741 2013 741 CMS Medicare Plan Finder 11-11-13

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Overview

Welcome and Thank You Text
Current Model Qsts
Current Custom Qsts
Current Custom Qsts (6-13-13)
Custom Qsts (7-26-12)
Custom Qsts (9-28-11)

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Sheet 1: Welcome and Thank You Text

Model Instance Name:
CMS- Medicare Plan Finder
MID:	wUxpJUFY8RcZRIhIgYp54g==
Date:	6/13/2011
Welcome and Thank You Text
	Directions:
	This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome text shown in the box below.
					Examples
					Welcome Text Example
	Welcome Text
	Thank you for visiting our site. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.
					Thank You Text Example
	Thank You Text
	Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our web site.

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Sheet 2: Current Model Qsts

Model Instance Name:
CMS- Medicare Plan Finder
MID:	wUxpJUFY8RcZRIhIgYp54g==
Date:	6/13/2011
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Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Medicare Plan Information (1=Poor, 10=Excellent, Don't Know)		Satisfaction		Recommend (1=Very Unlikely, 10=Very Likely)
	Please rate the amount of information provided about Medicare plans.		What is your overall satisfaction with the Medicare Plan Finder? (1=Very Dissatisfied, 10=Very Satisfied)		How likely are you to recommend the Medicare Plan Finder to someone else?
	Please rate the usefulness of the information about Medicare plans.		How well does the Medicare Plan Finder meet your expectations? (1=Falls Short, 10=Exceeds)		Use Medicare.gov (1=Very Unlikely, 10=Very Likely)
	Please rate your perception of the accuracy of the information about Medicare plans.		How does the Medicare Plan Finder compare to your idea of an ideal website tool? (1=Not Very Close, 10=Very Close)		How likely are you to visit Medicare.gov (Medicare's website) for future Medicare-related needs?
	Medicare Plan Finder Process (1=Poor, 10=Excellent, Don't Know)				Trust
	Please rate the how well the Plan Finder feature streamlines the process of finding Medicare plans.				I can count on Medicare to act in my best interests. (=1 Very Unlikely, 10=Very Likely)
	Please rate the features available for finding a Medicare plan.				I consider Medicare to be trustworthy. (=1 Very Unlikely, 10=Very Likely)
	Please rate how well the Plan Finder feature minimizes the amount of time needed to get useful Medicare plan information.				Medicare can be trusted to do what is right. (=1 Very Unlikely, 10=Very Likely)
	Medicare Plan Finder- Results(1=Poor, 10=Excellent, Don't Know)
	Please rate how well the results provided by the Plan Finder match your request.
	Please rate the relevance of the results to your specific needs.
	Please rate the listing/ranking order of Plan Finder results.
	Look & Feel (1=Poor, 10=Excellent, Don't Know)
	Please rate the visual appeal of the Plan Finder.
	Please rate the balance of graphics and text on the Plan Finder.
	Please rate the readability of the pages on the Plan Finder.
	Navigation (1=Poor, 10=Excellent, Don't Know)
	Please rate how well the Plan Finder tool is organized.
	Please rate the options available for navigating the Plan Finder tool.
	Please rate how well the layout helps you find what you are looking for.
	Please rate the number of clicks to get the information you are looking for.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
	Please rate how quickly pages load on this tool.
	Please rate the consistency of speed from page to page on this tool.
	Please rate the ability to load pages without getting error messages on this tool.

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Sheet 3: Current Custom Qsts

CMS- Medicare Plan Finder			red & strike-through: DELETE
CMS- Medicare Plan Finder			underlined & italicized: RE-ORDER
MID: wUxpJUFY8RcZRIhIgYp54g==			pink: ADDITION
Date:	6/13/2011		blue + -->: REWORDING
CMS- Medicare Plan Finder CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BSH04351		Is this your first time using the Medicare Plan Finder tool on Medicare.gov?	Yes		Radio button, one-up vertical	single	Y		FIRST TIME?
			No
ACQhar0014457		Where did you learn about the Medicare.gov Plan Finder tool?	From a Search Engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learn of Plan Finder
			Saw it on the Medicare.gov website
			Read about it in an article
			Other, please specify
ACQhar0014458		Where else did you learn about the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Learn of Plan Finder
BSH04352		What kind of plan search did you choose?	General (zip code only)		Radio button, one-up vertical	single	Y		PERSONALIZED?
			Personalized (zip code + your Medicare information)
CAS0031507		Did you enter in your personal prescriptions while using the Plan Finder tool?	Yes		Radio button, one-up vertical	single	Y		Prescriptions
			No
BSH04353		Which of the following best describes your role in using the Plan Finder tool today?	I am enrolled in Medicare.		Radio button, one-up vertical	single	Y	Skip Logic Group	ROLE
			I will be enrolling in Medicare soon.
			I am a family member, friend or other representative of someone enrolled or enrolling in Medicare.
			I am a provider or health care professional (i.e. physicians, nurses, clinicians)
			I counsel people about their Medicare health and drug coverage)
			I am researching Medicare for academic project.
			I am interested in learning more about Medicare.
			I am a policymaker or policy analyst
			Other, please specify	A
BSH04354	A	Other, please describe your role in using the Plan Finder today:			Text field, <100 char	single	N	Skip Logic Group	Other ROLE
ACQhar0014464		What was the primary reason you were using the Medicare Plan Finder tool today?	Enroll in a plan	B	Radio button, one-up vertical	Single	Y	Skip Logic Group	Primary Reason
			View plans available in my area
			Compare plan costs
			Other, please specify	R
ACQhar0014465	R	What was the other primary reason you were using the Medicare Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Primary Reason
BSH04356	B	Did you enroll in any of the plans you found today?	Yes		Radio button, one-up vertical	single	Y	Skip Logic Group	DID YOU ENROLL?
			No	S
			Not sure
ACQhar0014466	S	Which of the following best describes why you will not enroll in the plan(s) you found today?	The enrollment process was too complicated. I was confused by the plan information provided.		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did Not Enroll
			The process takes too long.
			I don't have the necessary computer skills to complete the application.
			I received an error message.
			Other, please specify	D
BSH04358	D	Other, please describe why you did not enroll in a plan today:			Text field, <100 char	single	N	Skip Logic Group	Other DIDN’T ENROLL
ACQhar0014473		Did you find the information you were looking for?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did You Find
			No	S, T
ACQhar0014474	S	What information were you unable to find?			Text area, no char limit		N	Skip Logic Group	OE_Unable to Find
ACQhar0014475	T	What will you do next?			Text area, no char limit		N	Skip Logic Group	OE_Do Next
BSH04359		At any point during your experience, did your session time out?	Yes		Radio button, one-up vertical	single	Y		TIME OUT?
			No
			Not sure
ACQhar0014476		Which of the following resources did you use to help you understand the Medicare Plan Finder tool?	Medicare Plan Finder Online Demo video	X	Radio button, one-up vertical	Single	Y	Skip Logic Group	Resources
			Learn More About Plans	X
			Help	X
			Glossary	X
			Other, please specify	V, X
			I did not use any website resources to help me understand the Plan Finder tool.
ACQhar0014478	V	What other website resource did you use to help you understand the Medicare Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Resources
	X	Did the option(s) you used help guide you successfully?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Resources Help
ACQhar0014477			No	W
ACQhar0014479	W	What would provide more guidance to help you use the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	OE_Resources Didn't Help
ACQhar0014480		During this visit to Medicare.gov, approximately how long were you using the Plan Finder tool?	Less than 30 minutes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Time using Tool
			30 minutes - 1 hour
			1 - 2 hours	Z
			More than 2 hours	Z
			I'm not sure
ACQhar0014481	Z	What could have been done to help you reduce the time you spent on the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	OE_Less Time
BSH04361		If you could change or improve one thing about the process of finding Medicare plans on this site, what would it be?			Text area, no char limit	single	N		IMPROVEMENT
BSH04362		Please consider providing your email address if you would like to discuss your feedback further.			Text field, <100 char	single	N		EMAIL

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Sheet 4: Current Custom Qsts (6-13-13)

CMS- Medicare Plan Finder			red & strike-through: DELETE
CMS- Medicare Plan Finder			underlined & italicized: RE-ORDER
MID: wUxpJUFY8RcZRIhIgYp54g==			pink: ADDITION
Date:	6/13/2011		blue + -->: REWORDING
CMS- Medicare Plan Finder CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BSH04351		Is this your first time using the Medicare Plan Finder tool on Medicare.gov?	Yes		Radio button, one-up vertical	single	Y		FIRST TIME?
			No
		Where did you learn about the Medicare.gov Plan Finder tool?	From a Search Engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learn of Plan Finder
			Saw it on the Medicare.gov website
			Read about it in an article
			Other, please specify
		Where else did you learn about the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Learn of Plan Finder
BSH04352		What kind of plan search did you choose?	General (zip code only)		Radio button, one-up vertical	single	Y		PERSONALIZED?
			Personalized (zip code + your Medicare information)
		Did you enter in your personal prescriptions while using the Plan Finder tool?	Yes		Radio button, one-up vertical	single	Y		Prescriptions
			No
BSH04353		Which of the following best describes your role in using the Plan Finder tool today?	I am enrolled in Medicare.		Radio button, one-up vertical	single	Y	Skip Logic Group	ROLE
			I will be enrolling in Medicare soon.
			I am a family member, friend or other representative of someone enrolled or enrolling in Medicare.
			I am a provider or health care professional (i.e. physicians, nurses, clinicians)
			I counsel people about their Medicare health and drug coverage)
			I am researching Medicare for academic project.
			I am interested in learning more about Medicare.
			I am a policymaker or policy analyst
			Other, please specify	A
BSH04354	A	Other, please describe your role in using the Plan Finder today:			Text field, <100 char	single	N	Skip Logic Group	Other ROLE
		What was the primary reason you were using the Medicare Plan Finder tool today?	Enroll in a plan	B	Radio button, one-up vertical	Single	Y	Skip Logic Group	Primary Reason
			View plans available in my area
			Compare plan costs
			Other, please specify	R
	R	What was the other primary reason you were using the Medicare Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Primary Reason
BSH04356	B	Did you enroll in any of the plans you found today?	Yes		Radio button, one-up vertical	single	Y	Skip Logic Group	DID YOU ENROLL?
			No	S
			Not sure
	S	Which of the following best describes why you will not enroll in the plan(s) you found today?	The enrollment process was too complicated. I was confused by the plan information provided.		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did Not Enroll
			The process takes too long.
			I don't have the necessary computer skills to complete the application.
			I received an error message.
			Other, please specify	D
BSH04358	D	Other, please describe why you did not enroll in a plan today:			Text field, <100 char	single	N	Skip Logic Group	Other DIDN’T ENROLL
		Did you find the information you were looking for?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did You Find
			No	S, T
	S	What information were you unable to find?			Text area, no char limit		N	Skip Logic Group	OE_Unable to Find
	T	What will you do next?			Text area, no char limit		N	Skip Logic Group	OE_Do Next
BSH04359		At any point during your experience, did your session time out?	Yes		Radio button, one-up vertical	single	Y		TIME OUT?
			No
			Not sure
		Which of the following resources did you use to help you understand the Medicare Plan Finder tool?	Medicare Plan Finder Online Demo video	X	Radio button, one-up vertical	Single	Y	Skip Logic Group	Resources
			Learn More About Plans	X
			Help	X
			Glossary	X
			Other, please specify	V, X
			I did not use any website resources to help me understand the Plan Finder tool.
	V	What other website resource did you use to help you understand the Medicare Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Resources
	X	Did the option(s) you used help guide you successfully?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Resources Help
			No	W
	W	What would provide more guidance to help you use the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	OE_Resources Didn't Help
		During this visit to Medicare.gov, approximately how long were you using the Plan Finder tool?	Less than 30 minutes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Time using Tool
			30 minutes - 1 hour
			1 - 2 hours	Z
			More than 2 hours	Z
			I'm not sure
	Z	What could have been done to help you reduce the time you spent on the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	OE_Less Time
BSH04361		If you could change or improve one thing about the process of finding Medicare plans on this site, what would it be?			Text area, no char limit	single	N		IMPROVEMENT
BSH04362		Please consider providing your email address if you would like to discuss your feedback further.			Text field, <100 char	single	N		EMAIL

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Sheet 5: Custom Qsts (7-26-12)

CMS- Medicare Plan Finder			red & strike-through: DELETE
CMS- Medicare Plan Finder			underlined & italicized: RE-ORDER
MID: wUxpJUFY8RcZRIhIgYp54g==			pink: ADDITION
Date:	6/13/2011		blue + -->: REWORDING
CMS- Medicare Plan Finder CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BSH04351		Is this your first time using the Medicare Plan Finder tool on Medicare.gov?	Yes		Radio button, one-up vertical	single	Y		FIRST TIME?
			No
		Where did you learn about the Medicare.gov Plan Finder tool?	From a Search Engine		Radio button, one-up vertical	Single	Y	Skip Logic Group	Learn of Plan Finder
			Saw it on the Medicare.gov website
			Read about it in an article
			Other, please specify
		Where else did you learn about the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Learn of Plan Finder
BSH04352		What kind of plan search did you choose?	General (zip code only)		Radio button, one-up vertical	single	Y		PERSONALIZED?
			Personalized (zip code + your Medicare information)
BSH04353		Which of the following best describes your role in using the Plan Finder tool today?	I am enrolled in Medicare.		Radio button, one-up vertical	single	Y	Skip Logic Group	ROLE
			I will be enrolling in Medicare soon.
			I am a family member, friend or other representative of someone enrolled or enrolling in Medicare.
			I am a provider or health care professional (i.e. physicians, nurses, clinicians)
			I counsel people about their Medicare health and drug coverage)
			I am researching Medicare for academic project.
			I am a citizen interested in learning more about Medicare.
			I am a policymaker or policy analyst
			Other, please specify	A
BSH04354	A	Other, please describe your role in using the Plan Finder today:			Text field, <100 char	single	N	Skip Logic Group	Other ROLE
		What was the primary reason you were using the Medicare Plan Finder tool today?	Enroll in a plan	B	Radio button, one-up vertical	Single	Y	Skip Logic Group	Primary Reason
			View plans available in my area
			Compare plan costs
			Other, please specify	R
	R	What was the other primary reason you were using the Medicare Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Primary Reason
BSH04355		In your Plan Finder search did you find any Medicare plans today that meet your needs, or the needs of the beneficiary you represent?	Yes	B	Radio button, one-up vertical	single	Y	Skip Logic Group	DID YOU ENROLL?
			No, I did not find any plans.
			No, none of the plans met my needs.
			No, I was not looking for plans today.
BSH04356	B	Did you enroll in any of the plans you found today?	Yes		Radio button, one-up vertical	single	Y	Skip Logic Group	DID YOU ENROLL?
			No	C, S
			Not sure
BSH04357	C	Which of the following best describes why you will not enroll in the plan(s) you found today?	I did not intend to enroll today; I was just exploring my options		Radio button, one-up vertical		Y	Skip Logic Group	WHY DIDN’T ENROLL?
			I did not intend to enroll today; I was reviewing my current plan.
			I was confused by the plan information provided
			I was unable to enroll online.
			I was confused about how to enroll.
			Other, please specify	D
	S	Which of the following best describes why you will not enroll in the plan(s) you found today?	The enrollment process was too complicated. I was confused by the plan information provided.		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did Not Enroll
			The process takes too long.
			I don't have the necessary computer skills to complete the application.
			I received an error message.
			Other, please specify	D
BSH04358	D	Other, please describe why you did not enroll in a plan today:			Text field, <100 char	single	N	Skip Logic Group	Other DIDN’T ENROLL
		Did you find the information you were looking for?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Did You Find
			No	S, T
	S	What information were you unable to find?			Text area, no char limit		N	Skip Logic Group	OE_Unable to Find
	T	What will you do next?			Text area, no char limit		N	Skip Logic Group	OE_Do Next
BSH04359		At any point during your experience, did your session time out?	Yes		Radio button, one-up vertical	single	Y		TIME OUT?
			No
			Not sure
BSH04360		Did the instructions guide you to use the Plan Finder tool?	Yes		Radio button, one-up vertical	single	Y		PREPARED?
			No
			I did not read the instructions
		Which of the following resources did you use to help you understand the Medicare Plan Finder tool?	Medicare Plan Finder Online Demo video	X	Radio button, one-up vertical	Single	Y	Skip Logic Group	Resources
			Learn More About Plans	X
			Help	X
			Glossary	X
			Other, please specify	V, X
			I did not use any website resources to help me understand the Plan Finder tool.
	V	What other website resource did you use to help you understand the Medicare Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	Other_Resources
	X	Did the option(s) you used help guide you successfully?	Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Resources Help
			No	W
	W	What would provide more guidance to help you use the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	OE_Resources Didn't Help
		During this visit to Medicare.gov, approximately how long were you using the Plan Finder tool?	Less than 30 minutes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Time using Tool
			30 minutes - 1 hour
			1 - 2 hours	Z
			More than 2 hours	Z
	Z	What could have been done to help you reduce the time you spent on the Plan Finder tool?			Text area, no char limit		N	Skip Logic Group	OE_Less Time
BSH04361		If you could change or improve one thing about the process of finding Medicare plans on this site, what would it be?			Text area, no char limit	single	N		IMPROVEMENT
BSH04362		We're working to improve the Medicare Plan Finder. Please consider providing your email address if you would like to discuss your feedback further.			Text field, <100 char	single	N		EMAIL

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Sheet 6: Custom Qsts (9-28-11)

#REF!
CMS- Medicare Plan Finder
MID: wUxpJUFY8RcZRIhIgYp54g==
Date:	6/13/2011
CMS- Medicare Plan Finder CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
BSH04351		Is this your first time using the Medicare Plan Finder tool on Medicare.gov?		Radio button, one-up vertical	single	Y N		FIRST TIME?
BSH04352		What kind of plan search did you choose?		Radio button, one-up vertical	single	Y N		PERSONALIZED?
BSH04353		Which of the following best describes your role in using the Plan Finder tool today?		Radio button, one-up vertical	single	Y N	Skip Logic Group	ROLE
			A
BSH04354	A	Other, please describe your role in using the Plan Finder today:		Text field, <100 char	single	N	Skip Logic Group	Other ROLE
BSH04355		In your Plan Finder search did you find any Medicare plans today that meet your needs, or the needs of the beneficiary you represent?	B	Radio button, one-up vertical	single	Y N	Skip Logic Group	DID YOU ENROLL?
BSH04356	B	Did you enroll in any of the plans you found today?		Radio button, one-up vertical	single	Y N	Skip Logic Group	DID YOU ENROLL?
			C
BSH04357	C	Which of the following best describes why you will not enroll in the plan(s) you found today?		Radio button, one-up vertical		Y N	Skip Logic Group	WHY DIDN’T ENROLL?
			D
BSH04358	D	Other, please describe why you did not enroll in a plan today:		Text field, <100 char	single	N	Skip Logic Group	Other DIDN’T ENROLL
BSH04359		At any point during your experience, did your session time out?		Radio button, one-up vertical	single	Y N		TIME OUT?
BSH04360		Did the instructions guide you to use the Plan Finder tool?		Radio button, one-up vertical	single	Y N		PREPARED?
BSH04361		If you could change or improve one thing about the process of finding Medicare plans on this site, what would it be?		Text area, no char limit	single	N		IMPROVEMENT
BSH04362		We're working to improve the Medicare Plan Finder. Please consider providing your email address if you would like to discuss your feedback further.		Text field, <100 char	single	N		EMAIL