Information Collection for Transparency in Coverage Reporting by Qualified Health Plan Issuers (CMS-10572)

Forms and Documents

Document Name	Status
Form CMS-10572 Annual Submission of Transparency in Coverage Data Form and Instruction	Modified
CMS-10572 - Appendix E - 60-Day Comment Response.docx Supplementary Document	2025-10-01
CMS-10572 - Supporting Statement.docx Supporting Statement A	2025-10-01

IC Document Collections

IC ID	Document Title	Status
221316	Annual Submission of Transparency in Coverage Data Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1310	ICR Reference No: 202509-0938-031
Status: Received in OIRA	Previous ICR Reference No: 202111-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Information Collection for Transparency in Coverage Reporting by Qualified Health Plan Issuers (CMS-10572)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/01/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	400	0
Time Burden (Hours)	57,200	0
Cost Burden (Dollars)	0	0

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Abstract: Section 156.220 of Title 45 of the Code of Federal Regulations establishes new standards for qualified health plan (QHP) issuers to submit specific information related to transparency in coverage. QHPs are required to post and make are established for the submission of specific information data related to transparency in coverage available to the public in plain language and submit this data to the Department of Health and Human Services (HHS), the Exchange, and the State insurance commissioner and for posting this information to make it available to the public in plain language. Section 2715A of the Public Health Service Act as added by the ACA largely extends the transparency provisions set forth in section 1311(e)(3) to non-grandfathered group health plans and health insurance issuers offering group and individual health insurance coverage.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 1311 Name of Law: Patient Protection and Affordable Care Act (Affordable Care Act)
  

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

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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:
	90 FR 16685	04/21/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 45941	09/24/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Annual Submission of Transparency in Coverage Data	CMS-10572, CMS-10572 , CMS-10572, CMS-10572, CMS-10572, CMS-10572	QHP Issuer Data Collection - Appendix A2 ,   Data Submission Template - Appendix C ,   Data Elements - Appendix A1 ,   Data Templates Appendix B ,   Data Template Appendix B2 ,   Data Template - Appendix D

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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	400	0	0	0	40	360
Annual Time Burden (Hours)	57,200	0	0	0	5,720	51,480
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: There is an overall increase in the financial burden from the 2022 PRA package. The number of QHP issuers increased from 360 issuers to 400 issuers, an increase of 40 issuers. The total burden hours increased from 51,480 hours to 57,200 hours, an increase of 5,720 hours. The estimated cost increased from $3,404,476.80 to $3,949,648, an increase of $545,171.20. All prior iterations of wage data was based on mean values and the current iteration is based on median values.

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Annual Cost to Federal Government: $268,952

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: 10/01/2025

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