Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-1121
ICR Reference No:
201107-0938-013
Status:
Historical Active
Previous ICR Reference No:
201102-0938-012
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
Grants to States for Health Insurance Premium Review - Cycles I and II
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
09/14/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/26/2011
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2014
36 Months From Approved
09/30/2011
Responses
1,075
0
964
Time Burden (Hours)
42,872
0
52,292
Cost Burden (Dollars)
0
0
0
Abstract:
Cycle I Process The data collection is used by HHS to request that States and territories submit information for the Cycle I Health Insurance Premium Review Grants (quarterly reports, rate review transaction data, and a final Cycle I report) and Cycle II Health Insurance Premium Review Grants (application, quarterly reports, rate review transaction data, and a final Cycle II report). This information will assist HHS in planning for and executing grants to States for health insurance rate review.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 1003
Name of Law: Ensuring that consumers get value for their dollars
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
76 FR 28234
05/16/2011
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 44009
07/22/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
(Cycle I) Application re-release
CMS-10380
CMS-10380.Deliberative Document
(Cycle I) Final Report
CMS-10380
Cycle I FOA
(Cycle I) Quarterly Reports
CMS-10380
Cycle I - FOA
(Cycle I) Transaction Data Collection
CMS-10380
Cycle I FOA
(Cycle II ) Final Report - end of grant
CMS-10380
Cycle II FOA
(Cycle II) Annual Report
CMS-10380
Cycle II FOA
(Cycle II) Application
CMS-10380
Cycle II - FOA
(Cycle II) Quarterly Report
CMA-10380
Cycle II FOA
(Cycle II) Transaction Data Collection
CMS-10380
Cycle II FOA
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
1,075
964
0
111
0
0
Annual Time Burden (Hours)
42,872
52,292
0
-9,420
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The reason for the Program Changes or adjustments are due to the data collection needs for Cycle I grant awardees, including an update to the number of Cycle I applicants to correspond with the actual number of States and territories that applied and received grant awards and the associated burden for those 51 Cycle I participating States and territories in preparing and submitting quarterly reports and final reports. Similarly, we are revising the estimated burden for Cycle II applicants and potential grantees to correspond with the total possible number of applicants and their associated burden of applying, and preparing and submitting quarterly reports and final reports.
Annual Cost to Federal Government:
$203,554
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
William Parham 4107864669
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
07/26/2011
An official website of the United States government
The .gov means it's official.
The site is secure.
