CMS-10494-Supporting Statement Part A-PRA amendment for OMB 0938-1205 4 6 15 CLEAN 508MM

Supporting Statement – Part A
Patient Protection and Affordable Care Act; Consumer Assistance Tools and Programs of
an Exchange and Certified Application Counselors; Exchange and Insurance Market
Standards for 2015
A. Background
On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act.
On March 30, 2010, the Health Care and Education Reconciliation Act of 2010 was also signed
into law. The two laws collectively are referred to as the Affordable Care Act.
The Affordable Care Act creates Health Insurance Exchanges (Exchanges), new competitive
marketplaces where consumers and small businesses can purchase private health insurance.
Consumers who access health insurance coverage through Exchanges will be able to receive
skilled assistance from certified application counselors (CACs) who will provide information
about applying for coverage in a qualified health plan (QHP) and insurance affordability programs
through an Exchange, and will help to facilitate enrollment in QHPs and insurance affordability
programs. A robust range of enrollment assistance programs will be critical to helping consumers
enroll, particularly during the open enrollment periods (OEP); the initial OEP began October 1,
2013 and the subsequent OEP begins November 15, 2014. The certified application counselor
program supplements other consumer assistance programs established under the Affordable Care
Act, such as Navigators and non-Navigator Assistance Programs. As further discussed and
clarified in the Final Rule, “Patient Protection and Affordable Care Act; Exchange Functions:
Standards for Navigators and Non-Navigator Assistance Personnel; Consumer Assistance Tools
and Programs of an Exchange and Certified Application Counselors,” (78 FR 42824, July 17,
2013), codified at 45 CFR 155.225, certified application counselors will play a more limited role
relative to other assistance programs, as they will focus on providing skilled application
assistance.
This information collection already includes the following information collections: (1) certified
application counselor (CAC) organization application; (2) follow-up questions to certain
organizations that submit a CAC organization application; and (3) information collections
associated with entering into the agreement between CMS and the designated CAC organization,
including collection requirements in the agreement. These are discussed in more detail below.
This information collection request covers the following information collections: (1) Exchange or
organization-created recertification requests; (2) recertification notices issued by an Exchange or
organization; (3) training certificate disclosures; (4) recordkeeping requirements associated with
(1)-(3); (5) making updates and corrections to CAC organization information submitted to CMS
and (6) collection of information through an optional questionnaire included in the certification
1

and recertification training to evaluate the quality of the training. These are discussed in more
detail below. 1
B. Justification
1 . Need and Legal Basis
Section 1413 of the Affordable Care Act directs the Secretary of HHS to establish, subject to
minimum requirements, a streamlined enrollment system for qualified health plans offered
through the Exchange and insurance affordability programs. In addition, section 1321(a)(1) of the
Affordable Care Act directs and authorizes the Secretary to issue regulations setting standards for
meeting the requirements under title I of the Affordable Care Act, with respect to, among other
things, the establishment and operation of Exchanges. Pursuant to this authority, regulations
establishing the certified application counselor program were finalized at 45 CFR 155.225.
Specifically, 45 CFR 155.225(a) requires an Exchange to establish a certified application
counselor program that complies with the requirements of the rule. Section155.225(b)(1) allows
each Exchange to designate certain organizations, including organizations designated by state
Medicaid or CHIP agencies, which will certify their staff and volunteers to act as certified
application counselors. In accordance with 45 CFR 155.225(b)(2), Exchanges may choose to
certify directly individuals who seek to act as certified application counselors, designate certain
organizations which will certify staff or volunteers to perform application services, or do both.
The duties of certified application counselors and standards for certification, such as training and
disclosure of potential conflicts of interest, withdrawal and applicant/enrollee authorization
requirements are set forth under 45 CFR 155.225(c) through (f).
2.

Information Users

Exchanges will use the information collected to certify individual CACs or designate
organizations that may certify CACs and to maintain CMS records related to those certifications
and designations.
Exchanges will also use the information collected to inform the public about the availability of
application services from designated organizations.
Designated organizations will use the information collected to manage their internal processes to
1

There are other information collections associated with this program. This includes: (1) certified application
counselor application (for organization or individual, as applicable); (2) follow-up questions to certain organizations
that submit an application; (3) agreements executed between CMS and a designated CAC organization; (4) initial
training registration for CAC applicants, (5) disclosure requirements for CACs, (6) recordkeeping requirements for
CACs, (7) third-party disclosure requirements for CACs, (8) notice requirements for the Exchanges, (9) and other
collections associated with implementation of 45 § 155.225. CMS has obtained approval for these collections under
OMB control number 0938-1205
2

certify individual CACs.
Under 45 CFR 155.225(d)(1) and (7), certified application counselors in all Exchanges are
required to be initially certified and then recertified on at least an annual basis and successfully
complete Exchange-required recertification training, which will include an optional questionnaire
to evaluate the quality of the training.
3.

Use of Information Technology

We expect organizations seeking designation would submit an application, which we expect will
be available online in addition to a paper process. We expect that the Exchange will maintain the
model application and agreement and make training materials available through electronic means. 2
We also expect that the Exchange will use a public facing website to display information collected
from designated organizations when they apply for designation, and that updates and corrections
to that information can be submitted electronically by the designated organization to ensure that
the information available to the public is complete, up-to-date and accurate.3 In addition, we
expect that an Exchange will maintain a record of potential occurrences of noncompliance as a
basis for withdrawal by electronic means. The HHS-developed process will include training of
certified application counselors through an online portal maintained by CMS; the optional
questionnaire to evaluate the quality of the training will also be accessed through this portal. 4
Government Paperwork Elimination Act (GPEA)
Is this collection currently available for completion electronically?
•

No, this will be a new electronic data collection.

Does this collection require a signature from the respondent(s)?
•

Organizations, and individuals in certain State Exchanges, will submit applications using
the format prescribed by the Exchange. It is expected that a physical signature or esignature will be required on the agreement that is entered into by CMS and each
designated organization.

If CMS had the capability of accepting electronic signature(s), could this collection be made
available electronically?
2 See Appendix A, “Organization Application” for the application HHS uses to solicit applications from interested
organizations in FFMs.
3 See Appendix B, “CAC Agreement,” for the requirements to provide updated contact and location information; see
Appendix C,”FLH Updates,” for screen shots of an electronic option for updating contact information.
4 See Appendix D, “Registration Screen Shots,” for screen shots of the registration portal; see Appendix E for a
sample training completion certificate; see Appendix F “Training Quality Questionnaire,” for the optional training
quality questionnaire..
3

•

Yes, to the extent that the collection will be made available electronically once systems are
developed, we expect that an e-signature would be required on the application and
agreement.

If this collection isn’t currently electronic but will be made electronic in the future, please give
a date (month & year) as to when this will be available electronically and explain why it can’t
be done sooner.
•

Electronic collection of an e-signature on the agreement that is entered into by CMS and
the designated organizations is not currently required. However, CMS is developing an
electronic system for this collection and anticipates that it will have the capacity for the
collection of an electronic signature on the agreement sometime in Q3 or Q4 of 2015..

If this collection cannot be made electronic, or if it isn’t cost beneficial to make it electronic,
please explain.
•
4.

Not applicable. We expect that the collection will be made electronic in the future.

Duplication of Efforts

This information collection does not duplicate any other effort and the information cannot be
obtained from any other source. We expect that most organizations and individuals will go
through the designation or certification process, as applicable, as a one-time requirement only,
except when amendments to the agreement between CMS and the designated organization are
made and require a new signature or e-signature from the designated organization.
5.

Small Businesses

Small businesses may seek designation from the Exchange on a voluntary basis. Further,
organizations, including small businesses, which provide enrollment assistance, are not required to
be designated under these provisions to continue providing these services. The burden on small
businesses that are eligible organizations and choose to seek to be designated to certify staff or
volunteers to act as application counselors will be minimized by the use of a model application
and agreement developed by the Exchange as a one-time requirement. In addition, small
businesses that may be designated will have discretion in developing processes to register and
track the performance of certified application counselors, withdraw certification from an
individual staff or volunteer, and obtain authorization from applicants and enrollees. As provided
above, HHS will issue guidance with respect to implementation of the certified application
counselor program in Federally-facilitated Exchanges so that organizations will have a clear
understanding of what is required of the organization.
4

6.

Less Frequent Collection

Implementation of the certified application counselor program, in accordance with final
regulations at 45 CFR §155.225, will require collection to allow each Exchange to establish a
process for designating organizations or certifying individuals, as applicable. Collections will
allow designated organizations to comply with these provisions, such as maintaining a registration
process, providing required disclosures and obtaining required authorizations, and responding
appropriately to the withdrawal of designation. Organizations that seek to be designated to certify
staff or volunteers as application counselors would only be required to submit the required
application and agreement with the Exchange one time, unless, in accordance with law, there is a
change in eligibility that would require a new application for designation or a material change to
the terms to which an organization must agree to remain designated.
7.

Special Circumstances

None.
8.

Federal Register/Outside Consultation

Describe efforts to consult with persons outside the agency to obtain their views on the
availability of data, frequency of collection, the clarity of instructions and recordkeeping,
disclosure, or reporting format (if any), and on the data elements to be recorded, disclosed, or
reported.
A 60-day notice in the Federal Register will be published on January 28, 2015 to seek public
comments in response to the information collection request described below.

9.

Payments/Gifts to Respondents

Payments and gifts will not be provided.
10. Confidentiality
In the event of investigations into potential violations of program standards or noncompliance
with other requirements that apply to certified application counselors or designated organizations,
HHS may collect some personally identifiable information of certified application counselors
(e.g., name, unique ID number) or consumers (e.g., name), as this information is provided on the
consumer authorization form that is used prior to a certified application counselor assisting a
consumer. To the extent provided by law, we will maintain the privacy of any respondent with
respect to the information being collected.
11. Sensitive Questions
5

We do not foresee circumstances that would require the collection of any questions of a sensitive
nature.
12. Burden Estimates (Hours & Wages)
This is a revised collection related to the requirements of §155.225 to include an additional burden
associated with §155.225(b)(1) which requires that designated organizations enter into agreements
with CMS, and with §155.225(d)(1) and (7) which, require CACs to take initial certification
training and recertification training and become recertified on an annual basis. We have previously
obtained an OMB control number for certain collections related to §155.225 under OMB control
number 0938-1205.
Wage per hour for organization and Exchange staff: 5 certified application counselors, health
policy analysts, senior managers, and attorneys are as follows:
Certified Application Counselors
Mid-level Health Policy Analyst
Senior Manager
Attorney

$26.65
$49.35
$79.08
$90.15

A. CAC organization application
Organizations seeking to be designated by CMS as a CAC organization must submit an
application. A sample application is provided as an appendix (Appendix A) to this request.
We estimate that it will take an organization up to 1 hour to review instructions and complete and
submit an application. For purposes of the cost burden, we estimate it will take a senior manager
with a wage of $79.08 an hour up to 1 hour to complete and submit the application. The total
estimated cost burden is $79.08 for each organization seeking designation. We estimate that there
will be 5,000 total applicants.
B. Follow-up questions to certain organizations that submit a CAC organization application
The information submitted by some organizations on their CAC application will trigger CMS to
seek some additional information from these organizations. Many completed applications will not
require this follow-up information. The follow-up information that may be collected will consist
of:

5 Based on Bureau of Labor Statistics, Occupational Employment Statistics, Occupational Employment and Wages,
May 2012. Includes fringe benefits calculated at 35% of base wage.
6

•
•
•

Description of the processes the organization has in place to protect consumers’ personally
identifiable information (PII);
Identification of any rules concerning PII which the organization is already required to
follow; and
Description of the screening processes they use or intend to use for staff and volunteers
who they certify to be CACs.

We estimate that it will take an organization up to .5 hours total to respond to this collection. For
purposes of the cost burden, we estimate that it will take a senior manager with a wage of $79.08
an hour up to .5 hour to complete and submit the follow-up information electronically. The total
estimated cost burden is $39.54 for each organization that is required to provide the follow-up
information. While we do not know exactly how many applicants will receive these follow-up
questions, for purposes of analysis we estimate that no more than 20%of applicants might receive
them. Therefore, we estimate that these questions will be sent to no more than 1,000 applicants.
C. Information collections associated with the agreement between CMS and the designated CAC
organization
Each organization that CMS designates as a CAC organization must enter into an agreement with
CMS. That agreement will include a number of provisions, including the following information
collections:
Reporting
•

The organization must provide CMS with updates, changes and corrections to the
information originally provided on its application, so that information about the
organization that is provided to the public on a CMS website will remain current, accurate
and complete. These updates, changes and corrections will be submitted electronically.

We estimate that 5,000 organizations will electronically submit updates, changes and corrections
to CMS, on average, a total of 3 times. We estimate it will take a health policy analyst with a
professional wage of $49.35 up to .25 hours to provide this information to CMS each time, for a
total cost burden of $37.01 for each organization and a total cost burden of $185,050 for all 5,000
organizations.
•

The organization must attest that the organization has entered into agreements with its
individual CACs requiring their compliance with CAC requirements. 6

6 See appendix G for “Individual CAC Agreement,” for a model agreement between an organization and an
individual.
7

We estimate it will take a senior manager at the organization up to .25 hours (15 minutes) to enter
into each agreement. We estimate the cost burden is $19.77 per agreement, and we estimate that
there will be 5,000 agreements.
•

The organization must provide CMS with the names of individuals it has certified as
CACs.

We estimate it will take a health policy analyst with a professional wage of $49.35 up to .25 hours
(15 minutes) to provide a list to CMS for a cost burden of $12.34 per update. We estimate that
there will be up to 5,000 lists provided to CMS.
Third-party disclosures
• The organization must issue certificates to its CAC staff and volunteers when it certifies or
recertifies them.7
We estimate it will take a health policy analyst with a professional wage of $49.35 up to .016
hours (1 minute) to issue a certificate for a cost burden of $0.79 per certification. We estimate that
there will be 30,000 certificates.
Recordkeeping requirements
• The designated organization must retain a record of authorization provided by consumers
to the organization’s CACs for the CAC to obtain access to a consumer’s PII. 8
We estimate it will take a health policy analyst with a professional wage of $49.35 up to .016
hours (1 minute) to collect each record of authorization for a cost burden of $0.79 per
authorization. We estimate that the time burden associated with maintaining record of the
authorization is 0.016 hours (1 minute). We estimate the total cost for the organization to
maintain the record of authorization is $0.79, for a total cost burden of $1.58 per record of
authorization.
In addition, with respect to the requirement on the CAC to receive authorization from each
consumer before obtaining access to the consumer’s PII, we estimate it will take a certified
application counselor 0.25 hours (15 minutes) to obtain the authorization. The total cost estimate
for disclosures by each individual certified application counselor is therefore $6.66. We estimate
that the time burden associated with maintaining record of the authorization is 0.016 hours (1
minute). We estimate the total cost for the individual to maintain the record of authorization is
$0.43, for a total cost burden of $7.09 per authorization.
Therefore, assuming that 2.2 million individuals 9 provide authorization, this brings the total
7 See Appendices H and I for sample certification certificates, English and Spanish.
8
See Appendices J and K for a model authorization form, English and Spanish, which certified application counselors
may use to fulfill this requirement.
8

estimate for this recordkeeping requirement to $4,260,300.
D. CAC recertification request form
Third-party disclosures
• CACs seeking to be recertified by an Exchange or designated organization directly
certifying CACs must submit a recertification request form. We expect that establishing a
process for recertification would include creating a recertification request form (or similar
document) as a one-time requirement.
For an Exchange that performs direct certification, we estimate that up to 18 State Exchanges
would develop their own recertification request form. 10 It would take a health policy analyst (at
$49.35 labor cost per hour) up to 1 hour to create, a senior manager (at $79.08 cost per hour) up to
.5 hours (30 minutes) for review, and an attorney up to .5 hours (at $90.15 labor cost per hour) for
legal review. We estimate that the one-time cost burden would be $134 for each Exchange, and
the total cost for 18 State Exchanges would be $2,412 and the total time burden would be 36
hours.
For a designated organization that performs direct certification, we estimate that up to 5,000
designated organizations would develop their own recertification request form.11 We estimate
that the development of a recertification request form would take a health policy analyst (at $49.35
labor cost per hour) up to 1 hour to create, a senior manager (at $79.08 labor cost per hour) up to
.5 hours (30 minutes) for review, and an attorney (at $90.15 labor cost per hour) up to .5 hours (30
minutes) for legal review. We estimate that the one-time time burden would be two hours and the
one-time cost burden would be $134 for each organization. The total time burden for 5,000
organizations nationwide would be 80 hours and the total cost burden would be $670,000.
Recordkeeping requirements
For an Exchange that performs direct certification, we estimate that the time burden associated
with maintaining a copy of the request form would be .016 hours (1 minute); we assume a midlevel health policy analyst (would maintain the form through electronic copies at minimal cost,
which we estimate as $0.79 as a one-time requirement for the Exchange. The total cost burden for
18 State Exchanges would be $14.22, and the total time burden would be 1.08 hours.
For an organization that performs direct certification, there would be recordkeeping requirements
associated with developing and maintaining a request form. We estimate that the time burden
9

This number is based on number of consumers who sought assistance from counselors in the State Health Insurance
Assistance Programs (SHIPs) counselor program in 2012. CMS New SHIP Director Training 4 (7th ed., 2013).
10
We estimate 18 State Exchanges (which includes Utah) and one Federally-facilitated Exchange will develop their
own processes for recertification. HHS will establish a single process in all Federally-facilitated Exchanges.
11 A model recertification request form that organizations may use or modify is attached as appendix L.
9

associated with maintaining a copy of the request form would be .016 hours (1 minute); we
assume a mid-level health policy analyst with a labor cost of $49.35 an hour would maintain the
form through electronic copies at minimal cost, which we estimate as $0.79 as a one-time
requirement for each organization, and the total cost for 5,000 organizations nationwide would be
$3,950, and the total time burden would be 80 hours.
E. Recertification Submission
Reporting
Individual certified application counselors may provide responses to an optional training quality
questionnaire associated with completing the requirements for certification and recertification.
Completion of the optional training quality user questionnaire is estimated to have a burden of
0.25 hours (15 minutes) per respondent. 12 While completion of the questionnaire is optional, for
the purposes of estimating total time and cost burdens we are assuming all individual certified
application counselors will complete the questionnaire. For purposes of the cost burden, we
estimate that it would take a certified application counselor with a labor cost of $26.65 an hour up
to .25 hours (15 minutes) to complete the optional training quality questionnaire. The estimated
cost burden would be $6.66 for each individual completing the questionnaire. We estimate that
potentially 30,000 individual certified application counselors will complete the optional
questionnaire for a total cost burden of $199,800 and a total time burden of 7,500 hours.
Third-party disclosures
There would be third-party disclosure requirements for individual certified application counselors
associated with completing the requirements for recertification, whether done directly through the
Exchange or through an Exchange-designated certified application counselor organization.
•

On an annual basis, this would require completing Exchange required training and might
also include satisfying other requirements consistent with the Exchange-established
processes, such as providing conflicts of interest disclosures, other attestations and
submitting a recertification request form (or similar document) and other attestations.

We estimate that it would take an individual certified application counselor up to .17 hours (10
minutes) to respond to this collection. For purposes of the cost burden, we estimate that it would
take a certified application counselor with a labor cost of $26.65 an hour up to .17 hours (10
minutes) to complete and submit the recertification request to the organization or Exchange, as
applicable. 13 The estimated cost burden would be $4.53 for each individual seeking recertification.
12

See Appendix F “Training Quality Questionnaire,” for screen shots of the optional training quality questionnaire.
We estimate that a certified application counselor would have a professional wage equivalent to that of an eligibility
interviewer for assistance from government programs and agency resources. According to the U.S. Bureau of Labor
Statistics, an eligibility interviewer (occupation no. 43-4061) has a labor cost of $26.65 (including 35 percent fringe
benefits).
10
13

We estimate that there would be approximately 30,000 recertification requests provided, for a total
cost burden of $135,915 and a total time burden of 5,000 hours for all certified application
counselors nationwide.
F. Recertification Review
Third-party disclosures
There would also be third-party disclosure requirements for State Exchanges and designated
organizations associated with reviewing each certified application counselor’s recertification
request. This collection would be required on an annual basis.
•

The Exchange or designated organization would notify the individual of the result of its
review and issue a new certificate for each individual who successfully completes
recertification. 14 This notice requirement would apply to the Exchange or organization, as
applicable, on an annual basis for each individual certified application counselor.

For an Exchange directly recertifying, we estimate that it would take a mid-level health policy
analyst in the Exchange up to .08 hours (5 minutes) to notify an individual and issue a certificate if
appropriate. The estimated cost burden is $4.11 for each individual notice, including the
certificate. For purposes of this analysis, we estimate that there would be approximately 30,000
certified application counselors nationwide, or approximately 10,600 application counselors in 18
State Exchanges. The total cost burden would be approximately $2,422 for each State Exchange,
and the total cost for 18 State Exchanges would be approximately $43,593.
For an organization directly recertifying, we estimate that it would take a mid-level health policy
analyst up to .08 hours (5 minutes) to notify an individual and issue a certificate if appropriate.
The estimated cost burden is $4.11 for each individual notice. For purposes of estimating the
burden on designated organizations, of the estimated 30,000 certified application counselors
nationwide, we assume that approximately 19,400 of them would be directly certified by
designated organizations, or four certified applications counselors on average per designated
organization. We estimate that it would take a mid-level health policy analyst up to .08 hours (5
minutes) to notify an individual and issue a new certificate. The estimated cost burden is $4.11 for
each individual notice. For an estimated 19,400 certified application counselors nationwide, or
approximately four certified application counselors on average in each organization, the total cost
burden would be approximately $16.44 for each organization. The total burden for 5,000
designated organizations nationwide would be approximately 1,617 hours and the total cost
burden would be $79,734.
Recordkeeping requirements
14 A model certificate that an organization may use or modify is attached as an appendix H and I (in Spanish and
English language versions).
11

•

There would be recordkeeping requirements associated with issuing each individual notice.

For Exchanges that directly certify, we estimate that the time burden associated with maintaining a
copy of the notice and certificate would be .016 hours (1 minute); we assume a mid-level health
policy analyst with a labor cost of $49.35 an hour would maintain the form through electronic
copies at minimal cost, which we estimate as $0.79 per notice for each individual certified
application counselor. The total recordkeeping cost for 10,600 certified application counselors in
18 State Exchanges would be $8,374, or $265 per Exchange. The total time burden is 170 hours.
For organizations that directly certify, we estimate that the time burden associated with
maintaining a copy of each certificate issued at recertification would be .016 hours (1 minute); we
assume a mid-level health policy analyst with a labor cost of $49.35 an hour would maintain the
form through electronic copies at minimal cost, which we estimate as $0.79 as a per certificate for
each organization. The total recordkeeping cost per organization would be $3.16, and the total cost
for 5,000 organizations nationwide would be $15,326. The total time burden would be 323 hours.
G. Recertification Training
Third-party disclosures
•

On an annual basis, each individual certified application counselor would provide proof to
the organization or Exchange that he or she has successfully completed the recertification
training, in accordance with the Exchange’s process

We estimate that it would take an individual certified application counselor up to .03 hours (2
minutes) to respond to this collection. For purposes of the cost burden, we estimate that it would
take a certified application counselor with a labor cost of $26.65 an hour up to .03 hours (2
minutes) to provide the training certificate to the organization or Exchange, as may be required.
The total estimated cost burden is $0.80 for each individual seeking recertification. We estimate
that there would be approximately 30,000 training certificates provided, for a total cost burden of
$24,000, and the total time burden would be 1,000 hours for all certified application counselors
nationwide.
Recordkeeping requirements
•

Each person who receives training would obtain and maintain a record of training
certification

We estimate that the time burden associated with maintaining proof of training certification is .016
hours (1 minute), since we assume this proof would be maintained through electronic copies, at
minimal cost. The total cost estimated for each individual to maintain proof of training
12

certification would be $0.43. The total cost burden would be $12,900 and the total time burden
would be 500 hours for all certified application counselors nationwide.

Table 1 - Annual Recordkeeping and Reporting Requirements
Regulation Section(s)

Respondents

Responses
(total)

Total
Annual
Burden
(hours)
5,000

Labor Cost of
Reporting
($)

Total Cost
($)

5,000

Burden
per
Response
(hours)
1

§155.225(b)(1)
(organization designation
by Exchange)
§155.225(b)(1)
(organization designation
by Exchange Information
Updates)
§155.225(b)(1)
(organization follow-up
for application)
§155.225(b)(1)(i)
(organization attestation)
§155.225(b)(1)
(organization list)
§155.225(b)(1)(i)
(certificate issuance)
§155.225(d)(1) and (7)
(training quality optional
questionnaire)
§155.225(d)(2) and (f)
(organization record of
authorization)
§155.225(d)(2) and (f)
(CAC authorization to
consumer)
§155.225(d)(7)
(recertification request
form by Exchange)
§155.225(d)(7)
(recertification request
form by organization)
§155.225(d)(7)
(recertification request
form recordkeeping by
Exchange)
§155.225(d)(7)
(recertification request
form recordkeeping by
organization)
§155.225(d)(7)
(recertification request
submission)
§155.225(d)(7) (proof of
training)
§155.225(d)(7) (training

5,000

79.08 (for one
respondent)

395,400

5,000

15,000

.25

3,750

12.34 (per update
response)

185,050

1,000

1,000

.5

500

39.54 (for one
respondent)

19,770

5,000

5,000

.25

1,250

19.77 (per agreement)

24,712.50

5,000

5,000

.25

1,250

12.34 per updated list

15,425

5,000

30,000

.016

480

.79 per certificate

379.20

30,000

30,000

.25

7,500

6.66 (per user feedback)

199,800

5,000

2,200,000

.032

70,400

1.58 (per authorization)

111,232

30,000

2,200,000

.266

585,200

7.09 (per respondent)

4,149,068

18

18

2

36

134 (for one respondent)

2.412

5,000

5,000

2

10,000

134 (for one respondent)

670,000

18

18

.016

1.08

0.79 (for one respondent)

14.22

5,000

5,000

.016

80

0.79 (for one respondent)

3,950

30,000

30,000

.17

5,000

4.53 (for one respondent)

135,915

30,000

30,000

.03

1,000

0.80 (for one respondent)

24,000

30,000

30,000

.016

500

0.43 (for one respondent)

12,900

13

certificate recordkeeping)
§155.225(d)(7)
(recertification review by
Exchange)
§155.225(d)(7)
(recertification review
recordkeeping by
Exchange)
§155.225(d)(7)
(recertification review by
organization)
§155.225(d)(7)
(recertification review
recordkeeping by
organization)
Total………….

18

10,600

.08

883

4.11 (for one response)

43,593

18

10,600

.016

170

0.79 (for one response)

8,374

5,000

19.400

.08

1,617

4.11 (for one response)

79,734

5,000

19.400

.016

323

0.79 (for one response)

15,326

166,072

4,651,036

…………..
.

694,940.08

………………

5,947,204.92

13. Capital Costs
There are no capital costs needed for this collection requirement.
14. Cost to Federal Government
The designation requirements provided under §155.225 would apply to an Exchange that is being
operated by HHS as a Federally-facilitated Exchange or as a State Partnership Exchange, pursuant
to HHS authority under section 1321(c)(1) of the Affordable Care Act. These Exchanges are
collectively referred to here as Federally-facilitated Exchanges. We note that it is anticipated that
HHS would create a single process for designating these organizations to certify their staff or
volunteers as certified application counselors, including the creation of a single model application
and agreement for use in the Federally-facilitated Exchanges. Therefore, the estimates with respect
to establishing a designation process, including the creation of an application and agreement, are
on a one-time basis. The burden associated with these provisions is the time and effort necessary
for the Federally-facilitated Exchange to create an application, as well as review applications and
execute agreements with designated organizations. Additionally, the Federally-facilitated
Exchange would investigate and verify potential noncompliance and determine whether to
withdrawal an entity’s designation. HHS will issue guidance on the implementation of the
certified application counselor program in Federally-facilitated Exchanges.
The burdens on HHS operating a Federally-facilitated Exchange and by extension, the certified
application counselor program in the Federally-facilitated Exchange, include the following
burdens: the time and effort necessary to establish a process for designating organizations seeking
to have its staff or volunteers certified as application counselors in accordance with
§155.225(b)(1) including the time and effort necessary to establish a withdrawal process in
accordance with §155.225(e)(1); the time and effort necessary to develop training materials for the
training described in §155.225(d)(1); the time and effort necessary to develop the agreement
14

identified in §155.225(b)(1)(A).
Developing a process for designating organizations would be required on a one-time basis for the
Federally-facilitated Exchange; we estimate that it will take the Federally-facilitated Exchange up
to 20 hours to create a model application and agreement and procedures for withdrawal. For
purposes of the cost burden, we estimate it would take a mid-level health policy analyst 15 up to 10
hours, a senior manager 16 up to 5 hours for review and an attorney 17 up to 5 hours for legal
review. The estimated cost burden would be $764.75 for the Federally-facilitated Exchange.

Labor
Number of
Category
Employees
Health Policy
Analyst
Attorney
Senior
Manager
Total

Hourly Labor Costs
(Hourly rate +
Fringe benefits)

Total Burden Costs
Burden
Hours

1
1

$31.33
$37.54

10
5

$313.30
$187.70

1
3

$52.75

5
20

$263.75
$764.75

There are recordkeeping requirements associated with developing and maintaining a model
application. The Federally-facilitated Exchange would be expected to maintain a copy of the
model application. It is estimated that the time burden associated with maintaining a copy of the
model application would be 0.016 hours (1 minute); we assume the model application will be
maintained through electronic copies with minimal cost. We assume a mid-level health policy
analyst with a professional wage of $31.33 an hour will maintain the model application through
electronic copies with minimal cost, which we estimate as $0.50 as a one-time requirement for the
Federally-facilitated Exchange.
The cost burden associated with reviewing each application and notifying the organization of the
result of its review would apply to the Federally-facilitated Exchange for each organization that
seeks to be designated. It is anticipated that this application would be a one-time requirement for
the organization seeking to be designated. Therefore, the burden estimated for reviewing the
application is on a per organization basis. We estimate that it would take the Federally-facilitated
Exchange up to 1.16 hours to review an application. For purposes of the cost burden, we estimate
it would take a health policy analyst up to 1 hour and a senior manager up to .16 hours to review.
The estimated cost burden would be $39.77 for each organization.
15

These positions are estimated to be equivalent to a GS-11 position with the Federal government.
http://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2012/general-schedule/gs_h.pdf.
16
These positions are estimated to be equivalent to a GS-14 position with the Federal government.
http://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2012/general-schedule/gs_h.pdf.
17
These positions are estimated to be equivalent to a GS-12 position with the Federal government.
http://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2012/general-schedule/gs_h.pdf.
15

Labor Category
Health Policy
Analyst
Senior Manager
Total

Hourly Labor
Costs (Hourly
Number of rate + Fringe
Employees benefits)
1
1
2

Total Burden Costs (per
organization)
Burden
Hours

$31.33
$52.75

1
.16
1.16

$31.33
$8.44
$39.77

The Federally-facilitated Exchange will enter into agreements with designated organizations
meeting all requirements in accordance with §155.225(b)(1)(A). The burden estimates for
executing each agreement is on a per organization basis. We estimate that it would take a senior
manager at the Federally-facilitated Exchange up to .25 hours to execute each agreement, using a
physical signature or e-signature.
Hourly Labor
Costs (Hourly
rate + Fringe
benefits)

Number of
Employees
Senior
Manager
Total

1
1

Burden Hours

$52.75

0.25
.25

Total Burden Costs (per
agreement)
$13.19
$13.19

There are recordkeeping requirements associated with this requirement. We estimate that the time
burden for maintaining proof of each signed agreement is 1 minute (.016 hours). We estimate the
cost estimate for the senior manager at the Federally-facilitated Exchange to maintain proof of
each agreement is $.84, for a total estimated cost burden of $14.03 per organization.
In accordance with §155.225(e), when appropriate, the Exchange will withdraw designation from
an organization when it finds noncompliance with the terms and conditions of the organization’s
application counselor agreement. The Exchange will investigate instances of noncompliance it
identifies or that are reported, and notify the appropriate organization, or individual as applicable,
when it determines noncompliance necessitates withdrawing the applicable entity’s designation.
There are recordkeeping requirements associated with these procedures. The Exchange is expected
to maintain a record of each verification review and copy of any withdrawal notification. We
estimate that it will take the Exchange up to 3 hours to investigate, maintain a record, and notify
an organization or individual, as applicable, of the withdrawal of its certification, respectively.
For purposes of the cost burden, we estimate it will take a mid-level health policy analyst up to 2
hours to investigate, draft, and send notification of withdrawal and a senior manager up to 1 hour
to review. We estimate the cost burden is $115.41 for each occurrence.
16

Hourly Labor
Costs (Hourly
rate + Fringe
benefits)

Number of
Employees
Health Policy
Analyst
Senior
Manager
Total

Total Burden Costs (per
reported occurrence)

Burden Hours

1

$31.33

2

$62.66

1
2

$52.75

1
3

$52.75
$115.41

There are recordkeeping requirements associated with this requirement. We estimate that the time
burden for maintaining an electronic record is 1 minute (.016 hours). We estimate the cost
estimate for a health policy analyst at the Exchange to maintain proof of each agreement is $.50,
for a total estimated cost burden of $115.91 per occurrence.
Responses to the training quality optional questionnaire will be reviewed by CMS staff
responsible for developing and updating the certification and recertification training, with an
estimated wage of $29 per hour. 18 The time to review each completed questionnaire is estimated
to be 0.25 hours (15 minutes total).
Hours: 0.25 hours (15 minutes) per submission
Cost: $29 mid-level range x .25 hours (15 minutes) per submission = $7.25 per submission
15. Changes to Burden
This revised collection increased the total time burden by 11,000 hours and the total cost burden
by $384,850. There are no changes in the labor costs rates. The change in burden is associated
with making updates and changes to the information posted about designated organizations on the
CMS public-facing website, completion of the optional training quality questionnaire at the end of
the initial certification, and annual recertification, trainings. The questionnaire is optional,
therefore actual increases in time and cost burdens may be lower.
16. Publication/Tabulation Dates
At this time, HHS does not expect that the data collected with respect to applications, agreements
or withdrawals in accordance with §155.225 will be published or shared with other agencies.
17. Expiration Date
18 Wage data from OPM GS Wage Tables at http://www.opm.gov/policy-data-oversight/pay-leave/salarieswages/2012/general-schedule/gs_h.pdf.
17

Not applicable.

18