2  N (7)
9  DK (7)
b. What is the name? Record in Table P below. ____
c. Does anyone in the family belong to any other Health Maintenance Organization or prepaid group practice plan?
[MK Note: There are two separate response areas for Plan 1 and Plan 2. Only one response area is represented here, as the information in each area is identical.]
2  Yrs.
2  Does not belong (NP)
2  N (NP)
9  DK (NP)
d. Is there any other reason -- sometimes sees doctors who are not part of this plan?
 N (NP)
2  N (10)
9  DK (10)
b. What is the name of the plan? Record in Table H.I. below ____
c. Is anyone in the family covered by any other health insurance plan?
9. Is -- covered under this (name) plan?
2  Not covered (NP)
2  N (NP)
If Hospital: Is this an outpatient clinic or the emergency room?
If Clinic: Is this a hospital outpatient clinic, a company clinic, or some other kind of clinic?
2  Home
3  Doctor's clinic
4  Group practice
5  Hosp. Outpatient Clinic
6  Hosp. Emerg. Room
7  Company or Industry Clinic
 Other -- Specify ____