The Patient Protection and Affordable
Care Act (the Affordable Care Act) was enacted on March 23, 2010.
Section 2712 of the PHS Act, as added by the Affordable Care Act,
and the Department's final regulation (26 CFR 54.9815-2712, 29 CFR
2590.715-2712, 45 CFR 147.2712) provides rules regarding
rescissions of health coverage for group health plans and health
insurance issuers offering group or individual health insurance
coverage. Under the statute and the final regulations, a group
health plan, or a health insurance issuer offering group or
individual health insurance coverage, generally must not rescind
coverage except in the case of fraud or an intentional
misrepresentation of a material fact. This standard applies to all
rescissions, whether in the group or individual insurance market,
or self-insured coverage. These rules also apply regardless of any
contestability period of the plan or issuer. PHS Act section 2712
adds a new advance notice requirement when coverage is rescinded
where still permissible. Specifically, the second sentence in
section 2712 provides that coverage may not be cancelled unless
prior notice is provided, and then only as permitted under PHS Act
sections 2702(c) and 2742(b). Under the final regulations, even if
prior notice is provided, rescission is only permitted in cases of
fraud or an intentional misrepresentation of a material fact as
permitted under the cited provisions
This ICR contains no program
changes. Adjustments to the burden estimates result from updated
estimates on the average number of participants in small plans, an
increase in the share of notices assumed to be transmitted
electronically, and increases in wage and postage rates. These
updated data inputs reduce the hour burden by two hours compared
with the prior submission and reduce the cost burden by $54
compared with the prior submission.
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:
(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;
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.