Information Collection

Pretest Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)

IC 223608 under ICR 201606-0607-003 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form MEPS – IC Pretest Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)	Form and Instructi
MEPS – IC Medical Expenditure Panel Survey – Insurance Component ( MEPS Interview Protocol 091316.docx	Form and Instruction
MEPS_IC_OMB_letter_9.13.2016.docx Memo	IC Document
meps10_2016Final.pdf MEPS-10	IC Document
meps10s_2016Final.pdf MESP_10s	IC Document
meps11_16Final.pdf MEPS-11	IC Document
meps11s_2016Final.pdf MEPS-11s	IC Document

IC Title:

Pretest Medical Expenditure Panel Survey â Insurance Component (MEPS-IC)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MEPS â IC	Medical Expenditure Panel Survey â Insurance Component (MEPS-IC)	MEPS Interview Protocol 091316.docx		Yes	Yes	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.