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OMB Control No: 0938-1285	ICR Reference No: 202606-0938-010
Status: Received in OIRA	Previous ICR Reference No: 202208-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Data Submission for the Federally-facilitated Exchange User Fee Adjustment (CMS-10492)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 06/10/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	315	0
Time Burden (Hours)	1,340	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	315	-10	325
Annual Time Burden (Hours)	1,340	-110	1,450
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: Based on the past years of experience with the collection of the contraceptive user fee adjustment data, we reduced the estimated number of participating issuers, from 40 to 30, which subsequently reduced the total number of burden hours (from 1,450 to 1,340). Wage rate estimates have also changed; therefore, costs per hour have been adjusted according to the most recently available BLS wage rates.

Annual Cost to Federal Government: $96,232

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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