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: 0938-1341	ICR Reference No: 202007-0938-013
Status: Historical Active	Previous ICR Reference No: 201703-0938-016
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers (CMS-10592)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/25/2021
	Date Received in OIRA: 08/03/2020
Terms of Clearance: In CMS' next revision, extension, or reinstatement request, CMS shall submit a copy of all then-effective public guidance issued by CMS on complying with this collection (if any) with the package.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2024	36 Months From Approved	02/28/2021
Responses	1,013	0	1,200
Time Burden (Hours)	122,981	0	104,800
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,013	1,200	-187
Annual Time Burden (Hours)	122,981	104,800	18,181
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: There is a total burden hour increase of 18,181 hours (from 104,800 to 122,981) because there are more QHP issuers participating in the Exchanges. There was an increase is due to the additional requirement for QHP Issuers to complete periodic surveys from the Exchanges.

Annual Cost to Federal Government: $150,878

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? No

Agency Contact: Jamaa Hill 301 492-4190

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.