Various Demographic Area Pretesting Activities

Generic Clearence for Questionnaire Pretesting Research

omb1208healthinsurancequestionsenc1

Various Demographic Area Pretesting Activities

OMB: 0607-0725

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Research Support Services Inc. (RSS) and the University of
Massachusetts are working with the U.S. Census Bureau to find out
about health insurance in Massachusetts. You may be eligible to earn
$40 if you have health insurance but do not have your insurance
through your employer or Medicare.

What: A face to face interview (a discussion between you and an
interviewer that lasts about 1 hour) at a time and place
that is convenient to you.
Who: People who have health insurance but do not have their
insurance through their work or Medicare.
How Much: $40 in cash.
If you are interested: Please call [RSS / CSR] at [PHONE NUMBER]
between [TIME] weekdays to complete a brief telephone screening in
order to determine if you are eligible. You will not be compensated
for completing the telephone screening.

Health Insurance
Interview - $40
1-888-5-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Research Support Services Inc. (RSS) and the University of
Massachusetts are working with the U.S. Census Bureau to find out
about health insurance in Massachusetts. You may be eligible to earn
$40 if you have health insurance and pay a monthly premium but do
not have your insurance through your employer or Medicare.

What: A face to face interview (a discussion between you and an
interviewer that lasts about 1 hour) at a time and place
that is convenient to you.
Who: People who have health insurance and pay a monthly
premium but do not have their insurance through their work or
Medicare.
How Much: $40 in cash.
If you are interested: Please call [RSS / CSR] at [PHONE NUMBER]
between [TIME] weekdays to complete a brief telephone screening in
order to determine if you are eligible. You will not be compensated
for completing the telephone screening.

Health Insurance
Interview - $40
1-888-5-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Health Insurance
Interview - $40
1-888-540-6770

Research Support Services Inc. (RSS) and the University of
Massachusetts are working with the U.S. Census Bureau to find out
about health insurance in Massachusetts. You may be eligible to earn
$40 if you have health insurance through Commonwealth Care
(CommCare) or Commonwealth Choice ((CommChoice) and pay a
monthly premium.

What: A face to face interview (a discussion between you and an
interviewer that lasts about 1 hour) at a time and place
that is convenient to you
you.
Who: People who have gotten their health insurance through
Commonwealth Care or Commonwealth Choice and pay
a monthly premium.
How Much: $40 in cash.
If you are interested: Please call [RSS / CSR] at [PHONE NUMBER]
between [TIME] weekdays to complete a brief telephone screening in
order to determine if you are eligible
eligible. You will not be compensated
for completing the telephone screening
screening.

CommCare or
CommChoice?
Interview - $40
1-888-5-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

Research Support Services Inc. (RSS) and the University of
Massachusetts are working with the U.S. Census Bureau to find out
about health insurance in Massachusetts. You may be eligible to earn
$40 if you have the Health Connector symbol on your insurance card.

What: A face to face interview (a discussion between you and an
interviewer that lasts about 1 hour).
Who: People who have gotten their health insurance through
the Massachusetts Health Connector and/or have the
Health Connector logo on their insurance card.
How Much: $40 in cash.

If you are interested: Please call [RSS / CSR] at [PHONE NUMBER]
between [TIME] weekdays to complete a brief telephone screening in
order to determine if you are eligible
eligible. You will not be compensated
for completing the telephone screening
screening.

Insurance thru the
Health Connector?
Interview - $40
1-888-5-6770

Insurance thru the
Health Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Health Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Health Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Health Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Health Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Health Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Connector?
Interview - $40
1-888-540-6770

Insurance thru the
Health Connector?
Interview - $40
1-888-540-6770

Research Support Services Inc. (RSS) and the University of
Massachusetts are working with the U.S. Census Bureau to find out
about health insurance in Massachusetts. You may be eligible to earn
$40 if you have health insurance through CommonwealthChoice
Choice
(CommChoice).

What: A face to face interview (a discussion between you and an
interviewer that lasts about 1 hour
hour) at a time and place
that is convenient to you
you.
Who: People who have gotten their health insurance through
CommonwealthChoice and the Massachusetts Health
Connector.
How Much: $40 in cash.
If you are interested: Please call [RSS / CSR] at [PHONE NUMBER]
between [TIME] weekdays to complete a brief telephone screening in
order to determine if you are eligible
eligible. You will not be compensated
for completing the telephone screening
screening.

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-5-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

Commonwealth Choice
Health Insurance?
Interview - $40
1-888-540-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

CommonwealthChoice
Health Insurance?
Interview - $40
1-888-540-6770

Research Support Services Inc. (RSS) and the University of
Massachusetts are working with the U.S. Census Bureau to find out
about health insurance in Massachusetts. You may be eligible to earn
$40 if you have health insurance through CommonwealthCare
Care
(CommCare) or Commonwealth
onwealthChoice (CommChoice).

What: A face to face interview (a discussion between you and an
interviewer that lasts about 1 hour
hour).
Who: People who have gotten their health insurance through
the Massachusetts Health Connector and/or have the
Health Connector logo on their insurance card.
How Much: $40 in cash.
If you are interested: Please call [RSS / CSR] at [PHONE NUMBER]
between [TIME] weekdays to complete a brief telephone screening in
order to determine if you are eligible
eligible. You will not be compensated
for completing the telephone screening
screening.

CommCare or
CommChoice?
Interview - $40
1-888-5-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770

CommCare or
CommChoice?
Interview - $40
1-888-540-6770


File Typeapplication/pdf
File Modified2012-02-13
File Created2012-02-13

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