View Information Collection Request (ICR) Package
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:
0935-0110
ICR Reference No:
201110-0935-001
Status:
Historical Active
Previous ICR Reference No:
200909-0935-003
Agency/Subagency:
HHS/AHRQ
Agency Tracking No:
Title:
2012 and 2013 Medical Expenditure Panel Survey - Insurance Componenet (MEPS-IC)
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/12/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/05/2011
Terms of Clearance:
This ICR is approved for three years. AHRQ has agreed to consult with OMB as it determines how to modify this questionnaire for 2013 to address the need for additional data to monitor the implementation of the ACA.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2014
36 Months From Approved
01/31/2013
Responses
106,174
0
101,989
Time Burden (Hours)
21,440
0
20,471
Cost Burden (Dollars)
0
0
0
Abstract:
Data is used by the Agency, other Federal, State and local agencies and the private sector to monitor and perform research on the topic of employer sponsor health insurance. Data from this survey supports calculation of Gross domestic product by the Bureau of Economic Analysis. Respondents are all public and private sector employers in the United States.
Authorizing Statute(s):
US Code:
42 USC 299b-2
Name of Law: Health Care Quality Act of 1999
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 38397
06/30/2011
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 57048
09/15/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
Establishment Questionnaire
Form #2
Establishment Questionnaire
Plan Questionnaire
Form #3
Plan Questionnaire
Prescreener Questionnaire
Form #1
Prescreener Questionnaire
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
106,174
101,989
0
4,185
0
0
Annual Time Burden (Hours)
21,440
20,471
0
969
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:
Total estimated burden hours will go up 4.7 percent from the 2010/2011 clearance estimates. This rise is due to an increase for recent years in the number of respondents to both the establishment and plan questionnaires, despite no change in the overall sample size. A clarification to existing collection procedures also resulted in an increase in the number of completed plan questionnaires.
Annual Cost to Federal Government:
$11,477,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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]?
No
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:
Doris Lefkowitz 3014271477
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:
10/05/2011
An official website of the United States government
The .gov means it's official.
The site is secure.
