OMB control number

Data Collection to Support Eligibility Determinations and Enrollment for Small Businesses in the Small Business Health Options Program (CMS-10439)

OMB 0938-1193 · HHS/CMS.

OMB 0938-1193

On March 23, 2010, the President signed into law H.R. 3590, the Patient Protection and Affordable Care Act, Public Law 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. 111-152, collectively referred to as "The Affordable Care Act." The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of Affordable Insurance Exchanges (Exchanges), and the assurance of coordination between Medicaid, CHIP, and Exchanges. Through the Small Business Health Options Program (SHOP), the new Exchanges will assist qualified small employers in facilitating the enrollment of their employees in Qualified Health Plans (QHPs) offered in the small group market. The Exchanges, which will offer these QHPs, will become operational on January 1, 2014. Employers will be able to begin applying for coverage through the SHOP October 1, 2013, for coverage beginning as early as January 1, 2014. The employer's application for the SHOP will be a single, streamlined form that will be used to determine employer eligibility for the SHOP. The submission seeks OMB approval of the data collection elements needed to support eligibility determinations for small businesses in the SHOP.

The latest form for Data Collection to Support Eligibility Determinations and Enrollment for Small Businesses in the Small Business Health Options Program (CMS-10439) expires 2026-08-31 and is listed under ICR 202301-0938-019.

Latest Forms, Documents, and Supporting Material

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202603-0938-005 Extension without change of a currently approved collection 2026-03-09
202301-0938-019 Extension without change of a currently approved collection 2023-01-27 Approved without change
201908-0938-013 Revision of a currently approved collection 2019-08-28 Approved with change
201603-0938-019 Revision of a currently approved collection 2016-03-28 Approved with change
201302-0938-003 New collection (Request for a new OMB Control Number) 2013-02-05 Approved with change