Medical Expenditure Panel Survey - Insurance Component (MEPS-IC)

ICR 202301-0935-001

OMB: 0935-0110

Federal Form Document

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0935-0110 can be found here:

2025-06-17 - Extension without change of a currently approved collection

Forms and Documents

Document Name	Status
Form Form #3 Plan Questionnaire Form and Instruction	Unchanged
Form Form #2 Establishment Questionnaire Form and Instruction	Unchanged
Form Form #1 Prescreener Questionnaire Form and Instruction	Unchanged
SS Part B -- MEPS-IC 2023 - 2025_080322.docx Supporting Statement B	2023-01-06
SS Part A -- MEPS-IC 2023-2025.docx Supporting Statement A	2023-01-06
Attachment O -- Non-Response Bias Analysis of the 2014 MEPS-IC.docx Supplementary Document	2022-12-01
Attachment N - Definitions.pdf Supplementary Document	2022-12-01
Attachment M - Multi Unit Private Sector.pdf Supplementary Document	2022-12-01
Attachment L - Single Unit Private Sector.pdf Supplementary Document	2022-12-01
Attachment K - CMU Advance Letter.pdf Supplementary Document	2022-12-01
Attachment J - Certainty Government Initial Letter.pdf Supplementary Document	2022-12-01
Attachment I - Certainty Government Advance Letter.pdf Supplementary Document	2022-12-01
Attachment H - Noncertainty Government Initial Letter.pdf Supplementary Document	2022-12-01
Attachment G - Sample Strata 2023-2025.docx Supplementary Document	2022-12-01
Attachment F - Allocation by State 2023-2025.docx Supplementary Document	2022-12-01
Attachment E -- Confidentiality Form.docx Supplementary Document	2022-12-01

IC Document Collections

IC ID	Document Title	Status
182461	Plan Questionnaire Form and Instruction	Unchanged
182460	Establishment Questionnaire Form and Instruction	Unchanged
182459	Prescreener Questionnaire Form and Instruction	Unchanged

ICR Details

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