Student Health Insurance Coverage (CMS-10377)

ICR 201907-0938-009

OMB: 0938-1157

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2019-07-30
IC Document Collections
IC ID
Document
Title
Status
200070
Modified
ICR Details
0938-1157 201907-0938-009
Active 201606-0938-006
HHS/CMS CCIIO
Student Health Insurance Coverage (CMS-10377)
Extension without change of a currently approved collection   No
Regular
Approved without change 08/29/2019
Retrieve Notice of Action (NOA) 07/30/2019
  Inventory as of this Action Requested Previously Approved
08/31/2022 36 Months From Approved 08/31/2019
1,331,824 0 1,254,988
52 0 49
0 0 0

Under the Student Health Insurance Final Rule, issuers of student health insurance are required to disclose to the student and any dependents in the insurance policy or certificate and any other written materials that the policy being issued does not meet all of the requirements under the Affordable Care Act.

US Code: 42 USC 18118(c) Name of Law: Public Health Service Act
  
US Code: 42 USC 18118(c) Name of Law: Public Health Service Act

Not associated with rulemaking

  83 FR 63647 12/11/2018
84 FR 10094 03/19/2019
No

1
IC Title Form No. Form Name
Student Health Insurance Notice Requirement

  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 1,331,824 1,254,988 0 0 76,836 0
Annual Time Burden (Hours) 52 49 0 0 3 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The burden hours for the AV and metal level disclosure has increased by 3 hours (from 49 to 52) due to the increase in the estimated number of issuers offering student health coverage.

$0
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.
07/30/2019


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