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
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.