Information Collection Request

Generic Social Marketing & Consumer Testing Research (CMS-10437)

ICR 201708-0938-025 · OMB 0938-1247 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10437.GenIC#21 CMS-10437.GenIC#21 - Testing Form 500 Form and Instruction New Available
Form CMS-10437.GenIC#20 GenIC#20 - Medicare Online Qualitative Panel Monthly Survey Form and Instruction New Available
Form CMS-10437.GenIC#23 CMS-10437.GenIC#23 - OE Marketplace Customer Service Survey Form and Instruction New Available
Form CMS--10437.GenIC#2 GenIC#22 - Medicare Telehealth Beneficiary Survey Form and Instruction New Available
Form CMS-10437.GenIC#19 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research Form and Instruction New Available
Form CMS-10437- GenIC#1 GenIC#18 - Medicare Advantage Regional Outreach Experiment Survey Form and Instruction New Available
Form CMS-10437.GenIC#17 CMS-10437.GenIC#17 - Formative Research and Materials Testing for Medicare Form and Instruction New Available
Form CMS-10437.GenIC#16 GenIC#16 Qualitative Testing of Creative Materials for Medicare Form and Instruction New Available
Form CMS-10437.GenIC#14 CMS-10437.GenIC#14 - Medicare Beneficiary Consumer Survey Form and Instruction New Available
Form CMS-10437.GenIC#13 CMS-10437.GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 Form and Instruction New Available
Form CMS-10437.GenIC#12 CMS-10437.GenIC #12 - Web Intercept Survey of HealthCare.gov Visitors Form and Instruction New Available
Form CMS-10437.GenIC#11 CMS-10437.GenIC#11 - CMS Consumer Research on Websites and Tools Form and Instruction New Available
Form CMS-10437.GenIC#10 CMS-10437.GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey Form and Instruction New Available
Form CMS-10437.GenIC#8 CMS-10437.GenIC#8 - Qualitative Testing of Creative Materials Form and Instruction New Available
Form CMS-10437.GenIC#7 CMS-10437.GenIC#7 - Formative Research on Communications and Decision Support in Marketplace 2017 Form and Instruction New Available
Form CMS-10437.GenIC#5 CMS-10437.GenIC#5 - Consumer Survey of Marketplace Disenrollees Form and Instruction New Available
Form CMS-10437.GenIC#3 CMS-10437.GenIC#3 - Medicare Open Enrollment Survey Form and Instruction New Available
CMS-10437.GenericExtension_Supporting Statement A_FINAL-12-21-17.doc Supporting Statement A Uploaded 2017-12-21 Available
CMS-10437.GenericSMTestingItemBank_FINAL.docx Supplementary Document Uploaded 2017-08-30 Available
CMS-10437.GenericExtension_Supporting Statement B_FINAL 12-21-17.docx Supporting Statement B Uploaded 2017-12-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
244633 CMS-10437.GenIC#21 - Testing Form 500 Form and Instruction New
243004 GenIC#20 - Medicare Online Qualitative Panel Monthly Survey Form and Instruction New
242273 CMS-10437.GenIC#23 - OE Marketplace Customer Service Survey Form and Instruction New
242248 GenIC#22 - Medicare Telehealth Beneficiary Survey Form and Instruction New
240055 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research Form and Instruction New
234140 GenIC#18 - Medicare Advantage Regional Outreach Experiment Survey Form and Instruction New
230136 CMS-10437.GenIC#17 - Formative Research and Materials Testing for Medicare Form and Instruction New
230129 GenIC#16 Qualitative Testing of Creative Materials for Medicare Form and Instruction New
228104 CMS-10437.GenIC#14 - Medicare Beneficiary Consumer Survey Form and Instruction New
228103 CMS-10437.GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 Form and Instruction New
228102 CMS-10437.GenIC #12 - Web Intercept Survey of HealthCare.gov Visitors Form and Instruction New
228100 CMS-10437.GenIC#11 - CMS Consumer Research on Websites and Tools Form and Instruction New
228099 CMS-10437.GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey Form and Instruction New
228098 CMS-10437.GenIC#8 - Qualitative Testing of Creative Materials Form and Instruction New
228096 CMS-10437.GenIC#7 - Formative Research on Communications and Decision Support in Marketplace 2017 Form and Instruction New
228095 CMS-10437.GenIC#5 - Consumer Survey of Marketplace Disenrollees Form and Instruction New
228094 CMS-10437.GenIC#3 - Medicare Open Enrollment Survey Form and Instruction New

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
61,992 0 41,592
26,588 0 21,488
0 0 0





Reginfo record details
17
table that charts list of burden
IC Title Form No. Form Name
CMS-10437.GenIC#7 - Formative Research on Communications and Decision Support in Marketplace 2017 CMS-10437.GenIC#7 Marketplace 2017 Focus Group Guide
CMS-10437.GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey CMS-10437.GenIC#10 Quality Payment Program Provider Awareness Tracking Survey
CMS-10437.GenIC#14 - Medicare Beneficiary Consumer Survey CMS-10437.GenIC#14 Medicare Beneficiary Consumer Survey
CMS-10437.GenIC#11 - CMS Consumer Research on Websites and Tools CMS-10437.GenIC#11 CMS Consumer Research on Websites and Tools
CMS-10437.GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 CMS-10437.GenIC#13 Qualitative Research on Communications and Decision Support for Provider Initiatives 2017
CMS-10437.GenIC#17 - Formative Research and Materials Testing for Medicare CMS-10437.GenIC#17 Formative Research and Materials Testing for Medicare Focus Group Guide
CMS-10437.GenIc#19 - Marketplace Consumer Persona Research CMS-10437.GenIC#19.HIM pre-group workbook uninsure, CMS-10437.GenIC#19, CMS-10437.GenIC#19, CMS-10437.GenIC#19. HIM pre-group workbook insured CMS-10437.GenIC#19. HIM pre-group workbook insured ,   CMS-10437.GenIC#19. HIM pre-group workbook uninsured ,   CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured ,   CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured
CMS-10437.GenIC#3 - Medicare Open Enrollment Survey CMS-10437.GenIC#3, CMS-10437.GenIC#3 OMB OE PRE CAMPAIGN SURVEY.docx ,   OMB OE POSTCAMPAIGN SURVEY.docx
GenIC#16 Qualitative Testing of Creative Materials for Medicare CMS-10437.GenIC#16 GenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx
GenIC#20 - Medicare Online Qualitative Panel Monthly Survey CMS-10437.GenIC#20 CMS-10437.GenIC#20 -Qualitative Panel Survey (final)
CMS-10437.GenIC#23 - OE Marketplace Customer Service Survey CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
CMS-10437.GenIC#21 - Testing Form 500 CMS-10437.GenIC#21 - Guide for Testing Form500 (fi CMS-10437.GenIC#21 - Guide for Testing Form500 (final 11-24-20)
CMS-10437.GenIC#5 - Consumer Survey of Marketplace Disenrollees CMS-10437.GenIC#5 Consumer Survey of Marketplace Disenrollees
GenIC#22 - Medicare Telehealth Beneficiary Survey CMS--10437.GenIC#22 Beneficiary Telemedicine Survey- Questionnaire
CMS-10437.GenIC#8 - Qualitative Testing of Creative Materials CMS-10437.GenIC#8 Qualitative Testing Creative Materials Focus Group Guide
GenIC#18 - Medicare Advantage Regional Outreach Experiment Survey CMS-10437- GenIC#18, CMS-1037 GenIC#18 Medicare Advantage Regional Outreach Experiment Survey (Online Version) ,   CMS-10437#18.Medicare Advantage Survey (Telephone Version)
CMS-10437.GenIC #12 - Web Intercept Survey of HealthCare.gov Visitors CMS-10437.GenIC#12 Web Intercept Survey

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 61,992 41,592 0 0 20,400 0
Annual Time Burden (Hours) 26,588 21,488 0 0 5,100 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No