State-based Marketplace Annual Reporting Tool (SMART) (CMS-10507)

Forms and Documents

Document Name	Status
Form CMS-10507 State-based Marketplace Annual Reporting Tool (SMART) Form and Instruction	Modified
CMS-10507 - Change Request Memo.docx Supplementary Document	2017-12-20
CMS-10507 -Supporting Statement_SMART_30 Day.docx Supporting Statement A	2017-08-24

IC Document Collections

IC ID	Document Title	Status
210245	State-based Marketplace Annual Reporting Tool (SMART) Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1244	ICR Reference No: 201708-0938-018
Status: Historical Active	Previous ICR Reference No: 201612-0938-013
Agency/Subagency: HHS/CMS	Agency Tracking No: 21393
Title: State-based Marketplace Annual Reporting Tool (SMART) (CMS-10507)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/20/2017
	Date Received in OIRA: 08/31/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2020	36 Months From Approved
Responses	17	0	0
Time Burden (Hours)	1,173	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Affordable Care Act (ACA). The ACA creates new competitive private health insurance markets - referred to as State-based Marketplaces (SBMs) - that will give millions of Americans and small businesses access to affordable healthcare coverage. HHS provides oversight and monitoring of SBMs to ensure they maintain adequate operational systems. Effective and efficient oversight of Marketplaces will help ensure that affordable and quality health coverage is available to all Americans through monitoring, reporting, and oversight of financial and other Marketplace activities. The SMAR is the primary vehicle to insure comprehensive compliance with all reporting requirements contained in the ACA and applicable Federal Regulations. It is specifically called for in Section 1313(a)(1) of the Act which requires an SBM to keep an accurate accounting of all activities, receipts, and expenditures, and to submit a report annually to the Secretary concerning such accounting. Instructions governing specific facets of the activities covered by the report are contained both in the Act and in various sections of applicable Federal Regulations. CMS has designed the SMAR to reduce the data collection to the maximum extent possible. While it is intended as a comprehensive compliance review to ensure SBM are fulfilling their statutory requirements, very little additional data gathering is required to complete the form. The respondents can answer most questions by attestations and uploading existing documents. Respondents complete the report entirely online.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1313(a)(1) Name of Law: Affordable Care Act

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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 23007	05/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 40157	08/24/2017
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
State-based Marketplace Annual Reporting Tool (SMART)	CMS-10507	2017 - SMART Tool

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ICR Summary 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	17	0	0	0	-2	19
Annual Time Burden (Hours)	1,173	0	0	0	-138	1,311
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: OMB previously approved this information collection in July 2014, with a total of 1,331 burden hours for 19 SBMs. Since the original approval, there have been two non-substantial changes approvals. The following changes have been made to the information collection: removal of the Executive Summary, State Blueprint Profiles, and Technology, Privacy and Security sections, and converting eligibility and enrollment and consumer assistance tool information from the Exchange Final Rule information collection and performance monitoring data information from the Establishment Grant information collection into attestations. This revision amends the total number of SBMs and SBM-FPs from 19 to 17 to reflect the current number of respondents. As a result, there is a total reduction of 138 hours.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 08/31/2017

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