Supporting Statement for Agent/Broker Consent Information Collection (CMS-10840)

ICR 202412-0938-007

OMB: 0938-1438

Federal Form Document

IC Document Collections
ICR Details
0938-1438 202412-0938-007
Received in OIRA 202304-0938-025
HHS/CMS CCIIO
Supporting Statement for Agent/Broker Consent Information Collection (CMS-10840)
Revision of a currently approved collection   No
Regular 12/11/2024
  Requested Previously Approved
36 Months From Approved 06/30/2026
9,800,600 4,948,029
1,666,601 841,385
52,268,080 26,388,358

The Patient Protection and Affordable Care Act, Public Law 111-148, enacted on March 23, 2010, and the Health Care and Education Reconciliation Act, Public Law 111-152, enacted on March 30, 2010 (collectively, “Affordable Care Act”), expanded access to health insurance for individuals and employees of small businesses through the establishment of new Affordable Insurance Exchanges (Exchanges), also called Marketplaces. The Exchanges, which became operational on January 1, 2014, enhance competition in the health insurance market, expand access to affordable health insurance for millions of Americans, and provide consumers with a place to easily compare and shop for health insurance coverage. Section 1312(e) of the Affordable Care Act directs the Secretary of the Department of Health and Human Services (HHS) to establish procedures under which a state may permit agents and brokers to enroll qualified individuals and employers into qualified health plans (QHPs) offered through an Exchange and to enable these agents and brokers to assist individuals in applying for advance payments of the premium tax credit and cost-sharing reductions. Authority for collection of this information comes from 45 C.F.R. §155.220(c)(5), which states that “HHS or its designee may periodically monitor and audit an agent, broker, or web-broker under this subpart to assess its compliance with the applicable requirements of this section.” This information collection specifically details what information will be required to be collected and maintained by agents, brokers, and web-brokers were they to receive a request from HHS for consent records. Currently, HHS only plans to collect information from a small percentage of agents, brokers, or web-brokers in conjunction with active investigations of potential fraud. Utilizing §155.220(c)(5) and the information to be collected under newly proposed §§ 155.220(j)(2)(ii)(A)(1-2) and 155.220(j)(2)(iii)(A-C), HHS will be able to verify whether or not an agent, broker, or web-broker has obtained consent from a consumer they are assisting in enrolling in coverage in the individual market, and whether the consumer has reviewed their eligibility information and confirmed its accuracy.

PL: Pub.L. 111 - 148 1312 Name of Law: Patient Protection and Affordable Care Act
   US Code: 45 USC 155.220 Name of Law: Exchange Establishment Standards and Other Related Standards under the Affordable Care Act
  
US Code: 45 USC 155.220 Name of Law: Exchange Establishment Standards and Other Related Standards under the Affordable Care Act
PL: Pub.L. 111 - 148 1312 Name of Law: Patient Protection and Affordable Care Act

0938-AV41 Proposed rulemaking 89 FR 82308 10/10/2024

No

  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 9,800,600 4,948,029 0 4,852,091 480 0
Annual Time Burden (Hours) 1,666,601 841,385 0 824,856 360 0
Annual Cost Burden (Dollars) 52,268,080 26,388,358 0 25,861,645 18,077 0
Yes
Miscellaneous Actions
No
There is an overall increase in the financial burden from the 2023 PRA package. The number of agents, brokers, or web-brokers that will produce retained records in limited circumstances related to fraud investigation or agency audits increased from 120 to 600, which is an increase of 480 agents, brokers, or web-brokers. Based on PY 2023 data, the number of policies submitted by agents increased from 4,947,909 to 9,800,000 policies, which is an increase of 4,852,091 policies. Lastly, an increase in labor costs contributed to the increase in burden costs. The total annual burden hours increased from 841,385 hours to 1,666,000, which is an increase of 824,615 hours. The estimated annual cost increased from $56,125,291.26 to $94,702,080, which is an increase of $38,576,788.74.

$68,142
No
    No
    No
Yes
No
No
No
Jamaa Hill 301 492-4190

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/11/2024


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