CMS-10494 Supporting Statement-PRA clean

Supporting Statement – Part A
Patient Protection and Affordable Care Act; Consumer Assistance Tools and Programs of an
Exchange and Certified Application Counselors; Exchange and Insurance Market
Standards for 2015
A. Background
On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act.
On March 30, 2010, the Health Care and Education Reconciliation Act of 2010 was also signed
into law. The two laws collectively are referred to as the Affordable Care Act.
The Affordable Care Act creates Health Insurance Exchanges (Exchanges), new competitive
marketplaces where consumers and small businesses can purchase private health insurance.
Consumers who access health insurance coverage through Exchanges will be able to receive
skilled assistance from certified application counselors (CACs) who will provide information
about applying for coverage in a qualified health plan (QHP) and insurance affordability programs
through an Exchange, , and will help to facilitate enrollment in QHPs and insurance affordability
programs. A robust range of enrollment assistance programs will be critical to helping consumers
enroll, particularly during the open enrollment periods (OEP); the initial OEP began October 1,
2013 and the subsequent OEP begins November 15, 2014. The certified application counselor
program supplements other consumer assistance programs established under the Affordable Care
Act, such as Navigators and non-Navigator Assistance Programs. As further discussed and
clarified in the Final Rule, “Patient Protection and Affordable Care Act; Exchange Functions:
Standards for Navigators and Non-Navigator Assistance Personnel; Consumer Assistance Tools
and Programs of an Exchange and Certified Application Counselors,” (78 FR 42824, July 17,
2013), codified at 45 CFR 155.225, certified application counselors will play a more limited role
relative to other assistance programs, as they will focus on providing skilled application assistance.
This information collection already includes the following information collections: (1) certified
application counselor (CAC) organization application; (2) follow-up questions to certain
organizations that submit a CAC organization application; and (3) information collections
associated with the agreement between CMS and the designated CAC organization. These are
discussed in more detail below.
This information collection request covers the following information collections: (1) Exchange or
organization-created recertification requests; (2) recertification notices issued by an Exchange or
organization; (3) training certificate disclosures; and (4) recordkeeping requirements associated
with (1)-(3). These are discussed in more detail below.1
1

There are other information collections associated with this program. This includes: (1) certified application
1

B. Justification
1 . Need and Legal Basis for an Emergency Review
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 were 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.
The duties of certified application counselors and standards for certification, such as training and
disclosure of potential conflicts of interest, withdrawal and applicant/enrollee authorization
requirements are set forth under 45 CFR 155.225(c) through (f).
2.

Information Users

Exchanges will use the information collected to certify individual CACs or designate organizations
that may certify CACs.
Designated organizations will use the information collected to manage their internal processes to
certify individual CACs.
Under 45 CFR 155.225(d)(7), certified application counselors in all Exchanges are required to be
recertified on at least an annual basis and successfully complete Exchange-required recertification
training.
counselor application (for organization or individual, as applicable); (2) follow-up questions to certain organizations
that submit an application; (3) agreements executed between CMS and a designated CAC organization; (4) initial
training registration for CAC applicants, (5) disclosure requirements for CACs, (6) recordkeeping requirements for
CACs, (7) third-party disclosure requirements for CACs, (8) notice requirements for the Exchanges, (9) and other
collections associated with implementation of 45 § 155.225. CMS has obtained approval for these collections under
OMB control number 0938-1205
2

3.

Use of Information Technology

We expect organizations seeking designation would submit an application, which we expect will
be available online in addition to a paper process. We expect that the Exchange will maintain the
model application and agreement and make training materials available through electronic means.2
In addition, we expect that an Exchange will maintain a record of potential occurrences of
noncompliance as a basis for withdrawal by electronic means. The HHS-developed process will
include training of certified application counselors through an online portal maintained by CMS.3
Government Paperwork Elimination Act (GPEA)
Is this collection currently available for completion electronically?


No, this will be a new electronic data collection.

Does this collection require a signature from the respondent(s)?


Organizations, and individuals in certain State Exchanges, will submit applications using
the format prescribed by the Exchange. While details on the format of the model
application and agreement have yet to be finalized, it is expected that a signature will be
required on each collection instrument.

If CMS had the capability of accepting electronic signature(s), could this collection be made
available electronically?


Yes, to the extent that the collection will be made available electronically once systems are
developed, we expect that an e-signature would be required on the application and
agreement.

If this collection isn’t currently electronic but will be made electronic in the future, please give
a date (month & year) as to when this will be available electronically and explain why it can’t
be done sooner.


Not applicable because this collection isn’t currently required and will be made electronic.

2 See Appendix C, “Sample Application, Apply to be a Certified Application Counselor Organization” for the
application HHS intends to use to solicit applications from interested organizations in FFMs.
3 See Appendix A, “Registration Screen Shots,” for screen shots of a sample registration portal and sample training
certificate; see Appendix B, “Registration Data Elements,” for specific data elements required for certified application
counselors registration.
3

If this collection cannot be made electronic, or if it isn’t cost beneficial to make it electronic,
please explain.

4.

Not applicable. We expect that the collection will be made electronic.

Duplication of Efforts

This information collection does not duplicate any other effort and the information cannot be
obtained from any other source. We expect that most organizations and individuals will go through
the designation or certification process, as applicable, as a one-time requirement only.
5.

Small Businesses

Small businesses may seek designation from the Exchange on a voluntary basis. Further,
organizations, including small businesses, which provide enrollment assistance, are not required to
be designated under these provisions to continue providing these services. The burden on small
businesses that are eligible organizations and choose to seek to be designated to certify staff or
volunteers to act as application counselors will be minimized by the use of a model application and
agreement developed by the Exchange as a one-time requirement. In addition, small businesses
that may be designated will have discretion in developing processes to register and track the
performance of certified application counselors, withdraw certification from an individual staff or
volunteer, and obtain authorization from applicants and enrollees. As provided above, HHS will
issue guidance with respect to implementation of the certified application counselor program in
Federally-facilitated Exchanges so that organizations will have a clear understanding of what is
required of the organization.
6.

Less Frequent Collection

Implementation of the certified application counselor program, in accordance with final
regulations at 45 CFR §155.225, will require collection to allow each Exchange to establish a
process for designating organizations or certifying individuals, as applicable. Collections will
allow designated organizations to comply with these provisions, such as maintaining a registration
process, providing required disclosures and obtaining required authorizations, and responding
appropriately to the withdrawal of designation. Organizations that seek to be designated to certify
staff or volunteers as application counselors would only be required to submit the required
application with the Exchange one time, unless, in accordance with law, there is a change in
eligibility that would require a new application for designation or a material change to the terms to
which an organization must agree to remain designated.
7.

Special Circumstances
4

None.
8.

Federal Register/Outside Consultation

Describe efforts to consult with persons outside the agency to obtain their views on the
availability of data, frequency of collection, the clarity of instructions and recordkeeping,
disclosure, or reporting format (if any), and on the data elements to be recorded, disclosed, or
reported.
In the January 22, 2013 (78 FR 4594, 4661) proposed rule, we requested public comment on each
of the proposed rule’s information collection requirements. In addition, we solicited comments in a
separate notice of proposed rulemaking dated April 5, 2013, in connection with the Navigator
proposed rule, regarding to what extent the requirements of Navigators, non-Navigator Assistance
personnel and certified assistance counselors should overlap. The comments and our responses are
discussed in the preamble to the final rule. No comments were received regarding estimated time
and cost burdens.
In the March 21, 2014 Exchange and Insurance Market Standards for 2015 and Beyond proposed
rule (79 FR 15854), we requested public comment on each of the proposed rule’s information
collection requirements. Because the comment period for the information collection requirements
was 60 days (ending May 20, 2014), whereas the proposed rule’s comment period was 30 days, we
did not discuss the comments and responses to the information collection requirements in the final
rule published on May 27, 2014. Accordingly, we will post a 30-day notice in the Federal Register
in advance of these information collection requirements being finalized. The comments we
received and our responses are attached as Appendix D.

Consultation with representatives of those from whom information is to be obtained or those
who must compile records should occur at least once every 3 years - even if the collection of
information activity is the same as in prior periods. There may be circumstances that may
preclude consultation in a specific situation. These circumstances should be explained.
We do not foresee circumstances that would preclude CMS from consulting with organizations or
application counselors.
9.

Payments/Gifts to Respondents

Payments and gifts will not be provided.
10. Confidentiality
5

In the event of investigations into potential violations of program standards or noncompliance with
other requirements that apply to certified application counselors or designated organizations, HHS
may collect some personally identifiable information of certified application counselors (e.g.,
name, unique ID number) or consumers (e.g., name), as this information is provided on the
consumer authorization form that is used prior to a certified application counselor assisting a
consumer. To the extent provided by law, we will maintain the privacy of any respondent with
respect to the information being collected.
11. Sensitive Questions
We do not foresee circumstances that would require the collection of any questions of a sensitive
nature.
12. Burden Estimates (Hours & Wages)
Wage per hour for organization and Exchange staff:4 certified application counselors, health policy
analysts, senior managers, and attorneys are as follows:
Certified Application Counselors
Mid-level Health Policy Analyst
Senior Manager
Attorney

$26.65
$49.35
$79.08
$90.15

A. CAC organization application
Organizations seeking to be designated by CMS as a CAC organization must submit an
application. A sample application is provided as an appendix (Appendix A) to this request.
We estimate that it will take an organization up to 1 hour to review instructions and complete and
submit an application. For purposes of the cost burden, we estimate it will take a senior manager
with a wage of $79.08 an hour up to 1 hour to complete and submit the application. The total
estimated cost burden is $79.08 for each organization seeking designation. We estimate that there
will be 5,000 total applicants.
B. Follow-up questions to certain organizations that submit a CAC organization application
The information submitted by some organizations on their CAC application will trigger CMS to
4 Based on Bureau of Labor Statistics, Occupational Employment Statistics, Occupational Employment and Wages,
May 2012. Includes fringe benefits calculated at 35% of base wage.
6

seek some additional information from these organizations. Many completed applications will not
require this follow-up information. The follow-up information that may be collected will consist
of:
 Description of the processes the organization has in place to protect consumers’ personally
identifiable information (PII);
 Identification of any rules concerning PII which the organization is already required to
follow; and
 Description of the screening processes they use or intend to use for staff and volunteers
who they certify to be CACs.
We estimate that it will take an organization up to .5 hour total to respond to this collection. For
purposes of the cost burden, we estimate that it will take a senior manager with a wage of $79.08
an hour up to .5 hour to complete and submit the follow-up information electronically. The total
estimated cost burden is $39.54 for each organization that is required to provide the follow-up
information. While we do not know exactly how many applicants will receive these follow-up
questions, for purposes of analysis we estimate that no more than 20%of applicants might receive
them. Therefore, we estimate that these questions will be sent to no more than 1,000 applicants.
C. Information collections associated with the agreement between CMS and the designated CAC
organization
Each organization that CMS designates as a CAC organization must enter into an agreement with
CMS. That agreement will include a number of provisions, including the following information
collections:
Reporting
 The organization must attest that the organization has entered into agreements with its
individual CACs requiring their compliance with CAC requirements.
We estimate it will take a senior manager at the organization up to .25 hours (15 minutes) to enter
into each agreement. We estimate the cost burden is $19.77 per agreement, and we estimate that
there will be 5,000 agreements.


The organization must provide CMS with the names of individuals it has certified as
CACs.

We estimate it will take a health policy analyst with a professional wage of $49.35 up to .25 hours
(15 minutes) to provide a list to CMS for a cost burden of $12.34 per update. We estimate that
there will be up to 5,000 lists provided to CMS.
Third-party disclosures
7



The organization must issue certificates to its CAC staff and volunteers when it certifies
them.

We estimate it will take a health policy analyst with a professional wage of $49.35 up to .016
hours (1 minute) to issue a certificate for a cost burden of $0.79 per certification. We estimate that
there will be 30,000 certificates.
Recordkeeping requirements
 The designated organization must retain a record of authorization provided by consumers
to the organization’s CACs for the CAC to obtain access to a consumer’s PII.
We estimate it will take a health policy analyst with a professional wage of $49.35 up to .016
hours (1 minute) to collect each record of authorization for a cost burden of $0.79 per
authorization. We estimate that the time burden associated with maintaining record of the
authorization is 0.016 hours (1 minute). We estimate the total cost for the organization to maintain
the record of authorization is $0.79, for a total cost burden of $1.58 per record of authorization.
In addition, with respect to the requirement on the CAC to receive authorization from each
consumer before obtaining access to the consumer’s PII, we estimate it will take a certified
application counselor 0.25 hours (15 minutes) to obtain the authorization. The total cost estimate
for disclosures by each individual certified application counselor is therefore $6.66. We estimate
that the time burden associated with maintaining record of the authorization is 0.016 hours (1
minute). We estimate the total cost for the individual to maintain the record of authorization is
$0.43, for a total cost burden of $7.09 per authorization.
Therefore, assuming that 2.2 million individuals5 provide authorization, this brings the total
estimate for this recordkeeping requirement to $4,260,300
D. CAC recertification request form
Third-party disclosures
 CACs seeking to be recertified by an Exchange or designated organization directly
certifying CACs must submit a recertification request form. We expect that establishing a
process for recertification would include creating a recertification request form (or similar
document) as a one-time requirement.
For an Exchange that performs direct certification, we estimate that up to 18 State Exchanges

5

This number is based on number of consumers who sought assistance from counselors in the State Health Insurance
Assistance Programs (SHIPs) counselor program in 2012. CMS New SHIP Director Training 4 (7th ed., 2013).
8

would develop their own recertification request form.6 It would take a health policy analyst (at
$49.35 labor cost per hour) up to 1 hour to create, a senior manager (at $79.08 cost per hour) up to
.5 hours (30 minutes) for review, and an attorney up to .5 hours (at $90.15 labor cost per hour) for
legal review. We estimate that the one-time cost burden would be $134 for each Exchange, and the
total cost for 18 State Exchanges would be $2,412 and the total time burden would be 36 hours.
For a designated organization that performs direct certification, we estimate that up to 5,000
designated organizations would develop their own recertification request form. We estimate that
the development of a recertification request form would take a health policy analyst (at $49.35
labor cost per hour) up to 1 hour to create, a senior manager (at $79.08 labor cost per hour) up to .5
hours (30 minutes) for review, and an attorney (at $90.15 labor cost per hour) up to .5 hours (30
minutes) for legal review. We estimate that the one-time time burden would be two hours and the
one-time cost burden would be $134 for each organization. The total time burden for 5,000
organizations nationwide would be 80 hours and the total cost burden would be $670,000.
Recordkeeping requirements
For an Exchange that performs direct certification, we estimate that the time burden associated
with maintaining a copy of the request form would be .016 hours (1 minute); we assume a midlevel health policy analyst (would maintain the form through electronic copies at minimal cost,
which we estimate as $0.79 as a one-time requirement for the Exchange. The total cost burden for
18 State Exchanges would be $14.22, and the total time burden would be 1.08 hours.
For an organization that performs direct certification, there would be recordkeeping requirements
associated with developing and maintaining a request form. We estimate that the time burden
associated with maintaining a copy of the request form would be .016 hours (1 minute); we assume
a mid-level health policy analyst with a labor cost of $49.35 an hour would maintain the form
through electronic copies at minimal cost, which we estimate as $0.79 as a one-time requirement
for each organization, and the total cost for 5,000 organizations nationwide would be $3,950, and
the total time burden would be 80 hours.
E. Recertification Submission
Third-party disclosures
There would be third-party disclosure requirements for individual certified application counselors
associated with completing the requirements for recertification, whether done directly through the
Exchange or through an Exchange-designated certified application counselor organization.

6

We estimate 18 State Exchanges (which includes Utah) and one Federally-facilitated Exchange will develop their
own processes for recertification. HHS will establish a single process in all Federally-facilitated Exchanges.
9



On an annual basis, completing Exchange required training and might also include
satisfying other requirements consistent with the Exchange-established processes, such as
providing conflicts of interest disclosures, other attestations and submitting a recertification
request form (or similar document) and other attestations

We estimate that it would take an individual certified application counselor up to .17 hours (10
minutes) to respond to this collection. For purposes of the cost burden, we estimate that it would
take a certified application counselor with a labor cost of $26.65 an hour up to .17 hours (10
minutes) to complete and submit the recertification request to the organization or Exchange, as
applicable.7 The estimated cost burden would be $4.53 for each individual seeking recertification.
We estimate that there would be approximately 30,000 recertification requests provided, for a total
cost burden of $135,915 and a total time burden of 5,000 hours for all certified application
counselors nationwide.
F. Recertification Review
Third-party disclosures
There would also be third-party disclosure requirements for State Exchanges and designated
organizations associated with reviewing each certified application counselor’s recertification
request. This collection would be required on an annual basis.


The Exchange or designated organization would notify the individual of the result of its
review and issue a new certificate for each individual who successfully completes
recertification. This notice requirement would apply to the Exchange or organization, as
applicable, on an annual basis for each individual certified application counselor.

For an Exchange directly recertifying, we estimate that it would take a mid-level health policy
analyst in the Exchange up to .08 hours (5 minutes) to notify an individual and issue a certificate if
appropriate. The estimated cost burden is $4.11 for each individual notice, including the
certificate. For purposes of this analysis, we estimate that there would be approximately 30,000
certified application counselors nationwide, or approximately 10,600 application counselors in 18
State Exchanges. The total cost burden would be approximately $2,422 for each State Exchange,
and the total cost for 18 State Exchanges would be approximately $43,593.
For an organization directly recertifying, we estimate that it would take a mid-level health policy
analyst up to .08 hours (5 minutes) to notify an individual and issue a certificate if appropriate. The
7

We estimate that a certified application counselor would have a professional wage equivalent to that of an eligibility
interviewer for assistance from government programs and agency resources. According to the U.S. Bureau of Labor
Statistics, an eligibility interviewer (occupation no. 43-4061) has a labor cost of $26.65 (including 35 percent fringe
benefits).
10

estimated cost burden is $4.11 for each individual notice. For purposes of estimating the burden on
designated organizations, of the estimated 30,000 certified application counselors nationwide, we
assume that approximately 19,400 of them would be directly certified by designated organizations,
or four certified applications counselors on average per designated organization. We estimate that
it would take a mid-level health policy analyst up to .08 hours (5 minutes) to notify an individual
and issue a new certificate. The estimated cost burden is $4.11 for each individual notice. For an
estimated 19,400 certified application counselors nationwide, or approximately four certified
application counselors on average in each organization, the total cost burden would be
approximately $16.44 for each organization. The total burden for 5,000 designated organizations
nationwide would be approximately 1,617 hours and the total cost burden would be $79,734.
Recordkeeping requirements


There would be recordkeeping requirements associated with issuing each individual notice.

For Exchanges that directly certify, we estimate that the time burden associated with maintaining a
copy of the notice and certificate would be .016 hours (1 minute); we assume a mid-level health
policy analyst with a labor cost of $49.35 an hour would maintain the form through electronic
copies at minimal cost, which we estimate as $0.79 per notice for each individual certified
application counselor. The total recordkeeping cost for 10,600 certified application counselors in
18 State Exchanges would be $8,374, or $265 per Exchange. The total time burden is 170 hours.
For organizations that directly certify, we estimate that the time burden associated with
maintaining a copy of each certificate issued at recertification would be .016 hours (1 minute); we
assume a mid-level health policy analyst with a labor cost of $49.35 an hour would maintain the
form through electronic copies at minimal cost, which we estimate as $0.79 as a per certificate for
each organization. The total recordkeeping cost per organization would be $3.16, and the total cost
for 5,000 organizations nationwide would be $15,326. The total time burden would be 323 hours.
G. Recertification Training
Third-party disclosures


On an annual basis, each individual certified application counselor would provide proof to
the organization or Exchange that he or she has successfully completed the recertification
training, in accordance with the Exchange’s process

We estimate that it would take an individual certified application counselor up to .03 hours (2
minutes) to respond to this collection. For purposes of the cost burden, we estimate that it would
take a certified application counselor with a labor cost of $26.65 an hour up to .03 hours (2
minutes) to provide the training certificate to the organization or Exchange, as may be required.
11

The total estimated cost burden is $0.80 for each individual seeking recertification. We estimate
that there would be approximately 30,000 training certificates provided, for a total cost burden of
$24,000, and the total time burden would be 1,000 hours for all certified application counselors
nationwide.
Recordkeeping requirements


Each person who receives training would obtain and maintain a record of training
certification

We estimate that the time burden associated with maintaining proof of training certification is .016
hours (1 minute), since we assume this proof would be maintained through electronic copies, at
minimal cost. The total cost estimated for each individual to maintain proof of training
certification would be $0.43. The total cost burden would be $12,900 and the total time burden
would be 500 hours for all certified application counselors nationwide.

Table 1 - Annual Recordkeeping and Reporting Requirements
Regulation Section(s)

Respondents

Responses
(total)

Total
Annual
Burden
(hours)
5,000

Labor Cost of
Reporting
($)

Total Cost
($)

5,000

Burden
per
Response
(hours)
1

§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)
(organization list)
§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(d)(7)
(recertification request
form by Exchange)
§155.225(d)(7)
(recertification request
form by organization)
§155.225(d)(7)
(recertification request

5,000

79.08 (for one
respondent)

395,400

1,000

1,000

.5

500

39.54 (for one
respondent)

19,770

5,000

5,000

.25

1,250

19.77 (per agreement)

24,712.50

5,000

5,000

.25

1,250

12.34 per updated list

15,425

5,000

30,000

.016

480

.79 per certificate

379.20

5,000

2,200,000

.032

70,400

1.58 (per authorization)

111,232

30,000

2,200,000

.266

585,200

7.09 (per respondent)

4,149,068

18

18

2

36

134 (for one respondent)

2.412

5,000

5,000

2

10,000

134 (for one respondent)

670,000

18

18

.016

1.08

0.79 (for one respondent)

14.22

12

form recordkeeping by
Exchange)
§155.225(d)(7)
(recertification request
form recordkeeping by
organization)
§155.225(d)(7)
(recertification request
submission)
§155.225(d)(7) (proof of
training)
§155.225(d)(7) (training
certificate recordkeeping)
§155.225(d)(7)
(recertification review by
Exchange)
§155.225(d)(7)
(recertification review
recordkeeping by
Exchange)
§155.225(d)(7)
(recertification review by
organization)
§155.225(d)(7)
(recertification review
recordkeeping by
organization)
Total………….

5,000

5,000

.016

80

0.79 (for one respondent)

3,950

30,000

30,000

.17

5,000

4.53 (for one respondent)

135,915

30,000

30,000

.03

1,000

0.80 (for one respondent)

24,000

30,000

30,000

.016

500

0.43 (for one respondent)

12,900

18

10,600

.08

883

4.11 (for one response)

43,593

18

10,600

.016

170

0.79 (for one response)

8,374

5,000

19.400

.08

1,617

4.11 (for one response)

79,734

5,000

19.400

.016

323

0.79 (for one response)

15,326

166,072

4,606,036

…………..
.

683,690.08

………………

5,712,204.92

13. Capital Costs
There are no capital costs needed for this collection requirement.
14. Cost to Federal Government
The designation requirements provided under §155.225 would apply to an Exchange that is being
operated by HHS as a Federally-facilitated Exchange or as a State Partnership Exchange, pursuant
to HHS authority under section 1321(c)(1) of the Affordable Care Act. These Exchanges are
collectively referred to here as Federally-facilitated Exchanges. We note that it is anticipated that
HHS would create a single process for designating these organizations to certify their staff or
volunteers as certified application counselors, including the creation of a single model application
and agreement for use in the Federally-facilitated Exchanges. Therefore, the estimates with respect
to establishing a designation process, including the creation of an application and agreement, are
on a one-time basis. The burden associated with these provisions is the time and effort necessary
for the Federally-facilitated Exchange to create an application, as well as review applications and
execute agreements with designated organizations. Additionally, the Federally-facilitated
Exchange would investigate and verify potential noncompliance and determine whether to
13

withdrawal an entity’s designation. HHS will issue guidance on the implementation of the certified
application counselor program in Federally-facilitated Exchanges.
The burdens on HHS operating a Federally-facilitated Exchange and by extension, the certified
application counselor program in the Federally-facilitated Exchange, include the following
burdens: the time and effort necessary to establish a process for designating organizations seeking
to have its staff or volunteers certified as application counselors in accordance with §155.225(b)(1)
including the time and effort necessary to establish a withdrawal process in accordance with
§155.225(e)(1); the time and effort necessary to develop training materials for the training
described in §155.225(d)(1); the time and effort necessary to develop the agreement identified in
§155.225(b)(1)(A).
Developing a process for designating organizations would be required on a one-time basis for the
Federally-facilitated Exchange; we estimate that it will take the Federally-facilitated Exchange up
to 20 hours to create a model application and agreement and procedures for withdrawal. For
purposes of the cost burden, we estimate it would take a mid-level health policy analyst8 up to 10
hours, a senior manager9 up to 5 hours for review and an attorney10 up to 5 hours for legal review.
The estimated cost burden would be $764.75 for the Federally-facilitated Exchange.

Labor
Number of
Category
Employees
Health Policy
Analyst
Attorney
Senior
Manager
Total

Hourly Labor Costs
(Hourly rate +
Fringe benefits)

Total Burden Costs
Burden
Hours

1
1

$31.33
$37.54

10
5

$313.30
$187.70

1
3

$52.75

5
20

$263.75
$764.75

There are recordkeeping requirements associated with developing and maintaining a model
application. The Federally-facilitated Exchange would be expected to maintain a copy of the
model application. It is estimated that the time burden associated with maintaining a copy of the
model application would be 0.016 hours (1 minute); we assume the model application will be
maintained through electronic copies with minimal cost. We assume a mid-level health policy
analyst with a professional wage of $31.33 an hour will maintain the model application through
8

These positions are estimated to be equivalent to a GS-11 position with the Federal government.
http://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2012/general-schedule/gs_h.pdf.
9
These positions are estimated to be equivalent to a GS-14 position with the Federal government.
http://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2012/general-schedule/gs_h.pdf.
10
These positions are estimated to be equivalent to a GS-12 position with the Federal government.
http://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2012/general-schedule/gs_h.pdf.
14

electronic copies with minimal cost, which we estimate as $0.50 as a one-time requirement for the
Federally-facilitated Exchange.
The cost burden associated with reviewing each application and notifying the organization of the
result of its review would apply to the Federally-facilitated Exchange for each organization that
seeks to be designated. It is anticipated that this application would be a one-time requirement for
the organization seeking to be designated. Therefore, the burden estimated for reviewing the
application is on a per organization basis. We estimate that it would take the Federally-facilitated
Exchange up to 1.16 hours to review an application. For purposes of the cost burden, we estimate
it would take a health policy analyst up to 1 hour and a senior manager up to .16 hours to review.
The estimated cost burden would be $39.77 for each organization.

Labor Category
Health Policy
Analyst
Senior Manager
Total

Hourly Labor
Costs (Hourly
Number of rate + Fringe
Employees benefits)
1
1
2

Total Burden Costs (per
organization)
Burden
Hours

$31.33
$52.75

1
.16
1.16

$31.33
$8.44
$39.77

The Federally-facilitated Exchange will enter into agreements with designated organizations
meeting all requirements in accordance with §155.225(b)(1)(A). The burden estimates for
executing each agreement is on a per organization basis. We estimate that it would take a senior
manager at the Federally-facilitated Exchange up to .25 hours to execute each agreement.
Hourly Labor
Costs (Hourly
rate + Fringe
benefits)

Number of
Employees
Senior
Manager
Total

1
1

Burden Hours

$52.75

0.25
.25

Total Burden Costs (per
agreement)
$13.19
$13.19

There are recordkeeping requirements associated with this requirement. We estimate that the time
burden for maintaining proof of each signed agreement is 1 minute (.016 hours). We estimate the
cost estimate for the senior manager at the Federally-facilitated Exchange to maintain proof of
each agreement is $.84, for a total estimated cost burden of $14.03 per organization.
In accordance with §155.225(e), when appropriate, the Exchange will withdraw designation from
15

an organization when it finds noncompliance with the terms and conditions of the organization’s
application counselor agreement. The Exchange will investigate instances of noncompliance it
identifies or that are reported, and notify the appropriate organization, or individual as applicable,
when it determines noncompliance necessitates withdrawing the applicable entity’s designation.
There are recordkeeping requirements associated with these procedures. The Exchange is expected
to maintain a record of each verification review and copy of any withdrawal notification. We
estimate that it will take the Exchange up to 3 hours to investigate, maintain a record, and notify an
organization or individual, as applicable, of the withdrawal of its certification, respectively. For
purposes of the cost burden, we estimate it will take a mid-level health policy analyst up to 2 hours
to investigate, draft, and send notification of withdrawal and a senior manager up to 1 hour to
review. We estimate the cost burden is $115.41 for each occurrence.

Hourly Labor
Costs (Hourly
rate + Fringe
benefits)

Number of
Employees
Health Policy
Analyst
Senior
Manager
Total

Total Burden Costs (per
reported occurrence)

Burden Hours

1

$31.33

2

$62.66

1
2

$52.75

1
3

$52.75
$115.41

There are recordkeeping requirements associated with this requirement. We estimate that the time
burden for maintaining an electronic record is 1 minute (.016 hours). We estimate the cost estimate
for a health policy analyst at the Exchange to maintain proof of each agreement is $.50, for a total
estimated cost burden of $115.91 per occurrence.
15. Changes to Burden
This is a revised collection related to the requirements of §155.225 to include an additional burden
associated with proposed §155.225(d)(7) which, as finalized, require CACs to be recertified on an
annual basis and take training. We solicited public comments for this proposed regulation in
conjunction with this revised collection. We have previously obtained OMB control number for
certain collections related to §155.225 under OMB control number 0938-1205. This revised
collection increased the total time burden by 19,610.08 hours and the total cost burden to
$996,218.22. There are no changes in the labor costs rates. The total time burden is683,690.08
hours and the total cost burden is $5,712,204.92.
16. Publication/Tabulation Dates
16

At this time, HHS does not expect that the data collected with respect to applications, agreements
or withdrawals in accordance with §155.225 will be published or shared with other agencies.
17. Expiration Date
Not applicable.

17