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OMB Control No: 0938-1187	ICR Reference No: 202604-0938-001
Status: Received in OIRA	Previous ICR Reference No: 202204-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Initial Plan Data Collection to Support QHP Certification and other Financial Management and Exchange Operations (CMS-10433)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 04/07/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	1,053	0
Time Burden (Hours)	61,155	0
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,053	-1,872	2,925
Annual Time Burden (Hours)	61,155	-10,505	71,660
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: The number of stand-alone dental issuers for the QHP certification decreased from 270 to 212, which is a decrease of 58 issuers. The number of issuers in the individual and small group market decreased from 2,400 to 623, which is a decrease of 1,777 issuers. The number of both State-based Exchanges using the Federal Platform decreased from 22 to 3, which is a decrease of 19 states. The total burden hours decreased from 71,660 hours to 61,155 hours (-10,505.33 hours).

Annual Cost to Federal Government: $177,504

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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