Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection (CMS-10595)

Forms and Documents

Document Name	Status
CMS-10595 - Supporting Statement 30-day.docx Supporting Statement A	2019-09-26

IC Document Collections

IC ID	Document Title	Status
219319	Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection – SEP Notice	Modified

ICR Details

OMB Control No: 0938-1301	ICR Reference No: 201909-0938-014
Status: Active	Previous ICR Reference No: 201604-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection (CMS-10595)
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: 01/03/2020
	Date Received in OIRA: 09/26/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2023	36 Months From Approved	01/31/2020
Responses	505	0	7,600
Time Burden (Hours)	1,700	0	3,800
Cost Burden (Dollars)	0	0	0

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Abstract: In the final rule, the Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017 (CMS-9937-F), we finalized 45 CFR 156.1256, which requires QHP issuers, in the case of a material plan or benefit display error included in 45 CFR 155.420(d)(12), to notify their enrollees of the error and the enrollees’ eligibility for a special enrollment period within 30 calendar days after the issuer is informed by an Federally- facilitated Exchange (FFE) that the error is corrected, if directed to do so by the FFE. This requirement provides notification to QHP enrollees of errors that may have impacted their QHP selection and enrollment and any associated monthly or annual costs, as well as the availability of a special enrollment period under §155.420(d)(12) for the enrollee to select a different QHP, if desired. The Centers for Medicare and Medicaid Services (CMS) is renewing this information collection request (ICR) in connection with these standards. The burden estimate for this ICR included in this package reflects the time and effort for QHP issuers to provide notifications to enrollees.

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Authorizing Statute(s): PL: Pub.L. 111 - 156 1311 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
   PL: Pub.L. 111 - 156 1312 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
   PL: Pub.L. 111 - 148 402 Name of Law: Indian Health Care Improvement Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 131 1312 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
PL: Pub.L. 111 - 148 1311 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
PL: Pub.L. 111 - 148 402 Name of Law: Indian Health Care Improvement Act

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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:
	84 FR 36099	07/26/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 50455	09/25/2019
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Third Party Payment of QHP Premiums and Additional Notices for QHP Issuers Data Collection – SEP Notice

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ICR Summary 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	505	7,600	0	0	-7,095	0
Annual Time Burden (Hours)	1,700	3,800	0	0	-2,100	0
Annual Cost Burden (Dollars)	0	0	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: Note The Agency inadvertently submitted an incorrect total number of respondents in the previous submission to OMB. The number of respondents should have been 475 issuers; however, the Agency submitted a total of 7,600 respondents. The number of burden hours have been reduced from 3,800 hours to 1,700 hours annually (a total reduction of 2,100 burden hours). These changes are due to the lower number of actual enrollees (8.4 million) compared to the higher number of anticipated enrollees in 2016(19 million) in the FFEs and SBE-FPs. The number of respondents (issuers) have increased from 475 to 505, a total increase of 30.

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Annual Cost to Federal Government: $0

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: 09/26/2019

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