Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)

ICR 202506-0938-001

OMB: 0938-1119

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2025-06-04
Supplementary Document
2025-06-04
Supplementary Document
2025-06-04
Supplementary Document
2025-06-04
Supporting Statement A
2025-06-04
ICR Details
0938-1119 202506-0938-001
Received in OIRA 202404-0938-009
HHS/CMS CCIIO
Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)
Reinstatement without change of a previously approved collection   No
Regular 06/04/2025
  Requested Previously Approved
36 Months From Approved
363 0
7,306 0
0 0

Information collected as a part of the application for this grant will be used to evaluate the applications and determine awardees. Information collected pursuant to the reporting requirements for awardees will be used to evaluate the progress of States in planning for and implementing Exchanges, and determine how the Secretary can provide assistance to achieve the goals of the grant program and the Affordable Care Act.

PL: Pub.L. 111 - 148 1311 Name of Law: Affordable choices of health benefit plans
  
None

Not associated with rulemaking

  89 FR 95217 12/04/2024
90 FR 21775 05/21/2025
No

  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 363 0 0 90 0 273
Annual Time Burden (Hours) 7,306 0 0 4,485 0 2,821
Annual Cost Burden (Dollars) 0 0 0 -1,251,236 0 1,251,236
Yes
Miscellaneous Actions
No
The number of respondents has been adjusted. CMS accounted for an increase in the number of SBE and SBE-FPs (from 21 to 23), which increased the total annual burden hours for the four reports remaining in this package from 2,821 to 7,306.

$79,956
No
    No
    No
Yes
No
No
No
Jamaa Hill 301 492-4190

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/04/2025


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