Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10527 Discontinuation Notices	Form and Instruction	New	Available
Form CMS-10527 Discontinuation Notices	Form and Instruction	New	Available
Form CMS-10527 Renewal Notice	Form and Instruction	New	Available
Form CMS-10527 Renewal Notice	Form and Instruction	New	Repair queued
CMS-10527 - Summary of Changes_final.pdf	Supplementary Document	Uploaded 2014-09-03	Available
CMS-10527 - Comment and Response_final.pdf	Supplementary Document	Uploaded 2014-09-03	Available
CMS-10527 Supporting Statement_final -rev 10-10-14_clean.docx	Supporting Statement A	Uploaded 2014-10-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212940	Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP)	Form and Instruction	New	Discontinuation Notices
212939	Product Discontinuance Notice for QHP Issuers	Form and Instruction	New	Discontinuation Notices
212938	Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP)	Form and Instruction	New	Renewal Notice
212937	Product Renewal Notice for QHP Issuers	Form and Instruction	New	Renewal Notice

ICR Details

OMB Control No: 0938-1254	ICR Reference No: 201409-0938-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 09/05/2014
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/17/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/03/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2015	6 Months From Approved
Responses	11,594	0	0
Time Burden (Hours)	149,188	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The final rule "Patient Protection and Affordable Care Act; Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs; Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges", provides that a Marketplace may choose to conduct the annual redetermination process for a plan year (1) in accordance with the existing procedures described in 45 CFR 155.335; (2) in accordance with procedures described in guidance issued by the Secretary for the coverage year; or (3) using an alternative proposed by the Marketplace and approved by the Secretary. The guidance document "Guidance on Annual Redeterminations for Coverage for 2015" contains the procedures that the Secretary is specifying for the 2015 coverage year, as noted in (2) above. These procedures will be adopted by the Federally-facilitated Marketplace. Under this option, the Marketplace will provide three notices. The final rule also amends the requirements for product renewal and re-enrollment (or nonrenewal) notices to be sent by Qualified Health Plan (QHP) issuers in the Exchanges and specifies content for these notices. The accompanying guidance document "Form and Manner of Notices When Discontinuing or Renewing a Product in the Group or Individual Market" provides standard notices for product discontinuation and renewal to be sent by issuers of QHPs and issuers in the individual market. Issuers in the small group market may use the draft Federal standard small group notices released in the June 26, 2014 bulletin "Draft Standard Notices When Discontinuing or Renewing a Product in the Small Group or Individual Market", or any forms of the notice otherwise permitted by applicable laws and regulations. States that are enforcing the Affordable Care Act may develop their own standard notices, for product discontinuances, renewals, or both, provided the State-developed notices are at least as protective as the Federal standard notices.

Emergency Justfication: The approval of these third party notifications is essential in ensuring that annual eligibility redetermination notices, and product discontinuation and renewal notices associated with the 2015 plan year are provided to consumers in a timely manner prior to the 2015 open enrollment period.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1411(f)(1)(B) Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 Section 1411(f)(1)(B) Name of Law: Affordable Care Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS32	Final or interim final rulemaking	79 FR 37262	07/01/2014

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Federal Register Notices & Comments
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 37262	07/01/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP)	CMS-10527	Renewal Notice
Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP)	CMS-10527	Discontinuation Notices
Product Discontinuance Notice for QHP Issuers	CMS-10527	Discontinuation Notices
Product Renewal Notice for QHP Issuers	CMS-10527	Renewal Notice

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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	11,594	0	11,594	0	0	0
Annual Time Burden (Hours)	149,188	0	149,188	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: This is a new information collection request.

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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: 09/03/2014

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