June 21 - June 23
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Email *
First Name *
Last Name *
Age *
Phone Number *
Gender *
What is your sexual orientation? *
Ethnicity *
If you are Hispanic, which of the following statements best describes you;
Clear selection
What CITY do you live in *
What COUNTY do you live in *
What STATE do you live in (ex- CA, NY, TX etc.) *
What is your Zip Code *
What region do you live in? *
What area do you live in? *
Highest Level of Education *
Employment Status *
What is your current occupation? (please list previous if unemployed, homemaker or retired) *
What industry do you work in? (please list previous if unemployed, homemaker or retired) *
Annual *Household* income (Everyone working adult in your home combined) *
Marital Status *
Do you own or rent you home? *
What type of home do you live in? *
If you have children, how old are they? *
Required
What is the year of your vehicle? *
What is the Make of your vehicle? (Ford, Chevrolet, BMW, etc.) *
What is the Model of your vehicle? (Escape, Tahoe, X3, etc.) *
Are you a legal resident of California? As a reminder, all your answers are anonymous and confidential; they will only be used to make sure we have the right mix of people and will not be passed along to anyone outside of this project. *
Who is responsible for making the health insurance decisions in your household? Primarily you, primarily someone else, or do you share responsibilities equally with someone else? *
Do you currently have health insurance? *
If you have insurance, what type of insurance do you have? (If none - put "No Insurance") *
What type of insurance do you have? *
Are you currently on Medi-Cal? *
In a typical week, how much time do you spend watching TV?   *
What was your total household income in 2021, before taxes, including you, a spouse and/or significant other?  Please give me your best estimate if you are not sure and/or you have not done your taxes. *
Thinking about your expected household income this year, do you expect it will be about the same, less, or more than your household income was last year?  Please include you, a spouse, significant other and/or children under 18. *
How familiar are you with Covered California? *
Have you ever looked into enrolling in health insurance through Covered California? *
Assuming an affordable option were available to you, would you consider getting health insurance? Which of these statements best describes you? *
Have you ever started an application with Covered California? *
And now I’d like to ask you something completely different.  I want you to imagine that you've been given a paid year off to write a book. What would your book be about? What would the title be? What has compelled you to write about this?   *
When you file your federal income tax return, how many people do you claim as part of your household? You should count yourself and anyone else—like a spouse or children—who you claim as a dependent on your tax return (1040). *
Which of the following statements best describes you in a group situation? *
When, if ever, was the last time you participated in a market research study in person, over the phone, or online? *
Are you or is any member of your household currently employed by, previously employed by, or retired from any of the following types of companies *
Required
You must have a working Desktop or Laptop computer with high-speed internet, webcam and audio capability to participate in this study. Do you have access to all of these things to participate in this study? *
Payment for participation will be paid by email with a Visa Gift Card (Unless otherwise stated) Payment can take up to 3-4 weeks to receive after the study is completed. Are you ok with this? *
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