[SURVEY VENDOR LOGO] and/or [QHP ISSUER LOGO ONLY NO ADDRESS]
[SURVEY VENDOR ADDRESS]
OMB No. 0938-1221: Approval Expires XX/XX/20XX
[FIRST AND LAST NAME]
[LINE
ONE OF ADDRESS]
[LINE TWO OF ADDRESS (IF ANY)]
[CITY, STATE
ZIP]
尊敬的[ENROLLEE FIRST AND LAST NAME]：
我們最近郵寄給你一份關於你的健康保險計劃的問卷調查。如果你已經寄回填寫完畢的調查問卷，那麼謝謝您並請忽略這封來信。
如果您還沒有填寫問卷，請填寫它並把它放入隨之郵寄的預付郵資的信封裡寄回。你的回答將幫助消費者對於他們的健康保險計劃作出重要的選擇，並且將幫助[QHP ISSUER NAME] 改進他們的服務。請記住，你所提供的信息都將是保密的，而且你不必回答任何你不想回答的問題。
如果你沒有收到調查問卷或者找不到它了，請致電[SURVEY VENDOR PHONE NUMBER]，我們將會給你重新寄出一份調查問卷。
謝謝你！
If you would prefer a survey in English, please call (XXX) [XXX-XXXX].
謹上，
[SIGNATURE]
[NAME & TITLE OF SENIOR EXECUTIVE FROM SURVEY VENDOR or QHP ISSUER]
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid Office of Management and Budget (OMB) control number. The valid OMB control number for this information collection is 0938-1221. The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | 2017 QHP Enrollee Survey Reminder Letter: Traditional Chinese |
| Subject | 2017 Qualified Health Plan Enrollee Experience Survey |
| Author | Centers for Medicare & Medicaid Services |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |