Attachment J -- Certainty Government Initial Letter

MEPS-18-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. In addition to the
completed questionnaire, please include the Summary of Benefits and Coverage or other
plan brochures describing the benefits offered by each of your plans. 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. If reporting online, plan brochures or benefits
summaries can be uploaded to our website.
We estimate this survey will take 45 minutes, on average, to complete. Additional information about
the authority 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 1-888-206-8023, 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-18-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
Section 913 of the Public Health Service Act (Title 42 United States Code, Section 299b-2(a))
authorizes the Census Bureau and Department of Health and Human Services to conduct this
collection and to request your voluntary assistance. Sections 924c and 308d of the same Act
(Title 42 United States Code, Sections 299c-3(c) and 242m), ensure that the information reported
will be released only to authorized staff of the Census Bureau, the Agency for Healthcare
Research and Quality, and their authorized researchers and contractors.
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.