Information Collection Request

Health Care Reform Insurance Web Portal Requirements 45 CFR part 159 (CMS-10320)

ICR 201707-0938-015 · OMB 0938-1086 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10320 Appendix D - Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendix C - Insurance Issuer and Product Level Data Form and Instruction Modified Repair queued
Form CMS-10320 CMS-10320 - Issuer - FINAL Instructions and Instruments Form and Instruction Modified Available
Form CMS-10320 Appendix D - Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendix C - Insurance Issuer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-1032 - .Issuer - FINAL Instructions and Instruments Form and Instruction Modified Repair queued
Form CMS-10320 Appendix D - Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendix C - Insurance Issuer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-10320 Issuer - FINAL Instructions and Instruments Form and Instruction Modified Available
Form CMS-10320 Appendix D - Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendix C - Insurance Issuer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments Form and Instruction Modified Available
Form CMS-10320 Appendix D - Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendix C - Insurance Issuer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments Form and Instruction Modified Available
Form CMS-10320 Appendix D - Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendix C - Issurance Issuer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments Form and Instruction Modified Repair queued
Form CMS-10320 Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendic C - Insurance Issuer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-10320 - Issuer - FINAL Instructions and Instruments Form and Instruction Modified Repair queued
Form CMS-10320 Appendix D - Data Collection 2017 Form and Instruction Modified Available
Form CMS-10320 Appendix C - Insurance Issurer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-10320 - Issuer - FINAL Instructions and Instruments Form and Instruction Modified Available
Form CMS-10320 Appendix D Form and Instruction Modified Available
Form CMS-10320 Appendix C Insurance Issuer and Product Level Data Form and Instruction Modified Available
Form CMS-10320 CMS-10320 - Issuer - Instructions and Instruments Form and Instruction Modified Available
Form CMS-10320 Appendix E - State Requirements Form and Instruction Modified Available
Form CMS-10320 State instructions and instruments Form and Instruction Modified Available
Form CMS-10320 Appendix E - State Requirements Form and Instruction Modified Available
Form CMS-10320 State Instructions and Instrument Form and Instruction Modified Available
Form CMS-10320 Appendix E - State Requirements Form and Instruction Modified Available
Form CMS-10320 Health Care Reform Insurance Web Portal Requirements - State Instructions and Instrument Form and Instruction Modified Available
60 Day Comments Response for KH 508 EJS.PDF Supplementary Document Uploaded 2017-07-27 Available
CMS -10320 - Supporting Statement 30-day 717.pdf Supporting Statement A Uploaded 2017-07-27 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
199284 Issuer - Attest (Small Group) Form and Instruction ModifiedAppendix D - Data Collection 2017
199284 Issuer - Attest (Small Group) Form and Instruction ModifiedAppendix C - Insurance Issuer and Product Level Data
199284 Issuer - Attest (Small Group) Form and Instruction ModifiedCMS-10320 - Issuer - FINAL Instructions and Instruments
199283 Issuer - Attest (Individual) Form and Instruction ModifiedAppendix D - Data Collection 2017
199283 Issuer - Attest (Individual) Form and Instruction ModifiedAppendix C - Insurance Issuer and Product Level Data
199283 Issuer - Attest (Individual) Form and Instruction ModifiedCMS-1032 - .Issuer - FINAL Instructions and Instruments
199282 Issuer - Troubleshoot (Small Group) Form and Instruction ModifiedAppendix D - Data Collection 2017
199282 Issuer - Troubleshoot (Small Group) Form and Instruction ModifiedAppendix C - Insurance Issuer and Product Level Data
199282 Issuer - Troubleshoot (Small Group) Form and Instruction ModifiedCMS-10320 Issuer - FINAL Instructions and Instruments
199281 Issuer - Troubleshoot (Individual) Form and Instruction ModifiedAppendix D - Data Collection 2017
199281 Issuer - Troubleshoot (Individual) Form and Instruction ModifiedAppendix C - Insurance Issuer and Product Level Data
199281 Issuer - Troubleshoot (Individual) Form and Instruction ModifiedCMS-10320.Issuer - FINAL Instructions and Instruments
199280 Issuer - Data Entry (Small Group) Form and Instruction ModifiedAppendix D - Data Collection 2017
199280 Issuer - Data Entry (Small Group) Form and Instruction ModifiedAppendix C - Insurance Issuer and Product Level Data
199280 Issuer - Data Entry (Small Group) Form and Instruction ModifiedCMS-10320.Issuer - FINAL Instructions and Instruments
199279 Issuer - Data Entry (Individual) Form and Instruction ModifiedAppendix D - Data Collection 2017
199279 Issuer - Data Entry (Individual) Form and Instruction ModifiedAppendix C - Issurance Issuer and Product Level Data
199279 Issuer - Data Entry (Individual) Form and Instruction ModifiedCMS-10320.Issuer - FINAL Instructions and Instruments
199278 Issuers - Submission Preparation (Small Group) Form and Instruction ModifiedData Collection 2017
199278 Issuers - Submission Preparation (Small Group) Form and Instruction ModifiedAppendic C - Insurance Issuer and Product Level Data
199278 Issuers - Submission Preparation (Small Group) Form and Instruction ModifiedCMS-10320 - Issuer - FINAL Instructions and Instruments
199277 Issuers - Submission Preparation (Individual) Form and Instruction ModifiedAppendix D - Data Collection 2017
199277 Issuers - Submission Preparation (Individual) Form and Instruction ModifiedAppendix C - Insurance Issurer and Product Level Data
199277 Issuers - Submission Preparation (Individual) Form and Instruction ModifiedCMS-10320 - Issuer - FINAL Instructions and Instruments
199276 Issuers Training and Communication Form and Instruction ModifiedAppendix D
199276 Issuers Training and Communication Form and Instruction ModifiedAppendix C Insurance Issuer and Product Level Data
199276 Issuers Training and Communication Form and Instruction ModifiedCMS-10320 - Issuer - Instructions and Instruments
199275 States - Data Collection Form and Instruction ModifiedAppendix E - State Requirements
199275 States - Data Collection Form and Instruction ModifiedState instructions and instruments
192726 States - Training, reviewing regulation, and analyzing data Form and Instruction ModifiedAppendix E - State Requirements
192726 States - Training, reviewing regulation, and analyzing data Form and Instruction ModifiedState Instructions and Instrument
192725 States - Data submission Form and Instruction ModifiedAppendix E - State Requirements
192725 States - Data submission Form and Instruction ModifiedHealth Care Reform Insurance Web Portal Requirements - State Instructions and Instrument

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2020 36 Months From Approved 12/31/2017
5,500 0 5,500
89,725 0 89,725
0 0 0





Reginfo record details
12
table that charts list of burden
IC Title Form No. Form Name
Issuer - Attest (Individual) CMS-10320, CMS-10320, CMS-10320 ,   ,  
Issuer - Attest (Small Group) CMS-10320, CMS-10320, CMS-10320 ,   ,  
Issuer - Data Entry (Individual) CMS-10320, CMS-10320, CMS-10320 ,   ,  
Issuer - Data Entry (Small Group) CMS-10320, CMS-10320, CMS-10320 ,   ,  
Issuer - Troubleshoot (Individual) CMS-10320, CMS-10320, CMS-10320 ,   ,  
Issuer - Troubleshoot (Small Group) CMS-10320, CMS-10320, CMS-10320 ,   ,  
Issuers - Submission Preparation (Individual) CMS-10320 , CMS-10320, CMS-10320 ,   ,  
Issuers - Submission Preparation (Small Group) CMS-10320, CMS-10320, CMS-10320 ,   ,  
Issuers Training and Communication CMS-10320, CMS-10320, CMS-10320 ,   ,  
States - Data submission CMS-10320, CMS-10320 ,  
States - Data Collection CMS-10320, CMS-10320 ,  
States - Training, reviewing regulation, and analyzing data CMS-10320, CMS-10320 ,  

table that charts list 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 5,500 5,500 0 0 0 0
Annual Time Burden (Hours) 89,725 89,725 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No