№ lp_2_1_04643
File format: docx
Character count: 13480
File size: 75 KB
This is a survey document that asks enrollees of a Qualified Health Plan to assess their experience with their health plan from July to December 2019.
Year:
2020
Region / city:
Not specified
Topic:
Health plan enrollee experience
Document type:
Survey
Organization / institution:
Not specified
Author:
Not specified
Target audience:
Health plan enrollees
Period of validity:
July – December 2019
Approval date:
Not specified
Date of changes:
Not specified
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Year:
2025
Region / City:
Not specified
Subject:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Health plan enrollees
Period of validity:
July – December 2024
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2023
Region / City:
Not specified
Theme:
Healthcare, Health Plans
Document Type:
Survey Script
Issuing Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees in Qualified Health Plans
Period of Validity:
2023
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2021
Region / City:
United States
Theme:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
QHP Issuer
Author:
Not specified
Target Audience:
QHP enrollees
Period of Action:
July through December 2020
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2026
Region / City:
Not specified
Subject:
Exception requests for variations from QHP Enrollee Survey requirements
Document Type:
Instructional Form
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Vendors conducting the QHP Enrollee Survey
Period of Action:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2026
Document type:
Internet survey script
Survey name:
Qualified Health Plan (QHP) Enrollee Experience Survey
Language:
English
Data collection mode:
Internet survey
Reference period:
July–December 2025
Reference period length:
6 months
Target population:
Qualified Health Plan enrollees
Subject area:
Health insurance enrollee experience
Regulatory authority:
Centers for Medicare & Medicaid Services
OMB control number:
0938-1221
OMB approval expiration:
September 30, 2026
Estimated completion time:
10 minutes
Survey sponsor:
Health plan issuers under QHP program
Data use purpose:
Enrollee experience measurement
Geographic scope:
United States
Document section:
Programming specifications and survey instructions
Source type:
Federal survey instrument documentation
Year:
2025
Region / City:
N/A
Theme:
Healthcare, Health Plans
Document Type:
Survey
Agency / Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
N/A
Target Audience:
Enrollees of Qualified Health Plans
Period of Validity:
From July to December 2024
Approval Date:
N/A
Date of Changes:
N/A
Year:
2024
Region / City:
Not specified
Topic:
Health care survey
Document Type:
Survey invitation
Organization / Institution:
Department of Health and Human Services
Author:
Not specified
Target Audience:
Enrollees of [QHP ISSUER NAME]
Period of Validity:
July - December 2024
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Contextual Description
Year:
2022
Region / City:
Not specified
Theme:
Healthcare, Health Insurance Surveys
Document Type:
Telephone Interview Script
Organization:
Not specified
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans
Period of validity:
From July to December 2021
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2022
Region / City:
United States
Theme:
Health care survey
Document Type:
Survey script
Organization / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans (QHP)
Effective Period:
2021-2022
Approval Date:
11/30/2023
Revision Date:
Not specified
Survey Format:
Online
Data Collection Method:
Internet survey
OMB Approval Number:
0938-1221
Year:
2022
Region / City:
United States
Topic:
Qualified Health Plan Enrollee Experience Survey
Document Type:
Vendor Participation Notice
Organization / Institution:
CMS (Centers for Medicare & Medicaid Services)
Author:
CMS
Target Audience:
Prospective vendors for the 2022 QHP Enrollee Survey
Effective Period:
July 15, 2021 - July 30, 2021
Approval Date:
July 30, 2021
Date of Changes:
None
Year:
2021
Region / City:
Not specified
Theme:
Quality Healthcare Programs, Enrollee Surveys
Document Type:
Instruction and Form
Organ / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Vendors involved in QHP Enrollee Survey
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
OMB Control Number:
0938-1394
Expiration Date:
XX/XX/20XX
Issuing Agency:
Centers for Medicare & Medicaid Services (CMS)
Department:
U.S. Department of Health and Human Services (HHS)
Related System:
Health Insurance Oversight System (HIOS)
Legal Basis:
45 CFR 156.295(a); 45 CFR 184.50(a); 45 C.F.R. 155.260
Frequency of Reporting:
Annual
Estimated Time per Response:
122 hours
Applicability:
QHP issuers and Pharmacy Benefit Managers (PBMs)
Subject:
Prescription drug data, pricing, and rebate reporting
Data Elements:
Issuer_HIOS_Plan_ID; NDC; Total_Prescriptions_Dispensed_All; Total_Prescriptions_Dispensed_Retail_Pharmacies; Total_Prescriptions_Dispensed_Mail_Order_Pharmacies; Total_Rebate_Dollars
Submission Format:
Pipe-delimited .csv file
Confidentiality:
Privacy and Security of Personally Identifiable Information under 45 C.F.R. 155.260
Year(s):
2022–2024
Country:
United States
Subject:
Essential Community Providers (ECP) requirements for Qualified Health Plan (QHP) certification
Document Type:
Supporting Statement / Administrative Justification
Issuing Authority:
Department of Health and Human Services (HHS)
Administering Agency:
Centers for Medicare & Medicaid Services (CMS)
Legal Basis:
Section 1311(c)(1)(C) of the Affordable Care Act; 45 CFR 156.235; Section 340B(a)(4) of the Public Health Service Act; Section 1927(c)(1)(D)(i)(IV) of the Social Security Act
OMB Control Number:
0938-1295
CMS Identifier:
CMS-10561
Applicable Programs:
Qualified Health Plans (QHPs); Stand-alone Dental Plans (SADPs)
Regulatory Focus:
Inclusion standards and data collection for Essential Community Providers
Geographic Scope:
Nationwide
Data Collection Method:
Online ECP Provider Petition
Target Entities:
Health care providers serving predominantly low-income, medically underserved individuals; QHP and SADP issuers
Related Benefit Year:
2022 benefit year
Year:
2025
Region / City:
Not specified
Subject:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Health plan enrollees
Period of validity:
July – December 2024
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2023
Region / City:
Not specified
Theme:
Healthcare, Health Plans
Document Type:
Survey Script
Issuing Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees in Qualified Health Plans
Period of Validity:
2023
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2021
Region / City:
United States
Theme:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
QHP Issuer
Author:
Not specified
Target Audience:
QHP enrollees
Period of Action:
July through December 2020
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2024
Survey period:
July–December 2023
Topic:
Health insurance enrollee experience
Program:
Qualified Health Plan (QHP)
Document type:
Survey questionnaire
Target population:
Qualified Health Plan enrollees
Geographic context:
United States
Content sections:
Health plan information, customer service, forms and accessibility, confidence in insurance knowledge, overall rating, discrimination experiences, recommendations, demographic information
Response format:
Multiple-choice scales and rating scales
Year:
2026
Region / City:
Not specified
Subject:
Exception requests for variations from QHP Enrollee Survey requirements
Document Type:
Instructional Form
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Vendors conducting the QHP Enrollee Survey
Period of Action:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2026
Document type:
Internet survey script
Survey name:
Qualified Health Plan (QHP) Enrollee Experience Survey
Language:
English
Data collection mode:
Internet survey
Reference period:
July–December 2025
Reference period length:
6 months
Target population:
Qualified Health Plan enrollees
Subject area:
Health insurance enrollee experience
Regulatory authority:
Centers for Medicare & Medicaid Services
OMB control number:
0938-1221
OMB approval expiration:
September 30, 2026
Estimated completion time:
10 minutes
Survey sponsor:
Health plan issuers under QHP program
Data use purpose:
Enrollee experience measurement
Geographic scope:
United States
Document section:
Programming specifications and survey instructions
Source type:
Federal survey instrument documentation
Year:
2025
Region / City:
N/A
Theme:
Healthcare, Health Plans
Document Type:
Survey
Agency / Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
N/A
Target Audience:
Enrollees of Qualified Health Plans
Period of Validity:
From July to December 2024
Approval Date:
N/A
Date of Changes:
N/A