Health Insurance Variables Clause Samples

The 'Health Insurance Variables' clause defines the specific terms and conditions related to health insurance coverage within an agreement. It typically outlines which parties are responsible for providing health insurance, the scope of coverage, and any relevant eligibility requirements or limitations. For example, it may specify whether an employer must offer health insurance to employees or clarify the types of plans that meet contractual obligations. This clause ensures clarity regarding health insurance responsibilities, helping to prevent misunderstandings and disputes over coverage during the term of the contract.
Health Insurance Variables. Constructed and edited variables are provided that indicate any coverage during the MEPS Panel 8 Round 1 and Panel 7 Round 3 interviews for the sources of health insurance coverage collected during the MEPS interview. With the exception of private insurance (PRIV13), the insurance variables for the Panel 8 Round 1 observations have been edited. For both the Panel 8 Round 1 sample and the Panel 7 Round 3 sample, minimal editing was performed on the Medicare and Medicaid or State Children’s Health Insurance Program (SCHIP) variables to assign persons to coverage from these sources. Beginning October 1, 2001, persons 65 years and older can retain TRICARE coverage in addition to Medicare. Therefore, persons over age 65 will no longer have their reported TRICARE coverage (TRINW13X) overturned. TRICARE will act as a supplemental insurance for Medicare much as Medigap insurance does now. As mentioned above, private insurance coverage was unedited and unimputed for Panel 8 Round 1. For Panel 7 Round 3, most of the insurance variables have been logically edited to address issues that arose during Rounds 2 and 3 when reviewing insurance reported in earlier rounds. One edit corrects for possible respondent confusion with respect to a question about covered benefits asked of respondents who reported a change in their private health insurance plan name. Additional edits were performed to address issues of missing data on the time period of coverage. Note that the Medicare and TRICARE variables indicate coverage at the time of the Panel 8 Round 1 or Panel 7 Round 3 interview dates. The private coverage and other public insurance variables indicate coverage at any time during Panel 8 Round 1 or Panel 7 Round 3. Public sources include Medicare, TRICARE, Medicaid, SCHIP, and other public hospital/physician coverage. State-specific program participation in non-comprehensive coverage (STPRG13) was also identified but is not considered health insurance for the purposes of this survey. Medicare (MCARE13) coverage was edited (MCARE13X) for persons age 65 or over. Within this age group, individuals were assigned Medicare coverage if: • They answered “yes” to a follow-up question on whether or not they received Social Security benefits; or • They were covered by Medicaid/SCHIP, other public hospital/physician coverage, or Medigap coverage; or • Their spouse was age 65 or older and covered by Medicare; or • They reported TRICARE coverage. Questions about other public hospital/phys...
Health Insurance Variables. 2.5.2.1 Managed Care Variables (MCDHMO31, MCDHMO42, MCDHMO98, MCDMC31, MCDMC42, MCDMC98, PRVHMO31, PRVHMO42, PRVHMO98, PRVMC31, PRVMC42, PRVMC98) Medicaid Managed Care Plans Medicaid HMOs