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: 0938-1119	ICR Reference No: 202604-0938-015
Status: Active	Previous ICR Reference No: 202506-0938-001
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/27/2026
	Date Received in OIRA: 04/16/2026
Terms of Clearance: Before submitting this package for revision or extension the agency will consider the possible addition of data elements covering complaint disposition and median cost to process activities like appeals, complaints, DMIs, etc. Additionally, the agency will consider publishing additional data elements from the bi-annual report on the agency’s public-facing website. Supporting Statement A shall be updated to reflect these considerations.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2028	09/30/2028	09/30/2028
Responses	363	0	363
Time Burden (Hours)	7,306	0	7,306
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved
Annual Number of Responses	363	363
Annual Time Burden (Hours)	7,306	7,306
Annual Cost Burden (Dollars)	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 respondents has been adjusted. CMS accounted for an increase in the number of SBE and SBE-FPs (from 21 to 23), which increased the total annual burden hours for the four reports remaining in this package from 2,821 to 7,306.

Annual Cost to Federal Government: $79,956

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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