Adult Qualified Health Plan Enrollee Experience Survey

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

OMB: 0938-1221

IC ID: 210330

Documents and Forms

Document Name Document Type
Form CMS-10488 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction
CMS-10488 Survey Vendor Application 2024QHPSrvyVndrPrtcptnFrm-RE.pdf Form and Instruction
CMS-10488 QHP Survey (Chinese) 2024-QHP-Enroll-Survey-CHI-508.pdf Form and Instruction
CMS-10488 Cover Letter (Chinese) 2024-QHP-Enrollee-Survey-Cover-Letter-1-Chinese-508.pdf Form
CMS-10488 QHP Survey (English) 2024-QHP-Enroll-Survey-ENG-508.pdf Form and Instruction
CMS-10488 Cover Letter 1 (English) 2024-QHP-Enrollee-Survey-Cover-Letter-1-English-508.pdf Form
CMS-10488 QHP Survey (Spanish) 2024-QHP-Enroll-Survey-SPA-508.pdf Form and Instruction
CMS-10488 Cover Letter (Spanish) 2024-QHP-Enrollee-Survey-Cover-Letter-1-Spanish-508.pdf Form and Instruction
CMS-10488 Chinese Cover Letter - 2 2024-QHP-Enrollee-Survey-Cover-Letter-2-Chinese-508.pdf Form and Instruction
CMS-10488 Chinese Prenotification Letter 2024-QHP-Enrollee-Survey-Prenotification-Letter-Chinese-508.pdf Form
CMS-10488 Chinese Reminder Letter 2024-QHP-Enrollee-Survey-Reminder-Letter-Chinese-508.pdf Form
CMS-10488 English Cover Letter 2 2024-QHP-Enrollee-Survey-Cover-Letter-2-English-508.pdf Form and Instruction
CMS-10488 English Cover Letter 2 2024-QHP-Enrollee-Survey-Cover-Letter-2-English-508.pdf Form and Instruction
CMS-10488 Prenotification Letter - English 2024-QHP-Enrollee-Survey-Prenotification-Letter-English-508.pdf Form
CMS-10488 Prenotification Letter (Spanish) 2024-QHP-Enrollee-Survey-Prenotification-Letter-Spanish-508.pdf Form
CMS_10488 Enrollee Survey Reminder Letter - Spanish 2024-QHP-Enrollee-Survey-Reminder-Letter-Spanish-508.pdf Form
CMS-10488 - Appendix A _Clean.docx CMS-10488 - Goals of the Psychometric and Beta Test Goals IC Document