Information Collection Request

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

ICR 201703-0938-005 · OMB 0938-1205 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form CMS-10494 Recertification request by organization Form and Instruction Modified Repair queued
Form CMS-10494 155.225(b)(1) Organization designation by Exchange Information Updates Form and Instruction Modified Available
Form CMS-10494 155.225(d)(1) and (7) Training Quality Optional Questionnaire Form and Instruction Modified Available
Form CMS-10494 155.225(d)(1) - Training certificate retention Form and Instruction Modified Available
Form CMS-10494 155.225(d)(1) - Training certificate proof Form and Instruction Modified Available
Form CMS-10494 155.225(d)(1) - Training Registration Form and Instruction Modified Repair queued
Form CMS-10494 155.225(b)(1)(ii) - Identification number record retention Form and Instruction Modified Available
Form CMS-10494 155.225(b)(1)(ii) - Issuance of unique registration identification number Form and Instruction Modified Available
Form CMS-10494 155.225(d)(2) and (f) (CAC authorization to consumer) Form and Instruction Modified Repair queued
Form CMS-10494 155.225(b)(1)(i) (certificate issuance) Form and Instruction Modified Repair queued
Form CMS-10494 155.225(b)(1) (organization follow-up for application) Form and Instruction Modified Repair queued
Form CMS-10494 155.225(b)(1) (organization designation by Exchange) Form and Instruction Modified Available
CMS-10494 Supporting Statement FinalS.doc Supporting Statement A Uploaded 2017-03-13 Repair queued
CMS-10494 Supporting Statement Part Bx.pdf Supporting Statement B Uploaded 2017-03-06 Available
CMS-10494 - Appendix M Response_to_Public_Comments 508MM.PDF Supplementary Document Uploaded 2016-03-02 Available
IC Document Collections
IC IDCollectionTypeStatusForm
220357 ?155.225 (b)(ii) (performance tracking form by organization) Unchanged
220355 ?155.225 (b)(ii) (reporting performance data by certified application counselor) Unchanged
220354 ?155.225 (b)(ii) (recordkeeping performance data by organization) Unchanged
220353 ?155.225 (b)(1)(iii)- (reporting by organizations) Unchanged
220352 ?155.225 (b)(1)(iii)- (review by State Exchange) Unchanged
220351 ?155.225(b)(1)(iii)-(review byFederally-facilitatedExchange) Unchanged
216275 Recertification Training Unchanged
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 Modified
208216 155.225(d)(1) - Training certificate proof Form and Instruction Modified
208215 155.225(d)(1) - Training Registration Form and Instruction Modified
208214 155.225(b)(1)(ii) - Identification number record retention Form and Instruction Modified
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
0938-1205 201703-0938-005
Active 201603-0938-001
HHS/CMS CCIIO
Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel - CAC (CMS-10494)
Revision of a currently approved collection   No
Regular
Approved with change 03/27/2017
Retrieve Notice of Action (NOA) 03/13/2017
  Inventory as of this Action Requested Previously Approved
03/31/2020 36 Months From Approved 05/31/2018
4,851,018 0 4,676,018
855,821 0 693,701
0 0 0

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.

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
  
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

0938-AS57 Final or interim final rulemaking 81 FR 12203 03/16/2016

No

23
IC Title Form No. Form Name
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)
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(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) (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)

  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 4,851,018 4,676,018 145,000 0 30,000 0
Annual Time Burden (Hours) 855,821 693,701 154,620 0 7,500 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This revised collection increased the total time burden by 162,120 hours, from 693,701 hours to 855,821 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.

$100,660
No
No
Yes
No
No
Uncollected
Jamaa Hill 301 492-4190

  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.
03/13/2017