Information Collection

CMS-10437.GenIc#19 - Marketplace Consumer Persona Research

IC 240055 under ICR 201708-0938-025 · OMB 0938-1247.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1247 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10437.GenIC#19 CMS-10437.GenIc#19 - Marketplace Consumer Persona Research	Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19. HIM pre-group workbook insured CMS-10437.GenIC#19. HIM pre-group workbook insured (final) 2-20-20.docx	Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19. HIM pre-group workbook uninsured CMS-10437.GenIC#19. HIM pre-group workbook uninsured (final) 2-20-20.docx	Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured (final) 2-20-20.docx	Form and Instruction
CMS-10437.GenIC#19 CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured (final) 2-20-20.docx	Form and Instruction
CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20.docx CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20	IC Document
CMS-10437.GenIC#19.MarketplacePersonaStudyInitiationRequest (final) 2-20-20.docx CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20	IC Document
CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20.docx CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20	IC Document

IC Title:

CMS-10437.GenIc#19 - Marketplace Consumer Persona Research

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	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 insured (final) 2-20-20.docx	Yes	No	Printable Only
Form and Instruction	CMS-10437.GenIC#19.HIM pre-group workbook uninsure	CMS-10437.GenIC#19. HIM pre-group workbook uninsured	CMS-10437.GenIC#19. HIM pre-group workbook uninsured (final) 2-20-20.docx	Yes	No	Printable Only
Form and Instruction	CMS-10437.GenIC#19	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Insured (final) 2-20-20.docx	Yes	No	Fillable Printable
Form and Instruction	CMS-10437.GenIC#19	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured	CMS-10437.GenIC#19.Marketplace Persona Focus Group Guide-Uninsured (final) 2-20-20.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 160

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20	CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20.docx	02/21/2020
CMS-10437.GenIC#19.MarketplacePersonaSupportingStatement (final)-2-20-20	CMS-10437.GenIC#19.MarketplacePersonaStudyInitiationRequest (final) 2-20-20.docx	02/21/2020
CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20	CMS-10437.GenIC#19.Justification for Providing Incentives (final)2-20-20.docx	02/21/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.