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View RCF - OIRA Conclusion
RCF ID:
202410-1210-001CF
Previous RCF ID:
Status:
Active
Expiration Date:
10/31/2027
Agency/Subagency:
DOL/EBSA
Agency Tracking No:
Host OMB Control No:
0938-1429
Host ICR Reference No:
202410-0938-006
Title:
Transparency in Pricing Information
Type of RCF:
RCF New
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/07/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/09/2024
Terms of Clearance:
Description of Agency Usage:
DOL will be using the internet-based self-service tool and paper form for group health plans, health insurance issuers, and TPAs.
Authorizing Statute(s):
US Code:
29 USC 2590.715A1
Name of Law: Transparency in Coverage
US Code:
29 USC 2590.715A2
Name of Law: Transparency in Coverage
US Code:
29 USC 2590.715A3
Name of Law: Transparency in Coverage
PL:
Pub.L. 111 - 148 1311(e)(3)
Name of Law: Patient Protection and Affordable Care Act
Annual Cost to Federal Government:
$0
Agency Contact:
James Butikofer 202 693-8434 Butikofer.James@dol.gov
Common Form Information Collections (IC) in this RCF:
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Allowed Amount File
4,082
808,513
0
Form and Instruction
CMS-10715
APPENDIX 2: In-network Rate Machine-Readable File Data Elements
Form and Instruction
CMS-10715
APPENDIX 3: The Allowed Amount Machine-Readable File Data Elements
Customer Service Representatives Training
3,270
6,540
0
Instruction
In-Network Rate File
4,082
1,566,739
0
Form and Instruction
CMS-10715
APPENDIX 2: In-network Rate Machine-Readable File Data Elements
Form and Instruction
CMS-10715
APPENDIX 3: The Allowed Amount Machine-Readable File Data Elements
Internet-based Self-Service Tool
490
11,417,705
0
Form and Instruction
CMS-10715
In-network Rate Machine-Readable File Data Elements
Form and Instruction
CMS-10715
APPENDIX 3: The Allowed Amount Machine-Readable File Data Elements
Prescription Drug File
4,082
504,831
0
Other
Requests for Mailed Disclosures
21,264
5,316
0
Other
RCF Summary of Burden:
Total Approved
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
37,270
0
0
0
37,270
0
Annual Time Burden (Hours)
14,309,644
0
0
0
14,309,644
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:
This is a new information collection.