Process for Obtaining Waivers of the Annual Limits Requirements of PHS Act Section 2711

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
195564	Attestation Requirement		Modified
195130	Model Notices		Modified
194479	Waiver Process		Modified

ICR Details

OMB Control No: 0938-1105	ICR Reference No: 201106-0938-022
Status: Historical Active	Previous ICR Reference No: 201012-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Process for Obtaining Waivers of the Annual Limits Requirements of PHS Act Section 2711
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/27/2012
	Date Received in OIRA: 06/29/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2015	36 Months From Approved	02/29/2012
Responses	4,608,372	0	2,979,958
Time Burden (Hours)	178,183	0	112,890
Cost Burden (Dollars)	2,256,818	0	1,459,409

---

Abstract: The annual limits waiver application process is used by The Department of Health and Human Services (HHS) to consider information provided by health insurance issuers, group health plans and State applicants, and to make determinations to approve or deny waivers of the annual limits applications. The process includes an application, issuance of model notices, and an attestation requirement.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 2711(a)(2) Name of Law: NO LIFETIME OR ANNUAL LIMITS.
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking
	Other Documents for OIRA Review

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 16790	03/25/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 35446	06/17/2011
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Waiver Process
Model Notices
Attestation Requirement

---

ICR Summary of Burden

table that charts list 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	4,608,372	2,979,958	0	0	1,628,414	0
Annual Time Burden (Hours)	178,183	112,890	0	0	65,293	0
Annual Cost Burden (Dollars)	2,256,818	1,459,409	0	0	797,409	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 currently approved burden hour estimate is being increased by 65,293 hours (from 112,890 to 178,183 hours). The currently approved information collection request estimated that 1,455 annual limit waiver applications would be submitted. Based on current receipt of annual limit waiver applications, it is now estimated that up to 2,500 respondents will submit applications.

---

Annual Cost to Federal Government: $1,800,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/29/2011

---