Information Collection

Healthcare.gov Visitor Satisfaction Survey

IC 200921 under ICR 201106-0990-001 · OMB 0990-0379.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0379 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0379_hcgov-vocquestions-v4.pdf	Other-survey
0990-0379_VOC Questions - HealthCaregov - Page Level.docx	Other-survey
0990-0379_Generic Clearance Submission Template - HealthCaregov (3).docx 0990-0379_Generic Clearance Submission Template - HealthCaregov (3)	IC Document

IC Title:

Healthcare.gov Visitor Satisfaction Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			0990-0379_hcgov-vocquestions-v4.pdf		Yes	Yes	Fillable Fileable
Other-survey			0990-0379_VOC Questions - HealthCaregov - Page Level.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	6,000	0	0	0	0	0
Annual IC Time Burden (Hours)	167	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0990-0379_Generic Clearance Submission Template - HealthCaregov (3)	0990-0379_Generic Clearance Submission Template - HealthCaregov (3).docx	01/27/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.