Supporting Statement for Direct Enrollment Entities (CMS-10877)

Forms and Documents

Document Name	Status
Form CMS-10877 DE Entity Operational Readiness Review (ORR) Form and Instruction	New
Form CMS-10877 Web-broker Operational Readiness Reviews (ORR) Form and Instruction	New
CMS-10877 - Direct_Enrollment_Entities_Supporting_Statement.docx Supporting Statement A	2023-11-07

IC Document Collections

IC ID	Document Title	Status
263481	Web-brokers to Prominently Display Consumer Eligibility Results for Advance Payments of the Premium Tax Credit and Cost-sharing Reductions	New
263480	Application to State Exchanges	New
263478	Web-brokers to Implement Application to State Exchanges	New
263477	Direct Enrollment Entities to Implement Application Assister Requirements	New
263476	Web-Brokers to Provide the State Exchange a List of Agents or Brokers	New
263474	DE Entity Web-brokers and QHP Issuers to Implement Mandate for HealthCare.gov website Changes	New
263473	Issuers to Implement Website Display Requirements for QHPs	New
263471	Direct Enrollment Entities to Implement Third-Party Entity Contractual Requirements	New
263333	Direct Enrollment Entity Separate Plan Display Exception Requirement	New
263332	DE Entities to Implement Separate Plan Display Requirement	New
263331	Web-brokers to Implement the General non-FFE Disclaimer Requirement	New
263330	DE Entities to Implement the Standardized Disclaimer Requirement	New
263329	Web-broker Website Explanation of Rationale for QHP Recommendations and Methodology for Default Display	New
263328	Web-broker Website Required QHP Comparative Information and Enrollment Support Disclaimer	New
263264	DE Entity Operational Readiness Review (ORR) Form and Instruction	New
263263	Web-broker Operational Readiness Reviews (ORR) Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202311-0938-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO - 10877
Title: Supporting Statement for Direct Enrollment Entities (CMS-10877)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/05/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2,348	0
Time Burden (Hours)	208,500	0
Cost Burden (Dollars)	10,469,071	0

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Abstract: This Information Collection Request (ICR) serves as the formal request for a new clearance associated with the Department of Health and Human Services (HHS) Program Integrity: Exchange, SHOP, and Eligibility Appeals Final Rule; and Notice of Benefit and Payment Parameters for 2018 Final Rule (2018 Payment Notice), 2020 Final Rule (2020 Payment Notice), 2022 Final Rule (2022 Payment Notice), 2023 Final Rule (2023 Payment Notice), and the 2025 Proposed Rule (2025 Payment Notice). This ICR details the burden associated with direct enrollment (DE) requirements that affect DE Entities (i.e., web-brokers and QHP issuers) as finalized in the 2020 Payment Notice covered under regulations in 45 C.F.R. §§ 155.205, 155.220, 155.221, and 156.1230; agreements between the Centers for Medicare & Medicaid Services (CMS) and DE Entities; and applicable program guidance issued by CMS; and 2022 and 2023 Payment Notices at 45 C.F.R. §§155.220 and 155.221. These DE requirements relate to Web-broker Operational Readiness Reviews (ORR); DE Entity ORR; Web-broker display of QHP comparative information and disclaimer; Web-broker rationale for QHP recommendations and methodology of QHP display; and required Disclaimers.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1312 Name of Law: Patient Protection and Affordable Care Act; Health Care and Education Reconciliation Act of 2010
   US Code: 45 USC 155 Name of Law: Exchange Establishment Standards under the Affordable Care Act
   US Code: 45 USC 156 Name of Law: Health Insurance Issuer Standards under the Affordable Care Act
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 148 1312 Name of Law: Patient Protection and Affordable Care Act; Health Care and Education Reconciliation Act of 2010

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV22	Proposed rulemaking	88 FR 82510	11/24/2023

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 16

IC Title	Form No.	Form Name
Application to State Exchanges
DE Entities to Implement Separate Plan Display Requirement
DE Entities to Implement the Standardized Disclaimer Requirement
DE Entity Operational Readiness Review (ORR)	CMS-10877, CMS-10877, CMS-10877, CMS-10877, CMS-10877, CMS-10877, CMS-10877, CMS-10877, CMS-10877, CMS-10877	Documentation and Audit Package ,   Privacy Questiionaire ,   Application User Interface Toolkit ,   Communications Toolkit ,   Eligibility Results Toolkit ,   Eligibility Results Toolkit - Phase 2 ,   Eligibility Results Toolkit - Phase 3 ,   Change Notification Form ,   Business Agreement BY 2024 ,   INTERCONNECTION SECURITY AGREEMENT
DE Entity Web-brokers and QHP Issuers to Implement Mandate for HealthCare.gov website Changes
Direct Enrollment Entities to Implement Application Assister Requirements
Direct Enrollment Entities to Implement Third-Party Entity Contractual Requirements
Direct Enrollment Entity Separate Plan Display Exception Requirement
Issuers to Implement Website Display Requirements for QHPs
Web-Brokers to Provide the State Exchange a List of Agents or Brokers
Web-broker Operational Readiness Reviews (ORR)	CMS-10877, CMS-10877, CMS-10877, CMS-10877	Web-Broker Agreement ,   Security and Privacy Assessment Reports (SARs) template ,   Plans of Action and Milestones (POA&Ms) template ,   System Security and Privacy Plans (SSPs) workbook
Web-broker Website Explanation of Rationale for QHP Recommendations and Methodology for Default Display
Web-broker Website Required QHP Comparative Information and Enrollment Support Disclaimer
Web-brokers to Implement Application to State Exchanges
Web-brokers to Implement the General non-FFE Disclaimer Requirement
Web-brokers to Prominently Display Consumer Eligibility Results for Advance Payments of the Premium Tax Credit and Cost-sharing Reductions

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ICR Summary of Burden

	Total Request	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	2,348	0	2,348	0	0	0
Annual Time Burden (Hours)	208,500	0	208,500	0	0	0
Annual Cost Burden (Dollars)	10,469,071	0	10,469,071	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 collection of information.

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Annual Cost to Federal Government: $1,056,824

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 12/05/2023

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