Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection (CMS-10595)

Forms and Documents

Document Name	Status
CMS-10595 - Notices Supporting Statement 090616.docx Supporting Statement A	2016-09-06

IC Document Collections

IC ID	Document Title	Status
219319	Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection – SEP Notice	Modified
219318	Third Party Payment Notification	Removed

ICR Details

OMB Control No: 0938-1301	ICR Reference No: 201604-0938-007
Status: Historical Active	Previous ICR Reference No: 201512-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection (CMS-10595)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/13/2016
	Date Received in OIRA: 04/14/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	36 Months From Approved
Responses	7,600	0	0
Time Burden (Hours)	3,800	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In proposed §156.1250, we are proposing to require entities that make third party payments of premiums on behalf of Qualified Health Plan enrollees to notify HHS, in a format and timeline specified in guidance. We expect that the notification would reflect the entity’s intent to make payments of premiums under this section and the number of consumers for whom it intends to make payments. We are considering whether we should expand the list of entities from whom issuers are required to accept payment under §156.1250 to include not-for-profit charitable organizations, beginning in 2018. In making this determination, we intend to carefully review the data provided by entities currently making third party premium payments to better understand the impact of these payments. We anticipate that any requirement to accept payments from not-for-profit charitable organizations would be limited to organizations that satisfy several criteria designed to minimize adverse selection. The data collection would exempt entities that are already providing the information to other HHS agencies, such as to the Health Resources and Services Administration (HRSA) or to the Indian Health Service (IHS). In such cases, we will work with the other agencies to avoid duplicative reporting. Under proposed §156.1256, a QHP issuer on a Federally-facilitated Exchange must, in the case of a plan or benefit display error included in §155.420(d)(4), notify their enrollees within 30 calendar days after the error is identified, if directed to do so by the FFE. We believe that enrollees should be made aware of any error that may have impacted their QHP selection and enrollment and any associated monthly or annual costs. Therefore, we are proposing a requirement for issuers to notify their enrollees of such error, should such error occur, as well as the availability of a special enrollment period, under §155.420(d)(4), for the enrollee to select a different QHP, if desired.

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Authorizing Statute(s): PL: Pub.L. 111 - 156 1311 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
   PL: Pub.L. 111 - 156 1312 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
   PL: Pub.L. 111 - 148 402 Name of Law: Indian Health Care Improvement Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1311 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
PL: Pub.L. 111 - 131 1312 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
PL: Pub.L. 111 - 148 402 Name of Law: Indian Health Care Improvement Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AS57	Final or interim final rulemaking	81 FR 12203	03/08/2016

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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: 1

IC Title	Form No.	Form Name
Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection – SEP Notice
Third Party Payment Notification

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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	7,600	0	8,100	0	-500	0
Annual Time Burden (Hours)	3,800	0	5,800	0	-2,000	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: No

Burden Reduction Due to:

Short Statement: This is a new information collection.

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Annual Cost to Federal Government:

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: 04/14/2016

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