Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment (CMS-10468)
ICR 201904-0938-006
OMB: 0938-1207
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1207 can be found here:
Essential Health Benefits in
Alternative Benefit Plans, Eligibility Notices, Fair Hearing and
Appeal Processes, and Premiums and Cost Sharing; Exchanges:
Eligibility and Enrollment (CMS-10468)
Prior to
publication of the final rule, the agency should provide to OMB a
summary of all comments received on the proposed information
collection and identify any changes made in response to these
comments.
Inventory as of this Action
Requested
Previously Approved
08/31/2020
36 Months From Approved
01/31/2021
13,236
0
13,236
138,899
0
138,899
53,773,570
0
53,773,570
The Patient Protection and Affordable
Care Act, Public Law 111-148, enacted on March 23, 2010, and the
Health Care and Education Reconciliation Act, Public Law 111-152,
enacted on March 30, 2010 (collectively, “Affordable Care Act”),
expands access to health insurance for individuals and employees of
small businesses through the establishment of new Affordable
Insurance Exchanges (Exchanges), including the Small Business
Health Options Program (SHOP). The Exchanges, which became
operational on January 1, 2014, enhanced competition in the health
insurance market, expanded access to affordable health insurance
for millions of Americans, and provided consumers with a place to
easily compare and shop for health insurance coverage. Benefit
Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and
Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment
(CMS-2334-F) address: (1) standards related to notices, (2)
procedures for the verification of enrollment in an eligible
employer-sponsored plan and eligibility for qualifying coverage in
an eligible employer-sponsored plan; and (3) other eligibility and
enrollment provisions to provide detail necessary for state
implementation. The submission seeks OMB approval of the
information collection requirements Sections 1311(b) and 1321(b) of
the Affordable Care Act provide that each state has the opportunity
to establish an Exchange that (1) facilitates the purchase of
insurance coverage by qualified individuals through QHPs; (2)
assists qualified employers in the enrollment of their employees in
QHPs; and (3) meets other standards specified in the Affordable
Care Act. Section 1311(k) of the Affordable Care Act specifies that
Exchanges may not establish rules that conflict with or prevent the
application of regulations promulgated by the Secretary. Section
1311(d) of the Affordable Care Act describes the minimum functions
of an Exchange, including the certification of QHPs.
As a result of the proposed new
information collection requirement for SEP verification in the
‘Patient Protection and Affordable Care Act; HHS Notice of Benefit
and Payment Parameters for 2020’, the burden hour is increasing by
4,700 hours. This is the only change in burden hours.
$5,306,600
No
No
No
Yes
No
No
Uncollected
Jamaa Hill 301 492-4190
No
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.
Form CMS-10468 Special Enrollment Periods
CMS-10468 - Supporting Statement NPRM.docx
Special Enrollment Periods