Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10488 English Cover Letter 2	Form and Instruction	Modified	Available
Form CMS-10488 English Cover Letter 2	Form and Instruction	Modified	Available
Form CMS-10488 Chinese Reminder Letter	Form	Modified	Available
Form CMS-10488 Chinese Prenotification Letter	Form	Modified	Available
Form CMS-10488 Chinese Cover Letter - 2	Form and Instruction	Modified	Available
Form CMS-10488 Cover Letter (Spanish)	Form and Instruction	Modified	Repair queued
Form CMS-10488 QHP Survey (Spanish)	Form and Instruction	Modified	Repair queued
Form CMS-10488 Cover Letter 1 (English)	Form and Instruction	Modified	Available
Form CMS-10488 QHP Survey (English)	Form and Instruction	Modified	Available
Form CMS-10488 Cover Letter (Chinese)	Form and Instruction	Modified	Repair queued
Form CMS-10488 2017 QHP Survey (Chinese)	Form and Instruction	Modified	Available
Form CMS-10488 Survey Vendor Application	Form and Instruction	Modified	Available
CMS-10488 - 2018 QHP Survey_Part B.docx	Supporting Statement B	Uploaded 2017-07-28	Available
CMS-10488 - 2018 QHP Survey_SSA 2017.docx	Supporting Statement A	Uploaded 2017-07-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	English Cover Letter 2
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	English Cover Letter 2
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form	Modified	Chinese Reminder Letter
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form	Modified	Chinese Prenotification Letter
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	Chinese Cover Letter - 2
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	Cover Letter (Spanish)
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	QHP Survey (Spanish)
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	Cover Letter 1 (English)
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	QHP Survey (English)
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	Cover Letter (Chinese)
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	2017 QHP Survey (Chinese)
210330	Adult Qualified Health Plan Enrollee Experience Survey	Form and Instruction	Modified	Survey Vendor Application

ICR Details

OMB Control No: 0938-1221	ICR Reference No: 201707-0938-017
Status: Historical Active	Previous ICR Reference No: 201610-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: 21457
Title: Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/13/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/02/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2020	36 Months From Approved	09/30/2017
Responses	90,015	0	105,015
Time Burden (Hours)	22,523	0	37,823
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1311(c)(4) of the ACA requires the Department of Health and Human Services (HHS) to develop an enrollee satisfaction survey system that assesses consumer experience with qualified health plans (QHPs) offered through an Exchange. It also requires public display of enrollee satisfaction information by the Exchange to allow individuals to easily compare enrollee satisfaction levels between comparable plans. CMS is developing, testing and implementing two surveys, a survey for adult enrollees in QHPs and a survey for health insurance Marketplace consumers. CMS is requesting approval for information collection associated with these surveys.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1311(c)(4) Name of Law: Affordable Care Act (ACA)
   PL: Pub.L. 111 - 148 1313 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1321(a) Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 17997	04/14/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 34529	07/25/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Adult Qualified Health Plan Enrollee Experience Survey	CMS-10488 , CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488	Survey Vendor Application ,   2017 QHP Survey (Chinese) ,   Cover Letter (Chinese) ,   QHP Survey (English) ,   Cover Letter 1 (English) ,   QHP Survey (Spanish) ,   Cover Letter (Spanish) ,   Chinese Cover Letter - 2 ,   Chinese Prenotification Letter ,   Chinese Reminder Letter ,   English Cover Letter 2 ,   English Cover Letter 2

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ICR Summary of Burden

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	90,015	105,015	0	0	-15,000	0
Annual Time Burden (Hours)	22,523	37,823	0	0	-15,300	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: The forecasted burden for implementing the 2018 - 2020 QHP Enrollee Survey has been reduced for two reasons. First, CMS has reduced its estimate for the number of reporting units that will be required to administer the survey. In previous Information Collection Reviews, CMS had been estimating that 350 reporting units would administer, while CMS is now estimating that 300 reporting units will be required to administer the QHP Enrollee Survey. This change reflects the reduced number of QHP issuers operating in the Exchange and the reduction of different product types offered by each issuer. There are currently 262 reporting units administering the 2017 QHP Enrollee Survey and CMS anticipates a similar number of reporting units in future administrations. Secondly, CMS has revised its estimate for the amount of time needed to complete the QHP Enrollee Survey to 15 minutes. Following the 2016 survey administration, HHS-approved survey vendors reported that on average telephone interviews took 16 minutes and respondents who completed the survey online completed the survey in approximately 13 minutes. Given that the 2018 questionnaire will be shortened by eight questions, CMS anticipates that respondents will be able to complete the QHP Enrollee Survey in 15 minutes or less. As a result of these changes CMS has reduced the burden estimates by 15,300 (3-year total decrease – 45,900) burden hours.

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Annual Cost to Federal Government: $5,100,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 08/02/2017

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