Generic Submission Template - Supporting Statement

Request for Approval under the “Generic Clearance for the Collection of

Routine Customer Feedback” (OMB Control Number: 0938-NEW) TITLE OF INFORMATION COLLECTION: Evaluation of Stakeholder Training - Health Insurance Marketplace and Market Stabilization Programs

PURPOSE:

The Patient Protection and Affordable Care Act of 2010 (ACA) was enacted to assist millions of Americans in obtaining affordable health care services and to allow more employers to offer insurance coverage in a cost effective manner to their employees. Beginning in 2014,

individuals and small businesses will be able to purchase private health insurance through competitive marketplaces called “Health Insurance Marketplace” (Marketplace), also known as “Affordable Insurance Exchanges” or ‘‘Exchanges.” The Centers for Medicare & Medicaid Services (CMS) has promulgated regulations for the establishment and practices of Marketplaces in States, as well as for the market stabilizing programs. The cooperation and coordination of States, health insurance issuers, the Federal Government and other key stakeholders is essential

to the success of the Marketplace and associated market stabilization programs.

CMS is strongly committed to providing appropriate education and technical outreach to States, issuers, self-insured group health plans and third-party administrators (TPA) participating in the Marketplace and/or market stabilization programs mandated by the ACA. In addition, CMS recognizes that the success of Marketplaces and associated programs relies on the cooperation and coordination of States, issuers, self-insured health plans, third-party administrators (TPA) of self-insured health plans, health insurance agents and brokers, and other stakeholders.

CMS procured the services of a contractor, A. Reddix & Associates (ARDX), to help with its training and technical outreach efforts that support Marketplace and market stabilization program development. With the services of the contractor, CMS will provide training and technical assistance primarily through weekly, bi-weekly, monthly, and quarterly webinars and user group series. A web portal (www.REGTAP.info) was developed to support CMS’ training efforts and to provide a centralized location for resource information, training session registration, and technical assistance. ARDX plans to utilize surveys as part of a comprehensive evaluation process and solicit voluntary feedback from stakeholders regarding individual training sessions and technical assistance provided under this contract and through www.regtap.info and

_{electronic communications. ARDX will use four instruments to conduct these evaluations:}

 On-site Post-Training Surveys are provided for each participants at the end of each day of the onsite event;

 Webinar Post-Training Participant Surveys and User Group Post-Training Surveys will be emailed to participants following those sessions in which they participated; and

 Web Portal Evaluation Forms will be available to web portal users 24-hours per day, 7 days per week. ARDX will also create a pop-up to encourage users to complete the survey.

We are submitting four related packages for simultaneous approval. Personally Identifiable

Information will not be collected as a part of any of these instruments.

Survey results will help to determine stakeholders’ level of satisfaction with trainings, identify any issues with training and technical assistance delivery, clarify stakeholders’ needs and preferences, and define best practices for training and technical assistance. ARDX will conduct on-going evaluations and utilize results to continually improve the services provided to stakeholders.

DESCRIPTION OF RESPONDENTS:

Respondents include stakeholders participating in the Health Insurance Marketplace and in the market stabilization programs (e.g., health insurance issuers, self-insured group health plans, third-party administrators, agents, brokers and other entities) who register for and participate in training programs. Approximately 1,000 participants may be registered for each training event. The following Stakeholder Training events are planned for Years 1-2: On-Site: 2 training days; Webinars: 162; User Groups: 94. Approximately 10,000 users are registered on the web portal, www.REGTAP.info.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [x] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

_{[ ] Focus Group [ ] Other:}

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

_Name:

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [x] No

2. If Yes, will any information that is collected be included in records that are subject to the

Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to

participants? [ ] Yes [x] No

_{BURDEN HOURS}

Category of Respondent	No. of Respondents	Participation Time	Total Burden
Private Sector – Health Insurance Marketplace Stakeholders
On-Site Training	9,000	15 minutes per respondent	37.50 hours
Webinar	60,000	15 minutes per respondent	250.00 hours
User Group	30,000	15 minutes per respondent	125.0 hours
Web Portal	1,000	15 minutes per respondent	4.17 hours
Totals	100,000	15 minutes per respondent	416.67 hours

FEDERAL COST: The estimated annual cost to the Federal government is $325,000

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential

respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [x] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

All registrants that participate in an on-site training, webinar, and/or user group session will be afforded the opportunity to voluntarily participate in the survey. A random sampling of registered users will be invited to participate in the Web Portal survey. A user will be offered the opportunity to fill out this survey every 10th time he/she logs into REGTAP.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[x] Web-based or other forms of Social Media

[ ] Telephone

[x] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [x] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not

been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in

prosecution to the fullest extent of the law

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