Information Collection Request

Generic Social Marketing & Consumer Testing Research

ICR 201307-0938-017 · OMB 0938-1247 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10437 - GenIC# Medicare Beneficiary Consumer Survey Form and Instruction New Available
Form CMS-10437 GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 Form and Instruction New Available
Form CMS-10437 (GenIC#1 Web Intercept Survey Form and Instruction New Available
Form CMS-10437 GenIC#11 - CMS Consumer Research on Websites and Tools Form and Instruction New Available
Form CMS-10437.GenIC#10 Quality Payment Program Provider Awareness Tracking Survey Form and Instruction New Available
Form CMS-10437 GenIC#8 Qualitative Testing Creative Materials Focus Group Guide Form and Instruction New Available
Form CMS-10427. GenIC#7 Marketplace 2017 Focus Group Guide Form and Instruction New Available
Form CMS-10437 Medicare Beneficiary Consumer Survey Form and Instruction New Available
Form CMS-10437 Consumer Survey of Marketplace Disenrollees Form and Instruction New Available
Form CMS-10437-GenIC#4 Web Intercept Survey of HealthCare.gov Visitors Form and Instruction New Available
Form CMS-10437 Post Campaign Survey Form and Instruction New Available
Form CMS-10437 Pre Campaign Survey Form and Instruction New Available
Form CMS-10437 (GenIC#1 QRS Wave 1 Interview Guide Form and Instruction New Available
Form CMS-10437: GenIC#2 2015 Online Provider Assessment Survey Form and Instruction New Available
Response to 30-day Public Comments CMS-10437_FF_7-31-13.doc Supplementary Document Uploaded 2013-08-08 Available
CMS-10437.SupStatemtB-GenericSM051013.docx Supporting Statement B Uploaded 2013-07-23 Available
GenericSMTestingItemBank051013.docx Supplementary Document Uploaded 2013-07-23 Available
CMS-10437.SupStatemtA-GenericSM-PRA051013.docx Supporting Statement A Uploaded 2013-07-23 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
227110 GenIC#14 - Medicare Beneficiary Consumer Survey Form and Instruction NewMedicare Beneficiary Consumer Survey
226609 GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 Form and Instruction NewGenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017
226507 GenIC #12 - Web Intercept Survey of HealthCare.gov Visitors Form and Instruction NewWeb Intercept Survey
226386 GenIC#11 - CMS Consumer Research on Websites and Tools Form and Instruction NewGenIC#11 - CMS Consumer Research on Websites and Tools
226169 GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey Form and Instruction NewQuality Payment Program Provider Awareness Tracking Survey
225019 Qualitative Testing of Creative Materials (GenIC#8) Form and Instruction NewQualitative Testing Creative Materials Focus Group Guide
224399 Formative Research on Communications and Decision Support in Marketplace 2017 Form and Instruction NewMarketplace 2017 Focus Group Guide
222296 Medicare Beneficiary Consumer Survey Form and Instruction NewMedicare Beneficiary Consumer Survey
219994 GenIC#5 - Consumer Survey of Marketplace Disenrollees Form and Instruction NewConsumer Survey of Marketplace Disenrollees
218875 GenIC # 4: Web Intercept Survey of HealthCare.gov Visitors Form and Instruction NewWeb Intercept Survey of HealthCare.gov Visitors
218112 GenIC#3 - Medicare Open Enrollment Survey Form and Instruction NewPost Campaign Survey
218112 GenIC#3 - Medicare Open Enrollment Survey Form and Instruction NewPre Campaign Survey
217808 GenIC#1 - Consumer Testing for the Health Insurance Marketplace's (HIM) Quality Rating System (QRS): Phase 1, Wave 1-Terminology Related to the Health Insurance and Quality Form and Instruction NewQRS Wave 1 Interview Guide
217697 GenIC#2 - 2015 Online Provider Assessment Survey Form and Instruction New2015 Online Provider Assessment Survey

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2017 36 Months From Approved
41,592 0 0
21,488 0 0
0 0 0





Reginfo record details
13
table that charts list of burden
IC Title Form No. Form Name
Medicare Beneficiary Consumer Survey CMS-10437
Formative Research on Communications and Decision Support in Marketplace 2017 CMS-10427. GenIC#7
GenIC # 4: Web Intercept Survey of HealthCare.gov Visitors CMS-10437-GenIC#4
GenIC #12 - Web Intercept Survey of HealthCare.gov Visitors CMS-10437 (GenIC#12)
GenIC#1 - Consumer Testing for the Health Insurance Marketplace's (HIM) Quality Rating System (QRS): Phase 1, Wave 1-Terminology Related to the Health Insurance and Quality CMS-10437 (GenIC#1)
GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey CMS-10437.GenIC#10
GenIC#11 - CMS Consumer Research on Websites and Tools CMS-10437
GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 CMS-10437
GenIC#14 - Medicare Beneficiary Consumer Survey CMS-10437 - GenIC#14
GenIC#2 - 2015 Online Provider Assessment Survey CMS-10437: GenIC#2
GenIC#3 - Medicare Open Enrollment Survey CMS-10437, CMS-10437 ,  
GenIC#5 - Consumer Survey of Marketplace Disenrollees CMS-10437
Qualitative Testing of Creative Materials (GenIC#8) CMS-10437 GenIC#8

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 41,592 0 41,592 0 0 0
Annual Time Burden (Hours) 21,488 0 21,488 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No