The testing portion of this collection was conducted before OMB approval.
table that charts list comparision
Inventory as of this Action
Requested
Previously Approved
06/30/2014
6 Months From Approved
7,875
0
0
52,375
0
0
0
0
0
CMS will collect enrollment and payment information using a spreadsheet. This is an interim process.
The Centers for Medicare & Medicaid Services (CMS) is requesting that an information collection request to support the Payment Collections Operations Contingency Plan be processed under the emergency clearance process associated with 5 CFR 1320.13(a)(2)(i) and the Paperwork Reduction Act of 1995 (PRA). Public harm is reasonably likely to occur if the normal, non-emergency clearance procedures are followed.
CMS seeks an emergency PRA collection to collect enrollment and payment data from health insurance issuers. This collection would be effectuated via a Microsoft Excel-based spreadsheet because the IT systems designed for this function are not yet complete. If CMS is unable to collect this information in a timely fashion, issuers participating in the Marketplaces will not be able to receive advance payments of the premium tax credit and cost-sharing reductions for enrollees who qualify for financial assistance. The vehicle for this collection of enrollment and payment information is new, and issuers will manually enter data into spreadsheets and submit this information to CMS. Not only is the vehicle for enrollment and payment data new, but also we would not be collecting this data under normal operations and therefore we did not seek a PRA for this collection.
Specifically, CMS will collect enrollment by QHP issuer and estimated payment amounts for enrollees in those plans. CMS will use this information to aggregate payments to issuers operating under the same Tax Identification Numbers. CMS had intended to present this information to issuers via an electronic "834" enrollment report generated from Marketplace data; however, because the information systems designed for this process are not yet complete, issuers will now enter and estimate amounts based on their own data, and will then submit this information to CMS.
o Data submitted via the template will include:
- QHP issuer and plan identification information
- aggregate premium amounts
- aggregate APTC and advance CSR payment amounts
- aggregate enrollment group and enrollee counts
Background - Under sections 1401, 1411, and 1412 of the Affordable Care Act and 45 CFR part 155 subpart D, an Exchange makes an advance determination of tax credit eligibility for individuals who enroll in QHP coverage through the Exchange and seek financial assistance. Using information available at the time of enrollment, the Exchange determines whether the individual meets the income and other requirements for advance payments and the amount of the advance payments that can be used to pay premiums. Advance payments are made periodically under section 1412 of the Affordable Care Act to the issuer of the QHP in which the individual enrolls.
Section 1402 of the Affordable Care Act provides for the reduction of cost sharing for certain individuals enrolled in a QHP through an Exchange, and section 1412 of the Affordable Care Act provides for the advance payment of these reductions to issuers. The statute directs issuers to reduce cost sharing for essential health benefits for individuals with household incomes between 100 and 400 percent of the Federal poverty level (FPL) who are enrolled in a silver level QHP through an individual market Exchange and are eligible for advance payments of the premium tax credit.
PL: Pub.L. 111 - 148 1401 Name of Law: Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 148 1402 Name of Law: Patient Protection and Affordable Care Act
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:
(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;
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.
Form CMS-10515 Monthly Data Submission Accuracy Certification Form
Signed - Emergency PRA - Payment Collections Operations Contingency Plan.pdf
OMBEdits_PaymentCollectionsOperations_ContingencyPlan_Supporting_Stateme....docx
Testing & Development