Information Collection Request

Health Care Reform Insurance Web Portal Requirements 45 CFR part 159 (CMS-10320)

ICR 202102-0938-012 · OMB 0938-1086 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10320 Issuer - Attest (Small Group) Form and Instruction Modified Missing upstream
Form CMS-10320 Issuer - Attest (Individual) Form and Instruction Modified Repair queued
Form CMS-10320 Issuer - Troubleshoot (Small Group) Form and Instruction Modified Missing upstream
Form CMS-10320 Issuer - Troubleshoot (Individual) Form and Instruction Unchanged Repair queued
Form CMS-10320 Issuer - Data Entry (Small Group) Form and Instruction Modified Repair queued
Form CMS-10320 Issuer - Data Entry (Individual) Form and Instruction Modified Repair queued
Form CMS-10320 Issuers - Submission Preparation (Small Group) Form and Instruction Modified Repair queued
Form CMS-10320 Issuers - Submission Preparation (Individual) Form and Instruction Modified Repair queued
Form CMS-10320 Issuers Training and Communication Form and Instruction Modified Repair queued
Form CMS-10320 States - Data Collection Form and Instruction Unchanged Repair queued
Form CMS-10320 States - Training, reviewing regulation, and analyzing data Form and Instruction Modified Repair queued
Form CMS-10320 States - Data submission Form and Instruction Modified Missing upstream
CMS 10320 Supporting Statement A_2020.docx Supporting Statement A Uploaded 2021-02-18 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
199284 Issuer - Attest (Small Group) Form and Instruction Modified
199283 Issuer - Attest (Individual) Form and Instruction Modified
199282 Issuer - Troubleshoot (Small Group) Form and Instruction Modified
199281 Issuer - Troubleshoot (Individual) Form and Instruction Unchanged
199280 Issuer - Data Entry (Small Group) Form and Instruction Modified
199279 Issuer - Data Entry (Individual) Form and Instruction Modified
199278 Issuers - Submission Preparation (Small Group) Form and Instruction Modified
199277 Issuers - Submission Preparation (Individual) Form and Instruction Modified
199276 Issuers Training and Communication Form and Instruction Modified
199275 States - Data Collection Form and Instruction Unchanged
192726 States - Training, reviewing regulation, and analyzing data Form and Instruction Modified
192725 States - Data submission Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
4,650 0
82,800 0
0 0





Reginfo record details
12
table that charts list of burden
IC Title Form No. Form Name
States - Data submission CMS-10320, CMS-10320 Health Care Reform Insurance Web Portal Requirements - State Instructions and Instrument ,   Appendix E - State Requirements
States - Training, reviewing regulation, and analyzing data CMS-10320, CMS-10320 State Instructions and Instrument ,   Appendix E - State Requirements
States - Data Collection CMS-10320, CMS-10320 State instructions and instruments ,   Appendix E - State Requirements
Issuers Training and Communication CMS-10320, CMS-10320, CMS-10320 Appendix C Insurance Issuer and Product Level Data ,   Appendix D ,   CMS-10320 - Issuer - Instructions and Instruments
Issuers - Submission Preparation (Individual) CMS-10320 , CMS-10320, CMS-10320 Appendix C - Insurance Issurer and Product Level Data ,   Appendix D - Data Collection 2021 ,   CMS-10320 - Issuer - FINAL Instructions and Instruments
Issuers - Submission Preparation (Small Group) CMS-10320, CMS-10320, CMS-10320 Data Collection 2020 ,   Appendic C - Insurance Issuer and Product Level Data ,   CMS-10320 - Issuer - FINAL Instructions and Instruments
Issuer - Data Entry (Individual) CMS-10320, CMS-10320, CMS-10320 Appendix C - Issurance Issuer and Product Level Data ,   Appendix D - Data Collection 2020 ,   CMS-10320.Issuer - FINAL Instructions and Instruments
Issuer - Data Entry (Small Group) CMS-10320, CMS-10320, CMS-10320 Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2020 ,   CMS-10320.Issuer - FINAL Instructions and Instruments
Issuer - Troubleshoot (Individual) CMS-10320, CMS-10320, CMS-10320 Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2017 ,   CMS-10320.Issuer - FINAL Instructions and Instruments
Issuer - Troubleshoot (Small Group) CMS-10320, CMS-10320, CMS-10320 Appendix D - Data Collection 2020 ,   Appendix C - Insurance Issuer and Product Level Data ,   CMS-10320 Issuer - FINAL Instructions and Instruments
Issuer - Attest (Individual) CMS-10320, CMS-10320, CMS-10320 Appendix C - Insurance Issuer and Product Level Data ,   Appendix D - Data Collection 2020 ,   CMS-1032 - .Issuer - FINAL Instructions and Instruments
Issuer - Attest (Small Group) CMS-10320, CMS-10320, CMS-10320 Appendix D - Data Collection ,   Appendix C - Insurance Issuer and Product Level Data ,   CMS-10320 - Issuer - FINAL Instructions and Instruments

table that charts list of burden
  Total Request 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 4,650 0 0 0 -850 5,500
Annual Time Burden (Hours) 82,800 0 0 0 -6,925 89,725
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No