Information Collection Request

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

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

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10437.GenIC#21 CMS-10437.GenIC#21 - Guide for Testing Form500 (final 11-24-20) Form and Instruction New Available
Form CMS-10437.GenIC#20 CMS-10437.GenIC#20 -Qualitative Panel Survey (final) Form and Instruction New Available
Form CMS-10437.GenIC#23 CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument Form and Instruction New Available
Form CMS--10437.GenIC#2 Beneficiary Telemedicine Survey- Questionnaire Form and Instruction New Available
Form CMS-10437.GenIC#19 CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured Form and Instruction New Available
Form CMS-10437.GenIC#19 CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured Form and Instruction New Available
Form CMS-10437.GenIC#19 CMS-10437.GenIC#19. HIM pre-group workbook uninsured Form and Instruction New Available
Form CMS-10437.GenIC#19 CMS-10437.GenIC#19. HIM pre-group workbook insured Form and Instruction New Available
Form CMS-1037 GenIC#18 CMS-10437#18.Medicare Advantage Survey (Telephone Version) Form and Instruction New Available
Form CMS-10437- GenIC#1 Medicare Advantage Regional Outreach Experiment Survey (Online Version) Form and Instruction New Available
Form CMS-10437.GenIC#17 Formative Research and Materials Testing for Medicare Focus Group Guide Form and Instruction New Available
Form CMS-10437.GenIC#16 GenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx Form and Instruction New Available
Form CMS-10437.GenIC#14 Medicare Beneficiary Consumer Survey Form and Instruction New Available
Form 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 Web Intercept Survey Form and Instruction New Available
Form CMS-10437.GenIC#11 CMS Consumer Research on Websites and Tools Form and Instruction New Available
Form CMS-10437.GenIC#10 Quality Payment Program Provider Awareness Tracking Survey Form and Instruction New Available
Form CMS-10437.GenIC#8 Qualitative Testing Creative Materials Focus Group Guide Form and Instruction New Available
Form CMS-10437.GenIC#7 Marketplace 2017 Focus Group Guide Form and Instruction New Available
Form CMS-10437.GenIC#5 Consumer Survey of Marketplace Disenrollees Form and Instruction New Available
Form CMS-10437.GenIC#3 OMB OE POSTCAMPAIGN SURVEY.docx Form and Instruction New Available
Form CMS-10437.GenIC#3 OMB OE PRE CAMPAIGN SURVEY.docx 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 NewCMS-10437.GenIC#21 - Guide for Testing Form500 (final 11-24-20)
243004 GenIC#20 - Medicare Online Qualitative Panel Monthly Survey Form and Instruction NewCMS-10437.GenIC#20 -Qualitative Panel Survey (final)
242273 CMS-10437.GenIC#23 - OE Marketplace Customer Service Survey Form and Instruction NewCMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
242248 GenIC#22 - Medicare Telehealth Beneficiary Survey Form and Instruction NewBeneficiary Telemedicine Survey- Questionnaire
240055 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research Form and Instruction NewCMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured
240055 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research Form and Instruction NewCMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured
240055 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research Form and Instruction NewCMS-10437.GenIC#19. HIM pre-group workbook uninsured
240055 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research Form and Instruction NewCMS-10437.GenIC#19. HIM pre-group workbook insured
234140 GenIC#18 - Medicare Advantage Regional Outreach Experiment Survey Form and Instruction NewCMS-10437#18.Medicare Advantage Survey (Telephone Version)
234140 GenIC#18 - Medicare Advantage Regional Outreach Experiment Survey Form and Instruction NewMedicare Advantage Regional Outreach Experiment Survey (Online Version)
230136 CMS-10437.GenIC#17 - Formative Research and Materials Testing for Medicare Form and Instruction NewFormative Research and Materials Testing for Medicare Focus Group Guide
230129 GenIC#16 Qualitative Testing of Creative Materials for Medicare Form and Instruction NewGenIC#16 - MedicareCreativeTesting_FGguide_FINAL.docx
228104 CMS-10437.GenIC#14 - Medicare Beneficiary Consumer Survey Form and Instruction NewMedicare Beneficiary Consumer Survey
228103 CMS-10437.GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 Form and Instruction NewQualitative Research on Communications and Decision Support for Provider Initiatives 2017
228102 CMS-10437.GenIC #12 - Web Intercept Survey of HealthCare.gov Visitors Form and Instruction NewWeb Intercept Survey
228100 CMS-10437.GenIC#11 - CMS Consumer Research on Websites and Tools Form and Instruction NewCMS Consumer Research on Websites and Tools
228099 CMS-10437.GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey Form and Instruction NewQuality Payment Program Provider Awareness Tracking Survey
228098 CMS-10437.GenIC#8 - Qualitative Testing of Creative Materials Form and Instruction NewQualitative Testing Creative Materials Focus Group Guide
228096 CMS-10437.GenIC#7 - Formative Research on Communications and Decision Support in Marketplace 2017 Form and Instruction NewMarketplace 2017 Focus Group Guide
228095 CMS-10437.GenIC#5 - Consumer Survey of Marketplace Disenrollees Form and Instruction NewConsumer Survey of Marketplace Disenrollees
228094 CMS-10437.GenIC#3 - Medicare Open Enrollment Survey Form and Instruction NewOMB OE POSTCAMPAIGN SURVEY.docx
228094 CMS-10437.GenIC#3 - Medicare Open Enrollment Survey Form and Instruction NewOMB OE PRE CAMPAIGN SURVEY.docx

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 #12 - Web Intercept Survey of HealthCare.gov Visitors CMS-10437.GenIC#12
CMS-10437.GenIC#10 - Quality Payment Program Provider Awareness Tracking Survey CMS-10437.GenIC#10
CMS-10437.GenIC#11 - CMS Consumer Research on Websites and Tools CMS-10437.GenIC#11
CMS-10437.GenIC#13 - Qualitative Research on Communications and Decision Support for Provider Initiatives 2017 CMS-10437.GenIC#13
CMS-10437.GenIC#14 - Medicare Beneficiary Consumer Survey CMS-10437.GenIC#14
CMS-10437.GenIC#17 - Formative Research and Materials Testing for Medicare CMS-10437.GenIC#17
CMS-10437.GenIC#21 - Testing Form 500 CMS-10437.GenIC#21 - Guide for Testing Form500 (fi
CMS-10437.GenIC#23 - OE Marketplace Customer Service Survey CMS-10437.GenIC#23 - MarketplaceOESurveyInstrument
CMS-10437.GenIC#3 - Medicare Open Enrollment Survey CMS-10437.GenIC#3, CMS-10437.GenIC#3 ,  
CMS-10437.GenIC#5 - Consumer Survey of Marketplace Disenrollees CMS-10437.GenIC#5
CMS-10437.GenIC#7 - Formative Research on Communications and Decision Support in Marketplace 2017 CMS-10437.GenIC#7
CMS-10437.GenIC#8 - Qualitative Testing of Creative Materials CMS-10437.GenIC#8
CMS-10437.GenIc#19 - Marketplace Consumer Persona Research CMS-10437.GenIC#19. HIM pre-group workbook insured, CMS-10437.GenIC#19.HIM pre-group workbook uninsure, CMS-10437.GenIC#19, CMS-10437.GenIC#19 ,   ,   ,  
GenIC#16 Qualitative Testing of Creative Materials for Medicare CMS-10437.GenIC#16
GenIC#18 - Medicare Advantage Regional Outreach Experiment Survey CMS-10437- GenIC#18, CMS-1037 GenIC#18 ,  
GenIC#20 - Medicare Online Qualitative Panel Monthly Survey CMS-10437.GenIC#20
GenIC#22 - Medicare Telehealth Beneficiary Survey CMS--10437.GenIC#22

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