National Beneficiary Survey of State Health Insurance Assistance Program (SHIP)

ICR 201702-0985-002

OMB: 0985-0057

Federal Form Document

IC Document Collections
ICR Details
0985-0057 201702-0985-002
Historical Active
HHS/ACL
National Beneficiary Survey of State Health Insurance Assistance Program (SHIP)
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 08/28/2017
Retrieve Notice of Action (NOA) 02/23/2017
  Inventory as of this Action Requested Previously Approved
08/31/2020 36 Months From Approved
1,350 0 0
180 0 0
0 0 0

Abstract (2000 characters maximum) The National Beneficiary Surveys will gauge individuals’ satisfaction with the services they receive from the State Health Insurance Assistance (SHIP) and Senior Medicare Patrol (SMP) Programs. The survey will be the first of its kind to ascertain the quality and effectiveness of the services provided by the SHIP and SMP and to determine if beneficiaries are receiving accurate, relevant and timely information. The survey will be conducted over a three-year period beginning in Fiscal Year (FY) 2017, with multiple sites in each of the 50 states and the territories of Guam, Puerto Rico and the Virgin Islands being surveyed once. The SHIP program satisfaction survey will be conducted on a sample of beneficiaries who received assistance/counseling during two points in the year (one week in the spring and one week during the Annual Medicare Open Enrollment Period). The SMP program satisfaction survey will focus on education session presentations to determine if the target audience is satisfied with the information they are receiving. The results from these surveys will be used to measure satisfaction among individuals who receive assistance/counseling or among individuals who attend SMP education sessions, as well, as how the program can be improved to provide better service to its target population.

US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  81 FR 41974 06/28/2016
81 FR 78601 11/08/2016
No

1
IC Title Form No. Form Name
National Beneficiary Survey State Health Insurance Assistance Program (SHIP) 1 SHIP Phone Counseling Survey

  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 1,350 0 0 1,350 0 0
Annual Time Burden (Hours) 180 0 0 180 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection for the SHIP program.

$214,952
No
    No
    No
No
No
No
Uncollected
Mark Snyderman 202 795-7439

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
02/23/2017


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