Establishment of Qualified Health Plans and American Health Benefit Exchanges

Forms and Documents

Document Name	Status
CMS-10400.FINAL-Supporting_Statement_Part_A.docx Supporting Statement A	2013-03-22

IC Document Collections

IC ID	Document Title	Status
198563	Qualified Health Plan Minimum Certification Standards	Removed
198562	Exchange Function: Certification of Qualified Health Plans	Removed
198561	Exchange Functions: Small Business Health Options Program (SHOP)	Removed
198560	Exchange Functions in the Individual Market: Enrollment in Qualified Health Plans	Removed
198559	General Functions of an Exchange (Website)	Removed
198558	Exchanges	Modified
198557	Issuers	Modified

ICR Details

OMB Control No: 0938-1156	ICR Reference No: 201205-0938-010
Status: Historical Active	Previous ICR Reference No: 201107-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Establishment of Qualified Health Plans and American Health Benefit Exchanges
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/25/2013
	Date Received in OIRA: 05/30/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	36 Months From Approved
Responses	21,879	0	0
Time Burden (Hours)	1,232,237	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Patient Protection and Affordable Care Act, Public Law 111-148, enacted on March 23, 2010, and the Health Care and Education Reconciliation Act, Public Law 111-152, enacted on March 30, 2010 (collectively, "Affordable Care Act"), expand access to health insurance for individuals and employees of small businesses through the establishment of new Affordable Insurance Exchanges (Exchanges), including the Small Business Health Options Program (SHOP). The Exchanges, which will become operational by January 1, 2014, will enhance competition in the health insurance market, expand access to affordable health insurance for millions of Americans, and provide consumers with a place to easily compare and shop for health insurance coverage. The reporting requirements and data collection in the Exchange rule address Federal requirements that States must meet with respect to the establishment and operation of an Exchange; minimum requirements that health insurance issuers must meet with respect to participation in a State based or Federally-facilitated Exchange; and requirements that employers must meet with respect to participation in the SHOP and compliance with other provisions of the Affordable Care Act. The submission seeks OMB approval of the regulatory PRA requirements associated with 45 CFR parts 155, 156, and 157.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1311 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1321 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1401 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1402 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1411 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1412 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1413 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 6005 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1311 Name of Law: Afforable Care Act
PL: Pub.L. 111 - 148 1321 Name of Law: Affordable Care Act
PL: Pub.L. 111 - 148 1401 Name of Law: Affordable Care Act
PL: Pub.L. 111 - 148 1402 Name of Law: Affordable Care Act
PL: Pub.L. 111 - 148 1411 Name of Law: Affordable Care Act
PL: Pub.L. 111 - 148 1412 Name of Law: Affordable Care Act
PL: Pub.L. 111 - 148 1413 Name of Law: Affordable Care Act
PL: Pub.L. 111 - 148 6005 Name of Law: Affordable Care Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AQ67	Final or interim final rulemaking	77 FR 18310	03/27/2012

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Issuers
Exchanges
Exchange Functions in the Individual Market: Enrollment in Qualified Health Plans
Exchange Functions: Small Business Health Options Program (SHOP)
Exchange Function: Certification of Qualified Health Plans
Qualified Health Plan Minimum Certification Standards
General Functions of an Exchange (Website)

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ICR 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	21,879	0	21,930	-51	0	0
Annual Time Burden (Hours)	1,232,237	0	1,248,557	-16,320	0	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 request.

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Annual Cost to Federal Government: $671,232

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

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Common Form ICR:  No

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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: 05/30/2012

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