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View ICR - Agency Submission
OMB Control No:
0938-1254
ICR Reference No:
202506-0938-018
Status:
Received in OIRA
Previous ICR Reference No:
202504-0938-012
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CCIIO
Title:
Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
Date Submitted to OIRA:
07/01/2025
Requested
Previously Approved
Expiration Date
36 Months From Approved
06/30/2026
Responses
5,397
5,881
Time Burden (Hours)
66,091
72,002
Cost Burden (Dollars)
0
0
Abstract:
The final rule "Patient Protection and Affordable Care Act; Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs; Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges", provides that a Marketplace may choose to conduct the annual redetermination process for a plan year (1) in accordance with the existing procedures described in 45 CFR 155.335; (2) in accordance with procedures described in guidance issued by the Secretary for the coverage year; or (3) using an alternative proposed by the Marketplace and approved by the Secretary. The guidance document "Guidance on Annual Redeterminations for Coverage for 2015" contains the procedures that the Secretary is specifying for the 2015 coverage year, as noted in (2) above. These procedures will be adopted by the Federally-facilitated Marketplace. Under this option, the Marketplace will provide three notices. The final rule also amends the requirements for product renewal and re-enrollment (or nonrenewal) notices to be sent by Qualified Health Plan (QHP) issuers in the Exchanges and specifies content for these notices. The accompanying guidance document "Form and Manner of Notices When Discontinuing or Renewing a Product in the Group or Individual Market" provides standard notices for product discontinuation and renewal to be sent by issuers of QHPs and issuers in the individual market. Issuers in the small group market may use the draft Federal standard small group notices released in the June 26, 2014 bulletin "Draft Standard Notices When Discontinuing or Renewing a Product in the Small Group or Individual Market", or any forms of the notice otherwise permitted by applicable laws and regulations. States that are enforcing the Affordable Care Act may develop their own standard notices, for product discontinuances, renewals, or both, provided the State-developed notices are at least as protective as the Federal standard notices.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 1411(f)(1)(B)
Name of Law: Affordable Care Act
Citations for New Statutory Requirements:
PL: Pub.L. 111 - 148 Section 1411(f)(1)(B) Name of Law: Affordable Care Act
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AV61
Final or interim final rulemaking
90 FR 27074
06/25/2025
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP)
CMS-10527
Renewal Notice
Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP)
CMS-10527, CMS-10527
Discontinuation Notices
,
Federal Standard Notices
Product Discontinuance Notice for QHP Issuers
CMS-10527, CMS-10527
Discontinuation Notices
,
Discontinuation without auto enrollment (QHP)
Product Renewal and Discontinuance Notice for QHP Issuers
CMS-10527
Renewal and Discontinuance Notice
ICR Summary of Burden
Total Request
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
5,397
5,881
0
0
-484
0
Annual Time Burden (Hours)
66,091
72,002
0
0
-5,911
0
Annual Cost Burden (Dollars)
0
0
0
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:
The burden for individual market QHP issuers has increased by approximately 423.5 hours (from 12,820.5 to 13,244) due to an increase in the estimated number of QHP issuers (from 333 to 344). The burden for issuers in the individual market outside the Exchange and issuers in the small group market has decreased by 6,335 hours (from 59,326 to 52,992) due to a decrease in the estimated number of issuers in those markets (from 1,340 to 1,206). In total, there is a reduction in burden by approximately 5,911 hours.
Annual Cost to Federal Government:
$0
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
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
07/01/2025
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