View Information Collection Request (ICR) Package
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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:
0938-1119
ICR Reference No:
201308-0938-024
Status:
Historical Active
Previous ICR Reference No:
201203-0938-011
Agency/Subagency:
HHS/CMS
Agency Tracking No:
20357
Title:
Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges
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:
09/30/2013
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/23/2013
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2016
36 Months From Approved
09/30/2014
Responses
1,068
0
700
Time Burden (Hours)
67,884
0
69,650
Cost Burden (Dollars)
28,081
0
42,770
Abstract:
Information collected as a part of the application for this grant will be used to evaluate the applications and determine awardees. Information collected pursuant to the reporting requirements for awardees will be used to evaluate the progress of States in planning for and implementing Exchanges, and determine how the Secretary can provide assistance to achieve the goals of the grant program and the Affordable Care Act.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 1311
Name of Law: Affordable choices of health benefit plans
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:
78 FR 31557
05/24/2013
30-day Notice:
Federal Register Citation:
Citation Date:
78 FR 50057
08/16/2013
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
12
IC Title
Form No.
Form Name
Application
CMS-10371
Revised FOA
Develpomental Phase Planning Review
CMS-10371
Exchange Establishment Grant FOA
Operational Metrics - Monthly Reports
CMS-10371, CMS-10371
Exchange Establishment Grants FOA
,
Operational Metric – SBM Open Enrollment Weekly Indicators
Operational Metrics - Weekly Reports
CMS-10371, CMS-10371
Exchange Establishment Grant FOA
,
Operational Metric – SBM Open Enrollment Weekly Indicators
Outcome Metrics - Annual Report
CMS-10371, CMS-10371
Outcome Metrics - Annual Report
,
Outcome Metric – SBM Exchange Metrics
Performance Reviews
CMS-10371
Revised FOA
Periodic Reporting
CMS-10371
Revised FOA
Public
CMS-10371
Revised FOA
Semi-Annual Reports
CMS-10371
Establishment Grant FOA
Start-Up Year Establishment Review
Start-up Outcomes Metrics - Quarterly Reports
CMS-10371, CMS-10371
Start-up Outcomes Metrics - Quarterly Reports
,
Outcome Metric – SBM Exchange Metrics
Work Plan Update
CMS-10371
Revised 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
1,068
700
0
-120
488
0
Annual Time Burden (Hours)
67,884
69,650
0
-13,288
11,522
0
Annual Cost Burden (Dollars)
28,081
42,770
0
0
-14,689
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 more substantial current revisions result in a net reduction in annual burden of over 4,000 hours and a net reduction of over $360,000 in annual cost to the respondents. These revisions to the ICR are necessary to reflect the maturation of the Marketplace development as well as the need for more robust oversight and monitoring of the grantees in their Start-up year. The revised estimates of respondents reflect the actual participation of States in these grants; while initially the estimate included all eligible jurisdictions, the current estimate is based on grants awarded through April 2013, and the anticipated grant requests and entry into Marketplace Development and Start-up. Revisions to the Establishment Review delineation of tasks appropriately reflect the comprehensive preparation required for the series of planning, design and implementation reviews during the Developmental Phase. In addition, during the Start-up year, there are robust additional monitoring requirements; these Outcomes and Performance Metrics have been developed as needs for critical performance assessment has been identified. An increase in reporting is offset by the previous reductions in reporting frequency, and more accurate number of respondents for many of the reports.
Annual Cost to Federal Government:
$394,912
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:
08/23/2013
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