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View ICR - OIRA Conclusion

OMB Control No: 0938-1217	ICR Reference No: 201711-0938-011
Status: Historical Active	Previous ICR Reference No: 201408-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: 21137
Title: Payment Collections Operations Contingency Plan (CMS-10515)
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: 07/02/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/29/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2021	36 Months From Approved	06/30/2018
Responses	1,800	0	14,775
Time Burden (Hours)	10,953	0	94,373
Cost Burden (Dollars)	0	0	0

Abstract: Under sections 1401, 1411, and 1412 of the Affordable Care Act and 45 CFR part 155 subpart D, an Exchange makes an advance determination of tax credit eligibility for individuals who enroll in QHP coverage through the Exchange and seek financial assistance. Using information available at the time of enrollment, the Exchange determines whether the individual meets the income and other requirements for advance payments and the amount of the advance payments that can be used to pay premiums. Advance payments are made periodically under section 1412 of the Affordable Care Act to the issuer of the QHP in which the individual enrolls. Section 1402 of the Affordable Care Act provides for the reduction of cost sharing for certain individuals enrolled in a QHP through an Exchange, and section 1412 of the Affordable Care Act provides for the advance payment of these reductions to issuers. The statute directs issuers to reduce cost sharing for essential health benefits for individuals with household incomes between 100 and 400 percent of the Federal poverty level (FPL) who are enrolled in a silver level QHP through an individual market Exchange and are eligible for advance payments of the premium tax credit. Health insurance issuers will manually enter enrollment and payment data into a Microsoft Excel-based spreadsheet, and submit the information to HHS. The data collection will be used by HHS to make payments or collect charges from issuers under the following programs: advance payments of the premium tax credit, advanced cost-sharing reductions, and Marketplace user fees. HHS will use the information collected to make payments and collect charges in January 2014 and for a number of months thereafter, as may be required based on HHS's operational progress.

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,800	14,775	-12,975
Annual Time Burden (Hours)	10,953	94,373	-83,420
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: The burden hours have decreased by -83,420 hours (94,373 hours to 10,953 hours). In January 2016, HHS implemented an automated payment approach, called policy-based payments (PBPs) to determine an issuer’s advance payment using enrollment and payment data in the Federally- FFE. As of April 2016, all FFE and SBE-FP issuers have fully transitioned to the PBP process. SBE issuers continue to use the manual payment process and will be transitioning to the PBP process in 2018 and 2019. In 2014, we estimated 575 issuers would be required to use a manual methodology to transmit enrollment and payment data, but since we have fully transitioned all FFE and SBE-FP issuers to the automated payment approach (PBPs), we now estimate that only 75 issuers would be required to use the manual methodology to transmit information via a manual system. Additionally, issuers will not be required to establish new systems to complete their enrollment and payment forms because their systems have already been established and the forms are not changing.

Annual Cost to Federal Government: $3,561

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. 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