Information Comparision with Insurance Data

Forms and Documents

Document Name	Status
Form 1 Insurance Match File Form and Instruction	Removed
Form 1 Components of an Insurance Match Agreement Form and Instruction	Modified
2014_09_02_Insurance_Match_PRA_Supporting_Statement_Final.docx Supporting Statement A	2014-09-11
01 Standard Input File.doc Supplementary Document	2014-09-11

IC Document Collections

IC ID	Document Title	Status
183595	Insurance Match File Form and Instruction	Removed
183594	Components of an Insurance Match Agreement Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0342	ICR Reference No: 201409-0970-001
Status: Historical Active	Previous ICR Reference No: 201106-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Information Comparision with Insurance Data
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: 12/23/2014
	Date Received in OIRA: 09/15/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	36 Months From Approved	12/31/2014
Responses	336	0	286
Time Burden (Hours)	168	0	143
Cost Burden (Dollars)	1,680	0	3,526

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Abstract: The Deficit Reduction Act of 2005 amended Section 452 of the Social Security Act (the Act) to authorize the Secretary of Health and Human Services, through the Federal Parent Locator Service (FPLS), to conduct comparisons of information concerning individuals owing past-due child support with information maintained by insurance companies (or their agents) concerning insurance claims, settlements, awards, and payments. The Federal Office of Child Support Enforcement (OCSE) operates the FPLS in accordance with section 453(a)(1) of the Act. The Federal Case Registry of Child Support Orders (FCR) is maintained in the FPLS and contains all State caseloads in accordance with section 453(h)(1) of the Act. At the option of an insurer, the comparison may be accomplished by either of the following methods: under the first method, an insurer or the insurer's agent will submit to OCSE information concerning claims, settlements, awards, and payments. OCSE will then compare that information with information pertaining to individuals owing past-due support; under the second method, OCSE will furnish to the insurer or the insurer's agent a file containing information pertaining to individuals owing past-due support. The insurer or the insurer's agent will then compare that information with information pertaining to claims, settlements, awards, and payments. The insurer will furnish the information resulting from the comparison to OCSE. On a daily basis, OCSE will furnish the results of the comparison to the State CSE agencies responsible for collecting the past-due child support by transmitting the Insurance Match Response Record via the FCR. The results of the comparison will be used by the State agencies to collect past-due child support from the insurance proceeds. This match is optional for both States and insurers or their agents.

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Authorizing Statute(s): US Code: 42 USC 652 Name of Law: Information Comparisons with Insurance Data
  

Citations for New Statutory Requirements: None

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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:
	79 FR 13656	03/11/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 53202	09/08/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Components of an Insurance Match Agreement	1	File input
Insurance Match File	1	Match File

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ICR Summary 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	336	286	0	314	-264	0
Annual Time Burden (Hours)	168	143	0	157	-132	0
Annual Cost Burden (Dollars)	1,680	3,526	0	360	-2,206	0

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

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There was a burden hour adjustment from the previous approval, from 143 hours to 168 hours. This adjustment is due to an increase in the number of new Insurance Match program participants and the removal of the U.S. DOL as a burden-impacted respondent

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Annual Cost to Federal Government: $868,308

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]? No

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: 09/15/2014

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