Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment

Forms and Documents

Document Name	Status
CMS-10401 Supporting Statement Part A (7-20-11).doc Supporting Statement A	2011-07-20

IC Document Collections

IC ID	Document Title	Status
198556	Health Insurance Issuer Standards for the Risk Adjustment Program (45 CFR 153.610 & 153.630)	New
198555	Health Insurance Issuer Standards Related to the Temporary Risk Corridors Program (45 CFR 153.520)	New
198554	Health Insurance Issuer Standards Related to the Transitional Reinsurance Program (45CFR153.400 & 153.410)	New
198553	State Standards for the Risk Adjustment Program (45 CFR 155.350)	New
198552	State Standards for the Risk Adjustment Program (45 CFR 155.330)	New
198551	State Standards for the Risk Adjustment Program (45CFR153.34(c))	New
198550	State Standards for the Risk Adjustment Program (45CFR153.310 & 153.340 )	New
198549	State Standards for the Transitional Reinsurance Program in the Individual Market	New
198548	State Notice of Insurance Benefits and Payment Parameters	New

ICR Details

OMB Control No: 0938-1155	ICR Reference No: 201107-0938-008
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule	Conclusion Date: 02/15/2012
	Date Received in OIRA: 07/20/2011
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Affordable Care Act provides for a reinsurance, risk corridor, and risk adjustment program to mitigate the negative impacts of adverse selection and market uncertainty due to insurance reforms that are the subject of separate rule-making, such as guaranteed issue, modified community rating, and prohibition of medical underwriting. The reporting requirements and data collection addresses requirements for these programs that States and health plans must meet both inside and outside of an Affordable Insurance Exchange.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 1321; 1341; 1342; 1343 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1321; 1341; 1342; 1343 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AR07	Proposed rulemaking	76 FR 41930	07/15/2011

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 9

IC Title	Form No.	Form Name
State Notice of Insurance Benefits and Payment Parameters
State Standards for the Transitional Reinsurance Program in the Individual Market
State Standards for the Risk Adjustment Program (45CFR153.310 & 153.340 )
State Standards for the Risk Adjustment Program (45CFR153.34(c))
State Standards for the Risk Adjustment Program (45 CFR 155.330)
State Standards for the Risk Adjustment Program (45 CFR 155.350)
Health Insurance Issuer Standards Related to the Transitional Reinsurance Program (45CFR153.400 & 153.410)
Health Insurance Issuer Standards Related to the Temporary Risk Corridors Program (45 CFR 153.520)
Health Insurance Issuer Standards for the Risk Adjustment Program (45 CFR 153.610 & 153.630)

---

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: This is a new information collection.

---

Annual Cost to Federal Government: $274,936

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

---

Common Form ICR:  No

---

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: 07/20/2011

---