Information Collection Request

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

ICR 202607-0938-016 · OMB 0938-1221 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10488 QHP Enrollee Survey Reminder Email - Chinese Form Modified Available
Form CMS-10488 QHP - QHP Enrollee Survey Notification Email - Chinese Form Modified Available
Form CMS-10488 QHP Enrollee Survey Internet Script - Chinese Form Modified Available
Form CMS-10488 Enrollee Survey Reminder Letter - Spanish Form Modified Available
Form CMS-10488 Prenotification Letter (Spanish) Form Modified Available
Form CMS-10488 Prenotification Letter - English Form Modified Available
Form CMS-10488 English Cover Letter 2 Form and Instruction Modified Available
Form CMS-10488 English Cover Letter 2 Form and Instruction Modified Available
Form CMS-10488 Chinese Reminder Letter Form Modified Available
Form CMS-10488 Chinese Prenotification Letter Form Modified Available
Form CMS-10488 Chinese Cover Letter - 2 Form and Instruction Modified Available
Form CMS-10488 Cover Letter (Spanish) Form and Instruction Modified Available
Form CMS-10488 QHP Survey (Spanish) Form and Instruction Modified Available
Form CMS-10488 Cover Letter 1 (English) Form Modified Available
Form CMS-10488 QHP Survey (English) Form and Instruction Modified Available
Form CMS-10488 Cover Letter (Chinese) Form Modified Available
Form CMS-10488 QHP Survey (Chinese) Form and Instruction Modified Available
Form CMS-10488 Survey Vendor Application Form and Instruction Modified Available
Comment File.pdf Public Comments Uploaded 2026-09-03 Available
CMS-10488 - Supporting Statement B .docx Supporting Statement B Uploaded 2026-08-10 Available
Appendix A - Response to Comments - 60day.docx Supplementary Document Uploaded 2026-08-07 Available
2024-QHP-EnrollSurvey-SSA-508.docx Supporting Statement A Uploaded 2023-07-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedQHP Enrollee Survey Reminder Email - Chinese
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedQHP - QHP Enrollee Survey Notification Email - Chinese
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedQHP Enrollee Survey Internet Script - Chinese
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedEnrollee Survey Reminder Letter - Spanish
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedPrenotification Letter (Spanish)
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedPrenotification Letter - English
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedEnglish Cover Letter 2
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedEnglish Cover Letter 2
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedChinese Reminder Letter
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedChinese Prenotification Letter
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedChinese Cover Letter - 2
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedCover Letter (Spanish)
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedQHP Survey (Spanish)
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedCover Letter 1 (English)
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedQHP Survey (English)
210330 Adult Qualified Health Plan Enrollee Experience Survey Form ModifiedCover Letter (Chinese)
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedQHP Survey (Chinese)
210330 Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction ModifiedSurvey Vendor Application

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 09/30/2026
72,000 97,505
36,040 48,872
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Adult Qualified Health Plan Enrollee Experience Survey CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488 , CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488, CMS-10488 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  

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 72,000 97,505 0 0 -25,505 0
Annual Time Burden (Hours) 36,040 48,872 0 0 -12,832 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No