Minimum Essential Coverage (CMS-10465)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10465 Minimum Essential Coverage Certification (optional Excel file)	Form	Modified	Available
Form CMS-10465 Minimum Essential Coverage Certification	Form and Instruction	Modified	Available
CMS-10465 - MEC - Supporting Statement Part A Final.docx	Supporting Statement A	Uploaded 2019-08-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
205752	Minimum Essential Coverage Certification	Form	Modified	Minimum Essential Coverage Certification (optional Excel file)
205752	Minimum Essential Coverage Certification	Form and Instruction	Modified	Minimum Essential Coverage Certification

ICR Details

OMB Control No: 0938-1189	ICR Reference No: 201907-0938-007
Status: Historical Active	Previous ICR Reference No: 201606-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Minimum Essential Coverage (CMS-10465)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/17/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/30/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2022	36 Months From Approved	09/30/2019
Responses	10	0	10
Time Burden (Hours)	53	0	53
Cost Burden (Dollars)	2,200	0	2,200

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Abstract: The NPRM titled "Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage Provisions" proposes to designate certain types of health coverage as minimum essential coverage. Other types of coverage, not statutorily designated and not designated as minimum essential coverage in this regulation, may be recognized as minimum essential coverage if certain substantive and procedural requirements are met. The proposed rule would require coverage recognized to be minimum essential coverage to offer substantially the same consumer protections as those enumerated in the Title I of Affordable Care Act relating to non-grandfathered, individual coverage to ensure consumers are receiving adequate coverage. The proposed rule would require sponsors of individual coverage that seek to have such coverage designated as minimum essential coverage to adhere to certain procedures. Sponsoring organizations would have to submit to HHS information about their coverage and an attestation that the plan substantially complies with the provisions of Title I of the Affordable Care Act as applicable to non-grandfathered individual health insurance coverage. Sponsors would also have to a notice to enrollees informing them that the plan has been designated minimum essential coverage for the purposes of the individual coverage requirement.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1501 Name of Law: Amendment to the Internal Revenue Code
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 64843	12/18/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 10094	03/19/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Minimum Essential Coverage Certification	CMS-10465, CMS-10465	Minimum Essential Coverage Certification ,   Minimum Essential Coverage Certification (optional Excel file)

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ICR Summary of Burden

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	10	10	0	0	0	0
Annual Time Burden (Hours)	53	53	0	0	0	0
Annual Cost Burden (Dollars)	2,200	2,200	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $3,295

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/30/2019

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