Common use of Employers, Exchanges, and Other Establishments Clause in Contracts

Employers, Exchanges, and Other Establishments. The type of establishment providing coverage (TYPEFLAG) is on the record. This variable is the source for types of establishments providing employer-based and non-employer-based, private coverage. In this file, TYPEFLAG includes the answers to HX03 and HX23. TYPEFLAG reflects the type of establishment when the establishment was first reported, but it is not necessarily updated. For example, users must link to the JOBS file to obtain information on employees who left their job since the interview in which the employer was first reported (see Section 3.6). For employment-based coverage through both an employer and a union (such as insurance through a labor-management committee), for most cases, only the coverage record through the employer establishment is retained. These cases are identifiable through the PROVDINS variable on the JOBS File. In some cases, the union and employer may provide different types of coverage. It is important for researchers to review coverage type variables - HOSPINSX, MSUPINSX, PMEDINS, DENTLINS, VISIONIN, and COBRA - to determine which establishment would be most helpful in answering analytic questions. As of Panel 14 Round 5 and Panel 15 Round 3, “High Risk Pool” (TYPEFLAG = 20) was added to the list of sources of coverage at HX03 and HX23, where information is collected about purchased insurance associated with a self-employed job and firm-size = 1, and privately purchased health insurance not obtained through an employer. Note that when TYPEFLAG has a value of 10, “spouse’s/deceased spouse’s previous employer,” and the spouse resides in the RU, and the respondent selects the spouse as the policyholder at HP11, then the policyholder’s ID is the spouse’s ID. Beginning in 2014, the MEPS HC asks about State Exchanges, so the PRPL File has four variables and one TYPEFLAG (HX03, HX23) value related to State Exchanges. These variables and value pertain to sources of health insurance coverage created as part of the 2010 Affordable Care Act. The exchanges were launched in 2014 to simplify shopping for private health insurance coverage. Note that the terms “marketplace” and “exchange” are interchangeable. Individuals may purchase care directly from a State Exchange for themselves or family members. The Small Business Health Options Program (SHOP) Marketplaces help small businesses offer health insurance to their employees. For more information, please see the Health Insurance Marketplaces page on the CMS website on the CMS website. The questions about State Exchanges and SHOPs are asked of respondents in every state. The name of the exchange in the respondent’s state is used in the questions, but states are not identified on this file. The variables are as follows:

Employers, Exchanges, and Other Establishments. The type of establishment providing coverage (TYPEFLAG) is on the record. This variable is the source for types of establishments providing employer-based and non-employer-based, private coverage. In this file, TYPEFLAG includes the answers to HX03 and HX23. TYPEFLAG reflects the type of establishment when the establishment was first reported, but it is not necessarily updated. For example, users must link to the JOBS file to obtain information on employees who left their job since the interview in which the employer was first reported (see Section 3.6). For employment-based coverage through both an employer and a union (such as insurance through a labor-management committee), for most cases, only the coverage record through the employer establishment is retained. These cases are identifiable through the PROVDINS variable on the JOBS File. In some cases, the union and employer may provide different types of coverage. It is important for researchers to review coverage type variables - HOSPINSX, MSUPINSX, PMEDINS, DENTLINS, VISIONIN, and COBRA - to determine which establishment would be most helpful in answering analytic questions. As of Panel 14 Round 5 and Panel 15 Round 3, “High Risk Pool” (TYPEFLAG = 20) was added to the list of sources of coverage at HX03 and HX23, where information is collected about purchased insurance associated with a self-employed job and firm-size = 1, and privately purchased health insurance not obtained through an employer. Note that when TYPEFLAG has a value of 10, “spouse’s/deceased spouse’s previous employer,” and the spouse resides in the RU, and the respondent selects the spouse as the policyholder at HP11, then the policyholder’s ID is the spouse’s ID. Beginning in 2014, the MEPS HC asks about State Exchangesstate exchanges, so the PRPL File has four new variables and one new TYPEFLAG (HX03, HX23) value related to State Exchangesvalue. These new variables and value pertain to new sources of health insurance coverage created as part of the 2010 Affordable Care Act. The exchanges were launched in 2014 to simplify shopping for private health insurance coverage. Note that the terms “marketplace” and “exchange” are interchangeable. Individuals may purchase care directly from a State Exchange for themselves or family members. The Small Business Health Options Program (SHOP) Marketplaces help small businesses offer health insurance to their employees. For more information, please see the Health Insurance Marketplaces page on the CMS website on the CMS website. xxxxx://xxx.xxx.xxx/CCIIO/Programs-and-Initiatives/Health-Insurance- Marketplaces/index.html The questions about State Exchanges state exchanges and SHOPs are asked of respondents in every state. The name of the exchange in the respondent’s state is used in the questions, but states are not identified on this file. The new variables are as follows:: Coverage through a State Exchange STEXCH03 and STEXCH23 indicate whether insurance was obtained through an exchange. STEXCH03 provides this information for insurance obtained by a self-employed person with firm size = 1 through that job, STEXCH23 is for all other cases. Both variables are set to inapplicable (-1) for insurance obtained through a current or former employer, union, school, high risk pool, or unknown source. Applicable values exist only for insurance obtained through other groups, insurance companies, insurance agents, HMOs, state exchanges, or other private sources. These variables are automatically set to ‘1,’ indicating that the source of coverage was from a State Exchange when State Exchange was selected as the source of insurance at HX03 or HX23. Otherwise, these variables are the responses to HP04A. After the interview, STEXCH03 and STEXCH23 were edited to ‘2,’ indicating that the source of coverage is not from a State Exchange, when either of the following was true: • The respondent reported Medigap coverage (MUSPINSX = 1) was obtained through the State Exchange, or • For persons 65 years and older, the person had Medicare (reported elsewhere in the health insurance section of the survey).

Employers, Exchanges, and Other Establishments. The type of establishment providing coverage (TYPEFLAG) is on the record. This variable is the source for types of establishments providing employer-based and non-employer-based, private coverage. In this file, TYPEFLAG includes the answers to HX03 and HX23. TYPEFLAG reflects the type of establishment when the establishment was first reported, but it is not necessarily updated. For example, users must link to the JOBS file to obtain information on employees who left their job since the interview in which the employer was first reported (see Section 3.6). For employment-based coverage through both an employer and a union (such as insurance through a labor-management committee), for most cases, only the coverage record through the employer establishment is retained. These cases are identifiable through the PROVDINS variable on the JOBS File. In some cases, the union and employer may provide different types of coverage. It is important for researchers to review coverage type variables - HOSPINSX, MSUPINSX, PMEDINS, DENTLINS, VISIONIN, and COBRA - to determine which establishment would be most helpful in answering analytic questions. As of Panel 14 Round 5 and Panel 15 Round 3, “High Risk Pool” (TYPEFLAG = 20) was added to the list of sources of coverage at HX03 and HX23, where information is collected about purchased insurance associated with a self-employed job and firm-size = 1, and privately purchased health insurance not obtained through an employer. Note that when TYPEFLAG has a value of 10, “spouse’s/deceased spouse’s previous employer,” and the spouse resides in the RU, and the respondent selects the spouse as the policyholder at HP11, then the policyholder’s ID is the spouse’s ID. Beginning in 2014, the MEPS HC asks about State Exchanges, so the PRPL File has four variables and one TYPEFLAG (HX03, HX23) value related to State Exchanges. These variables and value pertain to sources of health insurance coverage created as part of the 2010 Affordable Care Act. The exchanges were launched in 2014 to simplify shopping for private health insurance coverage. Note that the terms “marketplace” and “exchange” are interchangeable. Individuals may purchase care directly from a State Exchange for themselves or family members. The Small Business Health Options Program (SHOP) Marketplaces help small businesses offer health insurance to their employees. For more information, please see the Health Insurance Marketplaces page on the CMS website on the CMS website. xxxxx://xxx.xxx.xxx/CCIIO/Programs-and-Initiatives/Health-Insurance- Marketplaces/index.html The questions about State Exchanges and SHOPs are asked of respondents in every state. The name of the exchange in the respondent’s state is used in the questions, but states are not identified on this file. The variables are as follows:

Employers, Exchanges, and Other Establishments. ‌ The type of establishment providing coverage (TYPEFLAG) is on the record. This variable is the source for types of establishments providing employer-based and non-employer-based, private coverage. In this file, TYPEFLAG includes the answers to HX03 HX200, HX300, and HX23HP40. TYPEFLAG reflects the type of establishment when the establishment was first reported, but it is not necessarily updated. For example, users must link to the JOBS file to obtain information on employees who left their job since the interview in which the employer was first reported (see Section 3.6). For employment-based coverage through both an employer and a union (such as insurance through a labor-management committee), for most cases, only the coverage record through the employer establishment is retained. These cases are identifiable through the PROVDINS variable on the JOBS File. In some cases, the union and employer may provide different types of coverage. It is important for researchers to review coverage type variables - HOSPINSX, MSUPINSX, PMEDINS, DENTLINS, VISIONIN, and COBRA - to determine which establishment would be most helpful in answering analytic questions. As of Beginning in 2018 (Panel 14 23 Round 5 1, Panel 22 Round 3 and Panel 15 21 Round 35), “High Risk Pool” (TYPEFLAG = 20) was added to the list CAPI does not differentiate types of sources private coverage as COBRA or not COBRA when selecting a type of coverage at HX03 and HX23HP40, where information is collected about purchased insurance associated with a self-employed job and firm-size = 1HX200, and privately purchased health insurance not obtained through an employerHX300. Instead, respondents may select FROM ANYONE’S PREVIOUS EMPLOYER at HP40/HX200/HX300 followed by a question at HP140 to determine if it is COBRA coverage. This change is reflected in values of TYPEFLAG. Instead of having separate values for “8 PREVIOUS EMPLOYER – COBRA” and “9 PREVIOUS EMPLOYER – NOT COBRA,” one value TYPEFLAG =“8 PREVIOUS EMPLOYER” is now used. Users should use the variable COBRA to make the required analytic distinction. Note that when TYPEFLAG has a value of 10, “spouse’s/deceased spouse’s previous employerSPOUSE PREVIOUS EMPLOYER,” and the spouse resides in the RU, and the respondent selects the spouse as the policyholder at HP11HP90, then the policyholder’s ID (PHLDRIDX) is the spouse’s IDperson ID (DUPERSID). Beginning in 2014Panel 23 Round 1 and Panel 22 Round 3, the TYPEFLAG="20 HIGH RISK POOL" is no longer an allowed CAPI value at HX200, HX300, and HP40. The MEPS HC asks about State Exchanges, so the PRPL File has four three variables and one TYPEFLAG (HX03HX200, HX23HX300, and HP40) value related to State Exchanges. These variables and value pertain to sources of health insurance coverage created as part of the 2010 Affordable Care Act. The exchanges were launched in 2014 to simplify shopping for private health insurance coverage. Note that the terms “marketplace” and “exchange” are interchangeable. Individuals may purchase care coverage directly from a State Exchange for themselves or family members. The Small Business Health Options Program (SHOP) Marketplaces help small businesses offer health insurance to their employees. For more informationBeginning in FY2019, please see the Health Insurance Marketplaces page on the CMS website on the CMS websiteCAPI no longer collects information in any round regarding employment-related health insurance coverage that is related to a SHOP marketplace. The variable STSHOP, which indicates coverage through a SHOP is no longer included. The questions about State Exchanges and SHOPs are asked of respondents in every state. The name of the exchange in the respondent’s state is used in the questions, but states are not identified on this file. The variables are as follows: