RIC         1  1                                        C

FILEYR      2  2                                        C

BASEID      4  8  $BSIDFMT                              C UNIQUE IDENTIFICATION NUMBER

                              13,039             LOW-HIGH BASEID Count

D_CARE1    12  1  $CAREFMT                              C JAN MEDICARE COVERAGE

                               1,305                    0 NO COVERAGE
                                 362                    1 PART A
                                 119                    2 PART B
                              11,253                    3 PARTS A & B

D_CAID1    13  1  $CAIDFMT                              C JAN MEDICAID COVERAGE OBTAINED FROM

                              10,479                    0 NO COVERAGE
                                 622                    1 SURVEY INFORMATION
                                  56                    2 HCFA RECORDS
                               1,882                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI1     14  1  $PHIFMT                               C JAN PRIVATE HEALTH INSURANCE

                               5,411                    0 NO COVERAGE
                               3,412                    1 EMPLOYER SPONSORED
                               3,583                    2 SELF PURCHASED
                                 484                    3 BOTH
                                 149                    4 UNKNOWN

D_HMO1     15  1  $HMOFMT                               C JAN HMO COVERAGE

                              11,837                    0 NO COVERAGE
                                 583                    1 PRIVATE
                                 609                    2 MEDICARE
                                  10                    3 BOTH

D_OTH1     16  1                                        C # OF OTHER JAN PLANS

D_CARE2    17  1  $CAREFMT                              C FEB MEDICARE COVERAGE

                               1,264                    0 NO COVERAGE
                                 358                    1 PART A
                                 119                    2 PART B
                              11,298                    3 PARTS A & B

D_CAID2    18  1  $CAIDFMT                              C FEB MEDICAID COVERAGE OBTAINED FROM

                              10,483                    0 NO COVERAGE
                                 611                    1 SURVEY INFORMATION
                                  55                    2 HCFA RECORDS
                               1,890                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI2     19  1  $PHIFMT                               C FEB PRIVATE HEALTH INSURANCE

                               5,430                    0 NO COVERAGE
                               3,395                    1 EMPLOYER SPONSORED
                               3,572                    2 SELF PURCHASED
                                 494                    3 BOTH
                                 148                    4 UNKNOWN

D_HMO2     20  1  $HMOFMT                               C FEB HMO COVERAGE

                              11,825                    0 NO COVERAGE
                                 589                    1 PRIVATE
                                 615                    2 MEDICARE
                                  10                    3 BOTH

D_OTH2     21  1                                        C # OF OTHER FEB PLANS

D_CARE3    22  1  $CAREFMT                              C MAR MEDICARE COVERAGE

                               1,193                    0 NO COVERAGE
                                 371                    1 PART A
                                 121                    2 PART B
                              11,354                    3 PARTS A & B

D_CAID3    23  1  $CAIDFMT                              C MAR MEDICAID COVERAGE OBTAINED FROM

                              10,497                    0 NO COVERAGE
                                 595                    1 SURVEY INFORMATION
                                  52                    2 HCFA RECORDS
                               1,895                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI3     24  1  $PHIFMT                               C MAR PRIVATE HEALTH INSURANCE

                               5,453                    0 NO COVERAGE
                               3,387                    1 EMPLOYER SPONSORED
                               3,548                    2 SELF PURCHASED
                                 499                    3 BOTH
                                 152                    4 UNKNOWN

D_HMO3     25  1  $HMOFMT                               C MAR HMO COVERAGE

                              11,826                    0 NO COVERAGE
                                 588                    1 PRIVATE
                                 613                    2 MEDICARE
                                  12                    3 BOTH

D_OTH3     26  1                                        C # OF OTHER MAR PLANS

D_CARE4    27  1  $CAREFMT                              C APR MEDICARE COVERAGE

                               1,127                    0 NO COVERAGE
                                 381                    1 PART A
                                 122                    2 PART B
                              11,409                    3 PARTS A & B

D_CAID4    28  1  $CAIDFMT                              C APR MEDICAID COVERAGE OBTAINED FROM

                              10,515                    0 NO COVERAGE
                                 566                    1 SURVEY INFORMATION
                                  54                    2 HCFA RECORDS
                               1,904                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI4     29  1  $PHIFMT                               C APR PRIVATE HEALTH INSURANCE

                               5,493                    0 NO COVERAGE
                               3,377                    1 EMPLOYER SPONSORED
                               3,517                    2 SELF PURCHASED
                                 498                    3 BOTH
                                 154                    4 UNKNOWN

D_HMO4     30  1  $HMOFMT                               C APR HMO COVERAGE

                              11,816                    0 NO COVERAGE
                                 588                    1 PRIVATE
                                 620                    2 MEDICARE
                                  15                    3 BOTH

D_OTH4     31  1                                        C # OF OTHER APR PLANS

D_CARE5    32  1  $CAREFMT                              C MAY MEDICARE COVERAGE

                               1,049                    0 NO COVERAGE
                                 390                    1 PART A
                                 123                    2 PART B
                              11,477                    3 PARTS A & B

D_CAID5    33  1  $CAIDFMT                              C MAY MEDICAID COVERAGE OBTAINED FROM

                              10,531                    0 NO COVERAGE
                                 541                    1 SURVEY INFORMATION
                                  53                    2 HCFA RECORDS
                               1,914                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI5     34  1  $PHIFMT                               C MAY PRIVATE HEALTH INSURANCE

                               5,532                    0 NO COVERAGE
                               3,371                    1 EMPLOYER SPONSORED
                               3,507                    2 SELF PURCHASED
                                 484                    3 BOTH
                                 145                    4 UNKNOWN

D_HMO5     35  1  $HMOFMT                               C MAY HMO COVERAGE

                              11,820                    0 NO COVERAGE
                                 576                    1 PRIVATE
                                 627                    2 MEDICARE
                                  16                    3 BOTH

D_OTH5     36  1                                        C # OF OTHER MAY PLANS

D_CARE6    37  1  $CAREFMT                              C JUN MEDICARE COVERAGE

                                 966                    0 NO COVERAGE
                                 399                    1 PART A
                                 125                    2 PART B
                              11,549                    3 PARTS A & B

D_CAID6    38  1  $CAIDFMT                              C JUN MEDICAID COVERAGE OBTAINED FROM

                              10,530                    0 NO COVERAGE
                                 524                    1 SURVEY INFORMATION
                                  53                    2 HCFA RECORDS
                               1,932                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI6     39  1  $PHIFMT                               C JUN PRIVATE HEALTH INSURANCE

                               5,552                    0 NO COVERAGE
                               3,356                    1 EMPLOYER SPONSORED
                               3,493                    2 SELF PURCHASED
                                 492                    3 BOTH
                                 146                    4 UNKNOWN

D_HMO6     40  1  $HMOFMT                               C JUN HMO COVERAGE

                              11,818                    0 NO COVERAGE
                                 573                    1 PRIVATE
                                 631                    2 MEDICARE
                                  17                    3 BOTH

D_OTH6     41  1                                        C # OF OTHER JUN PLANS

D_CARE7    42  1  $CAREFMT                              C JUL MEDICARE COVERAGE

                                 847                    0 NO COVERAGE
                                 372                    1 PART A
                                 127                    2 PART B
                              11,693                    3 PARTS A & B

D_CAID7    43  1  $CAIDFMT                              C JUL MEDICAID COVERAGE OBTAINED FROM

                              10,532                    0 NO COVERAGE
                                 500                    1 SURVEY INFORMATION
                                  53                    2 HCFA RECORDS
                               1,954                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI7     44  1  $PHIFMT                               C JUL PRIVATE HEALTH INSURANCE

                               5,558                    0 NO COVERAGE
                               3,340                    1 EMPLOYER SPONSORED
                               3,479                    2 SELF PURCHASED
                                 497                    3 BOTH
                                 165                    4 UNKNOWN

D_HMO7     45  1  $HMOFMT                               C JUL HMO COVERAGE

                              11,801                    0 NO COVERAGE
                                 580                    1 PRIVATE
                                 641                    2 MEDICARE
                                  17                    3 BOTH

D_OTH7     46  1                                        C # OF OTHER JUL PLANS

D_CARE8    47  1  $CAREFMT                              C AUG MEDICARE COVERAGE

                                 787                    0 NO COVERAGE
                                 378                    1 PART A
                                 123                    2 PART B
                              11,751                    3 PARTS A & B

D_CAID8    48  1  $CAIDFMT                              C AUG MEDICAID COVERAGE OBTAINED FROM

                              10,538                    0 NO COVERAGE
                                 478                    1 SURVEY INFORMATION
                                  52                    2 HCFA RECORDS
                               1,971                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI8     49  1  $PHIFMT                               C AUG PRIVATE HEALTH INSURANCE

                               5,573                    0 NO COVERAGE
                               3,331                    1 EMPLOYER SPONSORED
                               3,468                    2 SELF PURCHASED
                                 490                    3 BOTH
                                 177                    4 UNKNOWN

D_HMO8     50  1  $HMOFMT                               C AUG HMO COVERAGE

                              11,801                    0 NO COVERAGE
                                 575                    1 PRIVATE
                                 648                    2 MEDICARE
                                  15                    3 BOTH

D_OTH8     51  1                                        C # OF OTHER AUG PLANS

D_CARE9    52  1  $CAREFMT                              C SEP MEDICARE COVERAGE

                                 755                    0 NO COVERAGE
                                 372                    1 PART A
                                 123                    2 PART B
                              11,789                    3 PARTS A & B

D_CAID9    53  1  $CAIDFMT                              C SEP MEDICAID COVERAGE OBTAINED FROM

                              10,556                    0 NO COVERAGE
                                 447                    1 SURVEY INFORMATION
                                  54                    2 HCFA RECORDS
                               1,982                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI9     54  1  $PHIFMT                               C SEP PRIVATE HEALTH INSURANCE

                               5,594                    0 NO COVERAGE
                               3,323                    1 EMPLOYER SPONSORED
                               3,465                    2 SELF PURCHASED
                                 481                    3 BOTH
                                 176                    4 UNKNOWN

D_HMO9     55  1  $HMOFMT                               C SEP HMO COVERAGE

                              11,795                    0 NO COVERAGE
                                 576                    1 PRIVATE
                                 653                    2 MEDICARE
                                  15                    3 BOTH

D_OTH9     56  1                                        C # OF OTHER SEP PLANS

D_CARE10   57  1  $CAREFMT                              C OCT MEDICARE COVERAGE

                                 713                    0 NO COVERAGE
                                 383                    1 PART A
                                 124                    2 PART B
                              11,819                    3 PARTS A & B

D_CAID10   58  1  $CAIDFMT                              C OCT MEDICAID COVERAGE OBTAINED FROM

                              10,562                    0 NO COVERAGE
                                 449                    1 SURVEY INFORMATION
                                  54                    2 HCFA RECORDS
                               1,974                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI10    59  1  $PHIFMT                               C OCT PRIVATE HEALTH INSURANCE

                               5,631                    0 NO COVERAGE
                               3,305                    1 EMPLOYER SPONSORED
                               3,453                    2 SELF PURCHASED
                                 477                    3 BOTH
                                 173                    4 UNKNOWN

D_HMO10    60  1  $HMOFMT                               C OCT HMO COVERAGE

                              11,799                    0 NO COVERAGE
                                 567                    1 PRIVATE
                                 657                    2 MEDICARE
                                  16                    3 BOTH

D_OTH10    61  1                                        C # OF OTHER OCT PLANS

D_CARE11   62  1  $CAREFMT                              C NOV MEDICARE COVERAGE

                                 678                    0 NO COVERAGE
                                 388                    1 PART A
                                 124                    2 PART B
                              11,849                    3 PARTS A & B

D_CAID11   63  1  $CAIDFMT                              C NOV MEDICAID COVERAGE OBTAINED FROM

                              10,560                    0 NO COVERAGE
                                 452                    1 SURVEY INFORMATION
                                  56                    2 HCFA RECORDS
                               1,971                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI11    64  1  $PHIFMT                               C NOV PRIVATE HEALTH INSURANCE

                               5,706                    0 NO COVERAGE
                               3,273                    1 EMPLOYER SPONSORED
                               3,410                    2 SELF PURCHASED
                                 480                    3 BOTH
                                 170                    4 UNKNOWN

D_HMO11    65  1  $HMOFMT                               C NOV HMO COVERAGE

                              11,802                    0 NO COVERAGE
                                 561                    1 PRIVATE
                                 659                    2 MEDICARE
                                  17                    3 BOTH

D_OTH11    66  1                                        C # OF OTHER NOV PLANS

D_CARE12   67  1  $CAREFMT                              C DEC MEDICARE COVERAGE

                                 636                    0 NO COVERAGE
                                 399                    1 PART A
                                 121                    2 PART B
                              11,883                    3 PARTS A & B

D_CAID12   68  1  $CAIDFMT                              C DEC MEDICAID COVERAGE OBTAINED FROM

                              10,586                    0 NO COVERAGE
                                 461                    1 SURVEY INFORMATION
                                  57                    2 HCFA RECORDS
                               1,935                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI12    69  1  $PHIFMT                               C DEC PRIVATE HEALTH INSURANCE

                               5,873                    0 NO COVERAGE
                               3,230                    1 EMPLOYER SPONSORED
                               3,328                    2 SELF PURCHASED
                                 478                    3 BOTH
                                 130                    4 UNKNOWN

D_HMO12    70  1  $HMOFMT                               C DEC HMO COVERAGE

                              11,809                    0 NO COVERAGE
                                 553                    1 PRIVATE
                                 660                    2 MEDICARE
                                  17                    3 BOTH

D_OTH12    71  1                                        C # OF OTHER DEC PLANS

D_CARE     72  1  $CAREFMT                              C ANNUAL MEDICARE COVERAGE

                                  16                    0 NO COVERAGE
                                 388                    1 PART A
                                 129                    2 PART B
                              12,506                    3 PARTS A & B

D_CAID     73  1  $CAIDFMT                              C ANNUAL MEDICAID COVERAGE OBTAINED FROM

                              10,235                    0 NO COVERAGE
                                 555                    1 SURVEY INFORMATION
                                  71                    2 HCFA RECORDS
                               2,178                    3 BOTH SURVEY AND HCFA RECORDS

D_PHI      74  1  $PHIFMT                               C ANNUAL PRIVATE HEALTH INSURANCE

                               5,152                    0 NO COVERAGE
                               3,415                    1 EMPLOYER SPONSORED
                               3,677                    2 SELF PURCHASED
                                 593                    3 BOTH
                                 202                    4 UNKNOWN

D_HMO      75  1  $HMOFMT                               C ANNUAL HMO COVERAGE

                              11,695                    0 NO COVERAGE
                                 627                    1 PRIVATE
                                 691                    2 MEDICARE
                                  26                    3 BOTH

D_OTH      76  1                                        C # OF OTHER ANNUAL PLANS

TOT_PREM   77  8  PREMFMT                               N TOTAL HEALTH INSURANCE PREMIUMS

                               4,919                    . NOT APPLICABLE
                                 309                0-100 $100 OR LESS
                                 931           100.01-500 $101-$500
                               4,789          500.01-1000 $501-$1000
                               1,201         1000.01-1500 $1001-$1500
                                 603         1500.01-2000 $1501-$2000
                                 160         2000.01-2500 $2001-$2500
                                  66         2500.01-3000 $2501-$3000
                                  28         3000.01-3500 $3001-$3500
                                  12         3500.01-4000 $3501-$4000
                                   6         4000.01-4500 $4001-$4500
                                   2         4500.01-5000 $4501-$5000
                                  13                      OVER $5000

                  Note: See Notes for derivation

D_TYPPL1   85  2  PLANFMT            HI17               N TYPE OF PLAN - PLAN 1

                               4,115                    . INAPPLICABLE
                               3,719                    1 PRIVATE EMPLOYER SPONSORED
                               3,777                    2 PRIVATE SELF PURCHASED
                                 201                    3 PRIVATE UNKNOWN
                                 578                    4 PRIVATE HMO
                                 649                    5 MEDICARE HMO

                  Note: Applies only if D_PHI is not equal to zero or D_HMO is not equal to zero

D_BEGPL1   87  6  DTE6FMT                               N PLAN 1 BEGIN DATE

                               4,115                    . INAPPLICABLE
                               8,924             0-999999 DATE AS YYMMDD

D_ENDPL1   93  6  DTE6FMT                               N PLAN 1 END DATE

                               4,115                    . INAPPLICABLE
                               8,924             0-999999 DATE AS YYMMDD

D_PHREL1   99  2  RELFMT                                N PLAN 1 POLICY HOLDER

                               5,779                    . INAPPLICABLE
                                   0                   -5 NEVER ASK AGN
                               5,909                    1 SAMPLE PERSON
                               1,257                    2 SPOUSE
                                  10                    3 SON
                                   6                    4 DAUGHTER
                                   0                    5 BROTHER
                                   1                    6 SISTER
                                  47                    7 FATHER
                                  18                    8 MOTHER
                                   1                    9 SON-IN-LAW
                                   0                   10 DAUGHTER-IN-LAW
                                   0                   11 GRANDSON
                                   2                   12 GRANDDAUGHTER
                                   0                   13 NEPHEW
                                   0                   14 NIECE
                                   0                   50 PARTNER/ROOMATE
                                   0                   51 FRIEND/NEIGHBOR
                                   0                   52 BOARDER
                                   0                   53 NURSE/NURSES AIDE
                                   0                   54 LEGAL/FINAN OFFICER
                                   0                   55 GUARDIAN
                                   9                   91 OTHER RELATIVE
                                   0                   92 OTHER NON-RELATIVE

D_COVNM1  101  2  NMFMT                                 N # OF PEOPLE COVERED BY PLAN 1

                               5,779                    . INAPPLICABLE
                                   2                   -9 NOT ASCERTAINED
                                   4                   -8 DONT KNOW
                                   4                   -7 REFUSED
                               4,077                    1 1
                               2,905                    2 2
                                 152                    3 3
                                  80                    4 4
                                  21                    5 5
                                  10                    6 6
                                   5                    7 7
                                   0                    8 8

D_COVRX1  103  2  RXFMT                                 N PLAN 1 PRESCRIPTION DRUG COVERAGE

                               5,779                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                 335                   -8 DONT KNOW
                                   2                   -7 REFUSED
                               3,300                    1 PLAN COVERS DRUGS
                               3,622                    2 DOES NOT COVER DRUGS

D_COVNH1  105  2  NHFMT                                 N PLAN 1 NURSING HOME COVERAGE

                               5,779                    . INAPPLICABLE
                                   2                   -9 NOT ASCERTAINED
                               2,186                   -8 DONT KNOW
                                  18                   -7 REFUSED
                               1,233                    1 PLAN COVERS NH
                               3,821                    2 DOES NOT COVER NH

D_PAYSP1  107  2  INSFMT                                N DOES INSURED PAY A PREMIUM FOR PLAN 1

                               5,777                    . INAPPLICABLE
                                   2                   -9 NOT ASCERTAINED
                                  94                   -8 DONT KNOW
                                   3                   -7 REFUSED
                               5,505                    1 YES
                               1,658                    2 NO

D_ANAMT1  109  8  PREMFMT                               N ANNUAL PREMIUM FOR PLAN 1

                               8,765                    . NOT APPLICABLE
                                  66                0-100 $100 OR LESS
                                 626           100.01-500 $101-$500
                               1,620          500.01-1000 $501-$1000
                               1,141         1000.01-1500 $1001-$1500
                                 457         1500.01-2000 $1501-$2000
                                 162         2000.01-2500 $2001-$2500
                                 105         2500.01-3000 $2501-$3000
                                  46         3000.01-3500 $3001-$3500
                                  18         3500.01-4000 $3501-$4000
                                  15         4000.01-4500 $4001-$4500
                                   5         4500.01-5000 $4501-$5000
                                  13                      OVER $5000

                  Note: Applies only if D_PAYSP1 = 1

D_HMOPL1  117  2  INSFMT             HI25               N IS PLAN 1 AN HMO

                               4,452                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                  97                   -8 DONT KNOW
                                   4                   -7 REFUSED
                               1,227                    1 YES
                               7,258                    2 NO

D_MHMO1   119  5                                        C PLAN 1 MEDICARE HMO CODE

                  Note: Applies only if D_HMOPL1 equals 1.

D_OBTNP1  124  2  OBTFMT                                N HOW DID INSURED GET PLAN 1

                               4,503                    . INAPPLICABLE
                                   5                   -9 NOT ASCERTAINED
                                  69                   -8 DONT KNOW
                                   2                   -7 REFUSED
                               3,389                    1 DIRECTLY
                                 621                    2 CURRENT EMPLOYER
                               3,082                    3 FORMER EMPLOYER
                                 192                    4 UNION
                                  95                    5 FAMILY BUSINESS
                                 578                    6 AARP
                                 248                    7 DECEASED SPOUSES FORMER EMPLOYER
                                  10                    8 DECEASED SPOUSES FORMER UNION
                                 245                   91 SOME OTHER WAY

D_INDUS1  126  2  $INDUFMT                              C PLAN 1 INDUSTRY CODE

                               9,252                      INAPPLICABLE
                                   7                   -7 REFUSED
                                   3                   -8 DK
                                 132                   -9 NOT ASCERTAINED
                                   3                    A AGRICULTURE, FORESTRY, AND FISHING
                                  11                    B MINING
                                  10                    C CONSTRUCTION
                                  38                    D MANUFACTURING
                                  21                    E TRANSPORTATION AND PUBLIC UTILITIES
                                   2                    F WHOLESALE TRADE
                                  30                    G RETAIL TRADE
                                  16                    H FINANCE, INSURANCE, AND REAL ESTATE
                                   7                    I SERVICES
                                 132                    J PUBLIC ADMINISTRATION
                                  34                    K NONCLASSIFIABLE ESTABLISHMENTS
                                   6                   01 AGRICULTURAL PRODUCTION - CROPS
                                   4                   02 AGRICULTURAL PRODUCTION - LIVESTOCK
                                   5                   07 AGRICULTURAL SERVICES
                                   2                   08 FORESTRY
                                   3                   09 FISHING, HUNTING, AND TRAPPING
                                   2                   10 METAL MINING
                                  11                   12 COAL MINING
                                   4                   13 OIL AND GAS EXTRACTION
                                   1                   14 NONMETALLIC MINERALS. EXCEPT FUELS
                                   7                   15 GENERAL BUILDING CONTRACTORS
                                  16                   16 HEAVY CONSTRUCTION, EX. BUILDING
                                  29                   17 SPECIAL TRADE CONTRACTORS
                                  90                   20 FOOD AND KINDRED PRODUCTS
                                   2                   21 TOBACCO PRODUCTS
                                  36                   22 TEXTILE MILL PRODUCTS
                                  54                   23 APPAREL AND OTHER TEXTILE PRODUCTS
                                   9                   24 LUMBER AND WOOD PRODUCTS
                                  17                   25 FURNITURE AND FIXTURES
                                  12                   26 PAPER AND ALLIED PRODUCTS
                                  32                   27 PRINTING AND PUBLISHING
                                  85                   28 CHEMICALS AND ALLIED PRODUCTS
                                  90                   29 PETROLEUM AND COAL PRODUCTS
                                  40                   30 RUBBER AND MISC. PLASTICS PRODUCTS
                                   5                   31 LEATHER AND LEATHER PRODUCTS
                                  28                   32 STONE, CLAY, AND GLASS PRODUCTS
                                 128                   33 PRIMARY METAL INDUSTRIES
                                  58                   34 FABRICATED METAL PRODUCTS
                                 110                   35 INDUSTRIAL MACHINERY AND EQUIPMENT
                                  94                   36 ELECTRONIC & OTHER ELECTRIC EQUIPMENT
                                 251                   37 TRANSPORTATION EQUIPMENT
                                  13                   38 INSTRUMENTS AND RELATED PRODUCTS
                                  22                   39 MISCELLANEOUS MANUFACTURING INDUSTRIES
                                  52                   40 RAILROAD TRANSPORTATION
                                  18                   41 LOCAL AND INTERURBAN PASSENGER TRANSIT
                                  13                   42 TRUCKING AND WAREHOUSING
                                  78                   43 U.S. POSTAL SERVICE
                                   2                   44 WATER TRANSPORTATION
                                  24                   45 TRANSPORTATION BY AIR
                                   2                   46 PIPELINES, EXCEPT NATURAL GAS
                                   5                   47 TRANSPORTATION SERVICES
                                 113                   48 COMMUNICATIONS
                                  79                   49 ELECTRIC, GAS, AND SANITARY SERVICES
                                  18                   50 WHOLESALE TRADE - DURABLE GOODS
                                  17                   51 WHOLESALE TRADE - NONDURABLE GOODS
                                  12                   52 BUILDING MATERIALS & GARDEN SUPPLIES
                                  53                   53 GENERAL MERCHANDISE STORES
                                  34                   54 FOOD STORES
                                  20                   55 AUTOMOTIVE DEALERS & SERVICE STATIONS
                                   5                   56 APPAREL AND ACCESSORY STORES
                                   8                   57 FURNITURE AND HOMEFURNISHINGS STORES
                                  23                   58 EATING AND DRINKING PLACES
                                  24                   59 MISCELLANEOUS RETAIL
                                  70                   60 DEPOSITORY INSTITUTIONS
                                   7                   61 NONDEPOSITORY INSTITUTIONS
                                   7                   62 SECURITY AND COMMODITY BROKERS
                                  51                   63 INSURANCE CARRIERS
                                  29                   64 INSURANCE AGENTS, BROKERS & SERVICES
                                  12                   65 REAL ESTATE
                                   2                   67 HOLDING AND OTHER INVESTMENT OFFICES
                                   9                   70 HOTELS AND OTHER LODGING PLACES
                                  16                   72 PERSONAL SERVICES
                                  51                   73 BUSINESS SERVICES
                                  19                   75 AUTO REPAIR, SERVICES, AND PARKING
                                   3                   76 MISCELLANEOUS REPAIR SERVICES
                                   4                   78 MOTION PICTURES
                                  11                   79 AMUSEMENT & RECREATION SERVICES
                                 157                   80 HEALTH SERVICES
                                  21                   81 LEGAL SERVICES
                                 438                   82 EDUCATIONAL SERVICES
                                  12                   83 SOCIAL SERVICES
                                   0                   84 MUSEUMS, BOTANICAL, ZOOLOGICAL GARDENS
                                  56                   86 MEMBERSHIP ORGANIZATIONS
                                  14                   87 ENGINEERING & MANAGEMENT SERVICES
                                   0                   88 PRIVATE HOUSEHOLDS
                                   6                   89 SERVICES, NEC
                                 228                   91 EXECUTIVE, LEGISLATIVE, AND GENERAL
                                  73                   92 JUSTICE, PUBLIC ORDER, AND SAFETY
                                  15                   93 FINANCE, TAXATION, & MONETARY POLICY
                                  16                   94 ADMINISTRATION OF HUMAN RESOURCES
                                  14                   95 ENVIRONMENTAL QUALITY AND HOUSING
                                  15                   96 ADMINISTRATION OF ECONOMIC PROGRAMS
                                 119                   97 NATIONAL SECURITY AND INST. AFFAIRS
                                   0                   99 NONCLASSIFIABLE ESTABLISHMENTS

                  Note: Applies only if D_OBTNP1 = 2, 3, 5, or 8

D_TYPPL2  128  2  PLANFMT            HI17               N TYPE OF PLAN - PLAN 2

                              10,987                    . INAPPLICABLE
                                 844                    1 PRIVATE EMPLOYER SPONSORED
                                 999                    2 PRIVATE SELF PURCHASED
                                  27                    3 PRIVATE UNKNOWN
                                 105                    4 PRIVATE HMO
                                  77                    5 MEDICARE HMO

                  Note: Applies only if D_PHI is not equal to zero or D_HMO is not equal to zero

D_BEGPL2  130  6  DTE6FMT                               N PLAN 2 BEGIN DATE

                              10,987                    . INAPPLICABLE
                               2,052             0-999999 DATE AS YYMMDD

D_ENDPL2  136  6  DTE6FMT                               N PLAN 2 END DATE

                              10,987                    . INAPPLICABLE
                               2,052             0-999999 DATE AS YYMMDD

D_PHREL2  142  2  RELFMT                                N PLAN 2 POLICY HOLDER

                              11,456                    . INAPPLICABLE
                                   0                   -5 NEVER ASK AGN
                               1,284                    1 SAMPLE PERSON
                                 281                    2 SPOUSE
                                   3                    3 SON
                                   0                    4 DAUGHTER
                                   0                    5 BROTHER
                                   1                    6 SISTER
                                   5                    7 FATHER
                                   7                    8 MOTHER
                                   0                    9 SON-IN-LAW
                                   0                   10 DAUGHTER-IN-LAW
                                   0                   11 GRANDSON
                                   2                   12 GRANDDAUGHTER
                                   0                   13 NEPHEW
                                   0                   14 NIECE
                                   0                   50 PARTNER/ROOMATE
                                   0                   51 FRIEND/NEIGHBOR
                                   0                   52 BOARDER
                                   0                   53 NURSE/NURSES AIDE
                                   0                   54 LEGAL/FINAN OFFICER
                                   0                   55 GUARDIAN
                                   0                   91 OTHER RELATIVE
                                   0                   92 OTHER NON-RELATIVE

D_COVNM2  144  2  NMFMT                                 N # OF PEOPLE COVERED BY PLAN 2

                              11,456                    . INAPPLICABLE
                                   3                   -9 NOT ASCERTAINED
                                   3                   -8 DONT KNOW
                                 861                    1 1
                                 670                    2 2
                                  28                    3 3
                                  16                    4 4
                                   2                    5 5
                                   0                    6 6
                                   0                    7 7
                                   0                    8 8

D_COVRX2  146  2  RXFMT                                 N PLAN 2 PRESCRIPTION DRUG COVERAGE

                              11,456                    . INAPPLICABLE
                                   2                   -9 NOT ASCERTAINED
                                 146                   -8 DONT KNOW
                                   1                   -7 REFUSED
                                 491                    1 PLAN COVERS DRUGS
                                 943                    2 DOES NOT COVER DRUGS

D_COVNH2  148  2  NHFMT                                 N PLAN 2 NURSING HOME COVERAGE

                              11,456                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                 278                   -8 DONT KNOW
                                 340                    1 PLAN COVERS NH
                                 964                    2 DOES NOT COVER NH

D_PAYSP2  150  2  INSFMT                                N DOES INSURED PAY A PREMIUM FOR PLAN 2

                              11,455                    . INAPPLICABLE
                                  24                   -8 DONT KNOW
                               1,095                    1 YES
                                 465                    2 NO

D_ANAMT2  152  8  PREMFMT                               N ANNUAL PREMIUM FOR PLAN 2

                              12,278                    . NOT APPLICABLE
                                  84                0-100 $100 OR LESS
                                 275           100.01-500 $101-$500
                                 178          500.01-1000 $501-$1000
                                 120         1000.01-1500 $1001-$1500
                                  60         1500.01-2000 $1501-$2000
                                  18         2000.01-2500 $2001-$2500
                                  15         2500.01-3000 $2501-$3000
                                   2         3000.01-3500 $3001-$3500
                                   6         3500.01-4000 $3501-$4000
                                   0         4000.01-4500 $4001-$4500
                                   2         4500.01-5000 $4501-$5000
                                   1                      OVER $5000

                  Note: Applies only if D_PAYSP2 = 1

D_HMOPL2  160  2  INSFMT             HI25               N IS PLAN 2 AN HMO

                              11,154                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                  33                   -8 DONT KNOW
                                 182                    1 YES
                               1,669                    2 NO

D_MHMO2   162  5                                        C PLAN 2 MEDICARE HMO CODE

                  Note: Applies only if D_HMOPL2 equals 1.

D_OBTNP2  167  2  OBTFMT                                N HOW DID INSURED GET PLAN 2

                              11,195                    . INAPPLICABLE
                                   3                   -9 NOT ASCERTAINED
                                   8                   -8 DONT KNOW
                                 794                    1 DIRECTLY
                                 120                    2 CURRENT EMPLOYER
                                 566                    3 FORMER EMPLOYER
                                  80                    4 UNION
                                   6                    5 FAMILY BUSINESS
                                 164                    6 AARP
                                  49                    7 DECEASED SPOUSES FORMER EMPLOYER
                                   1                    8 DECEASED SPOUSES FORMER UNION
                                  53                   91 SOME OTHER WAY

D_INDUS2  169  2  $INDUFMT                              C PLAN 2 INDUSTRY CODE

                              12,362                      INAPPLICABLE
                                  18                   -9 NOT ASCERTAINED
                                   0                    A AGRICULTURE, FORESTRY, AND FISHING
                                   1                    B MINING
                                   1                    C CONSTRUCTION
                                   9                    D MANUFACTURING
                                   4                    E TRANSPORTATION AND PUBLIC UTILITIES
                                   0                    F WHOLESALE TRADE
                                   4                    G RETAIL TRADE
                                   6                    H FINANCE, INSURANCE, AND REAL ESTATE
                                   4                    I SERVICES
                                  24                    J PUBLIC ADMINISTRATION
                                   7                    K NONCLASSIFIABLE ESTABLISHMENTS
                                   1                   01 AGRICULTURAL PRODUCTION - CROPS
                                   0                   02 AGRICULTURAL PRODUCTION - LIVESTOCK
                                   3                   07 AGRICULTURAL SERVICES
                                   0                   08 FORESTRY
                                   0                   09 FISHING, HUNTING, AND TRAPPING
                                   0                   10 METAL MINING
                                   4                   12 COAL MINING
                                   5                   13 OIL AND GAS EXTRACTION
                                   0                   14 NONMETALLIC MINERALS. EXCEPT FUELS
                                   1                   15 GENERAL BUILDING CONTRACTORS
                                   1                   16 HEAVY CONSTRUCTION, EX. BUILDING
                                   4                   17 SPECIAL TRADE CONTRACTORS
                                  15                   20 FOOD AND KINDRED PRODUCTS
                                   2                   21 TOBACCO PRODUCTS
                                   8                   22 TEXTILE MILL PRODUCTS
                                   5                   23 APPAREL AND OTHER TEXTILE PRODUCTS
                                   3                   24 LUMBER AND WOOD PRODUCTS
                                   1                   25 FURNITURE AND FIXTURES
                                   3                   26 PAPER AND ALLIED PRODUCTS
                                   3                   27 PRINTING AND PUBLISHING
                                  18                   28 CHEMICALS AND ALLIED PRODUCTS
                                   5                   29 PETROLEUM AND COAL PRODUCTS
                                   9                   30 RUBBER AND MISC. PLASTICS PRODUCTS
                                   0                   31 LEATHER AND LEATHER PRODUCTS
                                   2                   32 STONE, CLAY, AND GLASS PRODUCTS
                                  25                   33 PRIMARY METAL INDUSTRIES
                                   9                   34 FABRICATED METAL PRODUCTS
                                  22                   35 INDUSTRIAL MACHINERY AND EQUIPMENT
                                  31                   36 ELECTRONIC & OTHER ELECTRIC EQUIPMENT
                                  64                   37 TRANSPORTATION EQUIPMENT
                                   1                   38 INSTRUMENTS AND RELATED PRODUCTS
                                   1                   39 MISCELLANEOUS MANUFACTURING INDUSTRIES
                                   7                   40 RAILROAD TRANSPORTATION
                                   2                   41 LOCAL AND INTERURBAN PASSENGER TRANSIT
                                   9                   42 TRUCKING AND WAREHOUSING
                                   5                   43 U.S. POSTAL SERVICE
                                   0                   44 WATER TRANSPORTATION
                                  10                   45 TRANSPORTATION BY AIR
                                   1                   46 PIPELINES, EXCEPT NATURAL GAS
                                   1                   47 TRANSPORTATION SERVICES
                                  33                   48 COMMUNICATIONS
                                  18                   49 ELECTRIC, GAS, AND SANITARY SERVICES
                                   5                   50 WHOLESALE TRADE - DURABLE GOODS
                                   0                   51 WHOLESALE TRADE - NONDURABLE GOODS
                                   0                   52 BUILDING MATERIALS & GARDEN SUPPLIES
                                   6                   53 GENERAL MERCHANDISE STORES
                                   7                   54 FOOD STORES
                                   2                   55 AUTOMOTIVE DEALERS & SERVICE STATIONS
                                   1                   56 APPAREL AND ACCESSORY STORES
                                   2                   57 FURNITURE AND HOMEFURNISHINGS STORES
                                   2                   58 EATING AND DRINKING PLACES
                                   1                   59 MISCELLANEOUS RETAIL
                                  22                   60 DEPOSITORY INSTITUTIONS
                                   0                   61 NONDEPOSITORY INSTITUTIONS
                                   1                   62 SECURITY AND COMMODITY BROKERS
                                   4                   63 INSURANCE CARRIERS
                                   4                   64 INSURANCE AGENTS, BROKERS & SERVICES
                                   0                   65 REAL ESTATE
                                   0                   67 HOLDING AND OTHER INVESTMENT OFFICES
                                   2                   70 HOTELS AND OTHER LODGING PLACES
                                   0                   72 PERSONAL SERVICES
                                  10                   73 BUSINESS SERVICES
                                   1                   75 AUTO REPAIR, SERVICES, AND PARKING
                                   2                   76 MISCELLANEOUS REPAIR SERVICES
                                   0                   78 MOTION PICTURES
                                   3                   79 AMUSEMENT & RECREATION SERVICES
                                  19                   80 HEALTH SERVICES
                                   2                   81 LEGAL SERVICES
                                  96                   82 EDUCATIONAL SERVICES
                                   6                   83 SOCIAL SERVICES
                                   0                   84 MUSEUMS, BOTANICAL, ZOOLOGICAL GARDENS
                                   4                   86 MEMBERSHIP ORGANIZATIONS
                                   4                   87 ENGINEERING & MANAGEMENT SERVICES
                                   0                   88 PRIVATE HOUSEHOLDS
                                   0                   89 SERVICES, NEC
                                  26                   91 EXECUTIVE, LEGISLATIVE, AND GENERAL
                                  11                   92 JUSTICE, PUBLIC ORDER, AND SAFETY
                                   4                   93 FINANCE, TAXATION, & MONETARY POLICY
                                  10                   94 ADMINISTRATION OF HUMAN RESOURCES
                                   2                   95 ENVIRONMENTAL QUALITY AND HOUSING
                                   4                   96 ADMINISTRATION OF ECONOMIC PROGRAMS
                                   4                   97 NATIONAL SECURITY AND INST. AFFAIRS
                                   0                   99 NONCLASSIFIABLE ESTABLISHMENTS

                  Note: Applies only if D_OBTNP2 = 2, 3, 5, or 8

D_TYPPL3  171  2  PLANFMT            HI17               N TYPE OF PLAN - PLAN 3

                              12,624                    . INAPPLICABLE
                                 190                    1 PRIVATE EMPLOYER SPONSORED
                                 174                    2 PRIVATE SELF PURCHASED
                                   4                    3 PRIVATE UNKNOWN
                                  27                    4 PRIVATE HMO
                                  20                    5 MEDICARE HMO

                  Note: Applies only if D_PHI is not equal to zero or D_HMO is not equal to zero

D_BEGPL3  173  6  DTE6FMT                               N PLAN 3 BEGIN DATE

                              12,624                    . INAPPLICABLE
                                 415             0-999999 DATE AS YYMMDD

D_ENDPL3  179  6  DTE6FMT                               N PLAN 3 END DATE

                              12,624                    . INAPPLICABLE
                                 415             0-999999 DATE AS YYMMDD

D_PHREL3  185  2  RELFMT                                N PLAN 3 POLICY HOLDER

                              12,746                    . INAPPLICABLE
                                   0                   -5 NEVER ASK AGN
                                 246                    1 SAMPLE PERSON
                                  45                    2 SPOUSE
                                   2                    3 SON
                                   0                    4 DAUGHTER
                                   0                    5 BROTHER
                                   0                    6 SISTER
                                   0                    7 FATHER
                                   0                    8 MOTHER
                                   0                    9 SON-IN-LAW
                                   0                   10 DAUGHTER-IN-LAW
                                   0                   11 GRANDSON
                                   0                   12 GRANDDAUGHTER
                                   0                   13 NEPHEW
                                   0                   14 NIECE
                                   0                   50 PARTNER/ROOMATE
                                   0                   51 FRIEND/NEIGHBOR
                                   0                   52 BOARDER
                                   0                   53 NURSE/NURSES AIDE
                                   0                   54 LEGAL/FINAN OFFICER
                                   0                   55 GUARDIAN
                                   0                   91 OTHER RELATIVE
                                   0                   92 OTHER NON-RELATIVE

D_COVNM3  187  2  NMFMT                                 N # OF PEOPLE COVERED BY PLAN 3

                              12,746                    . INAPPLICABLE
                                   4                   -9 NOT ASCERTAINED
                                   1                   -8 DONT KNOW
                                 155                    1 1
                                 120                    2 2
                                  12                    3 3
                                   1                    4 4
                                   0                    5 5
                                   0                    6 6
                                   0                    7 7
                                   0                    8 8

D_COVRX3  189  2  RXFMT                                 N PLAN 3 PRESCRIPTION DRUG COVERAGE

                              12,746                    . INAPPLICABLE
                                   4                   -9 NOT ASCERTAINED
                                  20                   -8 DONT KNOW
                                  76                    1 PLAN COVERS DRUGS
                                 193                    2 DOES NOT COVER DRUGS

D_COVNH3  191  2  NHFMT                                 N PLAN 3 NURSING HOME COVERAGE

                              12,746                    . INAPPLICABLE
                                   4                   -9 NOT ASCERTAINED
                                  35                   -8 DONT KNOW
                                  56                    1 PLAN COVERS NH
                                 198                    2 DOES NOT COVER NH

D_PAYSP3  193  2  INSFMT                                N DOES INSURED PAY A PREMIUM FOR PLAN 3

                              12,746                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                   8                   -8 DONT KNOW
                                 186                    1 YES
                                  98                    2 NO

D_ANAMT3  195  8  PREMFMT                               N ANNUAL PREMIUM FOR PLAN 3

                              12,913                    . NOT APPLICABLE
                                  15                0-100 $100 OR LESS
                                  41           100.01-500 $101-$500
                                  29          500.01-1000 $501-$1000
                                  28         1000.01-1500 $1001-$1500
                                   6         1500.01-2000 $1501-$2000
                                   2         2000.01-2500 $2001-$2500
                                   3         2500.01-3000 $2501-$3000
                                   0         3000.01-3500 $3001-$3500
                                   0         3500.01-4000 $3501-$4000
                                   0         4000.01-4500 $4001-$4500
                                   1         4500.01-5000 $4501-$5000
                                   1                      OVER $5000

                  Note: Applies only if D_PAYSP3 = 1

D_HMOPL3  203  2  INSFMT             HI25               N IS PLAN 3 AN HMO

                              12,684                    . INAPPLICABLE
                                   3                   -9 NOT ASCERTAINED
                                   2                   -8 DONT KNOW
                                  47                    1 YES
                                 303                    2 NO

D_MHMO3   205  5                                        C PLAN 3 MEDICARE HMO CODE

                  Note: Applies only if D_HMOPL3 equals 1.

D_OBTNP3  210  2  OBTFMT                                N HOW DID INSURED GET PLAN 3

                              12,706                    . INAPPLICABLE
                                   3                   -9 NOT ASCERTAINED
                                   1                   -8 DONT KNOW
                                 138                    1 DIRECTLY
                                  37                    2 CURRENT EMPLOYER
                                 112                    3 FORMER EMPLOYER
                                  11                    4 UNION
                                   2                    5 FAMILY BUSINESS
                                  14                    6 AARP
                                   7                    7 DECEASED SPOUSES FORMER EMPLOYER
                                   0                    8 DECEASED SPOUSES FORMER UNION
                                   8                   91 SOME OTHER WAY

D_INDUS3  212  2  $INDUFMT                              C PLAN 3 INDUSTRY CODE

                              12,892                      INAPPLICABLE
                                   3                   -9 NOT ASCERTAINED
                                   0                    A AGRICULTURE, FORESTRY, AND FISHING
                                   0                    B MINING
                                   1                    C CONSTRUCTION
                                   3                    D MANUFACTURING
                                   1                    E TRANSPORTATION AND PUBLIC UTILITIES
                                   0                    F WHOLESALE TRADE
                                   0                    G RETAIL TRADE
                                   1                    H FINANCE, INSURANCE, AND REAL ESTATE
                                   0                    I SERVICES
                                   3                    J PUBLIC ADMINISTRATION
                                   1                    K NONCLASSIFIABLE ESTABLISHMENTS
                                   0                   01 AGRICULTURAL PRODUCTION - CROPS
                                   0                   02 AGRICULTURAL PRODUCTION - LIVESTOCK
                                   0                   07 AGRICULTURAL SERVICES
                                   0                   08 FORESTRY
                                   1                   09 FISHING, HUNTING, AND TRAPPING
                                   0                   10 METAL MINING
                                   0                   12 COAL MINING
                                   1                   13 OIL AND GAS EXTRACTION
                                   0                   14 NONMETALLIC MINERALS. EXCEPT FUELS
                                   0                   15 GENERAL BUILDING CONTRACTORS
                                   0                   16 HEAVY CONSTRUCTION, EX. BUILDING
                                   0                   17 SPECIAL TRADE CONTRACTORS
                                   2                   20 FOOD AND KINDRED PRODUCTS
                                   0                   21 TOBACCO PRODUCTS
                                   0                   22 TEXTILE MILL PRODUCTS
                                   0                   23 APPAREL AND OTHER TEXTILE PRODUCTS
                                   0                   24 LUMBER AND WOOD PRODUCTS
                                   0                   25 FURNITURE AND FIXTURES
                                   1                   26 PAPER AND ALLIED PRODUCTS
                                   0                   27 PRINTING AND PUBLISHING
                                   4                   28 CHEMICALS AND ALLIED PRODUCTS
                                   1                   29 PETROLEUM AND COAL PRODUCTS
                                   2                   30 RUBBER AND MISC. PLASTICS PRODUCTS
                                   0                   31 LEATHER AND LEATHER PRODUCTS
                                   4                   32 STONE, CLAY, AND GLASS PRODUCTS
                                   8                   33 PRIMARY METAL INDUSTRIES
                                   0                   34 FABRICATED METAL PRODUCTS
                                  16                   35 INDUSTRIAL MACHINERY AND EQUIPMENT
                                   3                   36 ELECTRONIC & OTHER ELECTRIC EQUIPMENT
                                  13                   37 TRANSPORTATION EQUIPMENT
                                   1                   38 INSTRUMENTS AND RELATED PRODUCTS
                                   0                   39 MISCELLANEOUS MANUFACTURING INDUSTRIES
                                   0                   40 RAILROAD TRANSPORTATION
                                   0                   41 LOCAL AND INTERURBAN PASSENGER TRANSIT
                                   0                   42 TRUCKING AND WAREHOUSING
                                   0                   43 U.S. POSTAL SERVICE
                                   0                   44 WATER TRANSPORTATION
                                   1                   45 TRANSPORTATION BY AIR
                                   0                   46 PIPELINES, EXCEPT NATURAL GAS
                                   1                   47 TRANSPORTATION SERVICES
                                   7                   48 COMMUNICATIONS
                                   2                   49 ELECTRIC, GAS, AND SANITARY SERVICES
                                   0                   50 WHOLESALE TRADE - DURABLE GOODS
                                   0                   51 WHOLESALE TRADE - NONDURABLE GOODS
                                   0                   52 BUILDING MATERIALS & GARDEN SUPPLIES
                                   5                   53 GENERAL MERCHANDISE STORES
                                   0                   54 FOOD STORES
                                   0                   55 AUTOMOTIVE DEALERS & SERVICE STATIONS
                                   1                   56 APPAREL AND ACCESSORY STORES
                                   0                   57 FURNITURE AND HOMEFURNISHINGS STORES
                                   0                   58 EATING AND DRINKING PLACES
                                   0                   59 MISCELLANEOUS RETAIL
                                   1                   60 DEPOSITORY INSTITUTIONS
                                   0                   61 NONDEPOSITORY INSTITUTIONS
                                   0                   62 SECURITY AND COMMODITY BROKERS
                                   3                   63 INSURANCE CARRIERS
                                   1                   64 INSURANCE AGENTS, BROKERS & SERVICES
                                   0                   65 REAL ESTATE
                                   0                   67 HOLDING AND OTHER INVESTMENT OFFICES
                                   3                   70 HOTELS AND OTHER LODGING PLACES
                                   0                   72 PERSONAL SERVICES
                                   3                   73 BUSINESS SERVICES
                                   0                   75 AUTO REPAIR, SERVICES, AND PARKING
                                   0                   76 MISCELLANEOUS REPAIR SERVICES
                                   0                   78 MOTION PICTURES
                                   0                   79 AMUSEMENT & RECREATION SERVICES
                                   3                   80 HEALTH SERVICES
                                   2                   81 LEGAL SERVICES
                                  29                   82 EDUCATIONAL SERVICES
                                   0                   83 SOCIAL SERVICES
                                   0                   84 MUSEUMS, BOTANICAL, ZOOLOGICAL GARDENS
                                   0                   86 MEMBERSHIP ORGANIZATIONS
                                   0                   87 ENGINEERING & MANAGEMENT SERVICES
                                   0                   88 PRIVATE HOUSEHOLDS
                                   0                   89 SERVICES, NEC
                                   8                   91 EXECUTIVE, LEGISLATIVE, AND GENERAL
                                   1                   92 JUSTICE, PUBLIC ORDER, AND SAFETY
                                   0                   93 FINANCE, TAXATION, & MONETARY POLICY
                                   6                   94 ADMINISTRATION OF HUMAN RESOURCES
                                   0                   95 ENVIRONMENTAL QUALITY AND HOUSING
                                   0                   96 ADMINISTRATION OF ECONOMIC PROGRAMS
                                   0                   97 NATIONAL SECURITY AND INST. AFFAIRS
                                   0                   99 NONCLASSIFIABLE ESTABLISHMENTS

                  Note: Applies only if D_OBTNP3 = 2, 3, 5, or 8

D_TYPPL4  214  2  PLANFMT            HI17               N TYPE OF PLAN - PLAN 4

                              12,957                    . INAPPLICABLE
                                  38                    1 PRIVATE EMPLOYER SPONSORED
                                  41                    2 PRIVATE SELF PURCHASED
                                   0                    3 PRIVATE UNKNOWN
                                   0                    4 PRIVATE HMO
                                   3                    5 MEDICARE HMO

                  Note: Applies only if D_PHI is not equal to zero or D_HMO is not equal to zero

D_BEGPL4  216  6  DTE6FMT                               N PLAN 4 BEGIN DATE

                              12,957                    . INAPPLICABLE
                                  82             0-999999 DATE AS YYMMDD

D_ENDPL4  222  6  DTE6FMT                               N PLAN 4 END DATE

                              12,957                    . INAPPLICABLE
                                  82             0-999999 DATE AS YYMMDD

D_PHREL4  228  2  RELFMT                                N PLAN 4 POLICY HOLDER

                              12,978                    . INAPPLICABLE
                                   0                   -5 NEVER ASK AGN
                                  56                    1 SAMPLE PERSON
                                   5                    2 SPOUSE
                                   0                    3 SON
                                   0                    4 DAUGHTER
                                   0                    5 BROTHER
                                   0                    6 SISTER
                                   0                    7 FATHER
                                   0                    8 MOTHER
                                   0                    9 SON-IN-LAW
                                   0                   10 DAUGHTER-IN-LAW
                                   0                   11 GRANDSON
                                   0                   12 GRANDDAUGHTER
                                   0                   13 NEPHEW
                                   0                   14 NIECE
                                   0                   50 PARTNER/ROOMATE
                                   0                   51 FRIEND/NEIGHBOR
                                   0                   52 BOARDER
                                   0                   53 NURSE/NURSES AIDE
                                   0                   54 LEGAL/FINAN OFFICER
                                   0                   55 GUARDIAN
                                   0                   91 OTHER RELATIVE
                                   0                   92 OTHER NON-RELATIVE

D_COVNM4  230  2  NMFMT                                 N # OF PEOPLE COVERED BY PLAN 4

                              12,978                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                  28                    1 1
                                  22                    2 2
                                  10                    3 3
                                   0                    4 4
                                   0                    5 5
                                   0                    6 6
                                   0                    7 7
                                   0                    8 8

D_COVRX4  232  2  RXFMT                                 N PLAN 4 PRESCRIPTION DRUG COVERAGE

                              12,978                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                  22                    1 PLAN COVERS DRUGS
                                  38                    2 DOES NOT COVER DRUGS

D_COVNH4  234  2  NHFMT                                 N PLAN 4 NURSING HOME COVERAGE

                              12,978                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                  15                    1 PLAN COVERS NH
                                  45                    2 DOES NOT COVER NH

D_PAYSP4  236  2  INSFMT                                N DOES INSURED PAY A PREMIUM FOR PLAN 4

                              12,978                    . INAPPLICABLE
                                   1                   -8 DONT KNOW
                                  35                    1 YES
                                  25                    2 NO

D_ANAMT4  238  8  PREMFMT                               N ANNUAL PREMIUM FOR PLAN 4

                              13,012                    . NOT APPLICABLE
                                   2                0-100 $100 OR LESS
                                   8           100.01-500 $101-$500
                                   5          500.01-1000 $501-$1000
                                   5         1000.01-1500 $1001-$1500
                                   2         1500.01-2000 $1501-$2000
                                   2         2000.01-2500 $2001-$2500
                                   1         2500.01-3000 $2501-$3000
                                   0         3000.01-3500 $3001-$3500
                                   0         3500.01-4000 $3501-$4000
                                   1         4000.01-4500 $4001-$4500
                                   0         4500.01-5000 $4501-$5000
                                   1                      OVER $5000

                  Note: Applies only if D_PAYSP4 = 1

D_HMOPL4  246  2  INSFMT             HI25               N IS PLAN 4 AN HMO

                              12,969                    . INAPPLICABLE
                                   1                   -8 DONT KNOW
                                   3                    1 YES
                                  66                    2 NO

D_MHMO4   248  5                                        C PLAN 4 MEDICARE HMO CODE

                  Note: Applies only if D_HMOPL4 equals 1.

D_OBTNP4  253  2  OBTFMT                                N HOW DID INSURED GET PLAN 4

                              12,972                    . INAPPLICABLE
                                   1                   -9 NOT ASCERTAINED
                                  33                    1 DIRECTLY
                                  12                    2 CURRENT EMPLOYER
                                  15                    3 FORMER EMPLOYER
                                   6                    4 UNION
                                   0                    5 FAMILY BUSINESS
                                   0                    6 AARP
                                   0                    7 DECEASED SPOUSES FORMER EMPLOYER
                                   0                    8 DECEASED SPOUSES FORMER UNION
                                   0                   91 SOME OTHER WAY

D_INDUS4  255  2  $INDUFMT                              C PLAN 4 INDUSTRY CODE

                              13,012                      INAPPLICABLE
                                   0                    A AGRICULTURE, FORESTRY, AND FISHING
                                   0                    B MINING
                                   0                    C CONSTRUCTION
                                   0                    D MANUFACTURING
                                   0                    E TRANSPORTATION AND PUBLIC UTILITIES
                                   0                    F WHOLESALE TRADE
                                   0                    G RETAIL TRADE
                                   0                    H FINANCE, INSURANCE, AND REAL ESTATE
                                   0                    I SERVICES
                                   0                    J PUBLIC ADMINISTRATION
                                   0                    K NONCLASSIFIABLE ESTABLISHMENTS
                                   0                   01 AGRICULTURAL PRODUCTION - CROPS
                                   0                   02 AGRICULTURAL PRODUCTION - LIVESTOCK
                                   0                   07 AGRICULTURAL SERVICES
                                   0                   08 FORESTRY
                                   0                   09 FISHING, HUNTING, AND TRAPPING
                                   3                   10 METAL MINING
                                   0                   12 COAL MINING
                                   0                   13 OIL AND GAS EXTRACTION
                                   0                   14 NONMETALLIC MINERALS. EXCEPT FUELS
                                   0                   15 GENERAL BUILDING CONTRACTORS
                                   0                   16 HEAVY CONSTRUCTION, EX. BUILDING
                                   0                   17 SPECIAL TRADE CONTRACTORS
                                   1                   20 FOOD AND KINDRED PRODUCTS
                                   0                   21 TOBACCO PRODUCTS
                                   0                   22 TEXTILE MILL PRODUCTS
                                   0                   23 APPAREL AND OTHER TEXTILE PRODUCTS
                                   0                   24 LUMBER AND WOOD PRODUCTS
                                   0                   25 FURNITURE AND FIXTURES
                                   0                   26 PAPER AND ALLIED PRODUCTS
                                   0                   27 PRINTING AND PUBLISHING
                                   0                   28 CHEMICALS AND ALLIED PRODUCTS
                                   0                   29 PETROLEUM AND COAL PRODUCTS
                                   1                   30 RUBBER AND MISC. PLASTICS PRODUCTS
                                   0                   31 LEATHER AND LEATHER PRODUCTS
                                   0                   32 STONE, CLAY, AND GLASS PRODUCTS
                                   0                   33 PRIMARY METAL INDUSTRIES
                                   0                   34 FABRICATED METAL PRODUCTS
                                   8                   35 INDUSTRIAL MACHINERY AND EQUIPMENT
                                   2                   36 ELECTRONIC & OTHER ELECTRIC EQUIPMENT
                                   5                   37 TRANSPORTATION EQUIPMENT
                                   0                   38 INSTRUMENTS AND RELATED PRODUCTS
                                   0                   39 MISCELLANEOUS MANUFACTURING INDUSTRIES
                                   0                   40 RAILROAD TRANSPORTATION
                                   0                   41 LOCAL AND INTERURBAN PASSENGER TRANSIT
                                   0                   42 TRUCKING AND WAREHOUSING
                                   0                   43 U.S. POSTAL SERVICE
                                   0                   44 WATER TRANSPORTATION
                                   0                   45 TRANSPORTATION BY AIR
                                   0                   46 PIPELINES, EXCEPT NATURAL GAS
                                   0                   47 TRANSPORTATION SERVICES
                                   0                   48 COMMUNICATIONS
                                   1                   49 ELECTRIC, GAS, AND SANITARY SERVICES
                                   0                   50 WHOLESALE TRADE - DURABLE GOODS
                                   0                   51 WHOLESALE TRADE - NONDURABLE GOODS
                                   0                   52 BUILDING MATERIALS & GARDEN SUPPLIES
                                   0                   53 GENERAL MERCHANDISE STORES
                                   0                   54 FOOD STORES
                                   0                   55 AUTOMOTIVE DEALERS & SERVICE STATIONS
                                   0                   56 APPAREL AND ACCESSORY STORES
                                   0                   57 FURNITURE AND HOMEFURNISHINGS STORES
                                   0                   58 EATING AND DRINKING PLACES
                                   0                   59 MISCELLANEOUS RETAIL
                                   0                   60 DEPOSITORY INSTITUTIONS
                                   0                   61 NONDEPOSITORY INSTITUTIONS
                                   0                   62 SECURITY AND COMMODITY BROKERS
                                   0                   63 INSURANCE CARRIERS
                                   0                   64 INSURANCE AGENTS, BROKERS & SERVICES
                                   1                   65 REAL ESTATE
                                   0                   67 HOLDING AND OTHER INVESTMENT OFFICES
                                   0                   70 HOTELS AND OTHER LODGING PLACES
                                   0                   72 PERSONAL SERVICES
                                   0                   73 BUSINESS SERVICES
                                   0                   75 AUTO REPAIR, SERVICES, AND PARKING
                                   0                   76 MISCELLANEOUS REPAIR SERVICES
                                   0                   78 MOTION PICTURES
                                   0                   79 AMUSEMENT & RECREATION SERVICES
                                   0                   80 HEALTH SERVICES
                                   0                   81 LEGAL SERVICES
                                   2                   82 EDUCATIONAL SERVICES
                                   0                   83 SOCIAL SERVICES
                                   0                   84 MUSEUMS, BOTANICAL, ZOOLOGICAL GARDENS
                                   0                   86 MEMBERSHIP ORGANIZATIONS
                                   0                   87 ENGINEERING & MANAGEMENT SERVICES
                                   0                   88 PRIVATE HOUSEHOLDS
                                   0                   89 SERVICES, NEC
                                   2                   91 EXECUTIVE, LEGISLATIVE, AND GENERAL
                                   1                   92 JUSTICE, PUBLIC ORDER, AND SAFETY
                                   0                   93 FINANCE, TAXATION, & MONETARY POLICY
                                   0                   94 ADMINISTRATION OF HUMAN RESOURCES
                                   0                   95 ENVIRONMENTAL QUALITY AND HOUSING
                                   0                   96 ADMINISTRATION OF ECONOMIC PROGRAMS
                                   0                   97 NATIONAL SECURITY AND INST. AFFAIRS
                                   0                   99 NONCLASSIFIABLE ESTABLISHMENTS

                  Note: Applies only if D_OBTNP4 = 2, 3, 5, or 8

D_TYPPL5  257  2  PLANFMT            HI17               N TYPE OF PLAN - PLAN 5

                              13,022                    . INAPPLICABLE
                                   7                    1 PRIVATE EMPLOYER SPONSORED
                                   9                    2 PRIVATE SELF PURCHASED
                                   0                    3 PRIVATE UNKNOWN
                                   1                    4 PRIVATE HMO
                                   0                    5 MEDICARE HMO

                  Note: Applies only if D_PHI is not equal to zero or D_HMO is not equal to zero

D_BEGPL5  259  6  DTE6FMT                               N PLAN 5 BEGIN DATE

                              13,022                    . INAPPLICABLE
                                  17             0-999999 DATE AS YYMMDD

D_ENDPL5  265  6  DTE6FMT                               N PLAN 5 END DATE

                              13,022                    . INAPPLICABLE
                                  17             0-999999 DATE AS YYMMDD

D_PHREL5  271  2  RELFMT                                N PLAN 5 POLICY HOLDER

                              13,025                    . INAPPLICABLE
                                   0                   -5 NEVER ASK AGN
                                  10                    1 SAMPLE PERSON
                                   4                    2 SPOUSE
                                   0                    3 SON
                                   0                    4 DAUGHTER
                                   0                    5 BROTHER
                                   0                    6 SISTER
                                   0                    7 FATHER
                                   0                    8 MOTHER
                                   0                    9 SON-IN-LAW
                                   0                   10 DAUGHTER-IN-LAW
                                   0                   11 GRANDSON
                                   0                   12 GRANDDAUGHTER
                                   0                   13 NEPHEW
                                   0                   14 NIECE
                                   0                   50 PARTNER/ROOMATE
                                   0                   51 FRIEND/NEIGHBOR
                                   0                   52 BOARDER
                                   0                   53 NURSE/NURSES AIDE
                                   0                   54 LEGAL/FINAN OFFICER
                                   0                   55 GUARDIAN
                                   0                   91 OTHER RELATIVE
                                   0                   92 OTHER NON-RELATIVE

D_COVNM5  273  2  NMFMT                                 N # OF PEOPLE COVERED BY PLAN 5

                              13,025                    . INAPPLICABLE
                                   3                    1 1
                                   9                    2 2
                                   2                    3 3
                                   0                    4 4
                                   0                    5 5
                                   0                    6 6
                                   0                    7 7
                                   0                    8 8

D_COVRX5  275  2  RXFMT                                 N PLAN 5 PRESCRIPTION DRUG COVERAGE

                              13,025                    . INAPPLICABLE
                                   4                    1 PLAN COVERS DRUGS
                                  10                    2 DOES NOT COVER DRUGS

D_COVNH5  277  2  NHFMT                                 N PLAN 5 NURSING HOME COVERAGE

                              13,025                    . INAPPLICABLE
                                   3                   -8 DONT KNOW
                                   0                    1 PLAN COVERS NH
                                  11                    2 DOES NOT COVER NH

D_PAYSP5  279  2  INSFMT                                N DOES INSURED PAY A PREMIUM FOR PLAN 5

                              13,025                    . INAPPLICABLE
                                   8                    1 YES
                                   6                    2 NO

D_ANAMT5  281  8  PREMFMT                               N ANNUAL PREMIUM FOR PLAN 5

                              13,036                    . NOT APPLICABLE
                                   2                0-100 $100 OR LESS
                                   1           100.01-500 $101-$500
                                   0          500.01-1000 $501-$1000
                                   0         1000.01-1500 $1001-$1500
                                   0         1500.01-2000 $1501-$2000
                                   0         2000.01-2500 $2001-$2500
                                   0         2500.01-3000 $2501-$3000
                                   0         3000.01-3500 $3001-$3500
                                   0         3500.01-4000 $3501-$4000
                                   0         4000.01-4500 $4001-$4500
                                   0         4500.01-5000 $4501-$5000

                  Note: Applies only if D_PAYSP5 = 1

D_HMOPL5  289  2  INSFMT             HI25               N IS PLAN 5 AN HMO

                              13,024                    . INAPPLICABLE
                                   1                    1 YES
                                  14                    2 NO

D_MHMO5   291  5                                        C PLAN 5 MEDICARE HMO CODE

                  Note: Applies only if D_HMOPL5 equals 1.

D_OBTNP5  296  2  OBTFMT                                N HOW DID INSURED GET PLAN 5

                              13,024                    . INAPPLICABLE
                                   6                    1 DIRECTLY
                                   0                    2 CURRENT EMPLOYER
                                   2                    3 FORMER EMPLOYER
                                   5                    4 UNION
                                   0                    5 FAMILY BUSINESS
                                   0                    6 AARP
                                   0                    7 DECEASED SPOUSES FORMER EMPLOYER
                                   0                    8 DECEASED SPOUSES FORMER UNION
                                   2                   91 SOME OTHER WAY

D_INDUS5  298  2  $INDUFMT                              C PLAN 5 INDUSTRY CODE

                              13,037                      INAPPLICABLE
                                   0                    A AGRICULTURE, FORESTRY, AND FISHING
                                   0                    B MINING
                                   0                    C CONSTRUCTION
                                   0                    D MANUFACTURING
                                   0                    E TRANSPORTATION AND PUBLIC UTILITIES
                                   0                    F WHOLESALE TRADE
                                   0                    G RETAIL TRADE
                                   0                    H FINANCE, INSURANCE, AND REAL ESTATE
                                   0                    I SERVICES
                                   0                    J PUBLIC ADMINISTRATION
                                   0                    K NONCLASSIFIABLE ESTABLISHMENTS
                                   0                   01 AGRICULTURAL PRODUCTION - CROPS
                                   0                   02 AGRICULTURAL PRODUCTION - LIVESTOCK
                                   0                   07 AGRICULTURAL SERVICES
                                   0                   08 FORESTRY
                                   0                   09 FISHING, HUNTING, AND TRAPPING
                                   0                   10 METAL MINING
                                   0                   12 COAL MINING
                                   0                   13 OIL AND GAS EXTRACTION
                                   0                   14 NONMETALLIC MINERALS. EXCEPT FUELS
                                   0                   15 GENERAL BUILDING CONTRACTORS
                                   0                   16 HEAVY CONSTRUCTION, EX. BUILDING
                                   0                   17 SPECIAL TRADE CONTRACTORS
                                   0                   20 FOOD AND KINDRED PRODUCTS
                                   0                   21 TOBACCO PRODUCTS
                                   0                   22 TEXTILE MILL PRODUCTS
                                   0                   23 APPAREL AND OTHER TEXTILE PRODUCTS
                                   0                   24 LUMBER AND WOOD PRODUCTS
                                   0                   25 FURNITURE AND FIXTURES
                                   0                   26 PAPER AND ALLIED PRODUCTS
                                   0                   27 PRINTING AND PUBLISHING
                                   0                   28 CHEMICALS AND ALLIED PRODUCTS
                                   0                   29 PETROLEUM AND COAL PRODUCTS
                                   0                   30 RUBBER AND MISC. PLASTICS PRODUCTS
                                   0                   31 LEATHER AND LEATHER PRODUCTS
                                   0                   32 STONE, CLAY, AND GLASS PRODUCTS
                                   0                   33 PRIMARY METAL INDUSTRIES
                                   0                   34 FABRICATED METAL PRODUCTS
                                   0                   35 INDUSTRIAL MACHINERY AND EQUIPMENT
                                   0                   36 ELECTRONIC & OTHER ELECTRIC EQUIPMENT
                                   1                   37 TRANSPORTATION EQUIPMENT
                                   0                   38 INSTRUMENTS AND RELATED PRODUCTS
                                   0                   39 MISCELLANEOUS MANUFACTURING INDUSTRIES
                                   0                   40 RAILROAD TRANSPORTATION
                                   0                   41 LOCAL AND INTERURBAN PASSENGER TRANSIT
                                   0                   42 TRUCKING AND WAREHOUSING
                                   0                   43 U.S. POSTAL SERVICE
                                   0                   44 WATER TRANSPORTATION
                                   0                   45 TRANSPORTATION BY AIR
                                   0                   46 PIPELINES, EXCEPT NATURAL GAS
                                   0                   47 TRANSPORTATION SERVICES
                                   0                   48 COMMUNICATIONS
                                   1                   49 ELECTRIC, GAS, AND SANITARY SERVICES
                                   0                   50 WHOLESALE TRADE - DURABLE GOODS
                                   0                   51 WHOLESALE TRADE - NONDURABLE GOODS
                                   0                   52 BUILDING MATERIALS & GARDEN SUPPLIES
                                   0                   53 GENERAL MERCHANDISE STORES
                                   0                   54 FOOD STORES
                                   0                   55 AUTOMOTIVE DEALERS & SERVICE STATIONS
                                   0                   56 APPAREL AND ACCESSORY STORES
                                   0                   57 FURNITURE AND HOMEFURNISHINGS STORES
                                   0                   58 EATING AND DRINKING PLACES
                                   0                   59 MISCELLANEOUS RETAIL
                                   0                   60 DEPOSITORY INSTITUTIONS
                                   0                   61 NONDEPOSITORY INSTITUTIONS
                                   0                   62 SECURITY AND COMMODITY BROKERS
                                   0                   63 INSURANCE CARRIERS
                                   0                   64 INSURANCE AGENTS, BROKERS & SERVICES
                                   0                   65 REAL ESTATE
                                   0                   67 HOLDING AND OTHER INVESTMENT OFFICES
                                   0                   70 HOTELS AND OTHER LODGING PLACES
                                   0                   72 PERSONAL SERVICES
                                   0                   73 BUSINESS SERVICES
                                   0                   75 AUTO REPAIR, SERVICES, AND PARKING
                                   0                   76 MISCELLANEOUS REPAIR SERVICES
                                   0                   78 MOTION PICTURES
                                   0                   79 AMUSEMENT & RECREATION SERVICES
                                   0                   80 HEALTH SERVICES
                                   0                   81 LEGAL SERVICES
                                   0                   82 EDUCATIONAL SERVICES
                                   0                   83 SOCIAL SERVICES
                                   0                   84 MUSEUMS, BOTANICAL, ZOOLOGICAL GARDENS
                                   0                   86 MEMBERSHIP ORGANIZATIONS
                                   0                   87 ENGINEERING & MANAGEMENT SERVICES
                                   0                   88 PRIVATE HOUSEHOLDS
                                   0                   89 SERVICES, NEC
                                   0                   91 EXECUTIVE, LEGISLATIVE, AND GENERAL
                                   0                   92 JUSTICE, PUBLIC ORDER, AND SAFETY
                                   0                   93 FINANCE, TAXATION, & MONETARY POLICY
                                   0                   94 ADMINISTRATION OF HUMAN RESOURCES
                                   0                   95 ENVIRONMENTAL QUALITY AND HOUSING
                                   0                   96 ADMINISTRATION OF ECONOMIC PROGRAMS
                                   0                   97 NATIONAL SECURITY AND INST. AFFAIRS
                                   0                   99 NONCLASSIFIABLE ESTABLISHMENTS

                  Note: Applies only if D_OBTNP5 = 2, 3, 5, or 8

