Medical Loss Ratio (IFR) Information Collection Requirements and Supporting Regulations

Forms and Documents

Document Name	Status
CMS-10361.Supporting Statement Part A (4-1-11).docx Supporting Statement A	2011-05-31

IC Document Collections

IC ID	Document Title	Status
195389	Record Retention Requirement	Modified
195248	Waiver Application	Modified

ICR Details

OMB Control No: 0938-1114	ICR Reference No: 201105-0938-017
Status: Historical Active	Previous ICR Reference No: 201012-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medical Loss Ratio (IFR) Information Collection Requirements and Supporting Regulations
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/12/2011
	Date Received in OIRA: 05/31/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2014	36 Months From Approved	08/31/2011
Responses	462	0	462
Time Burden (Hours)	4,142	0	4,142
Cost Burden (Dollars)	0	0	0

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Abstract: Section 2718 of the Public Health Service Act (PHS Act) requires health insurance issuers offering group or individual health insurance coverage to submit an annual report to the Secretary beginning in 2012. The reported data will allow for the calculation of an issuer's medical lass ratio (MLR) by market (individual, small group, and large group) within each State in which the issuer conducts business. Section 2718 sets out a minimum MLR standard for each market segment that issuers must meet. If an issuer doed not meet the MLR standard, it must provide rebates to enrollees. Section 2718 allows for the Secretary to lower the 80% MLR standard in the individual market on a state-by-state basis if there is a risk of destabilization caused by the requirement to meet the MLR standard. States requesting that HHS lower the MLR standard must submit information supporting their assertion that the individual market in their State would destabilize absent an adjustment to the MLR standard. HHS must obtain such information in order to ascertain whether destabillization has a high likelihood of occuring within the respective State.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 2718 Name of Law: BRINGING DOWN THE COST OF HEALTH CARE COVERAGE.
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 18221	03/01/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 31337	05/31/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Waiver Application
Record Retention Requirement

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	462	462	0	0	0	0
Annual Time Burden (Hours)	4,142	4,142	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $43,200

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/31/2011

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