| Model Instance Name: |
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| IRS ACA | |||||||||
| MID: | |||||||||
| Partitioned (Y/N)? N | |||||||||
| Date: | |||||||||
| IRS ACA | |||||||||
| Model questions utilize the ForeSee CXA methodology to determine scores and impacts | |||||||||
| CUSTOMER SATISFACTION | FUTURE BEHAVIORS | ||||||||
| MQ Label | MQ Label | ||||||||
| Satisfaction | Return (1=Very Unlikely, 10=Very Likely) | ||||||||
| 1 | Satisfaction - Overall | What is your overall satisfaction with the ACA section of the IRS.gov website? (1=Very Dissatisfied, 10=Very Satisfied) |
4 | Return | How likely are you to return to the ACA section of the IRS.gov website? | ||||
| 2 | Satisfaction - Expectations | How well does the ACA section of the IRS.gov website meet your expectations? (1=Falls Short, 10=Exceeds) |
Recommend (1=Very Unlikely, 10=Very Likely) | ||||||
| 3 | Satisfaction - Ideal | How does this website compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close) |
5 | Recommend | How likely are you to recommend the ACA section of the IRS.gov website to someone else? | ||||
| Primary Resource (1=Very Unlikely, 10=Very Likely) | |||||||||
| 6 | Primary Resource | How likely are you to use the IRS.gov website as your primary resource for all Affordable Care Act (ACA) Tax Provisions information? | |||||||
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| Model Instance Name: | ||||||||||||
| IRS ACA | underlined & italicized: RE-ORDER | |||||||||||
| MID: | pink: ADDITION | |||||||||||
| Date: 3/31/14 | blue + -->: REWORDING | |||||||||||
| IRS ACA CUSTOM QUESTION LIST | ||||||||||||
| QID | Skip Logic Label | Question Text | Answer Choices (limited to 50 characters) |
Skip to | Type (select from list) | Single or Multi | Required Y/N |
Special Instructions | CQ Label | |||
| How frequently do you visit the ACA section of the IRS.gov website? | This is my first time | Drop down, select one | Single | Y | Frequency | |||||||
| Daily | ||||||||||||
| Weekly | ||||||||||||
| Monthly | ||||||||||||
| Every couple of months or less often | ||||||||||||
| Which category best describes you? Are you …? | Individual/family | Drop down, select one | Single | Y | Role | |||||||
| Small employer/self-employed | ||||||||||||
| Large employer/corporation | ||||||||||||
| Partnership | ||||||||||||
| Insurer | ||||||||||||
| Pharmaceutical manufacturer | ||||||||||||
| Importer/international business | ||||||||||||
| Hospital | ||||||||||||
| Tax return preparer | ||||||||||||
| Tax exempt or government organization | ||||||||||||
| Non-profit health insurance issuer | ||||||||||||
| Other business type | ||||||||||||
| What are your main reasons for visiting the ACA section of the IRS.gov website today? | Information about general tax filing requirements associated with ACA | Checkbox, one-up vertical | Multi | Y | Reason | |||||||
| Information regarding the Premium Tax Credit or Advanced Premium Tax Credit | ||||||||||||
| Information regarding the Individual Shared Responsibility provision | ||||||||||||
| Information regarding the Additional Medicare Tax | ||||||||||||
| Information regarding the Net Investment Income Tax | ||||||||||||
| Information regarding the Small Business Health Care Tax Credit | ||||||||||||
| Information regarding the Small business health options program (SHOP) | ||||||||||||
| Changes to itemized deductions for medical expenses | ||||||||||||
| ACA Tax provisions for insurers | ||||||||||||
| ACA Tax provisions for miscellaneous business types | ||||||||||||
| ACA Tax provisions for tax exempt and government organizations | ||||||||||||
| Information on how to e-file ACA information reports | ||||||||||||
| List of other ACA tax provisions | ||||||||||||
| Legal guidance and other resources | ||||||||||||
| News releases | ||||||||||||
| Health care tax tips | ||||||||||||
| Questions and answers | ||||||||||||
| Information in Spanish | ||||||||||||
| Other | ||||||||||||
| Did you find the information you were looking for? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic Group* | Find info | ||||||
| No | A | |||||||||||
| Partially | ||||||||||||
| A | Please tell us in as much detail as possible what specifically were you looking for today? | Text area, no char limit | N | Skip Logic Group* | No info | |||||||
| Did you find the ACA information useful? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic Group* | Useful | ||||||
| No | ||||||||||||
| Not sure | ||||||||||||
| What could IRS do to improve the ACA section to better meet your needs? | Text area, no char limit | N | Improve | |||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |