View Information Collection (IC)

View Information Collection (IC)

IC Title:	Pretest Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MEPS – IC	Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)	MEPS Interview Protocol 091316.docx		Yes	Yes	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	50	0	50	0	0	0
Annual IC Time Burden (Hours)	29	0	29	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Memo	MEPS_IC_OMB_letter_9.13.2016.docx	09/20/2016
MEPS-10	meps10_2016Final.pdf	09/20/2016
MESP_10s	meps10s_2016Final.pdf	09/20/2016
MEPS-11	meps11_16Final.pdf	09/20/2016
MEPS-11s	meps11s_2016Final.pdf	09/20/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.