Information Collection

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

IC 217808 under ICR 201307-0938-017 · OMB 0938-1247.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1247 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10437 (GenIC#1 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
CMS-10437 (GenIC#1 QRS Wave 1 Interview Guide CMS-10437.GenIC #1 - QRS_Wave 1 Interview Guide_.docx	Form and Instruction
CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research_8-7-15.docx Justification for Providing Incentives for Participation	IC Document
CMS-10437 GenIC#1 - Supporting Statement.docx GenIC #1 - Supporting Statement	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

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

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
Form and Instruction	CMS-10437 (GenIC#1)	QRS Wave 1 Interview Guide	CMS-10437.GenIC #1 - QRS_Wave 1 Interview Guide_.docx		Yes	No	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

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 Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for Providing Incentives for Participation	CMS-10437.Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research_8-7-15.docx	08/07/2015
GenIC #1 - Supporting Statement	CMS-10437 GenIC#1 - Supporting Statement.docx	08/07/2015

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