View Information Collection Request (ICR) Package
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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:
0938-1119
ICR Reference No:
201411-0938-005
Status:
Historical Active
Previous ICR Reference No:
201308-0938-024
Agency/Subagency:
HHS/CMS
Agency Tracking No:
20357
Title:
Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Emergency
Approval Requested By:
11/14/2014
OIRA Conclusion Action:
Approved without change
Conclusion Date:
11/14/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/10/2014
Terms of Clearance:
If CMS receives comments by 11/14/2014, it will provide OMB with a response to those comments within 5 business days.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2015
6 Months From Approved
09/30/2016
Responses
860
0
1,068
Time Burden (Hours)
64,140
0
67,884
Cost Burden (Dollars)
28,081
0
28,081
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.
Emergency Justfication:
Public harm is reasonably likely to ensue if the normal clearance procedures are followed. Existing collections gather information from the grant awardee to ensure the CMS is able to conduct their statutory oversight responsibilities. The revision is necessary to obtain more accurate and consistent enrollment data during the upcoming Open Enrollment Period which begins November 15, 2014. The immediate need for this revision is due to the State-Based Marketplaces (SBM) maturing business processes and the requirement for more precise reporting of comparison data between the first and second years of ACA implementation. Of particular concern is the need to capture certain demographic data and information on new versus re-enrolled individuals in accordance with uniform definitions so as not to produce misleading results. A delay in finalizing this ICR will result in key data being unavailable to CMS during the 2014 Open Enrollment Period. CMS will not be able to use the data to provide technical and policy mid-course corrections to the State Exchanges during the Open Enrollment Period.
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
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
,
Cooperative Agreements to Support Establishment of State-Operated Health Insurance
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
860
1,068
0
0
-208
0
Annual Time Burden (Hours)
64,140
67,884
0
0
-3,744
0
Annual Cost Burden (Dollars)
28,081
28,081
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:
There is a total decrease of -3,744 hours due to a 50% reduction of weekly reporting responses (from 1,068 to 860 responses).
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:
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:
11/10/2014
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