Rate Increase Disclosure and Review Reporting Requirements (CMS-10379)

Forms and Documents

Document Name	Status
CMS-10379 - Nonsub change request.docx Justification for No Material/Nonsubstantive Change	2015-01-08
0938-1141 - Nonsub change request.docx Justification for No Material/Nonsubstantive Change	2015-01-06
Comment and Response for CMS.docx Supplementary Document	2014-04-04
508_CMS-10379_Rate_Review_Supporting_Statement_Part_A_clean.pdf Supporting Statement A	2015-01-06

IC Document Collections

IC ID	Document Title	Status
198022	State Unreasonable Rate Increase Determinations	Modified
198020	Health Insurance Issuer Submission of Final Justification for Unreasonable Rate Increases Other-Microsoft Word	Modified
198019	Health Insurance Issuer Submission of the Preliminary Justification Other-Microsoft Word	Modified

ICR Details

OMB Control No: 0938-1141	ICR Reference No: 201501-0938-004
Status: Historical Active	Previous ICR Reference No: 201501-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No: CMS-10379
Title: Rate Increase Disclosure and Review Reporting Requirements (CMS-10379)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/15/2015
	Date Received in OIRA: 01/15/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	07/31/2017	07/31/2017
Responses	9,356	0	359
Time Burden (Hours)	84,990	0	1,885
Cost Burden (Dollars)	0	0	0

---

Abstract: This information collection request covers the Rate Increase Disclosure and Review Reporting Requirements of 45 CFR Part 154.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 1003 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 78968	01/15/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 96118	04/02/2014
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Health Insurance Issuer Submission of Final Justification for Unreasonable Rate Increases
State Unreasonable Rate Increase Determinations
Health Insurance Issuer Submission of the Preliminary Justification

---

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	9,356	359	0	0	8,997	0
Annual Time Burden (Hours)	84,990	1,885	0	0	83,105	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: As noted in the non-substanative change request, the existing burden estimates have been revised to match the corrected supporting statement. The total burden is being revised from 1,885 hours to 84,990 hours.

---

Annual Cost to Federal Government: $0

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

---

Common Form ICR:  No

---

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: 01/15/2015

---