Plan Questionnaire

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

OMB: 0935-0110

IC ID: 182461

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Plan Questionnaire
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form #3 Plan Questionnaire Attachment C - Plan Questionnaire.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

19,246 0
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 44,266 0 -6,024 0 0 50,290
Annual IC Time Burden (Hours) 8,115 0 -1,105 0 0 9,220
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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