Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)

Forms and Documents

Document Name	Status
Form CMS-10488 Marketplace Survey Data Collection Form and Instruction	Modified
Form CMS-10488 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction	Unchanged
Del 8 1a Marketplace Survey Psychometric Rep_DRAFT.DOCX Supplementary Document	2015-02-04
CMS 10488- HIM Beta Test Change Request FINAL 508.docx Justification for No Material/Nonsubstantive Change	2015-01-29
CMS 10488-Beta Test Change Request-091114(1) (2).docx Justification for No Material/Nonsubstantive Change	2014-09-11
CMS-10488 - ESS OMB Supporting Statement Part A_121614 508 clean.docx Supporting Statement A	2015-01-29
CMS-10488 - ESS OMB Supporting Statement Part B_121614_508_Clean.docx Supporting Statement B	2015-01-29

IC Document Collections

IC ID	Document Title	Status
210331	Marketplace Survey Data Collection Form and Instruction	Modified
210330	Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction	Unchanged

ICR Details

OMB Control No: 0938-1221	ICR Reference No: 201501-0938-008
Status: Historical Active	Previous ICR Reference No: 201409-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: 21457
Title: Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)
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: 02/04/2015
	Date Received in OIRA: 01/29/2015
Terms of Clearance: OMB understands that CMS will use the beta test to continue to explore ways to increase the utility of the data collection while minimizing participant burden by streamlining the survey. Per the original terms of clearance for this ICR, CMS will carefully assess the quality and utility of the data from the beta test to determine if the beta test results and underlying data are appropriate for dissemination outside the agency.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	02/28/2017	02/28/2017
Responses	232,810	0	244,360
Time Burden (Hours)	70,282	0	83,350
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1311(c)(4) of the ACA requires the Department of Health and Human Services (HHS) to develop an enrollee satisfaction survey system that assesses consumer experience with qualified health plans (QHPs) offered through an Exchange. It also requires public display of enrollee satisfaction information by the Exchange to allow individuals to easily compare enrollee satisfaction levels between comparable plans. CMS is developing, testing and implementing two surveys, a survey for adult enrollees in QHPs and a survey for health insurance Marketplace consumers. CMS is requesting approval for information collection associated with these surveys.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1313 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1321(a) Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1311(c)(4) Name of Law: Affordable Care Act (ACA)
  

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

Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Adult Qualified Health Plan Enrollee Experience Survey	CMS-10488, CMS-10488, CMS-10488, CMS-10488	Vendor Form ,   QHP Enrollee Survey (Beta Test) - Chinese ,   QHP Enrollee Survey (Beta Test) - English ,   QHP Enrollee Survey (Beta Test) - Spanish
Marketplace Survey Data Collection	CMS-10488, CMS-10488, CMS-10488	Marketplace Survey for Beta Test English ,   Marketplace Survey for the Beta Test English ,   Marketplace Survey for Beta Test Chinese

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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	232,810	244,360	0	0	-11,550	0
Annual Time Burden (Hours)	70,282	83,350	0	0	-13,068	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: There are updates to the estimated burden based on this change request. For the QHP Enrollee Survey beta test, we have updated the number of items to 93 changing the burden for each respondent from .45 hours to .39 hours. We have also updated the burden for the survey vendors for the QHP Enrollee Survey beta test to 10 hours based on the number of survey vendors that applied. For the Marketplace Survey beta test, we have updated the number of items to 83 and updated the length of time to .24 hours based on the psychometric test.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 01/29/2015

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