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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:
0938-1174
ICR Reference No:
201804-0938-010
Status:
Historical Active
Previous ICR Reference No:
201710-0938-009
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CMS-10448
Title:
Essential Health Benefits Benchmark Plans (CMS-10448)
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:
06/04/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/18/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2021
36 Months From Approved
09/30/2018
Responses
580
0
226
Time Burden (Hours)
561
0
165
Cost Burden (Dollars)
0
0
0
Abstract:
The Affordable Care Act requires that all qualified health plans (QHPs) offered in the Exchanges provide the essential health benefits (EHB) and be accredited by an accrediting entity that is recognized by the Secretary of Health and Human Services. In order to establish EHB benchmark plans in each State, CMS will collect data from potential default benchmark plan issuers in each State and from States that select their own benchmark. CMS also intends to ask all States for a voluntary submission of their State mandated benefits. This data collection will include: administrative data necessary to identify the plan, all health benefits offered by the plans and associated limits, drug coverage, network type, and plan level enrollment. Finally, we plan to collect submissions from dental plan issuers on whether they intend to apply for certification to participate in the Exchanges as stand-alone plans.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 1201, 1301, 1302, 1311, 1321
Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
Citations for New Statutory Requirements:
US Code: 42 USC 156.111 Name of Law: Essential health benefits requirements
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AT12
Final or interim final rulemaking
83 FR 16930
04/17/2018
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
EHB Dental Plan Issuers
EHB Reporting
CMS-10448, CMS-10488, CMS-10448, CMS-10448
EHB Confirmation Template
,
EHB Benchmark Plan Certification
,
Benchmark Plans Prescription Template
,
Summary of Benefits Template
EHB Substitution
CMS-10488
Substitution Notification
Essential Health Benefits Benchmark Plans and Accrediting Entities Data Collection
CMS-10488
Data Collection Instructions
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
580
226
15
-51
390
0
Annual Time Burden (Hours)
561
165
402
-77
71
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
In response to 60-day comments (see Appendix F) and to align with the policy finalized in Final 2019 Payment Notice, certain modifications were made to the collection instruments in the Appendices. Burden estimates associated with §156.112(e)(2) increased from 16 hours to 18 hours for the actuary to complete the actuarial certification and associated report. The change was made in recognition of the extension of the generosity standard and in recognition that the definition of typical employer plan may require the actuary to determine whether the typical employer plan meets minimum value requirements as finalized in the Final 2019 Payment Notice. Lastly, the estimated number of States that need to respond to §156.112(e)(2) increased from 7 to 10 due to revisions in §156.111(b)(2)(i) and (ii). The overall burden hours increased by 395 hours (from 165 hours to 560 hours). However, the existing ICR assumed burden for 226 respondents and this ICR estimates an overall decrease to 190 respondents per year due to certain issuers and States no longer being required to respond to the information collection. The total costs for §156.111(e) per year is estimated to increase $25,605.20 (from $8,094 to $33,699.20) and the stand-alone dental plan data collection is estimated as $5,941 total costs per a year. The burden related to SADP issuers has risen due to increased fringe and overhead costs. The burden for §156.115(b)(2)(ii) of $165.10 is new to this ICR.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
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:
Jamaa Hill 301 492-4190
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:
04/18/2018