View Information Collection Request (ICR) Package

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: 0938-1191	ICR Reference No: 201603-0938-021
Status: Historical Active	Previous ICR Reference No: 201302-0938-004
Agency/Subagency: HHS/CMS	Agency Tracking No: 18760
Title: Data Collection to Support Eligibility Determinations for Insurance Affordability Programs and Enrollment through Health Benefits Exchanges, Medicaid and Children's Health Insurance Program Agencies
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/16/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/31/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved	06/30/2016
Responses	5,328,000	0	3,035,434
Time Burden (Hours)	1,081,584	0	1,428,822
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	5,328,000	3,035,434	2,292,566
Annual Time Burden (Hours)	1,081,584	1,428,822	-347,238
Annual Cost Burden (Dollars)	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: While a couple additional questions were added in response to comments received from the 60 day posting, none were substantial enough to warrant changes to burden estimates. The changes modified language for an attestation and optional questions. OMB previously approved this information collection in April, 2013 with a total of 3,035,434 responses and 1,428,822 burden hour. There have been no interim approvals. For this renewal, CMS estimates that the total new responses (applications) will be 5,328,000 per year and the total burden hours will be 2,410,767 per year. This reflects an increase of 2,292,566 responses and 981,945 total burden hours per year from the currently approved burden for this collection. For this renewal, CMS estimates that the total annual application cost burden will decrease by $20,708,891 (from $49,911,660 per year to $29,202,769 per year) due to administrative adjustments.