Standards for Navigators and Non-Navigator Assistance Personnel; Consumer Assistance Tools and Programs of an Exchange and Certified Application Counselors

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10494 155.225(d)(1) - Training certificate retention	Form and Instruction	New	Available
Form CMS-10494 155.225(d)(1) - Training certificate proof	Form and Instruction	New	Available
Form CMS-10494 155.225(d)(1) - Training Registration	Form and Instruction	New	Available
Form CMS-10494 155.225(b)(1)(ii) - Identification number record retention	Form and Instruction	New	Available
Form CMS-10494 155.225(b)(1)(ii) - Issuance of unique registration identification number	Form and Instruction	New	Available
CMS-2334-F2-APPENDIX B.PDF	Supplementary Document	Uploaded 2013-08-14	Available
CMS-2334-F2-APPENDIX B.PDF	Supplementary Document	Uploaded 2013-08-14	Available
CMS-2334-F2-APPENDIX B.PDF	Supplementary Document	Uploaded 2013-08-14	Available
CMS-2334-F2-APPENDIX B.PDF	Supplementary Document	Uploaded 2013-08-14	Available
CMS-2334-F2-APPENDIX B.PDF	Supplementary Document	Uploaded 2013-08-14	Available
CMS-10494.Supporting Statement Part A - Amended - 08 14 13 _clean.doc	Supporting Statement A	Uploaded 2013-08-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
208217	155.225(d)(1) - Training certificate retention	Form and Instruction	New
208216	155.225(d)(1) - Training certificate proof	Form and Instruction	New
208215	155.225(d)(1) - Training Registration	Form and Instruction	New
208214	155.225(b)(1)(ii) - Identification number record retention	Form and Instruction	New
208213	155.225(b)(1)(ii) - Issuance of unique registration identification number	Form and Instruction	New
207940	??155.225(d)(2) and (f) (CAC authorization to consumer)		Modified
207939	??155.225(d)(2) and (f) (organization record of authorization)		Modified
207938	??155.225(b)(1)(i) (certificate issuance)		Modified
207937	??155.225(b)(1) (organization list)		Modified
207874	??155.225(b)(1)(i) (organization attestation)		Modified
207873	??155.225(b)(1) (organization follow-up for application)		Modified
207872	??155.225(b)(1) (organization designation by Exchange)		Modified

ICR Details

OMB Control No: 0938-1205	ICR Reference No: 201308-0938-016
Status: Historical Active	Previous ICR Reference No: 201307-0938-015
Agency/Subagency: HHS/CMS	Agency Tracking No: 20316
Title: Standards for Navigators and Non-Navigator Assistance Personnel; Consumer Assistance Tools and Programs of an Exchange and Certified Application Counselors
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/16/2013
	Date Received in OIRA: 08/15/2013
Terms of Clearance: This approval adds the training registration for CAC applicants. Consistent with the prior terms, this control number extends only to the collections described in the supporting statement and burden estimates. For other information collections associated with this program, CMS will submit a revision to this control number to obtain approval. Consistent with 5 CFR Part 1320, such provisions will not be effective until OMB approves them.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	36 Months From Approved	07/31/2014
Responses	4,596,000	0	4,446,000
Time Burden (Hours)	667,740	0	664,080
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1413 of the Affordable Care Act directs the Secretary of HHS to establish, subject to minimum requirements, a streamlined enrollment system for qualified health plans offered through the Exchange and insurance affordability programs. In addition, section 1321(a)(1) of the Affordable Care Act directs and authorizes the Secretary to issue regulations setting standards for meeting the requirements under title I of the Affordable Care Act, with respect to, among other things, the establishment and operation of Exchanges. Pursuant to this authority, regulations establishing the certified application counselor program are being finalized at 45 CFR ?155.225. Specifically, 45 CFR ?155.225(a) requires an Exchange to establish a certified application counselor program that complies with the requirements of the rule. Section155.225(b)(1) allows each Exchange to designate certain organizations, including organizations designated by state Medicaid or CHIP agencies, which will certify their staff and volunteers to act as certified application counselors. In accordance with 45 CFR ?155.225(b)(2), Exchanges may choose to certify directly individuals who seek to act as certified application counselors, designate certain organizations which will certify staff or volunteers to perform application services, or do both.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1413 Name of Law: Streamlining of procedures for enrollment through an exchange
   PL: Pub.L. 111 - 148 1321(a)(1)(A) and (D) Name of Law: State Flexibility in Operation and Enforcement of Exchanges and Related Requirements
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1321(A) and (D) Name of Law: State Flexibility in Operation and Enforcement of Exchanges and Related Requirements
PL: Pub.L. 111 - 148 1413 Name of Law: Streamlining of procedures for enrollment through an exchange

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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 4661	01/22/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42778	07/17/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
??155.225(b)(1) (organization designation by Exchange)
??155.225(b)(1) (organization follow-up for application)
??155.225(b)(1)(i) (organization attestation)
??155.225(b)(1)(i) (certificate issuance)
??155.225(d)(2) and (f) (organization record of authorization)
??155.225(d)(2) and (f) (CAC authorization to consumer)
155.225(b)(1)(ii) - Issuance of unique registration identification number	CMS-10494	Registration
155.225(b)(1)(ii) - Identification number record retention	CMS-10494	Registration
155.225(d)(1) - Training Registration	CMS-10494	Registration
155.225(d)(1) - Training certificate proof	CMS-10494	Registration
??155.225(b)(1) (organization list)
155.225(d)(1) - Training certificate retention	CMS-10494	Registration

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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	4,596,000	4,446,000	150,000	0	0	0
Annual Time Burden (Hours)	667,740	664,080	3,660	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: The burden has been revised to account for the ICs associated with training.

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Annual Cost to Federal Government: $933

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: 08/15/2013

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