Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection

Forms and Documents

Document Name	Status
Form CMS-10488 Marketplace Survey Data Collection Form and Instruction	New
Form CMS-10488 English - Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction	New
ESS OMB Supporting Statement Part B_02_06_14.docx Supporting Statement B	2014-02-11
ESS OMB Supporting Statement Part A_02-06-14.docx Supporting Statement A	2014-02-11

IC Document Collections

IC ID	Document Title	Status
210331	Marketplace Survey Data Collection Form and Instruction	New
210330	English - Adult Qualified Health Plan Enrollee Experience Survey Form and Instruction	New

ICR Details

OMB Control No: 0938-1221	ICR Reference No: 201402-0938-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: 21430
Title: Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey Data Collection
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: Approved with change	Conclusion Date: 02/12/2014
	Date Received in OIRA: 02/11/2014
Terms of Clearance: The psychometric test component of this information collection is not designed to provide state-level or QHP-level estimates; as such only the aggregate results of this analysis will be discussed or disseminated. The second component of this information collection (in 2015) includes a provision for early feedback to States and QHPs, subject to the limitations associated with response rates (including non-response bias analyses) and data quality findings. Approval has not yet been provided for the early feedback/beta test component described in the supporting statements; rather CMS will submit a change package to OMB for that clearance once the results of the psychometric test component have been analyzed. CMS should confer with OMB to determine whether the changes made as a result of the psychometric test component constitute a substantive change.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2017	36 Months From Approved
Responses	668,590	0	0
Time Burden (Hours)	297,670	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Section 1311(c)(4) of the ACA requires the Department of Health and Human Services (HHS) to develop an enrollee satisfaction survey system that assesses consumer experience with qualified health plans (QHPs) offered through an Exchange. It also requires public display of enrollee satisfaction information by the Exchange to allow individuals to easily compare enrollee satisfaction levels between comparable plans. CMS is developing, testing and implementing two surveys, a survey for adult enrollees in QHPs and a survey for health insurance Marketplace consumers. CMS is requesting approval for information collection associated with these surveys.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1311(c)(4) Name of Law: Affordable Care Act (ACA)
   PL: Pub.L. 111 - 148 1313 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 148 1321(a) Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1311 Name of Law: Affordable Care Act

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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:
	78 FR 38986	06/28/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 65658	11/01/2013
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
English - Adult Qualified Health Plan Enrollee Experience Survey	CMS-10488	English - Adult Qualified Health Plan Enrollee Experience Survey
Marketplace Survey Data Collection	CMS-10488	English - Marketplace Survey

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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	668,590	0	668,590	0	0	0
Annual Time Burden (Hours)	297,670	0	297,670	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: This is a new information collection.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 02/11/2014

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