Information Collection Request

Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection (CMS-10488)

ICR 202407-0938-021 · OMB 0938-1221 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10488 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction Modified Repair queued
2025 Non-Substantive Change Request Memo (QHP Enrollee Survey-Chinese Internet) (004).pdf Justification for No Material/Nonsubstantive Change Uploaded 2024-07-31 Repair queued
2024-QHP-EnrollSurvey-SSA-508.docx Supporting Statement A Uploaded 2023-07-31 Repair queued
2024-QHP-EnrollSurvey-SS-B-508.docx Supporting Statement B Uploaded 2023-07-13 Repair queued
2024-QHP-Enrollee-Survey-Change-Crosswalk.docx Supplementary Document Uploaded 2023-07-13 Repair queued
2024-Responses-to-Public-Comments-to-the-QHP-Enrollee-Survey-Final.docx Supplementary Document Uploaded 2023-07-13 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
09/30/2026 09/30/2026
97,505 97,505
48,872 48,872
0 0





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 97,505 97,505 0 0 0 0
Annual Time Burden (Hours) 48,872 48,872 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No