My PBA Usability Study Screener

MyPBA Usability Study Screener

Thank you for your interest in providing feedback to PBGC about its service to pension plan participants. PBGC plans to hold several online usability studies. Each usability study will take approximately 90 minutes. Your participation is voluntary.

So that we may get a good cross-section of customers, please answer the questions below to provide some information about yourself and your experiences with PBGC. In addition, there are two threshold requirements to participate. Your responses to these threshold questions and to the screening questions should take about five minutes and are voluntary.

Paperwork Reduction Act notice: The questions below and the questions that will be used in the usability study have been approved by the Office of Management and Budget under OMB Control No. 1212-0066 (expires 10/31/2023). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless a currently valid OMB control number has been obtained. These screening questions are estimated to take five minutes, and for those selected for the usability study, participation is estimated to take 90 minutes. As noted, your participation in both cases is voluntary.

Confidentiality: Your responses will be used by PBGC solely to improve your customer service experience and will be treated with the confidentiality provided by the Privacy Act and the Freedom of Information Act. That is, your responses will be treated in a private manner unless their disclosure is otherwise compelled by law.

There are two threshold requirements to participate in a usability study:

1. Your equipment must meet the following technical requirement:

• Firefox 4.0 or newer, Internet Explorer 7.0 or newer, Chrome 5.0 or newer, or Safari 3.0 or newer

Please select one of the choices below.

o I am able to meet these technical requirements.

o I am not able to meet these technical requirements. [skip to end]

2. You are available for one or more of the following dates and times. Please check all dates and times for which you would be available. You will only be selected for one.

o Day, June XX, 2021, from XX – XX

o Day, June XX, 2021, from XX – XX

o Day, June XX, 2021, from XX – XX

o Day, June XX, 2021, from XX – XX

o I am not available at any of these times [skip to end]

Participant Agreement: Please indicate your consent to the following, if selected to be part of the online usability study:

o I understand that by participating in this voluntary session, some or all of my personally identifiable information (PII) accessible on MyPBA may be disclosed to PBGC employees who ordinarily may not have access to such information. Any accessed PII will only be viewed by those participating in the session and used only for the purpose of improving the functionality of MyPBA. The session is not recorded and cannot be reproduced. I am 18 years of age or older and have read the above participation agreement and I fully understand it contents. I understand that I may revoke my consent at any time.

Contact Information: What email address should we use to contact you about this usability study?

________________@_____________.____

Confirm email address: ­­­­­­­­­­­­­­­­­________________@_____________.____

Would a confirmation phone call be helpful? If so, please let us know the best number to use:

Thank you for your interest in participating in a PBGC-sponsored usability study. We will contact you by Date at the email address provided to confirm your scheduled participation, or to let you know we have filled all openings. If you have questions meanwhile, you may contact us at SurveyCallback@pbgc.gov.

[submit button]

[for those who are unable to participate (equipment that meets technical requirements not available, not available for any of the scheduled times, do not agree to the participant agreement, or fail to provide an email address)] Thank you for your interest in participating in a PBGC usability study. We regret that you will be unable to do so at this time. If you have questions, you may contact us at SurveyCallback@pbgc.gov.

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