Information Comparision with Insurance Data

Forms and Documents

Document Name	Status
Form 1 Insurance Match File: Daily Reporting Electronically Form and Instruction	Modified
Form 1 Insurance Match File: Weekly Reporting Electronically Form and Instruction	Modified
Form 1 Insurance Match File: Monthly Reporting Electronically Form and Instruction	Modified
0970-0342_Insurance Match_Supporting_Statement.docx Supporting Statement A	2020-10-30

IC Document Collections

IC ID	Document Title	Status
228579	Insurance Match File: Daily Reporting Manually Other-Daily Reporting Manual Submission	Modified
228578	Insurance Match File: Daily Reporting Electronically Form and Instruction	Modified
228577	Insurance Match File: Weekly Reporting Electronically Form and Instruction	Modified
228576	Insurance Match File: Monthly Reporting Electronically Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0342	ICR Reference No: 202010-0970-006
Status: Active	Previous ICR Reference No: 201710-0970-004
Agency/Subagency: HHS/ACF	Agency Tracking No: OCSE
Title: Information Comparision with Insurance Data
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/05/2021
	Date Received in OIRA: 11/04/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2024	36 Months From Approved	01/31/2021
Responses	28,390	0	21,210
Time Burden (Hours)	2,818	0	2,102
Cost Burden (Dollars)	0	0	0

---

Abstract: The Insurance Match program is a cooperative effort between states, insurers, and the federal Office of Child Support Enforcement (OCSE) to help state child support agencies collect past-due child support from noncustodial parents. Using an efficient, secure, and cost-effective automated matching process, OCSE works with participating insurers to help states collect past-due support for families by comparing noncustodial parents active on the OCSE Debtor File to individuals eligible to receive a payment from an insurance claim, settlement, award, or payment (hereinafter, “claim”). State agency and insurer participation in the Insurance Match program is voluntary; however, there are 12 states that have specific mandates for insurers to report claims. The Insurance Match program assists with meeting these state mandates. This request is for a revision of a currently approved information collection. Changes since the previous approval pertain to an increase in the burden due to an increase in the number of participating insurers. The information collection instruments have not changed.

---

Authorizing Statute(s): US Code: 42 USC 652(m) Name of Law: Information Comparisons with Insurance Data
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 27745	05/11/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 68885	10/30/2020
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Insurance Match File: Monthly Reporting Electronically	1	OCSE Insurance Match Standard Input File Record
Insurance Match File: Weekly Reporting Electronically	1	OCSE Insurance Match Standard Input File Record
Insurance Match File: Daily Reporting Electronically	1	OCSE Insurance Match Standard Input File Record
Insurance Match File: Daily Reporting Manually

---

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	28,390	21,210	0	7,180	0	0
Annual Time Burden (Hours)	2,818	2,102	0	716	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The burden hour increased from the previous approval, from 2,102 hours to 2,817.21 hours. This adjustment is the result of an increase in the number of new Insurance Match program respondents from 111 to 145. The estimated average amount of time for each response is unchanged.

---

Annual Cost to Federal Government: $1,254,610

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.     Yes

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.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

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? No

---

Common Form ICR:  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:

(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: 11/04/2020

---