[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