2014 and 2015 Medical Expenditure Panel Survey - Insurance Component (MEPS-IC)

ICR 201504-0935-001

OMB: 0935-0110

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Supporting Statement A
2015-06-15
Supporting Statement B
2015-06-15
Supplementary Document
2014-04-16
Supplementary Document
2014-04-14
Supplementary Document
2014-04-14
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
Supplementary Document
2013-09-30
IC Document Collections
ICR Details
0935-0110 201504-0935-001
Historical Active 201404-0935-001
HHS/AHRQ 20656
2014 and 2015 Medical Expenditure Panel Survey - Insurance Component (MEPS-IC)
Revision of a currently approved collection   No
Regular
Approved without change 06/26/2015
Retrieve Notice of Action (NOA) 05/08/2015
  Inventory as of this Action Requested Previously Approved
12/31/2016 12/31/2016 12/31/2016
124,404 0 113,429
25,151 0 23,150
0 0 0

Employer-sponsored health insurance is the source of coverage for 78 million current and former workers, plus many of their family members, and is a cornerstone of the U.S. health care system. The Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) measures the extent, cost, and coverage of employer-sponsored health insurance on an annual basis. These statistics are produced at the National, State, and sub-State (metropolitan area) level for private industry. Statistics are also produced for State and Local governments.

US Code: 42 USC 299b-2 Name of Law: Health Care Quality Act of 1999
  
None

Not associated with rulemaking

  80 FR 15229 02/18/2015
80 FR 26262 05/07/2015
Yes

3
IC Title Form No. Form Name
Prescreener Questionnaire Form #1 Prescreener Questionnaire
Establishment Questionnaire Form #2 Establishment Questionnaire
Plan Questionnaire Form #3 Plan Questionnaire

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 124,404 113,429 0 10,975 0 0
Annual Time Burden (Hours) 25,151 23,150 0 2,001 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The 2015 Longitudinal Sample increases the respondent burden by 2,002 hours.

$10,400,000
Yes Part B of Supporting Statement
No
Yes
No
No
Uncollected
Doris Lefkowitz 3014271477

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/08/2015


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