Rate Increase Disclosure and Review Reporting Requirements (CMS-10379)
Revision of a currently approved collection
No
Regular
11/09/2026
table that charts list comparision
Requested
Previously Approved
36 Months From Approved
11/30/2027
1,004
1,211
6,258,823
17,756
0
0
The Patient Protection and Affordable Care Act (Pub. L. 111â148) was enacted on March 23, 2010; the Health Care and Education Reconciliation Act (Pub. L. 111â152) was enacted on March 30, 2010. In this statement, we refer to the two statutes collectively as the Affordable Care Act. The Affordable Care Act reorganizes, amends, and adds to the provisions of Part A of title XXVII of the Public Health Service Act (PHS Act) relating to group health plans and health insurance issuers in the group and individual markets.
Section 1003 of the Affordable Care Act adds a new section 2794 of the PHS Act which directs the Secretary of the Department of Health and Human Services (the Secretary), in conjunction with the States, to establish a process for the annual review of âunreasonable increases in premiums for health insurance coverage.â Additionally, section 2794 also directs the Secretary, in conjunction with the States, to monitor all rate increases effective 2014. The statute provides that this process shall require health insurance issuers to submit to the Secretary and the applicable State justifications for unreasonable premium increases prior to the implementation of the increases. Section 2794 also directs the Secretary to ensure the public disclosure of information and justification relating to unreasonable rate increases.
This information collection reflects an increase in burden hours and costs due to new requirements for issuers to calculate and report CSR information using the standard methodology as set forth in the 2027 Payment Notice final rule. With the addition of the new CSR reporting requirements, 366 respondents (a subset of the 620 respondents already impacted by this ICR) will be further impacted and will incur an additional burden to develop and implement claim-level re-adjudication processes, update systems annually, enter CSR data into the URRT, and provide explanations in the Actuarial Memorandum. The three-year average annual overall burden will increase from 17,756 hours to 6,258,823 hours.
$2,829,469
No
No
No
Yes
No
No
No
Jamaa Hill 301 492-4190
Reginfo record details
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.