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OMB Control No: 0938-1438	ICR Reference No: 202602-0938-011
Status: Received in OIRA	Previous ICR Reference No: 202501-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Supporting Statement for Agent/Broker Consent Information Collection (CMS-10840)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 02/27/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2028
Responses	9,800,624	9,800,600
Time Burden (Hours)	1,666,624	1,666,601
Cost Burden (Dollars)	52,269,473	52,268,080

Abstract: The Patient Protection and Affordable Care Act, Public Law 111-148, enacted on March 23, 2010, and the Health Care and Education Reconciliation Act, Public Law 111-152, enacted on March 30, 2010 (collectively, “Affordable Care Act”), expanded access to health insurance for individuals and employees of small businesses through the establishment of new Affordable Insurance Exchanges (Exchanges), also called Marketplaces. The Exchanges, which became operational on January 1, 2014, enhance competition in the health insurance market, expand access to affordable health insurance for millions of Americans, and provide consumers with a place to easily compare and shop for health insurance coverage. Section 1312(e) of the Affordable Care Act directs the Secretary of the Department of Health and Human Services (HHS) to establish procedures under which a state may permit agents and brokers to enroll qualified individuals and employers into qualified health plans (QHPs) offered through an Exchange and to enable these agents and brokers to assist individuals in applying for advance payments of the premium tax credit and cost-sharing reductions. Authority for collection of this information comes from 45 C.F.R. §155.220(c)(5), which states that “HHS or its designee may periodically monitor and audit an agent, broker, or web-broker under this subpart to assess its compliance with the applicable requirements of this section.” This information collection specifically details what information will be required to be collected and maintained by agents, brokers, and web-brokers were they to receive a request from HHS for consent records. Currently, HHS only plans to collect information from a small percentage of agents, brokers, or web-brokers in conjunction with active investigations of potential fraud. Utilizing §155.220(c)(5) and the information to be collected under newly proposed §§ 155.220(j)(2)(ii)(A)(1-2) and 155.220(j)(2)(iii)(A-C), HHS will be able to verify whether or not an agent, broker, or web-broker has obtained consent from a consumer they are assisting in enrolling in coverage in the individual market, and whether the consumer has reviewed their eligibility information and confirmed its accuracy.

Authorizing Statute(s): US Code: 45 USC 155.220 Name of Law: Exchange Establishment Standards and Other Related Standards under the Affordable Care Act
PL: Pub.L. 111 - 148 1312 Name of Law: Patient Protection and Affordable Care Act

Citations for New Statutory Requirements: US Code: 45 USC 155.220 Name of Law: Exchange Establishment Standards and Other Related Standards under the Affordable Care Act
PL: Pub.L. 111 - 148 1312 Name of Law: Patient Protection and Affordable Care Act

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV62	Proposed rulemaking	91 FR 6292	02/11/2026

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Agent/Broker Eligibility and Consent Documentation	CMS-10840
Agent/Broker Eligibility and Consent Records	CMS-10840
Burden to Respond to Misleading Marketing

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	9,800,624	9,800,600	0	24
Annual Time Burden (Hours)	1,666,624	1,666,601	-1	24
Annual Cost Burden (Dollars)	52,269,473	52,268,080	0	1,393

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is an overall increase in the financial burden from the 2025 PRA package. There is no change in the number of agents, brokers, or web-brokers required to use the HHS-mandated model consent form to meet the eligibility application review requirements and the consumer consent documentation requirements. There is no change in the number of policies submitted by agents. There is a small increase in burden due to the new proposed activity of responding to HHS requests to provide compliant marketing. Lastly, an increase in labor costs also contributed to the increase in burden costs. The total annual burden hours increased from 1,666,600 to 1,666,624, which is an increase of 24 hours. The estimated annual cost increased from $94,702,080 to $96,762,217, which is an increase of $2,060,137.

Annual Cost to Federal Government: $72,638

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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