Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10464 Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges	Form and Instruction	New	Available
CMS-10464-30 day Appendix B data elements.pdf	Supplementary Document	Uploaded 2013-05-23	Available
CMS-10464 - 30_Day_Supporting_Statemen .pdf	Supporting Statement A	Uploaded 2013-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
207074	Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges	Form and Instruction	New

ICR Details

OMB Control No: 0938-1204	ICR Reference No: 201305-0938-019
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: 19676
Title: Agent/Broker Data Collection in Federally-facilitated Health Insurance 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 without change	Conclusion Date: 07/18/2013
	Date Received in OIRA: 05/23/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	36 Months From Approved
Responses	350,000	0	0
Time Burden (Hours)	175,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Center for Consumer Information and Insurance Oversight (CCIIO), the agency within Centers for Medicare & Medicaid Services (CMS) charged with helping implement many provisions of the Affordable Care Act including the establishment of Affordable Insurance Exchanges (Exchanges), needs to collect data from individual agent/brokers to register them with the Federally-facilitated Exchange (FFE) and provide the required training in Exchange enrollment policies and procedures. Both section 1312(e) of the Affordable Care Act and 45 CFR ?155.220 permit States to allow agent/brokers to enroll individuals, employers, and employees in Qualified Health Plans (QHPs), including through the Exchanges; and assist individuals in applying for advance payments of the premium tax credit and cost-sharing reductions. Agent/brokers will serve as additional access points to the Exchange for individuals or SHOP employers/employees requiring or desiring agent/broker assistance. Agent/brokers must register with the FFE and meet training requirements that enforce their understanding of eligibility and enrollment in Exchanges prior to enrolling individuals or SHOP employer/employees in QHPs through the Exchanges. They must also apply this understanding to the development of any non-Exchange Web site used as a tool for enrollment. Agent/broker designed and administered web sites or tools will improve the flow of information to the FFE, and State-based Exchanges may also find these tools useful toward streamlining data submissions and easing the burden on the Exchange. The collection of information from agent/brokers described in detail below is needed to register and completion training with the FFE. Collected information will be used by CMS/CCIIO to verify the completion of the training requirement, provide the public with a list of registered agent/brokers trained in Exchange enrollment requirements and functions, and perform oversight of agent/brokers operating through the FFE.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1312(e) Name of Law: the Patient Protection and Affordable Care Act - Enrollment through Agents and Brokers
   PL: Pub.L. 111 - 152 1217 Name of Law: the Health Care and Eduction Reconciliaton Act of 2010
  

Citations for New Statutory Requirements: Statute at Large: 155 Stat. 220 Name of Statute: null

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 9056	02/07/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 29135	05/17/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges	CMS-10464	Learning Management System

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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	350,000	0	350,000	0	0	0
Annual Time Burden (Hours)	175,000	0	175,000	0	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: New information collection.

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Annual Cost to Federal Government: $374,996

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: 05/23/2013

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