HDCI 2 Survey of Group Health Plans

HDCI 2 Survey of Group Health Plans

HDCI Telephone Questionnaire 11 1 06

HDCI 2 Survey of Group Health Plans

OMB: 1210-0129

Document [doc]
Download: doc | pdf

HDCI Telephone Questionnaire



Introduction [link to telephone script]


  1. Does your company currently offer health benefits to its employees?

Plans that provide solely worker’s compensation, unemployment, or disability income benefits do not count as health benefits.


Yes- CONTINUE

No - STOP


  1. Does the company health plan cover fewer than 2 employees who are not owners?


Yes - STOP

No - CONTINUE


(3) Is coverage provided through a multiemployer plan?

A multiemployer plan is generally one or more multiple employers contribute to and that is maintained according to one or more collective bargaining agreements.


Yes - STOP

No - CONTINUE


  1. Interviewer check item:

From the company name that appears above it appears that the organization is:


A church or church sponsored organization -- GO TO question 5

A governmental entity - GO TO question 6

Neither - GO TO question 7


  1. Is your organization a church or church sponsored organization?


No - GO TO question 8

Yes, it is a church or church sponsored organization - STOP


  1. Is your organization a governmental entity?


No - GO TO question 8

Yes, it is a governmental entity – STOP


(7) From its name, it appears that your organization is not a governmental entity, not a church, and not a church-sponsored organization. Is that correct?


Yes- CONTINUE

No, church or church sponsored organization - STOP

No, governmental entity - STOP






  1. Is your company’s health coverage provided by a parent company?

A parent-subsidiary relationship exists if a company is owned 50% or more by another company.


Yes - CONTINUE

No - STOP



(9) What is the name of the parent company?


____________________________________________________



  1. What is the address of the parent?


____________________________________


____________________________________


____________________________________


____________________________________



Thank you so much for your time.


File Typeapplication/msword
File TitleHDCI Telephone Questionnaire
AuthorA. Turner
Last Modified BySusan Lahne
File Modified2006-11-01
File Created2006-11-01

© 2024 OMB.report | Privacy Policy