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

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Pretest Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MEPS – IC	Medical Expenditure Panel Survey – 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 %

	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.