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View Information Collection (IC) List
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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:
0938-1187
ICR Reference No:
201902-0938-012
Status:
Historical Active
Previous ICR Reference No:
201511-0938-013
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CMS-10433
Title:
Initial Plan Data Collection to Support QHP Certification and other Financial Management and Exchange Operations (CMS-10433)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
06/28/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/28/2019
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2022
36 Months From Approved
06/30/2019
Responses
2,892
0
26,951
Time Burden (Hours)
68,666
0
235,153
Cost Burden (Dollars)
0
0
0
Abstract:
As required by the CMS-9989-F: Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers ("Exchange rule"), each Exchange must assume responsibilities related to the certification and offering of Qualified Health Plans ("QHP"). To offer insurance through an Exchange, a health insurance issuer must have its health plans certified as QHPs by the Exchange. A QHP must meet certain minimum certification standards, such as network adequacy, actuarial value standards, and the offering of the essential health benefits (EHB). The Exchange is responsible for ensuring that QHPs meet these minimum certification standards as described in the Exchange rule under 45 CFR 155 and 156, based on the Affordable Care Act, as well as other requirements determined by the Exchange.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 1343, 1401-1402
Name of Law: Affordable Care Act
PL:
Pub.L. 111 - 148 1411-1412
Name of Law: Affordable Care Act
PL:
Pub.L. 111 - 148 1301-1304, 1311-1312
Name of Law: Affordable Care Act
PL:
Pub.L. 111 - 148 1321-1322
Name of Law: Affordable Care Act
PL:
Pub.L. 111 - 148 1324, 1341
Name of Law: Affordable Care Act
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:
83 FR 53474
10/23/2018
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 6789
02/28/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
QHP Certification
CMS-10433, CMs-10433, CMS-10433, CMS-10433, CMS-10433, CMS-10433, CMS-10433, CMS-10433, CMS-10433, CMS-10433, CMS-10433
Administrative Data Template
,
Network Adequacy Template
,
Plan Benefits Template
,
Network ID Template
,
Plans and Benefits Template
,
Prescriptions Drug Formulary Template
,
Rate Table Template
,
Service Area Template
,
Business Rules Template
,
QHP Certification Instrument Screenshots
,
Reinsurance Program and Risk Adjustment Program
Reinsurance
Risk Adjustment
CMS-10433
Reinsurance and Risk Adjustment Bank Server
Stand-Alone Dental Issuers: QHP Certification
States
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
2,892
26,951
0
-23,800
-259
0
Annual Time Burden (Hours)
68,666
235,153
0
-119,000
-47,487
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:
The reduction in burden is primarily due to the removal of provisions related to the reinsurance program. This removal reduced the number of burden hours by 119,000 hours and respondents by 23,800 entities. The burden on issuers for the QHP certification is reduced from 450 to 200 issuers and a decrease in the number of state-based exchanges using the federal platform and partnership states from 51 to 22 states. Therefore, the current ICR burden is for 26,951 respondents and the proposed ICR estimates 2,892 respondents.The estimated burden hours for this data collection is currently approved for 235,153 hours. With this ICR, the estimated annualized burden hours are 68,666 hours. This is a reduction of 166,487 burden hours compared to the previously approved clearance. There is an increase of 80 hours (+270 respondents) as a result of adding burden associated with stand-alone dental issuers. While the stand-alone dental issuer burden is not a new data collection require, the burden was not accounted for during the last approval.
Annual Cost to Federal Government:
$227,166
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:
02/28/2019