OE) Section
Beta

OE35AAA

Help Enabled

Comment Enabled

Variable Name
EPRS.bw_OE35AAA

Jump Back Enabled

Label

Size

EPRS.BYFED
EPRS.BYSTATE

FEDERAL GOVT PAID FOR PRIV PLAN PREMIUM
STATE GOVT PAID FOR PRIV PLAN PREMIUM

2
2

EPRS.BYLOCAL
EPRS.BYSOMGOV

LOCAL GOVT PAID FOR PRIV PLAN PREMIUM
SOME GOVT PAID FOR PRIV PLAN PREMIUM

2
2

EPRS.BYEMPL

EMPLOYER PAID FOR PRIV PLAN PREMIUM

2

EPRS.BYUNION
EPRS.BYOTHER

UNION PAID FOR PRIV PLAN PREMIUM
OTHER PAID FOR PRIV PLAN PREMIUM

2
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {else} pays {some of/for} the premium or cost of this insurance?
CHECK ALL THAT APPLY.
FEDERAL GOVERNMENT
STATE GOVERNMENT

1
2

LOCAL GOVERNMENT

3

SOME GOVERNMENT
EMPLOYER
UNION
OTHER

4
5
6
91

{OE35AAAOV}

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Refused
Don't Know

RF
DK

{OE35}
{OE35}

DISPLAY INSTRUCTIONS:
DISPLAY ‘else’ IF OE35A IS CODED ‘2’ (YES, PAY SOME OF
PREMIUM/COST) OR ‘3’ (YES, BUT DON'T KNOW IF PAY ALL OR SOME
OF PREMIUM/COST). OTHERWISE, USE A NULL DISPLAY
DISPLAY ‘some of’ IF OE35A IS CODED ‘2’ (YES, PAY SOME OF
PREMIUM/COST) OR ‘3’ (YES, BUT DON'T KNOW IF PAY ALL OR SOME
OF PREMIUM/COST). DISPLAY ‘for’ IF OE35A IS CODED ‘4’ (NO, DO
NOT PAY).

99

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PROGRAMMER NOTES:
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW 'RF' OR
'DK' IN COMBINATION WITH ANY OTHER CODE.
ROUTING INSTRUCTION:
IF CODED ‘91’ (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER
CODE, CONTINUE WITH OE35AAAOV
OTHERWISE, GO TO OE35

OE35AAAOV

Help Enabled
Variable Name
EPRS.BYOTHOS

Comment Enabled

Jump Back Enabled

Label
OTHER SPECIFY OF WHO PAID PRIV PLAN PREM

Size
25

OTHER SPECIFY: _______________________
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

100

Old Empl/Priv Related Ins (OE) Section
Beta

OE35

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.NAMECHNG

Label
HAS THERE BEEN A CHANGE IN PLAN NAME

EPRS.HOSPINS
EPRS.DENTLINS

TYPE OF HI GOTTEN: HOSPITAL/HMO
TYPE OF HI GOTTEN: DENTAL

2
2

EPRS.PMEDINS
EPRS.VISIONIN

TYPE OF HI GOTTEN: PRESCRIPTION DRUG
TYPE OF HI GOTTEN: VISION

2
2

EPRS.MSUPINS

TYPE OF HI GOTTEN: MEDIGAP

2

EPRS.LTCINS
EPRS.CASHINS

TYPE OF HI GOTTEN: LTC-NURSING HOME
TYPE OF HI GOTTEN: EXTRA CASH

2
2

EPRS.DREADINS

TYPE OF HI GOTTEN: DREAD DISEASE

2

EPRS.DISABINS
EPRS.WCOMPINS

TYPE OF HI GOTTEN: DISABILITY
TYPE OF HI GOTTEN: WORKER'S COMP

2
2

EPRS.ACCDINS
EPRS.OTHINS

TYPE OF HI GOTTEN: ACCIDENT
TYPE OF HI GOTTEN: OTHER

2
2

EPRS.OTHINSOS

TYPE OF HI GOTTEN: OTH SPECIFY

25

EPRS.MCAREHMO
EPRS.MCARELET

MEDICARE: PERSON SIGNED WITH HMO
PLAN LETTER OF MEDICARE INSURANCE

2
4

EPRS.MCARELST

MEDICARE INSUR LISTED ON THIS CARD

2

EPRS.MCARENAM
EPRS.PROGDR

NAME OF MEDICARE HMO
PRIV PLAN REQUIRES SIGNING W/PHYS,GROUP

25
2

EPIN.EPINID
EPIN.EPINRURN

EPIN ID KEY: EPRSID + COUNTER(2)
ROUND STAMP: RU LETTER + ROUND NUMBER

22
2

EPIN.CREATEQ

CREATION STAMP

2

EPIN.DRLIST
EPIN.HMOPLAN

DOES PLAN HAVE A BOOK/LIST OF DOCTORS?
IS POLICYHOLDERS PLAN AN HMO PLAN?

2
2

EPIN.INSNAME

HX41/43/46 NAME OF INSURANCE CO OR HMO

25

EPIN.INSTYPE
EPIN.MAJORMED

HX41/43/46 TYPE OF INSURER
FLAG EPIN AS PROVIDING MAJOR MEDICAL COV

2
2

EPIN.MSUPFLG
EPIN.OTHNAME

FLAG-PROVIDE MEDICARE SUPPLEMENT/MEDIGAP
HX42/44/47 ANOTHER NAME FOR POLICY

2
2

EPIN.OTHNAMOS

HX42/44/47 OTH NAME FOR INSURANCE POLICY

25

EPIN.PROGDR
EPIN.VISITPAY

PRIV PLAN REQUIRES SIGNING W/PHYS,GROUP
PLAN PAY FOR NON-HMO, NON-REFER DR VISIT

2
2

HOME.PLANFLAG

RU PLAN FLAG-HOSP/PHYS INSR + HMO STATUS

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

101

{NAME OF

Size
2

Old Empl/Priv Related Ins (OE) Section
Beta

{Last time we recorded that (POLICYHOLDER) (were/was) covered by (READ
INSURER NAME BELOW).}
{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) {has/had} through (ESTABLISHMENT)?
{INSURER OF ESTAB-PERS-INSURER TRIPLE ON PREV RD INT DT}

YES

1

NO

2

{END_LP09}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP09}
{END_LP09}

DISPLAY INSTRUCTIONS:
DISPLAY FIRST PARAGRAPH AND THE ROSTER OF INSURER NAMES IF THE
INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR HAD ANY
INSURERS FLAGGED AS PROVIDING MEDIGAP OR HOSPITAL/PHYSICIAN
BENEFITS AT ANY TIME DURING THE PREVIOUS ROUND.
DISPLAY ‘Since (START DATE), has there been’ AND 'has' IF NOT
ROUND 5. DISPLAY 'Between (START DATE) and (END DATE), was
there' AND 'had' IF ROUND 5.
PROGRAMMER NOTES:
IF CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), FLAG
PREVIOUS ROUND’S INSURER AS CURRENT ROUND’S INSURER FOR THIS
ESTABLISHMENT-PERSON-PAIR.
ROUTING INSTRUCTION:
IF CODED ‘1’ (YES) AND ESTABLISHMENT IS FLAGGED AS AN
INSURANCE CO. OR HMO, CONTINUE WITH OE36
OTHERWISE (I.E., IF CODED ‘1’ (YES) AND ESTABLISHMENT IS NOT
FLAGGED AS AN INSURANCE CO. OR HMO), GO TO OE37

Roster Details
Title:

RU_ESTB_PERS_INSURER_TRPLS_1

Col #

Header

Instructions

PREV RND INSURER
WITH MEDIGAP OR
HOSP/PHYS

Display establishment name
ESTB.ESTBNAME

1

102

Old Empl/Priv Related Ins (OE) Section
Beta
Roster Definition:
This item displays insurers in the RU-ESTB-PERSON-INSURERTRPLS-ROSTER for display.
Roster Behavior:
1. Select, add, delete, and edit disallowed.
Roster Filter:
1. Flagged as ‘SUPPLYING HOSPITAL AND PHYSICIAN BENEFITS’
and/or ‘SUPPLYING MEDICARE SUPPLEMENT/MEDIGAP
BENEFITS’ and
2. Are associated with the insurance through this
Establishment-Person-Pair.

103

Old Empl/Priv Related Ins (OE) Section
Beta

OE36

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPRS.NEWPNAM

Label
NEW PLAN NAME/ESTABLISHMENT NAME

ESTB.ESTBNAME
TRNS.TRNSID

NAME OF EMPLOYER OR BUSINESS
TRNS ID KEY: RUNTID + TRANSACTION NUMBER

30
12

TRNS.TRNSRURN
TRNS.TRNSDATE

ROUND STAMP: RU LETTER + ROUND NUMBER
TRANSACTION DATE

2
8

TRNS.TRNSKEY

KEY OF RECORD BEING UPDATED

40

TRNS.TRNSSEG
TRNS.TRNSVAR

SEGMENT NAME OF RECORD BEING UPDATED
NAME OF VARIABLE BEING UPDATED

4
8

TRNS.WHOTRNS

ID OF INTERVIEWER INITIATING TRANSACTION

4

TRNS.OLDTRNS
TRNS.NEWTRNS

OLD VALUE OF VARIABLE BEING UPDATED
NEW VALUE OF VARIABLE BEING UPDATED

45
45

{POLICYHOLDER’S FIRST MIDDLE LAST NAME}
ESTABLISHMENT} {STR-DT} {END-DT}

Size
30

{NAME OF

What is the new plan name of (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT)?
PLAN NAME: _______________________

{OE37}

PROGRAMMER NOTES:
WRITE ESTABLISHMENT NAME CORRECTION TO THE RU-ESTABLISHMENTPERSONS-PAIRS-ROSTER. THIS IS THE CORRECTED ESTABLISHMENT
NAME.
FLAG INSURER ENTERED ABOVE AS CURRENT ROUND’S INSURER FOR THIS
POLICYHOLDER-ESTABLISHMENT PAIR.
IF A SOURCE OF INSURANCE WAS DIRECTLY PURCHASED FROM AN HMO OR
INSURANCE COMPANY, THE ESTABLISHMENT NAME IS THE SAME AS THE
INSURER NAME. THEREFORE, ANY CHANGE IN PLAN NAME
AUTOMATICALLY DICTATES A CHANGE IN THE ESTABLISHMENT NAME.

104

Old Empl/Priv Related Ins (OE) Section
Beta

OE37

Help Enabled (TYPEINS)

Comment Enabled

Variable Name
EPRS.OE37BLSWVS

Jump Back Enabled

Label

Size

EPRS.HOSPINS
EPRS.DENTLINS

TYPE OF HI GOTTEN: HOSPITAL/HMO
TYPE OF HI GOTTEN: DENTAL

2
2

EPRS.PMEDINS
EPRS.VISIONIN

TYPE OF HI GOTTEN: PRESCRIPTION DRUG
TYPE OF HI GOTTEN: VISION

2
2

EPRS.MSUPINS

TYPE OF HI GOTTEN: MEDIGAP

2

EPRS.LTCINS
EPRS.CASHINS

TYPE OF HI GOTTEN: LTC-NURSING HOME
TYPE OF HI GOTTEN: EXTRA CASH

2
2

EPRS.DREADINS

TYPE OF HI GOTTEN: DREAD DISEASE

2

EPRS.DISABINS
EPRS.WCOMPINS

TYPE OF HI GOTTEN: DISABILITY
TYPE OF HI GOTTEN: WORKER'S COMP

2
2

EPRS.ACCDINS
EPRS.OTHINS

TYPE OF HI GOTTEN: ACCIDENT
TYPE OF HI GOTTEN: OTHER

2
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
SHOW CARD OE-1.
What type of health insurance {(do/does)/did} (POLICYHOLDER) {now} have
through (ESTABLISHMENT)'s new plan {on (END DATE)}?
CHECK ALL THAT APPLY.
HOSPITAL AND PHYSICIAN BENEFITS,
INCLUDING COVERAGE THROUGH AN
HMO

1

DENTAL
PRESCRIPTION DRUGS

2
3

VISION
MEDICARE SUPPLEMENT/MEDIGAP

4
5

LONG TERM CARE IN A NURSING HOME 6
EXTRA CASH FOR HOSPITAL STAYS
7
SERIOUS DISEASE OR DREAD DISEASE 8
DISABILITY
WORKER'S COMPENSATION

9
10

ACCIDENT

11

OTHER

91
105

{OE37OV}

Old Empl/Priv Related Ins (OE) Section
Beta
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_26}
{BOX_26}

HELP AVAILABLE FOR DEFINITION OF ANSWER CATEGORIES.
[NOTE: 'DISABILITY', 'WORKER'S COMPENSATION', AND 'ACCIDENT'
WILL NOT APPEAR ON THE SHOW CARD.]
DISPLAY INSTRUCTIONS:
DISPLAY ‘(do/does)’ IF NOT ROUND 5.
DISPLAY ‘now’ IF NOT ROUND 5.

DISPLAY ‘did’

IF ROUND 5.

OTHERWISE, USE A NULL DISPLAY.

DISPLAY ‘on (END DATE)’ IF ROUND 5.
DISPLAY.

OTHERWISE, USE A NULL

PROGRAMMER NOTES:
FOR SPECIFICATIONS PURPOSES ONLY: CAPI DOES NOT ALLOW 'RF' OR
'DK' IN COMBINATION WITH ANY OTHER CODE.
ROUTING INSTRUCTION:
IF CODED '91' (OTHER), ALONE OR IN COMBINATION WITH ANY OTHER
CODES, CONTINUE WITH OE37OV.
OTHERWISE, GO TO BOX_26.

106

Old Empl/Priv Related Ins (OE) Section
Beta

OE37OV

Help Enabled
Variable Name
EPRS.OTHINSOS

Comment Enabled

Jump Back Enabled

Label

Size
25

TYPE OF HI GOTTEN: OTH SPECIFY

OTHER SPECIFY: _______________________

{BOX_26}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_26}
{BOX_26}

BOX_26
IF OE37 IS CODED '1' (HOSPITAL AND PHYSICIAN BENEFITS) OR '5' (MEDICARE
SUPPLEMENT/MEDIGAP), ALONE OR WITH ANY OTHER COMBINATION OF CODES,
CONTINUE WITH BOX_27.
OTHERWISE, GO TO END_LP09.

BOX_27
IF ESTABLISHMENT ALREADY FLAGGED AS 'INSURANCE CO.' OR 'HMO',
AUTOMATICALLY CODE OE38 WITH APPROPRIATE RESPONSES AND GO TO LOOP_12
OTHERWISE, CONTINUE WITH OE38

107

Old Empl/Priv Related Ins (OE) Section
Beta

OE38

Help Enabled (INSHMO)

Comment Enabled

Jump Back Enabled

Variable Name
EPIN.EPINID

EPIN ID KEY: EPRSID + COUNTER(2)

Label

Size
22

EPIN.EPINRURN
EPIN.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPIN.INSNAME
EPIN.INSTYPE

HX41/43/46 NAME OF INSURANCE CO OR HMO
HX41/43/46 TYPE OF INSURER

25
2

EPIN.MAJORMED

FLAG EPIN AS PROVIDING MAJOR MEDICAL COV

2

EPIN.MSUPFLG

FLAG-PROVIDE MEDICARE SUPPLEMENT/MEDIGAP

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
What is the new plan name for (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT) which provides the {hospital and physician
benefits/Medicare supplement or Medigap benefits}?
IF MORE THAN ONE NAME, PROBE: What is the main new plan name?
RECORD THE NAME OF THE MAIN INSURER THAT PROVIDES THE
{HOSPITAL AND PHYSICIAN/MEDIGAP} BENEFITS FOR THIS PAIR.
IF RESPONDENT SAYS BOTH INSURANCE COMPANY AND HMO,
SELECT 'HMO'.
NAME OF INSURER:
----------------------------------------------TYPE:
INSURANCE COMPANY

1

{LOOP_12}

HMO

2

{LOOP_12}

COMPANY IS SELF-INSURED

3

{LOOP_12}

HELP AVAILABLE FOR DEFINITION OF INSURANCE CO/HMO/SELFINSURED CO.
DISPLAY INSTRUCTIONS:
DISPLAY 'hospital and physician benefits' IF OE37 IS CODED ‘1’
(HOSPITAL AND PHYSICIAN BENEFITS), BUT NOT CODED ‘5’ (MEDICARE
SUPPLEMENT/MEDIGAP). DISPLAY 'Medicare supplement or Medigap
benefits' AND 'MEDIGAP' IF OE37 IS CODED ‘5’ (MEDICARE
SUPPLEMENT/MEDIGAP).

108

Old Empl/Priv Related Ins (OE) Section
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PROGRAMMER NOTES:
WRITE INSURER(S) TO THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER
FOR THE INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR.
FLAG INSURER(S) COLLECTED AT OE38 AS CURRENT ROUND’S
INSURER(S) FOR THIS ESTABLISHMENT-PERSON-PAIR.
IF OE37 IS CODED ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP) FLAG
INSURANCE CO./HMO AS 'SUPPLYING MEDICARE SUPPLEMENT/MEDIGAP
BENEFITS (WHICH INCLUDES HOSPITAL/PHYSICIAN BENEFITS)’ FOR THE
CURRENT ROUND.
IF OE37 IS CODED ‘1’ (HOSPITAL AND PHYSICIAN BENEFITS), BUT
NOT ‘5’ (MEDICARE SUPPLEMENT/MEDIGAP), FLAG INSURANCE CO./HMO
AS 'SUPPLYING HOSPITAL/PHYSICIAN BENEFITS' FOR THE CURRENT
ROUND.

LOOP_12
FOR EACH ELEMENT ON THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER, ASK
OE38A - END_LP12.
LOOP DEFINITION: LOOP_12 COLLECTS OTHER POLICY NAMES AND MANAGED CARE
INFORMATION FOR INSURERS COLLECTED AT OE38. THIS LOOP CYCLES ON TRIPLES
THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT-PERSON-PAIR PROVIDES THE INSURANCE BEING ASKED ABOUT
- INSURER IS ENTERED AT OE38

109

Old Empl/Priv Related Ins (OE) Section
Beta

OE38A

Help Enabled
Variable Name
EPIN.OTHNAME

Comment Enabled

Jump Back Enabled

Label
HX42/44/47 ANOTHER NAME FOR POLICY

Size
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Is there any other name for the {INSURANCE COMPANY OR HMO NAME}
policy, such as Option A, $100 Deductible, 90/80 Plan, Gold, or High Option?
YES, ANOTHER NAME
NO OTHER NAME

1
2

{OE38AOV}
{BOX_28A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_28A}
{BOX_28A}

HELP AVAILABLE FOR DEFINITION OF LOW OPTION/HIGH OPTION.
DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE INSURANCE CO/HMO RECORDED IN OE38
WHICH IS BEING LOOPED ON FOR ‘INSURANCE.... NAME’

110

Old Empl/Priv Related Ins (OE) Section
Beta

OE38AOV

Help Enabled
Variable Name
EPIN.OTHNAMOS

Comment Enabled

Jump Back Enabled

Label
HX42/44/47 OTH NAME FOR INSURANCE POLICY

Size
25

OTHER NAME: _______________________

{BOX_28A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_28A}
{BOX_28A}

HELP AVAILABLE FOR DEFINITION OF ANSWER CATEGORIES.

BOX_28A
IF INSURER BEING LOOPED ON IS CODED '2' (HMO) IN OE38, CONTINUE WITH OE38B.
OTHERWISE, CONTINUE WITH BOX_28.

111

Old Empl/Priv Related Ins (OE) Section
Beta

OE38B

Help Enabled
Variable Name
EPIN.VISITPAY

Comment Enabled

Jump Back Enabled

Label
PLAN PAY FOR NON-HMO, NON-REFER DR VISIT

Size
2

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
INSURER NAME: {NAME OF INSURER BEING LOOPED ON}
Will (POLICYHOLDER)’s plan pay for any of the costs of visits to doctors who
are not part of (POLICYHOLDER)’s HMO, even if (POLICYHOLDER)
(do/does) not have a referral?
YES
NO

1
2

{END_LP12}
{END_LP12}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP12}
{END_LP12}

BOX_28
ASK THE MANAGED CARE (MC) SECTION FOR THIS INSURER.
AT COMPLETION OF MANAGED CARE (MC) SECTION, CONTINUE WITH END_LP12.

END_LP12
CYCLE ON NEXT INSURER IN THE RU-ESTAB-PERSON-INSURER-TRIPLES-ROSTER THAT
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER INSURERS MEET THE STATED CONDITIONS, END LOOP_12 AND CONTINUE
WITH END_LP09.

112

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END_LP09
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEETS
THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_09 AND CONTINUE
WITH BOX_29.

BOX_29
IN ROUND 1 RETURN TO ORIGINAL QUESTIONNAIRE SECTION IN HX.
IF ONE OR MORE RU MEMBERS WAS COVERED PERSON BY AN ESTABLISHMENT-PERSONPAIR ON THE PREVIOUS ROUND'S INTERVIEW DATE WHERE THE ESTABLISHMENT IS A
PRIVATE SOURCE OF INSURANCE AND THE POLICYHOLDER IS FLAGGED AS
'POLICYHOLDER/DEPENDENT IN DIFFERENT RUS' AT THE CURRENT ROUND'S INTERVIEW
DATE, CONTINUE WITH LOOP_13.
OTHERWISE, GO TO BOX_33.
NOTE: WHEN A POLICYHOLDER LEAVES AN RU, WE WILL NEVER ASK RJ AND THAT
POLICYHOLDER WILL NEVER QUALIFY FOR LOOPS 01, 05, OR 09. WE CREATED A NEW
LOOP, LOOP_13 THAT WILL HANDLE THE SITUATIONS WHERE THE POLICYHOLDER HAS
LEFT THE RU AND LEFT DEPENDENTS BEHIND, OR THE SITUATION WHERE THE
DEPENDENTS HAVE LEFT THE RU (WITHOUT THE POLICYHOLDER). THIS SITUATION
WILL BE FLAGGED AS 'POLICYHOLDER/DEPENDENT IN DIFFERENT RUS'. THIS FLAG
CAN BE ASSOCIATED WITH ANY ESTABLISHMENT-PERSON-PAIR IN A PARTICULAR RU
WHERE THEY ARE COVERED PERSONS, BUT THE POLICYHOLDER IS IN ANOTHER RU.
THIS FLAG SHOULD NEVER EXIST ON A PAIR IN AN RU WHERE THE POLICYHOLDER OF
THE PAIR IS IN THE SAME RU AS ALL OF THE DEPENDENTS OR WHERE THE
POLICYHOLDER OF THE PAIR WAS ORIGINALLY CREATED AS 'POLICYHOLDER NOT IN
RU/DU' OR 'POLICYHOLDER DECEASED'.

LOOP_13
FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER, ASK OE39 END_LP13.
LOOP DEFINITION:
LOOP_13 COLLECTS INFORMATION ABOUT THE CONTINUATION OF INSURANCE COVERAGE
THROUGH AN ESTABLISHMENT-PERSON-PAIR WHERE THE POLICYHOLDER OR THE
ELIGIBLE DEPENDENT(S) HAVE MOVED FROM THE RU. THIS LOOP CYCLES ON
ESTABLISHMENT-PERSON-PAIRS THAT MEET THE FOLLOWING CONDITIONS:
- THE ESTABLISHMENT IS A PRIVATE SOURCE OF INSURANCE
- THE ESTABLISHMENT-PERSON-PAIR IS FLAGGED AS ‘POLICYHOLDER/DEPENDENT
MOVED’ AT THE CURRENT ROUND’S INTERVIEW DATE FOR THIS RU
- AT LEAST ONE RU MEMBER WAS A COVERED PERSON FOR THIS
ESTABLISHMENT-PERSON-PAIR ON THE PREVIOUS ROUND’S INTERVIEW DATE
- POLICYHOLDER IS NOT A CURRENT RU MEMBER

113

Old Empl/Priv Related Ins (OE) Section
Beta

OE39

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
HOME.REVWCOVR

Label
REVIEW STATUS OF NON RU PLCYHOLDER HI

Size
2

TRNS.TRNSID
TRNS.TRNSRURN

TRNS ID KEY: RUNTID + TRANSACTION NUMBER
ROUND STAMP: RU LETTER + ROUND NUMBER

12
2

TRNS.TRNSDATE
TRNS.TRNSKEY

TRANSACTION DATE
KEY OF RECORD BEING UPDATED

8
40

TRNS.TRNSSEG

SEGMENT NAME OF RECORD BEING UPDATED

4

TRNS.TRNSVAR
TRNS.WHOTRNS

NAME OF VARIABLE BEING UPDATED
ID OF INTERVIEWER INITIATING TRANSACTION

8
4

TRNS.OLDTRNS

OLD VALUE OF VARIABLE BEING UPDATED

45

TRNS.NEWTRNS

NEW VALUE OF VARIABLE BEING UPDATED

45

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
During the last interview, we recorded that someone in the family was covered
by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {Is/was}
anyone in the family, living here {now,} covered by (POLICYHOLDER)'s health
insurance through (ESTABLISHMENT) as of {today,} (END DATE)?
IF RESPONDENT VOLUNTEERS THAT THIS INSURANCE HAS ALREADY
BEEN DISCUSSED, SELECT 'INSURANCE ALREADY DISCUSSED.'
YES

1

{OE41}

NO
INSURANCE ALREADY DISCUSSED

2
3

{OE40}
{END_LP13}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know
DISPLAY INSTRUCTIONS:
DISPLAY ‘Is’ IF NOT ROUND 5.

RF
DK

{END_LP13}
{END_LP13}

DISPLAY ‘Was’ IF ROUND 5.

DISPLAY ‘today,’ AND ‘ now’ IF NOT ROUND 5.
NULL DISPLAY.

OTHERWISE, USE A

PROGRAMMER NOTES:
IF CODED ‘3’ (INSURANCE ALREADY DISCUSSED), FLAG ITEM FOR
SOURCE CLEAN-UP.

114

Old Empl/Priv Related Ins (OE) Section
Beta

115

Old Empl/Priv Related Ins (OE) Section
Beta

OE40

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
HOME.PLCYMM

Label
NON RU MEMBER PLCYHOLDER HI END-MONTH

Size
2

HOME.PLCYDD
HOME.PLCYYY

NON RU MEMBER PLCYHOLDER HI END-DAY
NON RU MEMBER PLCYHOLDER HI END-YEAR

2
4

TRNS.TRNSID
TRNS.TRNSRURN

TRNS ID KEY: RUNTID + TRANSACTION NUMBER
ROUND STAMP: RU LETTER + ROUND NUMBER

12
2

TRNS.TRNSDATE

TRANSACTION DATE

8

TRNS.TRNSKEY
TRNS.TRNSSEG

KEY OF RECORD BEING UPDATED
SEGMENT NAME OF RECORD BEING UPDATED

40
4

TRNS.TRNSVAR

NAME OF VARIABLE BEING UPDATED

8

TRNS.WHOTRNS
TRNS.OLDTRNS

ID OF INTERVIEWER INITIATING TRANSACTION
OLD VALUE OF VARIABLE BEING UPDATED

4
45

TRNS.NEWTRNS

NEW VALUE OF VARIABLE BEING UPDATED

45

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
On what date did this health insurance through (ESTABLISHMENT) end?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE40OV.
IF ONLY ONE PERSON COVERED AT THE END OF PREVIOUS ROUND, GO TO
LOOP_14.
OTHERWISE, CONTINUE WITH OE41.

Hard CHECK:
FOR ROUND 5 ONLY: COMPLETE DATE ENTERED CANNOT BE AFTER 12/31/{YEAR}, WHERE
'YEAR' IS THE SECOND CALENDAR YEAR OF THE PANEL. IF A DATE AFTER
12/31/{YEAR} IS ENTERED, DISPLAY THE FOLLOWING MESSAGE: 'DATE CANNOT BE
AFTER 12/31/{YEAR}. IF INSURANCE ENDED AFTER 12/31/{YEAR}, JUMPBACK AND
CHANGE RESPONSE TO OE39.
116

Old Empl/Priv Related Ins (OE) Section
Beta

OE40OV

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
HOME.PLCYWHOL

Label
NON RU MEMBER PLCYHOLDER HI LAST MONTH

Size
2

TRNS.TRNSID
TRNS.TRNSRURN

TRNS ID KEY: RUNTID + TRANSACTION NUMBER
ROUND STAMP: RU LETTER + ROUND NUMBER

12
2

TRNS.TRNSDATE
TRNS.TRNSKEY

TRANSACTION DATE
KEY OF RECORD BEING UPDATED

8
40

TRNS.TRNSSEG

SEGMENT NAME OF RECORD BEING UPDATED

4

TRNS.TRNSVAR
TRNS.WHOTRNS

NAME OF VARIABLE BEING UPDATED
ID OF INTERVIEWER INITIATING TRANSACTION

8
4

TRNS.OLDTRNS

OLD VALUE OF VARIABLE BEING UPDATED

45

TRNS.NEWTRNS

NEW VALUE OF VARIABLE BEING UPDATED

45

Can you just tell me if (POLICYHOLDER) was covered under that insurance
the whole month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

ROUTING INSTRUCTION:
IF ONLY ONE PERSON COVERED AT THE END OF PREVIOUS ROUND, GO TO
LOOP_14
OTHERWISE, CONTINUE WITH OE41

117

Old Empl/Priv Related Ins (OE) Section
Beta

OE41

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
HOME.PLCYALL

Label
ALL STILL COVERED BY NON RU PLCYHOLDER

Size
2

TRNS.TRNSID
TRNS.TRNSRURN

TRNS ID KEY: RUNTID + TRANSACTION NUMBER
ROUND STAMP: RU LETTER + ROUND NUMBER

12
2

TRNS.TRNSDATE
TRNS.TRNSKEY

TRANSACTION DATE
KEY OF RECORD BEING UPDATED

8
40

TRNS.TRNSSEG

SEGMENT NAME OF RECORD BEING UPDATED

4

TRNS.TRNSVAR
TRNS.WHOTRNS

NAME OF VARIABLE BEING UPDATED
ID OF INTERVIEWER INITIATING TRANSACTION

8
4

TRNS.OLDTRNS

OLD VALUE OF VARIABLE BEING UPDATED

45

TRNS.NEWTRNS
EPCP.EPCPID

NEW VALUE OF VARIABLE BEING UPDATED
EPCP ID KEY: EPRSID + PERSID

45
28

EPCP.EPCPRURN
EPCP.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
During the last interview, we recorded that (READ NAMES BELOW)
(were/was) covered by (POLICYHOLDER)’s health insurance through
(ESTABLISHMENT).
{Are/Were} they all covered by this health insurance {until {{OE40 DATE}/it
ended}/on (END-DT)}?
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
{PERSON WITH ESTAB-PERS-PAIR INSURANCE ON PREV RD INTV DT}
YES
NO

1
2

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

118

Old Empl/Priv Related Ins (OE) Section
Beta
DISPLAY INSTRUCTIONS:
DISPLAY 'Are' IF OE39 IS CODED ‘1’ (YES).
DISPLAY 'Were' IF OE39 IS CODED ‘2’ (NO) OR IF CURRENT ROUND
IS ROUND 5.
DISPLAY 'until {OE40 DATE}' IF OE39 IS CODED ‘2’ (NO).
DISPLAY 'on (END-DT)' IF OE39 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE40 FOR ‘OE40 DATE’. IF THE
MONTH AND DAY FIELD AT OE40 IS CODED ‘RF’ (REFUSED) OR ‘DK’
(DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE40 DATE’.
PROGRAMMER NOTES:
IF OE39 IS CODED '1' (YES) AND OE41 IS CODED '1' (YES),
FLAG INSURANCE FOR ALL COVERED PERSONS AS 'CONTINUOUS
COVERAGE' THROUGH THE REFERENCE PERIOD END DATE.
IF OE39 IS CODED '2' (NO) AND OE41 IS CODED '1' (YES),
FLAG INSURANCE FOR ALL COVERED PERSONS AS 'CONTINUOUS
COVERAGE' THROUGH THE DATE RECORDED AT OE40..
ROUTING INSTRUCTION:
IF OE41 IS CODED '1' (YES) AND OE39 IS CODED '1' (YES) OR '2'
(NO),
GO TO BOX_31.
OTHERWISE (I.E., OE41 CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’
(DON'T KNOW)), CONTINUE WITH OE42.

Roster Details
Title:

RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1

Col #

Header

Instructions

NAME

Display covered persons’ names
PERS.FULLNAME

1

Roster Definition:
This item displays persons on the RU-ESTB-PLCYHLDR-CVRD-PERSTRPLS-ROSTER for display.
Roster Behavior:
1. Select, add, delete, and edit disallowed.
Roster Filter:
1. Person was covered at the previous round’s interview date
by the insurance from this ESTABLISHMENT-PERSON-PAIR
and
2. Person is an RU member.

119

Old Empl/Priv Related Ins (OE) Section
Beta

OE42

Help Enabled

Comment Enabled

Variable Name
EPCP.bw_OE42

Jump Back Enabled

Label

Size

EPCP.EPCPID
EPCP.EPCPRURN

EPCP ID KEY: EPRSID + PERSID
ROUND STAMP: RU LETTER + ROUND NUMBER

28
2

EPCP.CREATEQ
EPCP.COVRSTOP

CREATION STAMP
PERSON IS NO LONGER COVERD THRU END DATE

2
2

EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {is/was} no longer covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {until {{OE40 DATE}/it ended}/on (END-DT)}?
[First name, [Middle Name], Last Name]
[First name, [Middle Name], Last Name]
[First name, [Middle Name], Last Name]
DISPLAY INSTRUCTIONS:
DISPLAY 'is' IF OE39 IS CODED ‘1’ (YES).
DISPLAY 'was' IF OE39 IS CODED ‘2’ (NO) OR IF CURRENT ROUND IS
ROUND 5.
DISPLAY 'until {OE40 DATE}' IF OE39 IS CODED ‘2’ (NO).
DISPLAY 'on (END-DT)' IF OE39 IS CODED ‘1’ (YES).
DISPLAY THE DATE RECORDED AT OE40 FOR ‘OE40 DATE’.
IF THE MONTH AND DAY FIELD AT OE40 IS CODED ‘RF’ (REFUSED) OR
‘DK’ (DON’T KNOW), DISPLAY ‘it ended’ FOR ‘OE40 DATE’.

120

Old Empl/Priv Related Ins (OE) Section
Beta
PROGRAMMER NOTES:
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR (OE39 IS CODED '1' (YES)), FLAG INSURANCE FOR ALL
PERSONS NOT SELECTED AT OE42 AS CONTINUOUS COVERAGE FROM THE
REFERENCE PERIOD START DATE UNTIL THE REFERENCE PERIOD END
DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR (OE39 IS CODED '2' (NO), FLAG
INSURANCE FOR ALL PERSONS NOT SELECTED AT OE42 AS 'CONTINUOUS
COVERAGE' FROM THE REFERENCE PERIOD START DATE UNTIL DATE
RECORDED AT OE40.

Roster Details
Title:

RU_ESTB_PLCYHLDR_COVRD_PERS_TRPLS_1

Col #

Header

Instructions

NAME

Display covered persons’ names
PERS.FULLNAME

1

Roster Definition:
This item displays the RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLSROSTER for selection.
Roster Behavior:
1. Multiple select allowed.
2. Add, delete, and edit disallowed.
Roster Filter:
1. Person was covered at the previous round’s interview
date by the insurance from this Establishment-Person-Pair,
and
2. Person is an RU member

LOOP_14
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE43 - END_LP14.
LOOP DEFINITION: LOOP_14 COLLECTS THE DATE ON WHICH THE INSURANCE
COVERAGE THROUGH THIS ESTABLISHMENT-PERSON-PAIR ENDED FOR EACH RU MEMBER
WHOSE COVERAGE ENDED EITHER PRIOR TO THE REFERENCE PERIOD END DATE OR THE
DATE REPORTED IN OE40. THIS LOOP CYCLES ON PERSONS SELECTED AT OE42.

121

Old Empl/Priv Related Ins (OE) Section
Beta

OE43

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPCP.COVREMM

MONTH HEALTH INSURANCE ENDED

Label

Size
2

EPCP.COVREDD
EPCP.COVREYY

DAY HEALTH INSURANCE ENDED
YEAR HEALTH INSURANCE ENDED

2
4

EPCP.ENDMONTH

END COVERAGE: COVER WHOLE/PART OF MONTH

2

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
On what date did the health insurance through (ESTABLISHMENT) end for
(PERSON)?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE43OV.
OTHERWISE, GO TO BOX_30.

122

Old Empl/Priv Related Ins (OE) Section
Beta

OE43OV

Help Enabled
Variable Name
EPCP.ENDMONTH

Comment Enabled

Jump Back Enabled

Label
END COVERAGE: COVER WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF MONTH

1
2

{BOX_30}
{BOX_30}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_30}
{BOX_30}

BOX_30
FLAG INSURANCE FOR PERSON AS 'CONTINUOUS COVERAGE' THROUGH THE COMPLETE
DATE RECORDED AT OE43 AND OE43OV.

END_LP14
CYCLE ON NEXT PERSON IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO
MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_14 AND CONTINUE
WITH BOX_31.

BOX_31
IF AT LEAST ONE CURRENT RU MEMBER NOT COVERED BY THE INSURANCE FROM THIS
ESTABLISHMENT-PERSON-PAIR, (THIS INCLUDES ALL NEW RU MEMBERS AND PREVIOUS
RU MEMBERS NOT COVERED BY THIS INSURANCE ON THE PREVIOUS ROUND’S INTERVIEW
DATE, BUT EXCLUDES RU MEMBERS JUST MARKED AS NO LONGER COVERED IN OE42),
CONTINUE WITH OE44.
OTHERWISE, GO TO OE47.

123

Old Empl/Priv Related Ins (OE) Section
Beta

OE44

Help Enabled (DEPENDENT)

Comment Enabled

Jump Back Enabled

Variable Name
HOME.PLCYMORE

Label
OTHERS COVERED BY NON RU PLCYHOLDER

Size
2

TRNS.TRNSID
TRNS.TRNSRURN

TRNS ID KEY: RUNTID + TRANSACTION NUMBER
ROUND STAMP: RU LETTER + ROUND NUMBER

12
2

TRNS.TRNSDATE
TRNS.TRNSKEY

TRANSACTION DATE
KEY OF RECORD BEING UPDATED

8
40

TRNS.TRNSSEG

SEGMENT NAME OF RECORD BEING UPDATED

4

TRNS.TRNSVAR
TRNS.WHOTRNS

NAME OF VARIABLE BEING UPDATED
ID OF INTERVIEWER INITIATING TRANSACTION

8
4

TRNS.OLDTRNS

OLD VALUE OF VARIABLE BEING UPDATED

45

TRNS.NEWTRNS

NEW VALUE OF VARIABLE BEING UPDATED

45

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, have any
persons living here, we have not yet mentioned, been covered by
(POLICYHOLDER)’s health insurance through (ESTABLISHMENT)?
YES
NO

1
2

{OE45}
{OE47}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{OE47}
{OE47}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT.
DISPLAY INSTRUCTIONS:
DISPLAY ‘Since (START DATE)’ IF NOT ROUND 5.
DISPLAY ‘Between (START DATE) and (END DATE)’ IF ROUND 5.

124

Old Empl/Priv Related Ins (OE) Section
Beta

OE45

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EPCP.EPCPID

EPCP ID KEY: EPRSID + PERSID

Label

Size
28

EPCP.EPCPRURN
EPCP.CREATEQ

ROUND STAMP: RU LETTER + ROUND NUMBER
CREATION STAMP

2
2

EPCP.COVRSTOP
EPCP.COVREMM

PERSON IS NO LONGER COVERD THRU END DATE
MONTH HEALTH INSURANCE ENDED

2
2

EPCP.COVREDD

DAY HEALTH INSURANCE ENDED

2

EPCP.COVREYY
EPCP.ENDMONTH

YEAR HEALTH INSURANCE ENDED
END COVERAGE: COVER WHOLE/PART OF MONTH

4
2

{POLICYHOLDER’S FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT} {STR-DT} {END-DT}
Who {has been/was} been covered by (POLICYHOLDER)’s health insurance
through (ESTABLISHMENT) {since (START DATE)/between (START DATE)
and (END DATE)} that we have not yet mentioned?
PROBE: Who else {has been/was} covered by (POLICYHOLDER)’s health
insurance through (ESTABLISHMENT) {since (START DATE)/between
(START DATE) and (END DATE)} that we have not yet mentioned?
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
[First Name, [Middle Name], Last Name]
DISPLAY INSTRUCTIONS:
DISPLAY ‘has been’ AND ‘since (START DATE)’ IF NOT ROUND 5.
DISPLAY ‘was’ AND ‘between (START DATE) and (END DATE)' IF
ROUND 5.
PROGRAMMER NOTES:
WRITE PERSONS SELECTED TO THE RU-ESTB-PLCYHLDR-COVRD-PERSTRPLS-ROSTER.
IF ‘PERSON NOT LISTED IN RU’ IS SELECTED, FLAG INSURANCE
THROUGH THIS ESTABLISHMENT-PERSON-PAIR AS ‘COVERING PERSON NOT
LISTED IN RU’.

125

Old Empl/Priv Related Ins (OE) Section
Beta

Roster Details
Title:

RU_Members_1

Col #

Header

Instructions

NAME

Display RU member's first, middle, and last names
PERS.FULLNAME

1

Roster Definition:
This item displays RU-MEMBERS-ROSTER for selection of RUmembers.
Roster Behavior:
1. Multiple select allowed. Interviewer may select one or
more from the listed members.
2. Add, delete, and edit disallowed.
3. Display ‘PERSON NOT LISTED IN RU’ as last entry on
this roster
Roster Filter:
Display persons who were not covered by the insurance
through this Establishment-Person-Pair on the previous
round’s interview date.

LOOP_15
FOR EACH ELEMENT IN THE RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER, ASK
OE46 - END_LP15.
LOOP DEFINITION: LOOP_15 COLLECTS THE COVERAGE START DATE FOR ALL PERSONS
NEWLY COVERED DURING THE CURRENT ROUND BY THE INSURANCE THROUGH THIS
ESTABLISHMENT-PERSON-PAIR. THIS LOOP CYCLES ON PERSONS SELECTED AT OE45.

126

Old Empl/Priv Related Ins (OE) Section
Beta

OE46

Help Enabled

Comment Enabled

Variable Name
EPCP.COVRBMM

MONTH HEALTH INSURANCE BEGAN

EPCP.COVRBDD
EPCP.COVRBYY

DAY HEALTH INSURANCE BEGAN
YEAR HEALTH INSURANCE BEGAN

Jump Back Enabled

Label

Size
2
2
4

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
On what date did the health insurance through (ESTABLISHMENT) begin for
(PERSON)?
_____/______/__________
MM DD YYYY
----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

ROUTING INSTRUCTION:
IF DAY FIELD IS CODED 'RF' (REFUSED) OR 'DK' (DON'T KNOW) AND
MONTH FIELD IS NOT CODED ‘RF' (REFUSED) OR 'DK' (DON'T KNOW),
CONTINUE WITH OE46OV.
OTHERWISE, GO TO BOX_32.

127

Old Empl/Priv Related Ins (OE) Section
Beta

OE46OV

Help Enabled
Variable Name
EPCP.BEGMONTH

Comment Enabled

Jump Back Enabled

Label
BEGIN COVERAGE: COV WHOLE/PART OF MONTH

Size
2

Can you just tell me if (PERSON) was covered under that insurance the whole
month or part of the month?
WHOLE MONTH
PART OF THE MONTH

1
2

{BOX_32}
{BOX_32}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_32}
{BOX_32}

Hard CHECK:
EDIT: COMPLETE DATE AT OE46 MUST BE < THAN COMPLETE DATE AT OE40 IF A DATE
IS RECORDED AT OE40 OR < THAN REFERENCE PERIOD END DATE IF NO DATE IS
RECORDED AT OE40.

BOX_32
IF FAMILY STILL HAS INSURANCE THROUGH THIS ESTABLISHMENT-PERSON-PAIR (OE39
IS CODED '1' (YES)), FLAG INSURANCE FOR THIS PERSON AS 'CONTINUOUS
COVERAGE' FROM DATE RECORDED AT OE46 UNTIL THE REFERENCE PERIOD END DATE.
IF FAMILY DOES NOT STILL HAVE INSURANCE THROUGH ESTABLISHMENT-PERSON-PAIR
(OE39 IS CODED '2' (NO)) FLAG INSURANCE FOR THIS PERSON AS 'CONTINUOUS
COVERAGE' FROM DATE RECORDED AT OE46 UNTIL DATE RECORDED AT OE40.

END_LP15
CYCLE ON NEXT PERSON IN RU-ESTB-PLCYHLDR-COVRD-PERS-TRPLS-ROSTER WHO MEETS
THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_15 AND GO TO
END_LP13.

128

Old Empl/Priv Related Ins (OE) Section
Beta

OE47

Help Enabled (DEPENDENT)

Comment Enabled

Jump Back Enabled

Variable Name
HOME.PLCYOUT

POLICY COVERS PERSON NOT IN RU

Label

Size
2

TRNS.TRNSID
TRNS.TRNSRURN

TRNS ID KEY: RUNTID + TRANSACTION NUMBER
ROUND STAMP: RU LETTER + ROUND NUMBER

12
2

TRNS.TRNSDATE
TRNS.TRNSKEY

TRANSACTION DATE
KEY OF RECORD BEING UPDATED

8
40

TRNS.TRNSSEG

SEGMENT NAME OF RECORD BEING UPDATED

4

TRNS.TRNSVAR
TRNS.WHOTRNS

NAME OF VARIABLE BEING UPDATED
ID OF INTERVIEWER INITIATING TRANSACTION

8
4

TRNS.OLDTRNS

OLD VALUE OF VARIABLE BEING UPDATED

45

TRNS.NEWTRNS

NEW VALUE OF VARIABLE BEING UPDATED

45

{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF ESTABLISHMENT}
{STR-DT} {END-DT}
{Does/Between (START DATE) and (END DATE), did} (POLICYHOLDER)'s
health coverage through (ESTABLISHMENT) cover as dependents any
persons who do not live here?
YES
NO

1
2

{END_LP13}
{END_LP13}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP13}
{END_LP13}

HELP AVAILABLE FOR DEFINITION OF DEPENDENT.
DISPLAY INSTRUCTIONS:
DISPLAY ‘Does’ IF NOT ROUND 5. DISPLAY ‘Between (START DATE)
and (END DATE), did’ IF ROUND 5.
PROGRAMMER NOTES:
IF CODED '1' (YES), FLAG INSURANCE THROUGH THIS ESTABLISHMENTPERSON-PAIR AS 'COVERING PERSON NOT LISTED IN RU' IN OE45.

129

Old Empl/Priv Related Ins (OE) Section
Beta

END_LP13
CYCLE ON NEXT PAIR IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEETS
THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO OTHER PAIRS MEET THE STATED CONDITIONS, END LOOP_13 AND CONTINUE
WITH BOX_33.

BOX_33
RETURN TO ORIGINAL QUESTIONNAIRE SECTION IN HX.

130


File Typeapplication/pdf
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Authormiller_n
File Modified2005-10-26
File Created2005-10-26

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