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:
0938-1221
ICR Reference No:
201407-0938-016
Status:
Historical Active
Previous ICR Reference No:
201402-0938-010
Agency/Subagency:
HHS/CMS
Agency Tracking No:
21457
Title:
Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
08/05/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/31/2014
Terms of Clearance:
Prior terms remain in effect: The psychometric test component of this information collection is not designed to provide state-level or QHP-level estimates; as such only the aggregate results of this analysis will be discussed or disseminated. The second component of this information collection (in 2015) includes a provision for early feedback to States and QHPs, subject to the limitations associated with response rates (including non-response bias analyses) and data quality findings. Approval has not yet been provided for the early feedback/beta test component described in the supporting statements; rather CMS will submit a change package to OMB for that clearance once the results of the psychometric test component have been analyzed. CMS should confer with OMB to determine whether the changes made as a result of the psychometric test component constitute a substantive change.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/28/2017
02/28/2017
02/28/2017
Responses
668,590
0
668,590
Time Burden (Hours)
297,670
0
297,670
Cost Burden (Dollars)
0
0
0
Abstract:
Section 1311(c)(4) of the ACA requires the Department of Health and Human Services (HHS) to develop an enrollee satisfaction survey system that assesses consumer experience with qualified health plans (QHPs) offered through an Exchange. It also requires public display of enrollee satisfaction information by the Exchange to allow individuals to easily compare enrollee satisfaction levels between comparable plans. CMS is developing, testing and implementing two surveys, a survey for adult enrollees in QHPs and a survey for health insurance Marketplace consumers. CMS is requesting approval for information collection associated with these surveys.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 1313
Name of Law: Affordable Care Act
PL:
Pub.L. 111 - 148 1321(a)
Name of Law: Affordable Care Act
PL:
Pub.L. 111 - 148 1311(c)(4)
Name of Law: Affordable Care Act (ACA)
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
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Adult Qualified Health Plan Enrollee Experience Survey
CMS-10488, CMS-10488, CMS-10488, CMS-10488
Vendor Form
,
English Adult QHP Enrollee Survey
,
Spanish - Qualified Health Plan Enrollee Experience Survey
,
Chinese - Qualified Health Plan Enrollee Experience
Marketplace Survey Data Collection
CMS-10488, CMS-10488, CMS-10488
English - Marketplace Survey
,
Spanish - Marketplace Survey
,
Chinese - Marketplace Survey
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
668,590
668,590
0
0
0
0
Annual Time Burden (Hours)
297,670
297,670
0
0
0
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:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$0
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]?
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:
07/31/2014
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