[Federal Register Volume 80, Number 79 (Friday, April 24, 2015)]
[Notices]
[Pages 23011-23013]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-09591]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-10392 and CMS-10418]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

ACTION: Notice.

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SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (PRA), federal agencies are required to publish notice in 
the Federal Register concerning each proposed collection of 
information, including each proposed extension or reinstatement of an 
existing collection of information, and to allow a second opportunity 
for public comment on the notice. Interested persons are invited to 
send comments regarding the 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.

DATES: Comments on the collection(s) of information must be received by 
the OMB desk officer by May 26, 2015.

ADDRESSES: When commenting on the proposed information collections, 
please reference the document identifier or OMB control number. To be 
assured consideration, comments and recommendations must be received by 
the OMB desk officer via one of the following transmissions: OMB, 
Office of Information and Regulatory Affairs, Attention: CMS Desk 
Officer, Fax Number: (202) 395-5806 OR, Email: 
[email protected].
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. The term ``collection of 
information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and 
includes agency requests or requirements that members of the public 
submit reports, keep records, or provide information to a third party. 
Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires 
federal agencies to publish a 30-day notice in the Federal Register 
concerning each proposed collection of information, including each 
proposed extension or reinstatement of an existing collection of 
information, before submitting the collection to OMB for approval. To 
comply with this requirement, CMS is publishing this notice that 
summarizes the following proposed collection(s) of information for 
public comment:
    1. Type of Information Collection Request: Revision of a currently 
approved information collection; Title of Information Collection: 
Consumer Operated and Oriented (CO-OP) Program; Use: The Consumer 
Operated and Oriented Plan (CO-OP) program was established by Section 
1322 of the Affordable Care Act. This program provides for loans to 
establish at least one consumer-operated, qualified nonprofit health 
insurance issuer in each State. Issuers supported by the

[[Page 23012]]

CO-OP program will offer at least one qualified health plan at the 
silver level of benefits and one at the gold level of benefits in the 
individual market State Health Benefit Exchanges (Exchanges). At least 
two-thirds of policies or contracts offered by a CO-OP will be open to 
individuals and small employers. Profits generated by the nonprofit CO-
OPs will be used to lower premiums, improve benefits, improve the 
quality of health care delivered to their members, expand enrollment, 
or otherwise contribute to the stability of coverage offered by the CO-
OP. By increasing competition in the health insurance market and 
operating with a strong consumer focus, the CO-OP program will provide 
consumers more choices, greater plan accountability, increased 
competition to lower prices, and better models of care, benefiting all 
consumers, not just CO-OP members.
    The CO-OP program will provide nonprofits with loans to fund start-
up costs and State reserve requirements, in the form of Start-up Loans 
and Solvency Loans. An applicant may apply for (1) joint Start-up and 
Solvency Loans; or (3) only a Solvency Loan. Planning Loans are 
intended to help loan recipients determine the feasibility of operating 
a CO-OP in a target market. Start-up Loans are intended to assist loan 
recipients with the many start-up costs associated with establishing a 
new health insurance issuer. Solvency Loans are intended to assist loan 
recipients with meeting the solvency requirements of States in which 
the applicant seeks to be licensed to issue qualified health plans. 
Form Number: CMS-10392 (OMB control number 0938-1139); Frequency: 
Occasionally; Affected Public: Private Sector (Not-for-profit 
institutions); Number of Respondents: 23; Total Annual Responses: 675; 
Total Annual Hours: 93,220. (For policy questions regarding this 
collection contact Deepti Loharikar at 301-492-4126.)
    2. Type of Information Collection Request: Revision of currently 
approved collection; Title of Information Collection: Annual MLR and 
Rebate Calculation Report and MLR Rebate Notices; Use: Under Section 
2718 of the Affordable Care Act and implementing regulation at 45 CFR 
part 158, a health insurance issuer (issuer) offering group or 
individual health insurance coverage must submit a report to the 
Secretary concerning the amount the issuer spends each year on claims, 
quality improvement expenses, non-claims costs, Federal and State taxes 
and licensing and regulatory fees, the amount of earned premium, and 
beginning with the 2014 reporting year, the amounts related to the 
reinsurance, risk corridors, and risk adjustment programs established 
under sections 1341, 1342, and 1343, respectively, of the Affordable 
Care Act. An issuer must provide an annual rebate if the amount it 
spends on certain costs compared to its premium revenue (excluding 
Federal and States taxes and licensing and regulatory fees) does not 
meet a certain ratio, referred to as the medical loss ratio (MLR). An 
interim final rule (IFR) implementing the MLR was published on December 
1, 2010 (75 FR 74865) and modified by technical corrections on December 
30, 2010 (75 FR 82277), which added Part 158 to Title 45 of the Code of 
Federal Regulations. The IFR is effective January 1, 2011. A final rule 
regarding selected provisions of the IFR was published on December 7, 
2011 (76 FR 76574, CMS-9998-FC) and an interim final rule regarding an 
issue not included in issuers' reporting obligations (disbursement of 
rebates by non-federal governmental plans) was also published December 
7, 2011 (76 FR 76596, CMS-9998-IFC2). Both rules published on December 
7, 2011 are effective January 1, 2012. Each issuer is required to 
submit annually MLR data, including information about any rebates it 
must provide, on a form prescribed by CMS, for each State in which the 
issuer conducts business. Each issuer is also required to provide a 
rebate notice to each policyholder that is owed a rebate and each 
subscriber of policyholders that are owed a rebate for any given MLR 
reporting year. Additionally, each issuer is required to maintain for a 
period of seven years all documents, records and other evidence that 
support the data included in each issuer's annual report to the 
Secretary.
    Under Section 1342 of the Patient Protection and Affordable Care 
Act and implementing regulation at 45 CFR part 153, issuers of 
qualified health plans (QHPs) must participate in a risk corridors 
program. A QHP issuer will pay risk corridors charges or be eligible to 
receive risk corridors payments based on the ratio of the issuer's 
allowable costs to the target amount. A final rule (Premium 
Stabilization Rule) implementing the risk corridors program was 
published on March 23, 2012 (77 FR 17220), which added part 153 to 
title 45 of the Code of Federal Regulations. The Premium Stabilization 
Rule is effective May 22, 2012. Final rules (2014 Payment Notice, 2015 
Payment Notice, and 2016 Payment Notice) outlining the risk corridors 
benefit and payment parameters for the 2014, 2015, and 2016 benefit 
years were published on March 11, 2013 (78 FR 15410), March 11, 2014 
(79 FR 13744), and February 27, 2015 (80 FR 10750), respectively. 
Additionally, on October 30, 2013, HHS published the Second Final 
Program Integrity rule (78 FR 65076) to align the risk corridors 
program with the requirements of the single risk pool provision at 45 
CFR 156.80. The risk corridors data collection applies to QHP issuers 
the individual and small group markets. Each QHP issuer is required to 
submit an annual report to CMS concerning the issuer's allowable costs, 
allowable administrative costs, premium, and proportion of market 
premium in QHPs. Risk corridors premium information that is specific to 
an issuer's QHPs is collected through a separate data reporting form. 
CMS is publishing the risk corridors plan-level reporting form, and 
instructions for completing the form for public comment as part of the 
proposed revision to this information collection requirement.
    On January 30, 2015, CMS published a 60-day notice in the Federal 
Register (80 FR 5118) for the public to submit written comments on this 
information collection; the public comment period closed on March 31, 
2015. As part of the 60-day notice, CMS updated its annual burden hour 
estimates, including to reflect the additional burden (published in the 
2015 Payment Notice) related to the risk corridors data submission 
requirements. The proposed revisions in the 60-day notice also made 
changes regarding the new MLR reporting and rebate distribution 
deadlines and the accounting for the reinsurance, risk adjustment, and 
risk corridors. We received a total of 3 public comments on a number of 
specific issues regarding the notice of the revised MLR PRA package. We 
have taken into consideration all of the comments and has modified the 
2014 MLR Annual Reporting Form, the Risk Corridors Plan Level Data 
Form, and the accompanying Instructions in order to correct minor 
errors and to provide additional clarifications. These modifications do 
not affect the previously estimated burden hours or costs. Form Number: 
CMS-10418 (OMB control number: 0938-1164); Frequency: Annually; 
Affected Public: Private sector (Business or other for-profits and Not-
for-profit institutions); Number of Respondents: 517; Number of 
Responses: 3,307; Total Annual Hours: 271,600. (For policy questions 
regarding this collection, contact Julie McCune at (301) 492-4196.)


[[Page 23013]]


    Dated: April 21, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-09591 Filed 4-23-15; 8:45 am]
BILLING CODE 4120-01-P