Various Economic Pretesting Activities

Proposed List of Questions for Testing – MEPS-IC

5-22-12

Group 1 – Employers offering a self-insured health plan in 2012

1. SELF-INSURED PLANS

Questions a, b and c will be placed after 6a and 6b on the 10(s), plan form, and be labeled 6c, 6d, and 6e.

For plans that have been identified as self-insured plans with stop-loss coverage, ask…

A) What is the specific stop-loss coverage amount per employee, that is, the individual attachment point?

$____________(individual attachment point)

OR

No individual attachment point

Would you be able to answer if given the following categories -- ?

a) $15,000 or less

b) More than $15,000 up to $30,000

c) More than $30,000, up to $60,000

d) More than $60,000, up to $90,000

e) More than $90,000

B) Does this plan have aggregate stop-loss coverage based on all claims? Yes/No/Don’t Know

If yes, what is the aggregate stop-loss coverage attachment point (as a percent of expected claims)?

____________% (aggregate attachment point)

For plans that have been identified as self-insured, ask …

C) Approximately, what percent of the total annual costs for this self-insured plan cover …

Medical claims (not covered by stop-loss coverage) _____%

Stop-loss coverage premiums _____%

Fees paid to the third party administrator (TPA) or

administrative services only (ASO), excluding

commissions _____%

Commissions paid _____%

Other _____%

Total _100_%

Group 2 – Employers who offered health insurance in 2012.

2. WELLNESS PROGRAM

For all plans (fully-insured and self-insured), ask…

Question a would be an additional checkbox in existing question 12a on the 10(s), plan form.

Question b would be additional checkboxes in existing question 12b on the 10(s), plan form.

Question c would be additional checkboxes in existing question 25 on the 10(s), plan form.

A) Did the PREMIUMS charged by the insurance company or carrier vary by any of these characteristics?

Age

Gender

Wage or salary levels

Smoker/non-smoker status

Other

OR

Premiums did not vary

B) Did the amount an EMPLOYEE CONTRIBUTED toward his/her own coverage vary by any of these employee characteristics?

Hours worked

Union status

Wage or salary level

Occupation

Length of employment

Participation in a smoking cessation program

Participation in a fitness and/or weight loss program

Other

OR

Employee contribution did not vary

C) Which of the services listed were covered by this plan?

Yes No Don’t know

Chiropractic care

Rehabilitative care

Habilitative care

Pediatric dental and vision care

Routine vision care

Routine dental care

Mental health care

Substance abuse treatment

3. ACTUARIAL VALUE OF PLAN

Question a would be placed in the “plan characteristics” section of the 10(s), plan form, as question 26, the last question on the form.

For all plans (fully-insured and self-insured) , ask…

a) Do you know the Actuarial Value of this plan? Yes/No/Don’t Know

If yes, what is the Actuarial Value? ______%

4. GRANDFATHERED PLANS

Question a would be placed in the “general plan information” section of the 10(s), plan form, between existing questions 4 and 5.

For all plans (fully-insured and self-insured) , ask…

1. Is this a grandfathered health plan as defined by the Affordable Care Act?

Yes/No/Don’t Know

5. UNMARRIED DOMESTIC PARTNERS

Questions a and b would be placed between existing questions 3 and 4, in section E, on the MEPS 10, main form.

For all employers, ask….

a) Did your organization offer health insurance coverage to unmarried domestic partners of the same sex? Yes/No/ Don’t Know

b) Did your organization offer health insurance coverage to unmarried domestic partners of the opposite sex? Yes/No/ Don’t Know

Group 3 – Small employers, both those offering and not offering health insurance to employees in 2012.

6. QUESTIONS FOR SMALL EMPLOYERS

Questions a, b and c would be placed after existing question 5 in section E of the MEPS 10, main form.

For small-employers – both those offering and not offering health insurance in 2013, ask….

a) How likely is it that your organization will obtain health insurance through a Health Insurance Exchange for small businesses that will be available in 2014? Highly likely/Very likely/Somewhat likely/Not very likely/Not likely at all

For small-employers (reporting less than 50 employees) NOT offering health insurance in 2013, ask….

b) Did your organization consider the Small Business Health Care Tax Credit (available to qualified employers with less than 50 employees) before deciding not to offer health insurance? Yes / No / Don’t Know

c) What is the reason that you still did not offer health insurance? _________________________

Would you be able to answer if given the following categories -- ?

Too costly

Too difficult or time consuming

Not eligible for tax credit

Other (Specify: ________________________ )

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