Attachment L -- Initial Letter for Single Unit Private Sector

Attachment L -- Initial Letter for Single Unit Private Sector.pdf

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

Attachment L -- Initial Letter for Single Unit Private Sector

OMB: 0935-0110

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MEPS-16-L1
(05-24-2017)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

A Message from the Director, U.S. Census Bureau:
We are requesting your cooperation with the Health Insurance Cost Study, the insurance component
of the 2017 Medical Expenditure Panel Survey. Healthcare is one of the most important issues in
the United States today. Policymakers and researchers need reliable and current information to guide
our Nation’s healthcare system.
The U.S. Census Bureau has conducted the insurance component of this survey annually since 1996
for the U.S. Department of Health and Human Services. Accurate measurements of the current health
insurance system and realistic assessments of proposed changes to that system can only be made
when organizations like yours respond.
Please visit http://www.meps.ahrq.gov to learn more about the Agency for Healthcare Research and
Quality and how they use the data you provide.
The requested information is not subject to the Health Insurance Portability and Accountability Act
(HIPAA) privacy rules because it does not ask for any individually identifiable health information.
Please complete within 30 days. You may use the enclosed questionnaire as a worksheet prior to
reporting online, or return the completed questionnaire in the enclosed envelope. Online reporting
is encouraged due to cost savings and reduced processing times. Instructions for online reporting
can be found on the front page of the questionnaire.
YOUR RESPONSE WILL BE KEPT STRICTLY CONFIDENTIAL. We estimate this survey will take
45 minutes, on average, to complete. Additional information about the authority, confidentiality, and
burden of this data collection can be found on the back of this letter.
For assistance with completing this survey, please call us on 1-888-273-3878, Monday through Friday,
8:30 a.m. to 5:00 p.m. Eastern time.
Thank you in advance for your time and cooperation. Your response makes a difference.
Sincerely,

John H. Thompson
Enclosures

census.gov

MEPS-16-L1
(05-24-2017)

OMB Number
This collection has been approved by the Office of Management and Budget (OMB). The
eight-digit OMB approval number is 0935-0110 and appears at the upper right of the survey
form/login screen. Without this approval, we could not conduct this survey.
Authority and Confidentiality
Title 13 United States Code, Section 8(b), and Section 913 of the Public Health Service Act
(Title 42 United States Code, Section 299b-2(a)) authorize the Census Bureau and Department of
Health and Human Services to conduct this collection and to request your voluntary assistance.
The U.S. Census Bureau is required by Title 13 United States Code, Section 9, to keep your
information confidential and can use your responses only to produce statistics. The Census
Bureau is not permitted to publicly release your responses in a way that could identify your
business, organization, or institution. Per the Federal Cybersecurity Enhancement Act of 2015,
your data are protected from cybersecurity risks through screening of the systems that transmit
your data.
Burden Estimate Statement
We estimate this survey will take 45 minutes, on average, to complete, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. If you offered more than
two plans, we estimate an extra 11 minutes per additional plan.


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File Modified2017-05-30
File Created2017-05-24

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