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OMB Control No: 0938-1146	ICR Reference No: 202210-0938-011
Status: Historical Active	Previous ICR Reference No: 201911-0938-018
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Summary of Benefits and Coverage and Uniform Glossary (CMS-10407)
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: 05/30/2023
	Date Received in OIRA: 11/01/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2026	36 Months From Approved	05/31/2023
Responses	24,211,595	0	41,805,055
Time Burden (Hours)	204,140	0	215,004
Cost Burden (Dollars)	10,494,154	0	4,180,463

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:
	87 FR 35783	06/13/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 64052	10/21/2022
Did the Agency receive public comments on this ICR? Yes

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

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

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	24,211,595	41,805,055	-17,593,460
Annual Time Burden (Hours)	204,140	215,004	-10,864
Annual Cost Burden (Dollars)	10,494,154	4,180,463	6,313,691

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: Based on the foregoing, the total hour burden reduced from 215,004 to 204,140 (a total reduction of 10,864 hours). The total hours are the sum of burden hours for issuers and TPAs to prepare the SBCs and coverage examples (28,462 hours), distribution of the SBCs (see item 13 below (175,102 hours), and deemed compliance (576 hours). The overall burden hour reduction is due to a decrease in the number of issuers associated with deemed compliance and a decrease in the number of notice of modifications issuers and plans are required to send.

Annual Cost to Federal Government: $41,423

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

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