Information Collection

QHP Issuers for the Appointment Wait Time Secret Shopper Data Collection

IC 266278 under ICR 202408-0938-010 · OMB 0938-1415.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1415 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CMS-10803 - AWT-SSS-Tech-Guide-QHP-FFE-508.pdf Appointment Wait Time Guidance	IC Document

IC Title:

QHP Issuers for the Appointment Wait Time Secret Shopper Data Collection

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 156.230(a)(2)(B)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 171

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	171	171
Annual IC Time Burden (Hours)	245,214	245,214
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appointment Wait Time Guidance		12/16/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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