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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
CMS-10437.GenIC #12 - Web Intercept Survey of HealthCare.gov Visitors
New
50000
3330
0
Form and Instruction
CMS-10437.GenIC#12
Web Intercept Survey
CMS-10437.GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey
New
2800
700
0
Form and Instruction
CMS-10437.GenIC#10
Quality Payment Program Provider Awareness Tracking Survey
CMS-10437.GenIC#11 - CMS Consumer Research on Websites and Tools
New
200
200
0
Form and Instruction
CMS-10437.GenIC#11
CMS Consumer Research on Websites and Tools
CMS-10437.GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017
New
600
900
0
Form and Instruction
CMS-10437.GenIC#13
Qualitative Research on Communications and Decision Support for Provider Initiatives 2017
CMS-10437.GenIC#14 - Medicare Beneficiary Consumer Survey
New
4800
1200
0
Form and Instruction
CMS-10437.GenIC#14
Medicare Beneficiary Consumer Survey
CMS-10437.GenIC#17 - Formative Research and Materials Testing for Medicare
New
600
900
0
Form and Instruction
CMS-10437.GenIC#17
Formative Research and Materials Testing for Medicare Focus Group Guide
CMS-10437.GenIC#21 - Testing Form 500
New
27
27
0
Form and Instruction
CMS-10437.GenIC#21 - Guide for Testing Form500 (fi
CMS-10437.GenIC#21 - Guide for Testing Form500 (final 11-24-20)
CMS-10437.GenIC#23 - OE Marketplace Customer Service Survey
New
4800
1200
0
Form and Instruction
CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
CMS-10437.GenIC#3 - Medicare Open Enrollment Survey
New
2000
400
0
Form and Instruction
CMS-10437.GenIC#3
OMB OE PRE CAMPAIGN SURVEY.docx
Form and Instruction
CMS-10437.GenIC#3
OMB OE POSTCAMPAIGN SURVEY.docx
CMS-10437.GenIC#5 - Consumer Survey of Marketplace Disenrollees
New
1000
100
0
Form and Instruction
CMS-10437.GenIC#5
Consumer Survey of Marketplace Disenrollees
CMS-10437.GenIC#7 - Formative Research on Communications and Decision Support in Marketplace 2017
New
600
900
0
Form and Instruction
CMS-10437.GenIC#7
Marketplace 2017 Focus Group Guide
CMS-10437.GenIC#8 - Qualitative Testing of Creative Materials
New
600
900
0
Form and Instruction
CMS-10437.GenIC#8
Qualitative Testing Creative Materials Focus Group Guide
CMS-10437.GenIc#19 - Marketplace Consumer Persona Research
New
160
400
0
Form and Instruction
CMS-10437.GenIC#19. HIM pre-group workbook insured
CMS-10437.GenIC#19. HIM pre-group workbook insured
Form and Instruction
CMS-10437.GenIC#19.HIM pre-group workbook uninsure
CMS-10437.GenIC#19. HIM pre-group workbook uninsured
Form and Instruction
CMS-10437.GenIC#19
CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured
Form and Instruction
CMS-10437.GenIC#19
CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured
GenIC#16 Qualitative Testing of Creative Materials for Medicare
New
1000
1500
0
Form and Instruction
CMS-10437.GenIC#16
GenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx
GenIC#18 - Medicare Advantage Regional Outreach Experiment Survey
New
1600
267
0
Form and Instruction
CMS-10437- GenIC#18
Medicare Advantage Regional Outreach Experiment Survey (Online Version)
Form and Instruction
CMS-1037 GenIC#18
CMS-10437#18.Medicare Advantage Survey (Telephone Version)
GenIC#20 - Medicare Online Qualitative Panel Monthly Survey
New
6000
500
0
Form and Instruction
CMS-10437.GenIC#20
CMS-10437.GenIC#20 -Qualitative Panel Survey (final)
GenIC#22 - Medicare Telehealth Beneficiary Survey
New
1000
167
0
Form and Instruction
CMS--10437.GenIC#22
Beneficiary Telemedicine Survey- Questionnaire
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
77787
13591
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
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