View Information Collection Request (ICR) Package

OMB Control No: 0938-1146	ICR Reference No: 201908-0938-004
Status: Historical Inactive	Previous ICR Reference No: 201903-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Summary of Benefits and Coverage and Uniform Glossary (CMS-10407)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted	Conclusion Date: 09/04/2019
	Date Received in OIRA: 08/29/2019
Terms of Clearance: CMS is requested to include the coverage calculator instrument when re-submitting this ICR to OMB for review.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

Abstract: The Patient Protection and Affordable Care Act, Pub. L. 111-148, was signed into law on March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, Pub. L. 111-152, was signed into law on March 30, 2010 (these are collectively known as the "Affordable Care Act"). The Affordable Care Act amends the Public Health Service Act (PHS Act) by adding section 2715 "Development and Utilization of Uniform Explanation of Coverage Documents and Standardized Definitions." Section 2715 directs the Secretary, in consultation with the National Association of Insurance Commissioners and a working group comprised of stakeholders, to develop standards for use by a group health plan and a health insurance issuer in compiling and providing to applicants, enrollees, and policyholders and certificate holders a summary of benefits and coverage (SBC) that accurately describes the benefits and coverage under the applicable plan or coverage. Section 2715 also directs the Secretary to provide for the development of standards for the defintions of terms used in health insuance. Finally, section 2715 requires 60-days advance notice of any material modification in any of the terms of the plan or coverage that is not reflected in the most recently provided SBC. To implement these disclosure requirements, the final rule would require a collection of information by health insurance issuers in the group and individual markets and third-party administrators. Collection of information requirements relate to the provision of the following: 1. Summary of benefits and coverage (SBC) 2. Coverage examples (as a component of each SBC) 3. A uniform glossary of health coverage and medical terms (uniform glossary) 4. Notice of modifications

Authorizing Statute(s): US Code: 42 USC Sec 300gg-21 Name of Law: Development and Utilization of Uniform Explanation of Coverage Documents & Standardized Definitions
PL: Pub.L. 111 - 148 Title 1, Subtitle A, Sec. 1001 Name of Law: Amendments to the Public Health Service Act

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
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 20890	05/13/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 43134	08/20/2019
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Deemed Compliance Reporting
SBC Disclosure	CMS-10407, CMS-10407, CMS-10407, CMS-10407, CMS-10407, CMS-10407, CMS-10407, CMS-10407, CMS-10407, CMS-10407, CMS-10407 , CMS-10407, CMS-10407, CMS-10407, CMS-10407	, , , , , , , , , , , , , ,

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: Burden estimates have been adjusted to account for new estimates of the number of issuers, plans, participants and beneficiaries affected by the information collection, as well as updated data on labor rates and an updated assumption on the usage of electronic distribution. As a result of these updated data inputs, the overall burden has decreased from 325,333 hours to 215,004 hours, resulting in a total burden decrease of 110,329 hours.

Annual Cost to Federal Government: $21,353

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

View ICR - OIRA Conclusion