Risk Corridors Transitional Policy (CMS-10532)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10532 Risk Corridors Transitional Policy	Form	New	Available
CMS-10532 Memo regarding change to transitional form.docx	Supplementary Document	Uploaded 2015-02-09	Available
CMS-10532 - Transitional Policy Supporting Statement (Final) Jan clean.pdf	Supporting Statement A	Uploaded 2015-01-07	Available
CMS-10532 - Summary of comments on RC transitional collection.xlsx	Supplementary Document	Uploaded 2015-01-05	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214480	Risk Corridors Transitional Policy	Form	New

ICR Details

OMB Control No: 0938-1267	ICR Reference No: 201501-0938-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: CMS-10532
Title: Risk Corridors Transitional Policy (CMS-10532)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/09/2015
	Date Received in OIRA: 01/07/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2018	36 Months From Approved
Responses	400	0	0
Time Burden (Hours)	400	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1342 of the Patient Protection and Affordable Care Act of 2010 (PPACA) and its implementing regulations require a health insurance issuer (issuer) offering individual or small group health insurance coverage in States that adopted the transitional policy announced in the Centers for Medicare and Medicaid (CMS) letter dated November 14, 2013 to submit a report concerning the count of its total enrollment in the individual market and small group market and the count of its enrollment in individual market and small group market policies that meet the criteria for transitional policies. The data will be used to calculate the risk corridors adjustment percentage for 2014 as defined in 45 CFR 153.500.

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Authorizing Statute(s): US Code: 45 USC 153 Name of Law: Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment Under the Affordable Care Act
  

Citations for New Statutory Requirements: US Code: 45 USC 153 Name of Law: Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment Under the Affordable Care Act

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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 53069	09/05/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 229	01/05/2015
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Risk Corridors Transitional Policy	CMS-10532	Transitional Policy Reporting Form

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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	400	0	400	0	0	0
Annual Time Burden (Hours)	400	0	400	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.

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Annual Cost to Federal Government: $52,600

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: 01/07/2015

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