Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel -CAC (CMS-10494)

Forms and Documents

Document Name	Status
Form CMS-10494 Recertification request by organization Form and Instruction	Modified
Form CMS-10494 155.225(b)(1) Organization designation by Exchange Information Updates Form and Instruction	Modified
Form CMS-10494 155.225(d)(1) and (7) Training Quality Optional Questionnaire Form and Instruction	Modified
Form CMS-10494 155.225(d)(1) - Training certificate retention Form and Instruction	Unchanged
Form CMS-10494 155.225(d)(1) - Training certificate proof Form and Instruction	Unchanged
Form CMS-10494 155.225(d)(1) - Training Registration Form and Instruction	Unchanged
Form CMS-10494 155.225(b)(1)(ii) - Identification number record retention Form and Instruction	Unchanged
Form CMS-10494 155.225(b)(1)(ii) - Issuance of unique registration identification number Form and Instruction	Modified
Form CMS-10494 155.225(d)(2) and (f) (CAC authorization to consumer) Form and Instruction	Modified
Form CMS-10494 155.225(b)(1)(i) (certificate issuance) Form and Instruction	Modified
Form CMS-10494 155.225(b)(1) (organization follow-up for application) Form and Instruction	Modified
Form CMS-10494 155.225(b)(1) (organization designation by Exchange) Form and Instruction	Modified
CMS-10494 - Appendix M Response_to_Public_Comments 508MM.PDF Supplementary Document	2016-03-02
CMS-10494 Supporting Statement Part B.pdf Supporting Statement B	2016-03-01
CMS-10494 Supporting Statement Rev15.doc Supporting Statement A	2016-03-02

IC Document Collections

IC ID	Document Title	Status
220357	?155.225 (b)(ii) (performance tracking form by organization)	New
220355	?155.225 (b)(ii) (reporting performance data by certified application counselor)	New
220354	?155.225 (b)(ii) (recordkeeping performance data by organization)	New
220353	?155.225 (b)(1)(iii)- (reporting by organizations)	New
220352	?155.225 (b)(1)(iii)- (review by State Exchange)	New
220351	?155.225(b)(1)(iii)-(review byFederally-facilitatedExchange)	New
216275	Recertification Training	Modified
216274	Recertification request by organization Form and Instruction	Modified
216273	CAC Recertification	Unchanged
216272	155.225(b)(1) Organization designation by Exchange Information Updates Form and Instruction	Modified
216271	155.225(d)(1) and (7) Training Quality Optional Questionnaire Form and Instruction	Modified
208217	155.225(d)(1) - Training certificate retention Form and Instruction	Unchanged
208216	155.225(d)(1) - Training certificate proof Form and Instruction	Unchanged
208215	155.225(d)(1) - Training Registration Form and Instruction	Unchanged
208214	155.225(b)(1)(ii) - Identification number record retention Form and Instruction	Unchanged
208213	155.225(b)(1)(ii) - Issuance of unique registration identification number Form and Instruction	Modified
207940	155.225(d)(2) and (f) (CAC authorization to consumer) Form and Instruction	Modified
207939	155.225(d)(2) and (f) (organization record of authorization)	Unchanged
207938	155.225(b)(1)(i) (certificate issuance) Form and Instruction	Modified
207937	155.225(b)(1) (organization list)	Unchanged
207874	155.225(b)(1)(i) (organization attestation)	Unchanged
207873	155.225(b)(1) (organization follow-up for application) Form and Instruction	Modified
207872	155.225(b)(1) (organization designation by Exchange) Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1205	ICR Reference No: 201603-0938-001
Status: Historical Inactive	Previous ICR Reference No: 201504-0938-012
Agency/Subagency: HHS/CMS	Agency Tracking No: 20316
Title: Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel -CAC (CMS-10494)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 06/15/2016
	Date Received in OIRA: 03/02/2016
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2018	36 Months From Approved	05/31/2018
Responses	4,676,018	0	4,676,018
Time Burden (Hours)	693,701	0	693,701
Cost Burden (Dollars)	0	0	0

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Abstract: 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 are being 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.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1413 Name of Law: Streamlining of procedures for enrollment through an exchange
   PL: Pub.L. 111 - 148 1321(a)(1)(A) and (D) Name of Law: State Flexibility in Operation and Enforcement of Exchanges and Related Requirements
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1321(A) and (D) Name of Law: State Flexibility in Operation and Enforcement of Exchanges and Related Requirements
PL: Pub.L. 111 - 148 1413 Name of Law: Streamlining of procedures for enrollment through an exchange

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS57	Proposed rulemaking	80 FR 75487	12/02/2015

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 23

IC Title	Form No.	Form Name
Recertification Training
155.225(d)(1) and (7) Training Quality Optional Questionnaire	CMS-10494	Training Quality Questionnaire
155.225(b)(1) Organization designation by Exchange Information Updates	CMS-10494	Find Local Help Instrument
CAC Recertification
Recertification request by organization	CMS-10494	Recertification Request Form
155.225(b)(1) (organization designation by Exchange)	CMS-10494	Individual CAC Agreement
155.225(b)(1) (organization follow-up for application)	CMS-10494	CAC Organization Application
155.225(b)(1)(i) (organization attestation)
155.225(b)(1)(i) (certificate issuance)	CMS-10494, CMS-10494, CMS-10494	Training Certificate ,   Training Certificate (English) ,   Sample Certification Certificate (Spanish)
155.225(d)(2) and (f) (organization record of authorization)
155.225(d)(2) and (f) (CAC authorization to consumer)	CMS-10494, CMS-10494, CMS-10494	CAC Agreement ,   Model Authorization Form (English) ,   Model Authorization Form (Spanish)
155.225(b)(1)(ii) - Issuance of unique registration identification number	CMS-10494	Registration Portal
155.225(b)(1)(ii) - Identification number record retention	CMS-10494	Registration
155.225(d)(1) - Training Registration	CMS-10494	Registration
155.225(d)(1) - Training certificate proof	CMS-10494	Registration
155.225(b)(1) (organization list)
155.225(d)(1) - Training certificate retention	CMS-10494	Registration
§155.225(b)(1)(iii)-(review byFederally-facilitatedExchange)
§155.225 (b)(1)(iii)- (reporting by organizations)
§155.225 (b)(ii) (recordkeeping performance data by organization)
§155.225 (b)(ii) (reporting performance data by certified application counselor)
§155.225 (b)(ii) (performance tracking form by organization)
§155.225 (b)(1)(iii)- (review by State Exchange)

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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: This revised collection increased the total time burden by 163,432 hours, from 693,701 hours to 857,133 hours. The change in burden is mainly due to newly proposed requirements associated with tracking performance data and information by each certified application counselor and designated organization. There are additional requirements being proposed related to reporting of performance data and information by each certified application counselor organization to an Exchange, and the review of that data and information by the Exchange to which it has been submitted. CMS inadvertently overlooked the burden associated with CMS' review of the optional training quality user questionnaire and is additional burden associated with the collection in this proposed submission.

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Annual Cost to Federal Government: $100,660

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 03/02/2016

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