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	Removed
Form CMS-10488 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction	Modified
CMS-10488 - BCBSA comment response.docx Supplementary Document	2015-09-10
CMS-10488 - 60-Day Response to Comment 71315.xlsx Supplementary Document	2015-08-07
QHP Survey_Revisions Crosswalk_071315_final.pdf Supplementary Document	2015-08-07
CMS-10488 - QHP Survey_SS Part B_Clean.docx Supporting Statement B	2015-09-10
CMS-10488 - QHP Survey_SS Part A Clean.docx Supporting Statement A	2015-09-10

IC Document Collections

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

ICR Details

OMB Control No: 0938-1221	ICR Reference No: 201508-0938-007
Status: Historical Active	Previous ICR Reference No: 201501-0938-008
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: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/16/2015
	Date Received in OIRA: 08/07/2015
Terms of Clearance: All reporting websites under CMS’ control will provide Marketplace consumers with the overall response rate and the minimum and maximum response rates obtained by reporting units nationwide. This information will also include a statement of findings from the nonresponse bias analysis and CMS’ assessment of the potential implications of those findings for use of the response rates by consumers in choosing a QHP. CMS will report back to OMB before posting results publicly regarding how it intends to communicate these concepts to consumers within the context of the Quality Rating System (QRS). This report should include a discussion of how measures of out-of pocket costs will take “metal level” into account. CMS will work with both the CHAPs program and stakeholders to improve the questions over time.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2018	36 Months From Approved	02/28/2017
Responses	120,015	0	232,810
Time Burden (Hours)	39,623	0	70,282
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 1311(c)(4) Name of Law: Affordable Care Act (ACA)
   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
  

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:
	80 FR 23556	04/28/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 44131	07/24/2015
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
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
Adult Qualified Health Plan Enrollee Experience Survey	CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488	Survey Vendor Application ,   QHP Survey (Chinese) ,   Cover Letter (Chinese) ,   QHP Survey (English) ,   Cover Letter (English) ,   QHP Survey (Spanish) ,   Cover Letter (Spanish)

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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	120,015	232,810	0	-52,800	-59,995	0
Annual Time Burden (Hours)	39,623	70,282	0	-12,672	-17,987	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There is an overall reduction of 17,987 hours is mainly due to the removal of all burden associated with the Marketplace survey. Additionally, 3,150 hours were removed because the 2014 psychometric testing of the surveys has ended. The increased annual burden of 39,623 hours (or 118,869 hours over three years) is being requested for the future administrations of the QHP Enrollee Survey and due to the estimated increased number of QHPs offered through the Marketplaces. The questionnaire length has been reduced by 22 items since the original approval.

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Annual Cost to Federal Government: $5,100,000

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: 08/07/2015

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