Disclosure and Recordkeeping Requirements for Grandfathered Health Plans under the Affordable Care Act

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
195310	Grandfathered Plan Change in Carrier Disclosure		Modified
193232	Disclosure and Recordkeeping Requirements		Modified

ICR Details

OMB Control No: 0938-1093	ICR Reference No: 201307-0938-010
Status: Historical Active	Previous ICR Reference No: 201011-0938-010
Agency/Subagency: HHS/CMS	Agency Tracking No: 19886
Title: Disclosure and Recordkeeping Requirements for Grandfathered Health Plans under the Affordable Care Act
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/26/2013
	Date Received in OIRA: 07/22/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2016	36 Months From Approved
Responses	2,573	0	0
Time Burden (Hours)	86	0	0
Cost Burden (Dollars)	2,573	0	0

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Abstract: Section 1251 of the ACA provides that certain plans and health insurance coverage in existence as of March 23, 2010, known as grandfathered health plans, are not required to comply with certain statutory provisions in the Act.To maintain its status as a grandfathered health plan, the interim final rule (75 FR 34538, June 17, 2010) require the plan to maintain records documenting the terms of the plan in effect on March 23, 2010, and any other documents that are necessary to verify, explain or clarify status as a grandfathered health plan.The plan must make such records available for examination upon request by participants,beneficiaries, individual policy subscribers, or a State or Federal agency official. A grandfathered health plan is also required to include a statement in any plan material provided to participants or beneficiaries describing the benefits provided under the plan or health insurance coverage, the plan or coverage believes it is a grandfathered health plan within the meaning of section 1251 of the ACA, that being a grandfathered health plan means that the plan does not include certain consumer protections of the ACA, and providing contact information for participants to direct questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status and to file complaints. The amendment to the interim final rule (75 FR 70114, November 17, 2010) requires a grandfathered group health plan that is changing health insurance issuers to provide the succeeding health insurance issuer (and the succeeding health insurance issuer must require) documentation of plan terms (including benefits, cost sharing, employer contributions, and annual limits) under the prior health insurance coverage sufficient to make a determination whether the standards of paragraph (g)(1) of the interim final regulations are exceeded.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1251 Name of Law: Preservation of right to maintain existing coverage.
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 20322	04/04/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 38983	06/28/2013
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Grandfathered Plan Change in Carrier Disclosure
Disclosure and Recordkeeping Requirements

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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	2,573	0	0	0	-20,610,427	20,613,000
Annual Time Burden (Hours)	86	0	0	0	-53,114	53,200
Annual Cost Burden (Dollars)	2,573	0	0	0	-327,427	330,000

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 burden has been updated to take into account that the number of grandfathered plans have been reduced since 2011 and that one-time costs have already been incurred by grandfathered plans. The burden hours have been reduced by 26,000 hours attributed to one-time set up costs for grandfathered health plan disclosures, 26,000 hours related to one-time set up costs for recordkeeping requirements and 115 hours related to grandfathered plan change in carrier disclosures.

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Annual Cost to Federal Government: $0

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: 07/22/2013

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