Federal Register / Vol. 77, No. 130 / Friday, July 6, 2012 / Notices 40061 

the Federal Food, Drug, and Cosmetic 

Act, 21 U.S.C. 360bbb–3(b)(4). 

Dated: June 28, 2012. 

Kathleen Sebelius, 

Secretary. 

[FR Doc. 2012–16588 Filed 7–5–12; 8:45am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10433, CMS– 

10438, CMS–10439 and CMS–10440] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request; Webinars 

AGENCY: Centers for Medicare & 

Medicaid Services. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS) is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this 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. 

1. Type of Information Collection 

Request: New collection; Title of 

Information Collection: Initial Plan Data 

Collection to Support Qualified Health 

Plan (QHP) Certification and Other 

Financial Management and Exchange 

Operations; Use: As required by the 

final rule that published on March 27, 

2012 (77 FR 18310), entitled CMS–9989– 

F: Establishment of Exchanges and 

Qualified Health Plans; Exchange 

Standards for Employers, each Exchange 

must assume responsibilities related to 

the certification and offering of 

Qualified Health Plans (QHPs). To offer 

insurance through an Exchange, a health 

insurance issuer must have its health 

plans certified as QHPs by the 

Exchange. A QHP must meet certain 

minimum certification standards, such 

as network adequacy, essential health 

benefits, and actuarial value. In order to 

meet those standards, the Exchange is 

responsible for collecting data and 

validating that QHPs meet these 

minimum requirements as described in 

the Exchange rule under 45 CFR 155 

and 156, based on the Affordable Care 

Act, as well as other requirements 

determined by the Exchange. In 

addition to data collection for the 

certification of QHPs, the reinsurance 

and risk adjustment programs outlined 

by the Affordable Care Act, detailed in 

45 CFR part 153 and in the final rule 

that published on March 23, 2012 (77 

FR 17220) entitled CMS- 9975–F: 

Standards for Reinsurance, Risk 

Corridors, and Risk Adjustment, have 

general information reporting 

requirements that apply to non-QHPs 

outside of the Exchanges. Form Number: 

CMS–10433 (OCN: 0938–New); 

Frequency: Annually; Affected Public: 

States and Private Sector: Business or 

other for-profits and not-for-profit 

institutions; Number of Respondents: 

3400; Number of Responses: 3400; Total 

Annual Hours: 224,435 hours in year 

one and 166,435 hours in years two and 

three (For policy questions regarding the 

QHP Certification data collection, 

contact Lourdes Grindal-Miller at (301) 

492- 4345. For policy questions 

regarding risk adjustment and 

reinsurance data collection, contact 

Milan Shah call (301) 492- 4427. For all 

other issues, call (410) 786–1326.) 

2. Type of Information Collection 

Request: New collection; Title of 

information collection: Data Collection 

to Support Eligibility Determinations 

and Enrollment for Employees in the 

Small Business Health Options Program; 

Use: In compliance with the 

requirement of section 3506(c)(2)(A) of 

the Paperwork Reduction Act of 1995, 

the Center for Consumer Information 

and Insurance Oversight, Centers for 

Medicare and Medicaid Services, 

Department of Health and Human 

Services, is publishing the following 

summary of a proposed information 

collection request for public comment. 

Interested persons are invited to send 

comments regarding this 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. 

Section 1311(b)(1)(B) of the 

Affordable Care Act requires that the 

Small Business Health Option Program 

(SHOP) assist qualified small employers 

in facilitating the enrollment of their 

employees in qualified health programs 

(QHPs) offered in the small group 

market. Section 1311(c)(1)(F) of the 

Affordable Care Act requires HHS to 

establish criteria for certification of 

health plans as QHPs and that these 

criteria must require plans to utilize a 

uniform enrollment form that qualified 

employers may use. Further, section 

1311(c)(5)(B) requires HHS to develop a 

model application and Web site that 

assists employers in determining if they 

are eligible to participate in SHOP. 

Consistent with these authorities, HHS 

has developed a single, streamlined 

form that employees will use apply to 

the SHOP. Section 155.730 of the 

Exchanges Final Rule (77 FR 18310) 

provides more detail about this ‘‘single 

employee application,’’ which will be 

used to determine employee eligibility, 

QHP selection, and enrollment of 

qualified employees and their 

dependents. 

The information will be required of 

each employee upon initial application 

with subsequent information collections 

for the purposes of confirming accuracy 

of previous submissions or updating 

information from previous submissions. 

Information collection will begin during 

initial open enrollment in October 2013, 

per § 155.410 of the Exchanges Final 

Rule. Applications for the SHOP will be 

collected year round, per the rolling 

enrollment requirements of § 155.725 of 

the Exchanges Final Rule. 

Employees will be able to submit an 

application for the SHOP online, using 

a paper application, over the phone 

through a call center operated by an 

Exchange, or in person through an 

agent, broker, or Navigator, per 

§ 155.730(f) of the Exchanges Final Rule. 

If an employee does not enroll in 

coverage through the SHOP, the 

information will be erased after a 

specified period of time. If an employee 

enrolls in coverage through the SHOP, 

the information will be retained to 

document the enrollment, to allow 

reconciliation with issuer records, and 

to provide information for future 

coverage renewals or changes in 

coverage. 

Every qualified employee of an 

employer participating in the SHOP 

who wishes to apply for coverage 

through the SHOP will need to complete 

an application to determine his or her 

eligibility, QHP selection, and 

enrollment of the employee and his or 

her dependents. The applicant will also 

be asked to verify his or her 


TKELLEY on DSK3SPTVN1PROD with NOTICES
40062 Federal Register / Vol. 77, No. 130 / Friday, July 6, 2012 / Notices 

understanding of the application and 

sign attestations regarding information 

in the application. The completed 

application will be submitted to the 

SHOP in the employer’s state. 

Applicants who choose to complete 

the electronic application will need to 

create an online account at the 

beginning of the application process. 

We estimate that it will take 

approximately 0.159 hours (9.53 

minutes) per applicant to submit a 

completed paper application. The 

Congressional Budget Office (CBO) 

estimates approximately 3 million 

people will enroll in health insurance 

through a SHOP in 2014. Assuming 

family size of approximately 3 per 

employee, we expect approximately 1 

million employees to complete an 

application in 2014 for a total of 

approximately 93,300 burden hours. 

CBO estimates approximately 2 

million people will enroll in health 

insurance through a SHOP in 2015 and 

3 million in 2016. Consequently, we 

estimate that approximately 666,666 

employees will apply to a SHOP in 2015 

and approximately 1 million will apply 

in 2016. Form Number: CMS–10438 

(OCN: 0938—NEW); Frequency: Once; 

Affected Public: Individuals or 

households; Number of Respondents: 

1,000,000; Total Annual Responses: 

1,000,000; Total Annual Hours: 93,300 

hours. (For policy questions regarding 

this collection contact Leigha Basini at 

301–492–4307. For all other issues call 

410–786–1326.) 

3. Type of Information Collection 

Request: New collection; Title of 

information collection: Data Collection 

to Support Eligibility Determinations 

and Enrollment for Small Businesses in 

the Small Business Health Options 

Program; Use: In compliance with the 

requirement of section 3506(c)(2)(A) of 

the Paperwork Reduction Act of 1995, 

the Center for Consumer Information 

and Insurance Oversight, Centers for 

Medicare and Medicaid Services, 

Department of Health and Human 

Services, is publishing the following 

summary of a proposed information 

collection request for public comment. 

Interested persons are invited to send 

comments regarding this 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. 

Section 1311(b)(1)(B) of the 

Affordable Care Act requires that the 

SHOP assist qualified small employers 

in facilitating the enrollment of their 

employees in QHPs offered in the small 

group market. Section 1311(c)(1)(F) of 

the Affordable Care Act requires HHS to 

establish criteria for certification of 

health plans as QHPs and that these 

criteria must require plans to utilize a 

uniform enrollment form that qualified 

employers may use. Further, section 

1311(c)(5)(B) requires HHS to develop a 

model application and Web site that 

assists employers in determining if they 

are eligible to participate in SHOP. 

Consistent with these authorities, HHS 

has developed a single, streamlined 

form that employers will use to apply to 

the SHOP. Section 155.730 of the 

Exchanges Final Rule (77 FR 18310) 

provides more detail about this ‘‘single 

employer application,’’ which will be 

used to determine employer eligibility 

and to collect information necessary for 

purchasing coverage through the SHOP. 

The information will be required of 

each employer upon initial application 

with subsequent information collections 

for the purposes of confirming accuracy 

of previous submissions or updating 

information from previous submissions. 

Information collection will begin during 

initial open enrollment in October 2013, 

per § 155.410 of the Exchanges Final 

Rule. Applications for the SHOP will be 

collected year round, per the rolling 

enrollment requirements of § 155.725 of 

the Exchanges Final Rule 

Employers will be able to submit an 

application for the SHOP online, using 

a paper application, over the phone 

through a call center operated by an 

Exchange, or in person through an 

agent, broker, or Navigator, per 

§ 155.730(f) of the Exchanges Final Rule. 

If an employer does not complete the 

application, the information will be 

erased after a specified period of time. 

If an employer completes the 

application and offers coverage to 

qualified employees through the SHOP, 

the information will be retained to 

document the offer of coverage, to allow 

reconciliation with issuer records, and 

to provide information for future 

coverage renewals or changes in 

coverage. 

Every employer wishing to apply for 

coverage through the SHOP will need to 

complete an application to determine its 

eligibility to participate in the SHOP 

and to provide the information 

necessary for the employer to purchase 

coverage through the SHOP. The 

applicant will also be asked to verify his 

or her understanding of the application 

and sign attestations regarding 

information in the application. The 

completed application will be submitted 

to the SHOP in the employer’s state. 

Applicants who choose to complete the 

electronic application will need to 

create an online account at the 

beginning of the application process. 

We estimate that it will take 

approximately 0.209 hours (12.57 

minutes) per applicant to submit a 

completed paper application. We had 

several individuals fill out the paper 

application, averaged their times to 

complete the application, and factored 

in additional time due to potential 

variation in applicants’ health literacy 

rate. The Congressional Budget Office 

(CBO) estimates approximately 3 

million people will enroll in health 

insurance through a SHOP in 2014. 

Assuming a small business size of 

approximately 5 employees and a family 

size of approximately 3 per employee, 

we estimate that approximately 200,000 

employers will apply to a SHOP in 

2014. Consequently, we expect 

approximately 200,000 employers to 

complete an application in 2014 for a 

total of approximately 24,520 burden 

hours. 

CBO estimates approximately 2 

million people will enroll in health 

insurance through a SHOP in 2015 and 

3 million in 2016. Consequently, we 

estimate that approximately 133,333 

employers will apply to a SHOP in 2015 

and approximately 200,000 will apply 

in 2016. Form Number: CMS–10439 

(OCN: 0938—NEW); Frequency: Once 

per year; Affected Public: Private Sector: 

Business or other for-profit, non-forprofit institutions, or farms; Number of 

Respondents: 200,000; Total Annual 

Responses: 200,000; Total Annual 

Hours: 24,520 hours. (For policy 

questions regarding this collection 

contact Leigha Basini at 301–492–4307. 

For all other issues call 410–786–1326.) 

4. Type of Information Collection 

Request: New collection; Title of 

information collection: Data Collection 

to Support Eligibility Determinations for 

Insurance Affordability Programs and 

Enrollment through Affordable 

Insurance Exchanges, Medicaid and 

Children’s Health Insurance Program 

Agencies; Use: In compliance with the 

requirement of section 3506(c)(2)(A) of 

the Paperwork Reduction Act of 1995, 

the Center for Consumer Information 

and Insurance Oversight, Centers for 

Medicare and Medicaid Services, 

Department of Health and Human 

Services, is publishing the following 

summary of a proposed information 

collection request for public comment. 

Interested persons are invited to send 

comments regarding this burden 


TKELLEY on DSK3SPTVN1PROD with NOTICES
Federal Register / Vol. 77, No. 130 / Friday, July 6, 2012 / Notices 40063 

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. 

Section 1413 of the Affordable Care 

Act directs the Secretary of Health and 

Human Services to develop and provide 

to each State a single, streamlined form 

that may be used to apply for coverage 

through the Exchange and Insurance 

Affordability Programs, including 

Medicaid, the Children’s Health 

Insurance Program (CHIP), and the Basic 

Health Program, as applicable. The 

application must be structured to 

maximize an applicant’s ability to 

complete the form satisfactorily, taking 

into account the characteristics of 

individuals who qualify for the 

programs. A State may develop and use 

its own single streamlined application if 

approved by the Secretary in accordance 

with section 1413 and if it meets the 

standards established by the Secretary. 

Section 155.405(a) of the Exchange 

Final Rule (77 FR 18310) provides more 

detail about the application that must be 

used by the Exchange to determine 

eligibility and to collect information 

necessary for enrollment. The 

regulations in § 435.907 and § 457.330 

establish the requirements for State 

Medicaid and CHIP agencies related to 

the use of the single streamlined 

application. CMS is designing the single 

streamlined application to be a dynamic 

online application that will tailor the 

amount of data required from an 

applicant based on the applicant’s 

circumstances and responses to 

particular questions. The paper version 

of the application will not be able to be 

tailored in the same way but is being 

designed to collect only the data 

required to determine eligibility. 

Individuals will be able to submit an 

application online, through the mail, 

over the phone through a call center, or 

in person, per § 155.405(c)(2) of the 

Exchange Final Rule, as well as through 

other commonly available electronic 

means as noted in § 435.907(a) and 

§ 457.330 of the Medicaid Final Rule. 

The application may be submitted to an 

Exchange, Medicaid or CHIP agency. 

The online application process will 

vary depending on each applicant’s 

circumstances, their experience with 

health insurance applications and 

online capabilities. The goal is to solicit 

sufficient information so that in most 

cases no further inquiry will be needed. 

We estimate that on average it will take 

approximately .50 hours (30 minutes) to 

complete for people applying for 

Insurance Affordability Programs. It will 

take an estimated .25 hours (15 minutes) 

to complete without consideration for 

Insurance Affordability Programs. We 

expect approximately 7,700,260 

applications to be submitted for 

Insurance Affordability Programs 

between 2014 and 2016. The total 

burden is estimated to be 2,264,329 

hours for 2014, and 605,920 hours and 

979,881 hours for years 2015 and 2016, 

respectively. We estimate 1,139, 240 

applications to be submitted online 

without consideration for Insurance 

Affordability Programs between 2014 

and 2016, resulting in 71,203 hours of 

burden each year in 2014 and in 2015, 

and 142,405 burden hours in 2016. The 

paper application process will take 

approximately .75 hours (45 minutes) to 

complete for those applying for 

Insurance Affordability Programs and 

.33 hours (20 minutes) for those 

applying without consideration for 

Insurance Affordability Programs. We 

expect approximately 855,584 

applications to be submitted for 

Insurance Affordability Programs on 

paper in 2014 through 2016 for a total 

of 377,388 estimated burden hours in 

2014. The burden hours are projected to 

be 100,987 hours and 163,314 hours in 

2015 and 2016, respectively. We 

estimate 126,581 applications will be 

submitted without consideration for 

Insurance Affordability Programs from 

2014 through 2016. Total burden hours 

are expected to be 10,443 hours in 2014 

and 2015, and 20,886, in 2016. Form 

Number: CMS–10440 (OCN: 0938– 

NEW); Frequency: Once per year; 

Affected Public: Individuals and 

households; Number of Respondents: 

3,273,889; Total Annual Responses: 

3,273,889; Total Annual Hours: 

1,669,683 hours. (For policy questions 

regarding this collection contact Hannah 

Moore at 301–492–4232. For all other 

issues call 410–786–1326.) 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS’ Web Site 

address at http://www.cms.hhs.gov/ 

PaperworkReductionActof1995, or 

Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or 

call the Reports Clearance Office on 

(410) 786–1326. 

In commenting on the proposed 

information collections please reference 

the document identifier or OMB control 

number. To be assured consideration, 

comments and recommendations must 

be submitted in one of the following 

ways by September 4, 2012: 

1. Electronically. You may submit 

your comments electronically to http:// 

www.regulations.gov. Follow the 

instructions for ‘‘Comment or 

Submission’’ or ‘‘More Search Options’’ 

to find the information collection 

document(s) accepting comments. 

2. By regular mail. You may mail 

written comments to the following 

address: CMS, Office of Strategic 

Operations and Regulatory Affairs, 

Division of Regulations Development, 

Attention: Document Identifier (lll), 

Room C4–26–05, 7500 Security 

Boulevard, Baltimore, Maryland 21244– 

1850. 

Dated: June 29, 2012. 

Martique Jones, 

Director, Regulations Development Group, 

Division B, Office of Strategic Operations and 

Regulatory Affairs. 

[FR Doc. 2012–16508 Filed 7–2–12; 11:15 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10427 and CMS– 

10437] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS), Department of Health 

and Human Services, is publishing the 

following summary of proposed 

collections for public comment. 

Interested persons are invited to send 

comments regarding this 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 function; 

(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. 


TKELLEY on DSK3SPTVN1PROD with NOTICES