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: 0938-1114	ICR Reference No: 201805-0938-009
Status: Historical Active	Previous ICR Reference No: 201711-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Medical Loss Ratio (IFR) Information Collection Requirements and Supporting Regulations (CMS-10361)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/14/2018
	Date Received in OIRA: 05/23/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved	08/31/2014
Responses	22	0	442
Time Burden (Hours)	3,080	0	442
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute
Annual Number of Responses	22	442	-420
Annual Time Burden (Hours)	3,080	442	2,638
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: In the HHS Notice of Benefit and Payment Parameters for 2019 final rule, HHS has reduced the burden on respondents by eliminating collection of some data elements that were included in the previously approved ICR and streamlining the requirements for other data elements. It is estimated that there will be a net reduction in total burden from 3,700 to 3,080.

Annual Cost to Federal Government: $38,544

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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