CMS-10488 Chinese Cover Letter - 2

Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)

2018-QHP-Ch-Cover2-031317-clean

Adult Qualified Health Plan Enrollee Experience Survey

OMB: 0938-1221

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[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]

我們需要你的幫忙。作爲正在全國範圍內進行的努力的一部分,最近我們郵寄給你一份調查問卷來評估你對健康保險計劃的體驗。調查結果將會有助于像你一樣的消費者作出有關他們醫療保健的重要選擇,並且將會幫助健康保險計劃改善它們所提供的醫療保健服務。如果你覺得這項調查並不適用於你,或者你有任何問題,請在週一到週五(聯邦節假日除外) [SURVEY VENDOR LOCAL TIME] [XX:XX] a.m. [XX:XX] p.m.之間致電[SURVEY VENDOR NAME]的免费热线(XXX) [XXX-XXXX]或發送郵件至[SURVEY VENDOR E-MAIL]

我們在此再次附上這份問卷。請抽出時間來告訴我們你怎么看待在過去6個月中從你的健康保險計劃得到的醫療保健。請將完成的問卷放入隨信附上的預付費信封中寄回給我們。這是一個你可以幫助你的健康保險計劃更好地為你服務的機會。

[QHP ISSUER NAME][SURVEY VENDOR NAME]簽訂了合約來進行這項調查。你是作為你的健康保險計劃的參保人被隨機抽中的。你的回答是很重要的,幷且我們無法用其他人取代你。如果你在2018年改變你的健康保險計劃,請根據你在2017年七月到十二月間的健康保險體驗來回答問卷中的問題。這項調查問卷需要大概15分鐘來完成。

你的答案將成為一個綜合信息庫的一部分,這個信息庫是由參加了和你相同的健康保險計劃的人們所提供的信息組成的。我們只會與得到授權的人員分享你所提供的信息。你的健康保險計劃不會看到你的回答。你可以選擇填寫這份問卷或不填寫。如果你選擇不填寫,這將不會影響到你所享受的福利。但是,你的知識和體驗將幫助像你一樣的其他人選擇健康保險計劃,所以我們希望你能幫助我們。

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 Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title2017 QHP Survey Cover Letter for Second Survey Mailing: Traditional Chinese
Subject2017 Qualified Health Plan Enrollee Experience Survey - Chinese
AuthorCenters for Medicare & Medicaid Services
File Modified0000-00-00
File Created2021-01-13

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