Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CMS-10401 - 3Rs Supporting_Statement 2015 PN Oct 17.pdf	Supporting Statement A	Uploaded 2014-10-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
211711	Confirmation of Interim Reports (153.710)		New
211710	Initial Validation Audit Identification and Inter-rater Reliability Report (153.630(b)(1) and (b)(8)		New
211709	Risk Adjustment Data Validation (153.630)		New
211708	Supplemental Diagnosis (153.700(a))		New
211707	Risk adjustment and reinsurance distributed data collection (153.700(a))		New
211675	Administrative Burden Related to Audits of the Risk Adjustment Covered Issuers (§153.410(d); §153.620(c))		New
211674	Risk Corridors Data Validation (153.530 and 153.540)		New
211663	Adminstative Appeals for Premium Stabilization Program, Federal Exchange User Fees, Premium Tax Credits and Costs Sharing Reductions (156.1220)		New
208839	Data Validation Requirements When HHS Operates Risk Adjustment		Removed
208838	Calculation of Reinsurance Contributions		Modified
208837	Upload of Risk Adjustment and Reinsurance Data for Masked Enrollee Identification Number (153.700(a))		Modified
198556	Health Insurance Issuer Standards for the Risk Adjustment Program (153.610-153.620)		Removed
198554	Health Insurance Issuer Standards Related to the Transitional Reinsurance Program (153.400-153.410)		Modified
198553	State Standards for the Risk Adjustment Program (153.310, 153.330) - Request and Update for Alternative Methodology		Removed
198550	State Standards for the Transitional Reinsurance Program in the Individual Market (153.210-153.220, 153.240) - Recordkeeping		Removed
198548	State Notice of Insurance Benefits and Payment Parameters (153.100-153.110)		Removed

ICR Details

OMB Control No: 0938-1155	ICR Reference No: 201405-0938-006
Status: Historical Active	Previous ICR Reference No: 201309-0938-028
Agency/Subagency: HHS/CMS	Agency Tracking No: 19687
Title: Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/17/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/29/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2017	36 Months From Approved	12/31/2016
Responses	6,495,970	0	568,485
Time Burden (Hours)	19,650,586	0	1,075,514
Cost Burden (Dollars)	0	0	0

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Abstract: The reinsurance program, risk corridors program, and risk adjustment program support the effective functioning of the American Health Benefit Exchanges ("Exchanges"), which will become operational by January 1, 2014. The program also mitigate the negative impacts of adverse selection and market uncertainty.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1321; 1341; 1342; 1343 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AR89	Final or interim final rulemaking	79 FR 13744	03/11/2014

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 73118	12/07/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 73118	12/07/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 11

table that charts list of burden

IC Title	Form No.	Form Name
Administrative Burden Related to Audits of the Risk Adjustment Covered Issuers (§153.410(d); §153.620(c))
Adminstative Appeals for Premium Stabilization Program, Federal Exchange User Fees, Premium Tax Credits and Costs Sharing Reductions (156.1220)
Calculation of Reinsurance Contributions
Confirmation of Interim Reports (153.710)
Data Validation Requirements When HHS Operates Risk Adjustment
Health Insurance Issuer Standards Related to the Transitional Reinsurance Program (153.400-153.410)
Health Insurance Issuer Standards for the Risk Adjustment Program (153.610-153.620)
Initial Validation Audit Identification and Inter-rater Reliability Report (153.630(b)(1) and (b)(8)
Risk Adjustment Data Validation (153.630)
Risk Corridors Data Validation (153.530 and 153.540)
Risk adjustment and reinsurance distributed data collection (153.700(a))
State Notice of Insurance Benefits and Payment Parameters (153.100-153.110)
State Standards for the Risk Adjustment Program (153.310, 153.330) - Request and Update for Alternative Methodology
State Standards for the Transitional Reinsurance Program in the Individual Market (153.210-153.220, 153.240) - Recordkeeping
Supplemental Diagnosis (153.700(a))
Upload of Risk Adjustment and Reinsurance Data for Masked Enrollee Identification Number (153.700(a))

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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	6,495,970	568,485	0	6,467,485	-540,000	0
Annual Time Burden (Hours)	19,650,586	1,075,514	0	19,536,272	-961,200	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Regulations

Short Statement: As detailed above, certain burden estimates for information collection requirements associated with the reinsurance, risk adjustment, risk corridors, premium tax credit, cost-sharing reduction, and user fee programs would change from what was previously estimated in the Premium Stabilization Rule and 2014 Payment Notice due to the proposed policy changes in the proposed HHS notice of benefit and payment parameters for 2015. We have also updated burden to reflect our most current estimates of program operations, including increasing our estimate of the number of risk adjustment covered issuers in the individual and small group insurance market.

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Annual Cost to Federal Government:

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: 05/29/2014

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