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 Issuer - Attest (Small Group) Form and Instruction Modified Available
Form CMS-10320 Issuer - Attest (Individual) Form and Instruction Modified Repair queued
Form CMS-10320 Issuer - Troubleshoot (Small Group) Form and Instruction Modified Available
Form CMS-10320 Issuer - Troubleshoot (Individual) Form and Instruction Modified Available
Form CMS-10320 Issuer - Data Entry (Small Group) Form and Instruction Modified Available
Form CMS-10320 Issuer - Data Entry (Individual) Form and Instruction Modified Repair queued
Form CMS-10320 Issuers - Submission Preparation (Small Group) Form and Instruction Modified Repair queued
Form CMS-10320 Issuers - Submission Preparation (Individual) Form and Instruction Modified Available
Form CMS-10320 Issuers Training and Communication Form and Instruction Modified Available
Form CMS-10320 States - Data Collection Form and Instruction Modified Available
Form CMS-10320 States - Training, reviewing regulation, and analyzing data Form and Instruction Modified Available
Form CMS-10320 States - Data submission 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 Modified
199283 Issuer - Attest (Individual) Form and Instruction Modified
199282 Issuer - Troubleshoot (Small Group) Form and Instruction Modified
199281 Issuer - Troubleshoot (Individual) Form and Instruction Modified
199280 Issuer - Data Entry (Small Group) Form and Instruction Modified
199279 Issuer - Data Entry (Individual) Form and Instruction Modified
199278 Issuers - Submission Preparation (Small Group) Form and Instruction Modified
199277 Issuers - Submission Preparation (Individual) Form and Instruction Modified
199276 Issuers Training and Communication Form and Instruction Modified
199275 States - Data Collection Form and Instruction Modified
192726 States - Training, reviewing regulation, and analyzing data Form and Instruction Modified
192725 States - Data submission Form and Instruction Modified

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





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table that charts list of burden
IC Title Form No. Form Name
States - Data submission CMS-10320, CMS-10320 Health Care Reform Insurance Web Portal Requirements - State Instructions and Instrument ,   Appendix E - State Requirements
States - Training, reviewing regulation, and analyzing data CMS-10320, CMS-10320 State Instructions and Instrument ,   Appendix E - State Requirements
States - Data Collection CMS-10320, CMS-10320 State instructions and instruments ,   Appendix E - State Requirements
Issuers Training and Communication CMS-10320, CMS-10320, CMS-10320 CMS-10320 - Issuer - Instructions and Instruments ,   Appendix C Insurance Issuer and Product Level Data ,   Appendix D
Issuers - Submission Preparation (Individual) CMS-10320 , CMS-10320, CMS-10320 CMS-10320 - Issuer - FINAL Instructions and Instruments ,   Appendix C - Insurance Issurer and Product Level Data ,   Appendix D - Data Collection 2017
Issuers - Submission Preparation (Small Group) CMS-10320, CMS-10320, CMS-10320 CMS-10320 - Issuer - FINAL Instructions and Instruments ,   Appendic C - Insurance Issuer and Product Level Data ,   Data Collection 2017
Issuer - Data Entry (Individual) CMS-10320, CMS-10320, CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments ,   Appendix C - Issurance Issuer and Product Level Data ,   Appendix D - Data Collection 2017
Issuer - Data Entry (Small Group) CMS-10320, CMS-10320, CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments ,   Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2017
Issuer - Troubleshoot (Individual) CMS-10320, CMS-10320, CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments ,   Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2017
Issuer - Troubleshoot (Small Group) CMS-10320, CMS-10320, CMS-10320 CMS-10320 Issuer - FINAL Instructions and Instruments ,   Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2017
Issuer - Attest (Individual) CMS-10320, CMS-10320, CMS-10320 CMS-1032 - .Issuer - FINAL Instructions and Instruments ,   Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2017
Issuer - Attest (Small Group) CMS-10320, CMS-10320, CMS-10320 CMS-10320 - Issuer - FINAL Instructions and Instruments ,   Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2017

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
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