Common use of Types of Coverage through the Establishment Clause in Contracts

Types of Coverage through the Establishment. The establishments in the PRPL file provide private health insurance covering hospital/physician, Medicare supplemental insurance, dental, vision, or prescription medication insurance. The variable PRIVCAT identifies the type of source for hospital and physician or Medicare supplemental insurance. HOSPINSX and MSUPINSX are edited establishment- policyholder flags for whether the policyholder has physician/hospital and Medigap coverage, respectively, through the establishment. However, even when PRIVCAT indicates there is either hospital/physician or Medigap coverage, both HOSPINSX and MSUPINSX may have missing values. Note also that both HOSPINSX and MSUPINSX may be coded “yes” (1) on the same record. DENTLINS, VISIONIN, and PMEDINS flags indicate the establishment provides coverage for dental care, vision care, and prescription medications, respectively. Below are examples of how to use these variables to identify types of insurance: Identifying Types of Insurance Variable and Values Hospital and physician or Medicare supplemental insurance PRIVCAT in (1, 2, 3, 4, 5, 99) Medicare supplemental insurance MSUPINSX = 1 Hospital and physician insurance PRIVCAT in (1, 2, 3, 4, 5, 99) & MSUPINSX ne 1 Dental insurance DENTLINS = 1 The variable COBRA is a flag for whether the respondent reported that the coverage was obtained through the requirements of the COBRA of 1986. This act requires that certain employers allow some former employees to continue their employment-based coverage by paying the employer the premium (U.S. Department of Labor). This flag does not, however, indicate all the coverage through former employers, which can be determined using TYPEFLAG and links to former jobs in the JOBS file. COBRA is set to “yes” if any of the three following conditions are met:

Types of Coverage through the Establishment. The establishments in the PRPL file provide private health insurance covering hospital/physician, Medicare supplemental insurance, dental, vision, or prescription medication insurance. The variable PRIVCAT identifies the type of source for hospital and physician or Medicare supplemental insurance. HOSPINSX and MSUPINSX are edited establishment- policyholder flags for whether the policyholder has physician/hospital and Medigap coverage, respectively, through the establishment. However, even when PRIVCAT indicates there is either hospital/physician or Medigap coverage, both HOSPINSX and MSUPINSX may have missing values. Note also that both HOSPINSX and MSUPINSX may be coded “yes” (1) on the same record. DENTLINS, VISIONIN, and PMEDINS flags indicate the establishment provides coverage for dental care, vision care, and prescription medications, respectively. Below are examples of how to use these variables to identify types of insurance: Identifying Types of Insurance Variable and Values Hospital and physician or Medicare supplemental insurance PRIVCAT in (1, 2, 3, 4, 5, 6, 99) Medicare supplemental insurance MSUPINSX = 1 Hospital and physician insurance PRIVCAT in (1, 2, 3, 4, 5, 6, 99) & MSUPINSX ne 1 Dental insurance DENTLINS = 1 The variable COBRA is a flag for whether the respondent reported that the coverage was obtained through the requirements of the COBRA of 1986. This act requires that certain employers allow some former employees to continue their employment-based coverage by paying the employer the premium (U.S. Department of Labor). This flag does not, however, indicate all the coverage through former employers, which can be determined using TYPEFLAG and links to former jobs in the JOBS file. COBRA is set to “yes” if any of the three following conditions are met:

Types of Coverage through the Establishment. The establishments in the PRPL file provide private health insurance covering hospital/physician, Medicare supplemental insurance, dental, vision, prescription medication, or prescription medication long-term care insurance. The variable PRIVCAT identifies the type of source for hospital and physician or Medicare supplemental insurance. HOSPINSX and MSUPINSX are edited establishment- policyholder flags for whether the policyholder has physician/hospital and Medigap medigap coverage, respectively, through the establishment. However, even when PRIVCAT indicates there is either hospital/physician or Medigap medigap coverage, both HOSPINSX and MSUPINSX may have missing C-9 MEPS HC-047: 1999 File values. Note also that both HOSPINSX and MSUPINSX may be coded “yes” (1) Ayes@ on the same record. DENTLINS, VISIONIN, PMEDINS, and PMEDINS LTCINS flags indicate the establishment provides coverage for dental care, vision care, and prescription medications, and long-term care, respectively. Below are examples of how to use these variables to identify types of insurance: Identifying Types of Insurance Variable and Values Hospital and physician or Medicare supplemental insurance PRIVCAT in (1, 2, 3, 4, 5, 991,2,3,4,5,99) Medicare supplemental insurance MSUPINSX = 1 Hospital and physician insurance PRIVCAT in (1, 2, 3, 4, 5, 991,2,3,4,5,99) & MSUPINSX ne 1 Dental insurance DENTLINS DNTLINS = 1 The variable COBRA is a flag for whether the respondent reported that the coverage was obtained through the requirements of the COBRA Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986. This act requires that certain employers allow some former employees to continue their employment-based coverage by paying the employer the premium (U.S. Department of LaborLabor 1999). This flag does not, however, indicate all the coverage through former employers, which can be determined using TYPEFLAG and links to former jobs in the JOBS file. COBRA is set to “yes” Ayes@ if any of the three following conditions are met:

Types of Coverage through the Establishment. The establishments in the PRPL file provide private health insurance covering hospital/physician, Medicare supplemental insurance, dental, vision, prescription medication, or prescription medication long-term care insurance. The variable PRIVCAT identifies the type of source for hospital and physician or Medicare supplemental insurance. HOSPINSX and MSUPINSX are edited establishment- policyholder flags for whether the policyholder has physician/hospital and Medigap medigap coverage, respectively, through the establishment. However, even when PRIVCAT indicates there is either hospital/physician or Medigap medigap coverage, both HOSPINSX and MSUPINSX may have missing values. Note also that both HOSPINSX and MSUPINSX may be coded “yes” (1) Ayes@ on the same record. DENTLINS, VISIONIN, PMEDINS, and PMEDINS LTCINS flags indicate the establishment provides coverage for dental care, vision care, and prescription medications, and long-term care, respectively. Below are examples of how to use these variables to identify types of insurance: Identifying Types of Insurance Variable and Values Hospital and physician or Medicare supplemental insurance PRIVCAT in (1, 2, 3, 4, 5, 991,2,3,4,5,99) Medicare supplemental insurance MSUPINSX = 1 Hospital and physician insurance PRIVCAT in (1, 2, 3, 4, 5, 991,2,3,4,5,99) & MSUPINSX ne 1 Dental insurance DENTLINS DNTLINS = 1 The variable COBRA is a flag for whether the respondent reported that the coverage was obtained through the requirements of the COBRA Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986. This act requires that certain employers allow some former employees to continue their employment-based coverage by paying the employer the premium (U.S. Department of LaborLabor 1999). This flag does not, however, indicate all the coverage through former employers, which can be C-9 MEPS HC-047: 2000 File determined using TYPEFLAG and links to former jobs in the JOBS file. COBRA is set to “yes” Ayes@ if any of the three following conditions are met:

Types of Coverage through the Establishment. ‌ The establishments in the PRPL file provide private health insurance covering hospital/physician, Medicare supplemental insurance, dental, vision, or prescription medication insurance. The variable PRIVCAT PrivateCat identifies the type of source for hospital and physician or Medicare supplemental insurance. HOSPINSX and MSUPINSX are edited establishment- establishment-policyholder flags for whether the policyholder has physician/hospital and Medigap coverage, respectively, through the establishment. However, even when PRIVCAT PrivateCat indicates there is either hospital/physician or Medigap coverage, both HOSPINSX and MSUPINSX may have missing values. Note also that both HOSPINSX and MSUPINSX may be coded “yes” (1) 1 YES on the same record. DENTLINS, VISIONIN, and PMEDINS flags indicate the establishment provides coverage for dental care, vision care, and prescription medications, respectively. Below are examples of how to use these variables to identify types of insurance: Identifying Types of Insurance Variable and Values Hospital and physician or Medicare supplemental insurance PRIVCAT PrivateCat in (1, 2, 3, 4, 5, 6, 99) Medicare supplemental insurance MSUPINSX = 1 Hospital and physician insurance PRIVCAT PrivateCat in (1, 2, 3, 4, 5, 6, 99) & MSUPINSX ne 1 Dental insurance DENTLINS = 1 The variable COBRA is a flag for whether the respondent reported that the coverage was obtained through the requirements of the COBRA of 1986. This act requires that certain employers allow some former employees to continue their employment-based coverage by paying the employer the premium (U.S. Department of Labor). This flag does not, however, indicate all the coverage through former employers, which can be determined using TYPEFLAG and links to former jobs in the JOBS file. In the PRPL file, COBRA is set to “yes” if any 1 YES when COBRA coverage is indicated at HP140. COBRA is set to 2 NO when the insurance was not COBRA coverage. COBRA is set to -1 INAPPLICABLE when the coverage was not employment-based, and when the coverage was through a current job. COBRA is set to -15 CANNOT BE COMPUTED for retirement jobs first reported in the Employment section in Round 1 (EM380 or EM390), retirement jobs first reported in the Employment section for new RU members (EM380 or EM390), and insurance through unions reported in the Insurance section (HX200/HX300). In a few cases, self-employed persons with firm size = 1 reported buying coverage through a previous job, and these cases are coded as yes or no, while other insurance through self-employment with firm size = 1 is coded -1 INAPPLICABLE. The variable COVTYPIN flags whether coverage was single or family, based on the number of persons covered in the RU, whether the establishment’s insurance covers someone outside the household, and whether the policyholder is outside the household. For Panel 24 Rounds 1 and 2, and Panel 23 Rounds 3 and 4, the number of covered persons was measured at the time of the three following conditions interview (or end of the reference period). For Panel 24 Round 3 and Panel 23 Round 5, the number is as of December 31st. When coverage ceased before the end of the reference period for every co-residing family member, XXXXXXXX is set based on the number of persons ever covered during the round. The variable COVROUT_M18 indicates whether out-of-RU persons were covered by the plan. Beginning in Panel 23 Round 1, Panel 22 Round 3, and Panel 21 Round 5, CAPI changed the universe of respondents for this question. Specifically, COVROUT_M18 is not asked if there is only one member of an RU and that person is covered by a policyholder who is deceased, no longer in the household, or not listed in the dwelling unit. Additionally, whether the policy covers dependents outside the RU is only asked if there are met:no dependents living in the RU covered under that policy. Consequently, researchers will note differences in the frequency of COVROUT_M18 compared with previous years.