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View ICR - OIRA Conclusion

OMB Control No: 0938-1258	ICR Reference No: 201802-0938-003
Status: Historical Active	Previous ICR Reference No: 201611-0938-012
Agency/Subagency: HHS/CMS	Agency Tracking No: 20436
Title: Disclosure of State Rating Requirements and Individual Market Special Enrollment Notice (CMS-10454)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/12/2018
	Date Received in OIRA: 02/06/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2021	36 Months From Approved
Responses	423	0	0
Time Burden (Hours)	2,338	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	423	-9	432
Annual Time Burden (Hours)	2,338	254	2,084
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: Total burden for reporting increased by 254 hours (from 2,084 hours to 2,338 hours) due to an increase in the number of states that establish and report age rating curves. The cost to the federal government increased by $6,360 due to use of updated labor cost and an increase in the number of states submitting notification they have developed their own age rating curve (from 5 to 7).

Annual Cost to Federal Government: $20,184

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

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