Supporting Statement 6-16-11

SUPPORTING STATEMENT
1. CIRCUMSTANCES NECESSITATING COLLECTION OF INFORMATION
Beginning in 2014, under the Patient Protection and Affordable Care Act, Public Law 111-148, and the Health Care and
Education Reconciliation Act, Public Law 111-152, states will establish exchanges to facilitate enrollment in qualified
health plans by individuals. Eligible individuals may claim a premium tax credit on their tax returns that will pay part of
the premiums for health plans. In many cases exchanges will approve monthly advance payments of the credit to
insurance companies. Section 36B(f)(3) of the Internal Revenue Code requires exchanges to report information
concerning individuals enrolling in qualified health plans that will assist the individuals to properly complete their tax
returns and assist the Internal Revenue Service to determine a taxpayer's eligibility for the premium tax credit and the
correct amount of the credit.

2. USE OF DATA
The collection of information is necessary (a) to evaluate a taxpayer's eligibility for a premium tax credit, (b) to
determine the amount of a taxpayer's premium tax credit, and (c) to properly reconcile a taxpayer's premium tax credit
with advance credit payments.

3. USE OF IMPROVED INFORMATION TECHNOLOGY TO REDUCE BURDEN
The exchanges will use electronic media to compile and provide the information to the Internal Revenue Service, but
we expect that exchanges will provide paper information statements to enrollees.

4. EFFORTS TO IDENTIFY DUPLICATION
We have attempted to eliminate duplication within the agency wherever possible.

5. METHODS TO MINIMIZE BURDEN ON SMALL BUSINESSES OR OTHER SMALL ENTITIES
Not applicable.

6. CONSEQUENCES OF LESS FREQUENT COLLECTION ON FEDERAL PROGRAMS OR
POLICY ACTIVITIES
Not applicable.

Form 14029 (Rev. 4-2009) Catalog Number 51944B Page 4

Department of the Treasury–Internal Revenue Service

7. SPECIAL CIRCUMSTANCES REQUIRING DATA COLLECTION TO BE INCONSISTENT
WITH GUIDELINES IN 5 CFR 1320.5(d)(2)
Not applicable.

8. CONSULTATION WITH INDIVIDUALS OUTSIDE OF THE AGENCY ON AVAILABILITY
OF DATA, FREQUENCY OF COLLECTION, CLARITY OF INSTRUCTIONS AND FORMS,
AND DATA ELEMENTS
This notice of proposed rulemaking will be published in the Federal Register to provide the public a 90-day period in
which to review and provide public comments relating to any aspect of the proposed regulation. A public hearing will
be held.

9. EXPLANATION OF DECISION TO PROVIDE ANY PAYMENT OR GIFT TO RESPONDENTS
Not applicable.

10. ASSURANCE OF CONFIDENTIALITY OF RESPONSES
Generally, tax returns and tax return information are confidential as required by 26 U.S.C. 6103.

11. JUSTIFICATION OF SENSITIVE QUESTIONS
Not applicable.

12. ESTIMATED BURDEN OF INFORMATION COLLECTION
This document contains proposed regulations relating to the health insurance premium assistance credit enacted by
the Patient Protection and Affordable Care Act (PPACA). The regulations provide guidance to individuals who claim
the premium assistance credit and exchanges that make qualified health plans available to individuals and employers.
The burden for the collection of information contained in proposed regulation § 1.36B–5 will be reflected in the burden
on a form that the IRS will create to request the information in the proposed regulation.

Form 14029 (Rev. 4-2009) Catalog Number 51944B

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Department of the Treasury–Internal Revenue Service

13. ESTIMATED TOTAL ANNUAL COST BURDEN TO RESPONDENTS
Estimates of capital or start-up costs and costs of operation, maintenance, and purchase of services to provide
information are not available at this time.

14. ESTIMATED ANNUALIZED COST TO THE FEDERAL GOVERNMENT
Not applicable.

15. REASONS FOR CHANGE IN BURDEN
This is a new collection. The burden for the collection of information contained in proposed regulation § 1.36B–5 will
be reflected in the burden on a form that the IRS will create to request the information in the proposed regulation.

16. PLANS FOR TABULATION, STATISTICAL ANALYSIS AND PUBLICATION
Not applicable.

17. REASONS WHY DISPLAYING THE OMB EXPIRATION DATE IS INAPPROPRIATE
Not applicable.

18. EXCEPTIONS TO THE CERTIFICATION STATEMENT ON OMB PRA SUBMISSION FORM
Not applicable.
Note: The following paragraph applies to all of the collections of information in this submission:
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless
the collection of information displays a valid OMB control number. Books or records relating to a collection of
information must be retained as long as their contents may become material in the administration of any internal
revenue law. Generally, tax returns and tax return information are confidential, as required by 26 U.S.C. 6103.

19. REASON FOR EMERGENCY SUBMISSION
Not applicable.

Form 14029 (Rev. 4-2009) Catalog Number 51944B

Page 6

Department of the Treasury–Internal Revenue Service