Part A, Appendix D--Advance Letter

PART A - APPENDIX D
DRAFT ADVANCE LETTER AND
STUDY INFORMATION SHEET

DRAFT ADVANCE LETTER
[to be printed on DOL Letterhead]

Date
Dear FIRST NAME, LAST NAME:
The U.S. Department of Labor (DOL) is sponsoring a study to learn more about the health
insurance needs and use among workers and their families after they become unemployed.
Mathematica, an independent research company based in Princeton, New Jersey, is conducting this
study on behalf of DOL. As part of this important study, Mathematica will survey individuals who
received unemployment compensation benefits in 20 states across the country. This letter invites
you to call in to see if you are eligible for the study.
To find out if you are eligible to participate in this study, you will need to answer a few short
questions about your job with [fill EMPLOYER NAME] and the health insurance options that were
available to you before that job ended in [fill MONTH, YEAR]. This screening survey will take
about two minutes of your time. Not everyone will be selected to participate in the study. If you are
selected, you will be asked to complete a telephone interview with one of Mathematica’s
interviewers. This interview will take about 45 minutes to complete. When you complete the full
interview, Mathematica will mail you a check as a token of our appreciation. You can complete the
screening interview and the full interview in either English or Spanish.
There are two ways to find out if you are eligible for the study. The easiest way is to call and
complete the brief screening survey using your touchtone telephone. You can call 1-xxx-xxx-xxx toll
free and answer the screening questions at your convenience—24 hours a day, seven days a week.
Because this screening method saves resources, callers who choose this method will receive $40 if
they are selected to participate in the full interview and complete it. You must call in by
[fill FOUR WEEKS FROM DATE] to qualify for this incentive.
The second way is to complete the screening survey with an interviewer at Mathematica. You
can call Mathematica toll free at 1-xxx-xxx-xxxx and ask for Carla Smith. Or, an interviewer from
Mathematica will contact you directly if they do not receive a call from you. If you choose this
method, you will receive $30 if you are selected to participate in the full interview and
complete it.
Please help us by calling one of the numbers above to see if you are eligible. You will need the
personal identification number (PIN) listed below when you call:
PIN #: XXXXXXXX
Your participation is voluntary, but we encourage you to call in to see if you are eligible and to
complete the full survey if you are selected. Your experiences will help DOL learn more about how
they can help workers who have become unemployed. Any information that we collect from you
will be used for research purposes only and will be kept private and confidential to the fullest extent
provided by law.
Thank you for taking the time to consider our request. An information sheet about the study is
enclosed. If you have any questions about the survey, please call Mathematica toll-free at
xxx-xxx-xxxx, and ask for Carla Smith. You can learn more about Mathematica by visiting our
website at www.mathematica-mpr.com. For more information about the study, please visit the DOL
website at http://www.dol.gov/.
Sincerely,
DOL OFFICIAL
Enclosure
Mathematica is conducting this study for DOL under Contract No. XX-XXXXX-XX-XX and OMB Control No. XXXX-XXXX

D.3

INFORMATION SHEET
STUDY ON HEALTH INSURANCE NEEDS AND USE
WHO/WHICH AGENCY IS SPONSORING THE STUDY?
This study is being sponsored by the United States Department of Labor (DOL).
WHO IS CONDUCTING THE STUDY?
Mathematica, an independent research company is conducting the study on behalf of DOL.
Mathematica has more than 40 years of policy research and program evaluation experience. You can
learn more about Mathematica by visiting our website at www.mathematica-mpr.com.
WHAT IS THE PURPOSE OF THE STUDY?
This study will look at how the health insurance status of individuals and their families change after
they become unemployed.
WHO IS ELIGIBLE TO PARTICIPATE IN THE STUDY?
Some people who became unemployed and filed for unemployment insurance benefits between
February 17, 2009 and March 31, 2011.
HOW DID YOU GET MY NAME?
Your name was scientifically selected from among persons in your state who filed for
unemployment insurance compensation benefits between February 17, 2009 and March 31, 2011.
IS THE SURVEY CONFIDENTIAL?
Yes. All of the information we collect in the survey will be kept confidential as provided in the
Privacy Act of 1974 and will be used for research purposes only. Your answers will be combined
with the answers of other survey participants. Your name will never be used in any reports. Only
members of the study team will have information about you.
HOW LONG WILL THIS TAKE?
The screening interview to see if you are eligible will take about two minutes to complete. If you are
selected for the full survey, it will take about 45 minutes to complete.
WHO GAVE YOU THE AUTHORITY TO CONDUCT THE STUDY?
This study is being sponsored by DOL and has been approved by the U.S. Office of Management
and Budget under OMB control number 1291-0001. Without this approval DOL would not be able
to conduct this survey.
WHO CAN I CONTACT FOR MORE INFORMATION?
For more information about the study, you can visit the DOL website at http://www.dol.gov/. You
can also call the study’s project officer, Mr. Jonathan Simonetta of DOL at (202) 693-5085 or
Mathematica’s Project Director, Dr. Anu Rangarajan at 609-936-2765. For questions about the
survey you can call Mathematica’s Survey Director, Ms. Julita Milliner-Waddell at 609-275-2206.

D.4