[Federal Register Volume 77, Number 130 (Friday, July 6, 2012)]
[Notices]
[Pages 40061-40063]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-16508]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10433, CMS-10438, CMS-10439 and CMS-10440]
Agency Information Collection Activities: Proposed Collection;
Comment Request; Webinars
AGENCY: Centers for Medicare & Medicaid Services.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid
Services (CMS) is publishing the following summary of proposed
collections for public comment. Interested persons are invited to send
comments regarding this burden estimate or any other aspect of this
collection of information, including any of the following subjects: (1)
The necessity and utility of the proposed information collection for
the proper performance of the agency's functions; (2) the accuracy of
the estimated burden; (3) ways to enhance the quality, utility, and
clarity of the information to be collected; and (4) the use of
automated collection techniques or other forms of information
technology to minimize the information collection burden.
1. Type of Information Collection Request: New collection; Title of
Information Collection: Initial Plan Data Collection to Support
Qualified Health Plan (QHP) Certification and Other Financial
Management and Exchange Operations; Use: As required by the final rule
that published on March 27, 2012 (77 FR 18310), entitled CMS-9989-F:
Establishment of Exchanges and Qualified Health Plans; Exchange
Standards for Employers, each Exchange must assume responsibilities
related to the certification and offering of Qualified Health Plans
(QHPs). To offer insurance through an Exchange, a health insurance
issuer must have its health plans certified as QHPs by the Exchange. A
QHP must meet certain minimum certification standards, such as network
adequacy, essential health benefits, and actuarial value. In order to
meet those standards, the Exchange is responsible for collecting data
and validating that QHPs meet these minimum requirements as described
in the Exchange rule under 45 CFR 155 and 156, based on the Affordable
Care Act, as well as other requirements determined by the Exchange. In
addition to data collection for the certification of QHPs, the
reinsurance and risk adjustment programs outlined by the Affordable
Care Act, detailed in 45 CFR part 153 and in the final rule that
published on March 23, 2012 (77 FR 17220) entitled CMS- 9975-F:
Standards for Reinsurance, Risk Corridors, and Risk Adjustment, have
general information reporting requirements that apply to non-QHPs
outside of the Exchanges. Form Number: CMS-10433 (OCN: 0938-New);
Frequency: Annually; Affected Public: States and Private Sector:
Business or other for-profits and not-for-profit institutions; Number
of Respondents: 3400; Number of Responses: 3400; Total Annual Hours:
224,435 hours in year one and 166,435 hours in years two and three (For
policy questions regarding the QHP Certification data collection,
contact Lourdes Grindal-Miller at (301) 492- 4345. For policy questions
regarding risk adjustment and reinsurance data collection, contact
Milan Shah call (301) 492- 4427. For all other issues, call (410) 786-
1326.)
2. Type of Information Collection Request: New collection; Title of
information collection: Data Collection to Support Eligibility
Determinations and Enrollment for Employees in the Small Business
Health Options Program; Use: In compliance with the requirement of
section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the
Center for Consumer Information and Insurance Oversight, Centers for
Medicare and Medicaid Services, Department of Health and Human
Services, is publishing the following summary of a proposed information
collection request for public comment. Interested persons are invited
to send comments regarding this burden estimate or any other aspect of
this collection of information, including any of the following
subjects: (1) The necessity and utility of the proposed information
collection for the proper performance of the agency's functions; (2)
the accuracy of the estimated burden; (3) ways to enhance the quality,
utility, and clarity of the information to be collected; and (4) the
use of automated collection techniques or other forms of information
technology to minimize the information collection burden.
Section 1311(b)(1)(B) of the Affordable Care Act requires that the
Small Business Health Option Program (SHOP) assist qualified small
employers in facilitating the enrollment of their employees in
qualified health programs (QHPs) offered in the small group market.
Section 1311(c)(1)(F) of the Affordable Care Act requires HHS to
establish criteria for certification of health plans as QHPs and that
these criteria must require plans to utilize a uniform enrollment form
that qualified employers may use. Further, section 1311(c)(5)(B)
requires HHS to develop a model application and Web site that assists
employers in determining if they are eligible to participate in SHOP.
Consistent with these authorities, HHS has developed a single,
streamlined form that employees will use apply to the SHOP. Section
155.730 of the Exchanges Final Rule (77 FR 18310) provides more detail
about this ``single employee application,'' which will be used to
determine employee eligibility, QHP selection, and enrollment of
qualified employees and their dependents.
The information will be required of each employee upon initial
application with subsequent information collections for the purposes of
confirming accuracy of previous submissions or updating information
from previous submissions. Information collection will begin during
initial open enrollment in October 2013, per Sec. 155.410 of the
Exchanges Final Rule. Applications for the SHOP will be collected year
round, per the rolling enrollment requirements of Sec. 155.725 of the
Exchanges Final Rule.
Employees will be able to submit an application for the SHOP
online, using a paper application, over the phone through a call center
operated by an Exchange, or in person through an agent, broker, or
Navigator, per Sec. 155.730(f) of the Exchanges Final Rule. If an
employee does not enroll in coverage through the SHOP, the information
will be erased after a specified period of time. If an employee enrolls
in coverage through the SHOP, the information will be retained to
document the enrollment, to allow reconciliation with issuer records,
and to provide information for future coverage renewals or changes in
coverage.
Every qualified employee of an employer participating in the SHOP
who wishes to apply for coverage through the SHOP will need to complete
an application to determine his or her eligibility, QHP selection, and
enrollment of the employee and his or her dependents. The applicant
will also be asked to verify his or her
[[Page 40062]]
understanding of the application and sign attestations regarding
information in the application. The completed application will be
submitted to the SHOP in the employer's state.
Applicants who choose to complete the electronic application will
need to create an online account at the beginning of the application
process.
We estimate that it will take approximately 0.159 hours (9.53
minutes) per applicant to submit a completed paper application. The
Congressional Budget Office (CBO) estimates approximately 3 million
people will enroll in health insurance through a SHOP in 2014. Assuming
family size of approximately 3 per employee, we expect approximately 1
million employees to complete an application in 2014 for a total of
approximately 93,300 burden hours.
CBO estimates approximately 2 million people will enroll in health
insurance through a SHOP in 2015 and 3 million in 2016. Consequently,
we estimate that approximately 666,666 employees will apply to a SHOP
in 2015 and approximately 1 million will apply in 2016. Form Number:
CMS-10438 (OCN: 0938--NEW); Frequency: Once; Affected Public:
Individuals or households; Number of Respondents: 1,000,000; Total
Annual Responses: 1,000,000; Total Annual Hours: 93,300 hours. (For
policy questions regarding this collection contact Leigha Basini at
301-492-4307. For all other issues call 410-786-1326.)
3. Type of Information Collection Request: New collection; Title of
information collection: Data Collection to Support Eligibility
Determinations and Enrollment for Small Businesses in the Small
Business Health Options Program; Use: In compliance with the
requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of
1995, the Center for Consumer Information and Insurance Oversight,
Centers for Medicare and Medicaid Services, Department of Health and
Human Services, is publishing the following summary of a proposed
information collection request for public comment. Interested persons
are invited to send comments regarding this burden estimate or any
other aspect of this collection of information, including any of the
following subjects: (1) The necessity and utility of the proposed
information collection for the proper performance of the agency's
functions; (2) the accuracy of the estimated burden; (3) ways to
enhance the quality, utility, and clarity of the information to be
collected; and (4) the use of automated collection techniques or other
forms of information technology to minimize the information collection
burden.
Section 1311(b)(1)(B) of the Affordable Care Act requires that the
SHOP assist qualified small employers in facilitating the enrollment of
their employees in QHPs offered in the small group market. Section
1311(c)(1)(F) of the Affordable Care Act requires HHS to establish
criteria for certification of health plans as QHPs and that these
criteria must require plans to utilize a uniform enrollment form that
qualified employers may use. Further, section 1311(c)(5)(B) requires
HHS to develop a model application and Web site that assists employers
in determining if they are eligible to participate in SHOP. Consistent
with these authorities, HHS has developed a single, streamlined form
that employers will use to apply to the SHOP. Section 155.730 of the
Exchanges Final Rule (77 FR 18310) provides more detail about this
``single employer application,'' which will be used to determine
employer eligibility and to collect information necessary for
purchasing coverage through the SHOP.
The information will be required of each employer upon initial
application with subsequent information collections for the purposes of
confirming accuracy of previous submissions or updating information
from previous submissions. Information collection will begin during
initial open enrollment in October 2013, per Sec. 155.410 of the
Exchanges Final Rule. Applications for the SHOP will be collected year
round, per the rolling enrollment requirements of Sec. 155.725 of the
Exchanges Final Rule
Employers will be able to submit an application for the SHOP
online, using a paper application, over the phone through a call center
operated by an Exchange, or in person through an agent, broker, or
Navigator, per Sec. 155.730(f) of the Exchanges Final Rule. If an
employer does not complete the application, the information will be
erased after a specified period of time. If an employer completes the
application and offers coverage to qualified employees through the
SHOP, the information will be retained to document the offer of
coverage, to allow reconciliation with issuer records, and to provide
information for future coverage renewals or changes in coverage.
Every employer wishing to apply for coverage through the SHOP will
need to complete an application to determine its eligibility to
participate in the SHOP and to provide the information necessary for
the employer to purchase coverage through the SHOP. The applicant will
also be asked to verify his or her understanding of the application and
sign attestations regarding information in the application. The
completed application will be submitted to the SHOP in the employer's
state. Applicants who choose to complete the electronic application
will need to create an online account at the beginning of the
application process.
We estimate that it will take approximately 0.209 hours (12.57
minutes) per applicant to submit a completed paper application. We had
several individuals fill out the paper application, averaged their
times to complete the application, and factored in additional time due
to potential variation in applicants' health literacy rate. The
Congressional Budget Office (CBO) estimates approximately 3 million
people will enroll in health insurance through a SHOP in 2014. Assuming
a small business size of approximately 5 employees and a family size of
approximately 3 per employee, we estimate that approximately 200,000
employers will apply to a SHOP in 2014. Consequently, we expect
approximately 200,000 employers to complete an application in 2014 for
a total of approximately 24,520 burden hours.
CBO estimates approximately 2 million people will enroll in health
insurance through a SHOP in 2015 and 3 million in 2016. Consequently,
we estimate that approximately 133,333 employers will apply to a SHOP
in 2015 and approximately 200,000 will apply in 2016. Form Number: CMS-
10439 (OCN: 0938--NEW); Frequency: Once per year; Affected Public:
Private Sector: Business or other for-profit, non-for-profit
institutions, or farms; Number of Respondents: 200,000; Total Annual
Responses: 200,000; Total Annual Hours: 24,520 hours. (For policy
questions regarding this collection contact Leigha Basini at 301-492-
4307. For all other issues call 410-786-1326.)
4. Type of Information Collection Request: New collection; Title of
information collection: Data Collection to Support Eligibility
Determinations for Insurance Affordability Programs and Enrollment
through Affordable Insurance Exchanges, Medicaid and Children's Health
Insurance Program Agencies; Use: In compliance with the requirement of
section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995, the
Center for Consumer Information and Insurance Oversight, Centers for
Medicare and Medicaid Services, Department of Health and Human
Services, is publishing the following summary of a proposed information
collection request for public comment. Interested persons are invited
to send comments regarding this burden
[[Page 40063]]
estimate or any other aspect of this collection of information,
including any of the following subjects: (1) The necessity and utility
of the proposed information collection for the proper performance of
the agency's functions; (2) the accuracy of the estimated burden; (3)
ways to enhance the quality, utility, and clarity of the information to
be collected; and (4) the use of automated collection techniques or
other forms of information technology to minimize the information
collection burden.
Section 1413 of the Affordable Care Act directs the Secretary of
Health and Human Services to develop and provide to each State a
single, streamlined form that may be used to apply for coverage through
the Exchange and Insurance Affordability Programs, including Medicaid,
the Children's Health Insurance Program (CHIP), and the Basic Health
Program, as applicable. The application must be structured to maximize
an applicant's ability to complete the form satisfactorily, taking into
account the characteristics of individuals who qualify for the
programs. A State may develop and use its own single streamlined
application if approved by the Secretary in accordance with section
1413 and if it meets the standards established by the Secretary.
Section 155.405(a) of the Exchange Final Rule (77 FR 18310)
provides more detail about the application that must be used by the
Exchange to determine eligibility and to collect information necessary
for enrollment. The regulations in Sec. 435.907 and Sec. 457.330
establish the requirements for State Medicaid and CHIP agencies related
to the use of the single streamlined application. CMS is designing the
single streamlined application to be a dynamic online application that
will tailor the amount of data required from an applicant based on the
applicant's circumstances and responses to particular questions. The
paper version of the application will not be able to be tailored in the
same way but is being designed to collect only the data required to
determine eligibility. Individuals will be able to submit an
application online, through the mail, over the phone through a call
center, or in person, per Sec. 155.405(c)(2) of the Exchange Final
Rule, as well as through other commonly available electronic means as
noted in Sec. 435.907(a) and Sec. 457.330 of the Medicaid Final Rule.
The application may be submitted to an Exchange, Medicaid or CHIP
agency.
The online application process will vary depending on each
applicant's circumstances, their experience with health insurance
applications and online capabilities. The goal is to solicit sufficient
information so that in most cases no further inquiry will be needed. We
estimate that on average it will take approximately .50 hours (30
minutes) to complete for people applying for Insurance Affordability
Programs. It will take an estimated .25 hours (15 minutes) to complete
without consideration for Insurance Affordability Programs. We expect
approximately 7,700,260 applications to be submitted for Insurance
Affordability Programs between 2014 and 2016. The total burden is
estimated to be 2,264,329 hours for 2014, and 605,920 hours and 979,881
hours for years 2015 and 2016, respectively. We estimate 1,139, 240
applications to be submitted online without consideration for Insurance
Affordability Programs between 2014 and 2016, resulting in 71,203 hours
of burden each year in 2014 and in 2015, and 142,405 burden hours in
2016. The paper application process will take approximately .75 hours
(45 minutes) to complete for those applying for Insurance Affordability
Programs and .33 hours (20 minutes) for those applying without
consideration for Insurance Affordability Programs. We expect
approximately 855,584 applications to be submitted for Insurance
Affordability Programs on paper in 2014 through 2016 for a total of
377,388 estimated burden hours in 2014. The burden hours are projected
to be 100,987 hours and 163,314 hours in 2015 and 2016, respectively.
We estimate 126,581 applications will be submitted without
consideration for Insurance Affordability Programs from 2014 through
2016. Total burden hours are expected to be 10,443 hours in 2014 and
2015, and 20,886, in 2016. Form Number: CMS-10440 (OCN: 0938-NEW);
Frequency: Once per year; Affected Public: Individuals and households;
Number of Respondents: 3,273,889; Total Annual Responses: 3,273,889;
Total Annual Hours: 1,669,683 hours. (For policy questions regarding
this collection contact Hannah Moore at 301-492-4232. For all other
issues call 410-786-1326.)
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS'
Web Site address at http://www.cms.hhs.gov/PaperworkReductionActof1995,
or Email your request, including your address, phone number, OMB
number, and CMS document identifier, to [email protected], or call
the Reports Clearance Office on (410) 786-1326.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by September 4, 2012:
1. Electronically. You may submit your comments electronically to
http://www.regulations.gov. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection document(s) accepting comments.
2. By regular mail. You may mail written comments to the following
address: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: Document Identifier (--
----), Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
Dated: June 29, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-16508 Filed 7-2-12; 11:15 am]
BILLING CODE 4120-01-P