Evaluation of Stakeholder Training - Health Insurance Marketplace and Market Stabilization Programs (CMS-10581)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1185 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10581 Evaluation of Stakeholder Training - Health Insurance Marketplace and Market Stabilization Programs (CMS-10581) Form and Instruction
CMS-10581 Online Training Evaluation Survey CMS015_OnlineEvaluationSurveys_final_081715.docx Form and Instruction
CMS-10581 Onsite Training Evaluation Survey CMS015_OnsiteEvaluationSurveys_final_081715.docx Form and Instruction
TrainingEvaluation_PRA_PackageJustification_final_081715.docx Stakeholder Training Evaluation Justification IC Document
PRACoverSheetTableofContents_final_081715.docx Cover Sheet and table of Contents IC Document

Information Collection (IC) Details

IC Title:	Evaluation of Stakeholder Training - Health Insurance Marketplace and Market Stabilization Programs (CMS-10581)	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10581	Online Training Evaluation Survey	CMS015_OnlineEvaluationSurveys_final_081715.docx		Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10581	Onsite Training Evaluation Survey	CMS015_OnsiteEvaluationSurveys_final_081715.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 32,362	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	32,362	-67,638	100,000
Annual IC Time Burden (Hours)	2,618	2,201	417
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Stakeholder Training Evaluation Justification	TrainingEvaluation_PRA_PackageJustification_final_081715.docx	08/28/2015
Cover Sheet and table of Contents	PRACoverSheetTableofContents_final_081715.docx	08/28/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.