CMS-10666-Supporting_Statementf

Supporting Statement for Information Collection Requirements
for Non-Exchange Entities (CMS-10666/OMB control number: 0938-1329)
A. Background
The Patient Protection and Affordable Care Act, Public Law 111-148, enacted on March 23,
2010, and the Health Care and Education Reconciliation Act, Public Law 111-152, enacted on
March 30, 2010 (collectively, “Affordable Care Act”), expanded access to health insurance for
individuals and employees of small businesses through the establishment of new Affordable
Insurance Exchanges (Exchanges), including the Small Business Health Options Program
(SHOP). The Exchanges, which became operational on January 1, 2014, enhance competition in
the health insurance market, expand access to affordable health insurance for millions of
Americans, and provide consumers with a place to easily compare and shop for health insurance
coverage.
Section 1312(e) of the Affordable Care Act directs the Secretary of the Department of Health and
Human Services (HHS) to establish procedures under which a State may permit agents and
brokers to enroll qualified individuals and employers into qualified health plans (QHPs) offered
through an Exchange and to enable these agents and brokers to assist individuals in applying for
advance payments of the premium tax credit and cost-sharing reductions.
The HHS Notice of Benefit and Payment Parameters for 2017 Final Rule (2017 Payment Notice)
finalized the definition of standardized plan options at § 155.20 as well as one set of standardized
plan options for plan year (PY) 2017. It also codified the authority for HHS to differentially
display standardized options on consumer-facing plan comparison and shopping tools, such as
those on HealthCare.gov, at § 155.205(b)(1).
The HHS Notice of Benefit and Payment Parameters for 2018 Final Rule (2018 Payment Notice)
finalized two updated sets of standardized plan options. The 2018 Payment Notice also finalized
requirements for web-brokers and issuers that use the Classic Direct Enrollment (Classic DE) and
Enhanced Direct Enrollment (EDE) pathways to differentially display standardized plan options
in a manner consistent with that adopted by HHS for display on HealthCare.gov, at §§
155.220(c)(3)(i)(H) and 156.265(b)(3)(iv), respectively. The 2018 Payment Notice also finalized
that a web-broker or issuer that utilizes the Classic DE and EDE pathways could submit a request
to deviate from the differential display of standardized plan options on HealthCare.gov with
approval from HHS at §§ 155.220(c)(3)(i)(H) and 156.265(b)(3)(iv), respectively.
The original information collection request (ICR) that provided HHS the authority to collect the
information necessary for these requests to deviate was titled Non-Exchange Entities (0938-1329)
and was approved on May 23, 2017. The original ICR was discontinued on March 4, 2020 due to
the concurrent discontinuation of standardized plan options in the HHS Notice of Benefit and
Payment Parameters for 2019 Final Rule (2019 Payment Notice).
The ICR that provided HHS the authority to collect the necessary information to enable webbrokers and issuers using the Classic DE and EDE pathways to submit a request to deviate from
the manner in which standardized plan options are differentially displayed on HealthCare.gov was
reinstated concurrently with the reintroduction of standardized plan option requirements in the
HHS Notice of Benefit and Payment Parameters for 2023 Final Rule (2023 Payment Notice). The

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standardized plan options that were differentially displayed on HealthCare.gov and that webbrokers or issuers utilizing the Classic DE and EDE pathways were required to differentially
display were updated in the HHS Notice of Benefit and Payment Parameters for 2024 Final Rule
(2024 Payment Notice) and HHS Notice of Benefit and Payment Parameters for 2025 Final Rule
(2025 Payment Notice). This ICR serves as a formal request for an extension without change of a
currently approved clearance.
B. Justification
1.

Need and Legal Basis

Section 1312(e) of the Affordable Care Act directs the Secretary of HHS to establish procedures
under which a State may permit agents and brokers to enroll qualified individuals and employers
into QHPs offered through an Exchange and to enable these agents and brokers to assist
individuals in applying for advance payments of the premium tax credit and cost sharing
reductions.
In the 2018 Payment Notice, at §§ 155.220(c)(3)(i)(H) and 156.265(b)(3)(iv), HHS codified the
authority to require web-brokers and issuers that use the Classic DE and EDE pathways to
differentially display standardized plan options in a manner consistent with that adopted by HHS
for display on HealthCare.gov in order to promote consistent messaging across all enrollment
platforms, including those of web-brokers and Classic DE and EDE issuers.
In the 2018 Payment Notice, HHS noted that it anticipated that the differential display of
standardized plan options would not require significant modification of web-broker and issuer
platforms but that such display would provide an important service for consumers seeking to
enroll in a standardized plan option. However, HHS noted that system constraints may prevent
web-brokers and issuers from precisely mirroring the differential display of standardized plan
options on HealthCare.gov.
For this reason, in the 2018 Payment Notice, HHS noted it would not require the manner of
differentiation of standardized plan options on non-Exchange web sites to be identical to that
adopted on HealthCare.gov. Instead, HHS noted that the display must have the same level of
differentiation and clarity as is provided on HealthCare.gov. Thus, to permit web-brokers and
issuers using the DE and EDE pathways additional flexibility, HHS allowed these entities to
submit a request to deviate from the manner in which standardized plan options are differentially
displayed on HealthCare.gov. HHS stated that these requests to deviate would be reviewed
based on whether the same level of differentiation and clarity is being provided under the
requested deviation as is provided on HealthCare.gov.
The 2023 Payment Notice reintroduced requirements for issuers offering QHPs through the
Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal Platform
(SBE-FPs) to offer standardized plan options at § 156.201. The 2023 Payment Notice also
resumed differential display of these standardized plan options on HealthCare.gov in accordance
with § 155.205(b)(1). The 2023 Payment Notice also resumed enforcement of the requirements
for web-brokers and issuers that use the Classic DE and EDE pathways to differentially display
standardized plan options in a manner consistent with that adopted by HHS for display on
HealthCare.gov, at §§ 155.220(c)(3)(i)(H) and 156.265(b)(3)(iv), respectively. Finally, the 2023
Payment Notice resumed the flexibility permitting web-brokers and issuers utilizing the Classic

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DE and EDE pathways to submit a request to deviate from the differential display of standardized
plan options on HealthCare.gov, with approval from HHS.
The current ICR provides the authority for HHS to request information from these entities to
submit a request to deviate from the manner in which standardized plan options are differentially
displayed on HealthCare.gov, if these entities so choose. This flexibility will ensure that webbrokers and issuers using the DE and EDE pathways can continue to enroll qualified consumers
into QHPs offered through the Exchanges without disruption.
2.

Information Users

This ICR will provide HHS the authority necessary to request information from web-brokers and
QHP issuers using the Classic DE and EDE pathways to request to deviate from the manner in
which standardized plan options are differentially displayed on HealthCare.gov, if they so choose.
3.

Use of Information Technology

HHS anticipates that a majority of the systems, notices, and information collection required will
be automated. A majority of the information that is required by the collection of information will
be submitted electronically. HHS staff will analyze or review the data in the same manner by
which it was submitted and communicate with States, health insurance issuers, and other entities
using e-mail, telephone, or other electronic means.
4.

Duplication of Efforts

This information collection does not duplicate any other Federal effort.
5.

Small Businesses

This information collection will not have a significant impact on small business.
6.

Less Frequent Collection

If this information is collected on a less frequent basis, HHS will be unable to allow web-brokers
and QHP issuers using a DE or an EDE pathway to request to deviate from the manner in which
standardized plan options are differentially displayed on HealthCare.gov, which could impede the
enrollment of qualified individuals into QHPs through these enrollment pathways. Therefore, this
information must be collected on an annual basis to allow these web-brokers and issuers to submit
a request to deviate, if they so choose.
7.

Special Circumstances

There are no anticipated special circumstances.
8.

Federal Register/Outside Consultation

A 60-day Notice will be published in the Federal Register on September 3, 2025 (90 FR 42587)
for the public to submit written comment on the information collection requirements. No
comments were received. The follow up 30-day notice published January 1, 2026 (91 FR
2534).
No additional outside consultation was sought.
9.

Payments/Gifts to Respondents
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No payments and/or gifts will be provided to respondents.
10. Confidentiality
All information collected will be kept private in accordance with regulations at § 155.260, Privacy
and Security of Personally Identifiable Information. Pursuant to this regulation, Exchanges may
only use or disclose personally identifiable information to the extent that such information is
necessary to carry out their statutory and regulatory mandated functions.
11. Sensitive Questions
There are no sensitive questions included in this information collection effort.
12. Burden Estimates (Hours & Wages)
We used the Bureau of Labor Statistics (BLS) website to estimate the burden for this collection.
The median hourly wage for web and digital interface designers is $47.37, plus a 100% fringe
benefit rate of $47.37, for an adjusted hourly wage of $94.74. The median hourly wage for
compliance officers is $36.38, plus a 100% fringe benefit rate of $36.38, for an adjusted hourly
wage of $72.76 per hour.
Table 1. Adjusted Hourly Wages Used in Burden Estimates
Occupational Title

Occupational
Code

Median Hourly
Wage ($/hour)
$47.37

Fringe Benefits
& Overhead
(100%) ($/hour)
$47.37

Adjusted
Hourly Wage
($/hour)
$94.74

Web and Digital
Interface Designers
Compliance Officer

15-1255
13-1041

$36.38

$36.38

$72.76

Burden for Web-Brokers and Issuers Utilizing the Classic DE and EDE Pathways to
Differentially Display Standardized Plan Options in a Manner Consistent with the Display
on HealthCare.gov
In accordance with §§ 155.220(c)(3)(i)(H) and 156.265(b)(3)(iv), web-brokers and issuers
utilizing the Classic DE and EDE pathways must differentially display standardized plan options
in a manner consistent with the display on HealthCare.gov, unless HHS approves a deviation.
We estimate that a total of 100 web-brokers and issuers utilizing the Classic DE and EDE
pathways will be subject to these requirements. We further estimate that it will take a web and
digital interface designer two hours annually, at cost of $94.74 per hour, to implement these
changes, at a total annual cost of $189.48 per entity. We therefore estimate a total annual burden
of 200 hours at a total annual cost of $18,948.00 for all applicable web-brokers and issuers
utilizing the Classic DE and EDE pathways.

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Table 2. Burden for Web-Brokers and Issuers Utilizing the Classic DE and EDE
Pathways to Differentially Display Standardized Plan Options in a Manner Consistent
with the Display on HealthCare.gov
Hourly Labor
Burden Total Burden Total Burden
Number of Costs (Hourly
Hours (Per Cost (Per
Costs (All
Labor Category
Respondents rate + 100%
Respondent) Respondent) Respondents)
Fringe Benefits)
Web and Digital
Interface
100
$94.74
2
$189.48
$18,948.00
Designers
Total - Annual

200

$189.48

$18,948.00

Burden for Web-Brokers and Issuers Utilizing the Classic DE and EDE Pathways to
Request to Deviate from the Display on HealthCare.gov
HHS is aware that system constraints may prevent web-brokers and issuers utilizing the Classic
DE and EDE pathways from precisely mirroring the differential display of standardized plan
options on HealthCare.gov on their own platforms. For this reason, HHS does not require the
differential display of standardized plan options on non-Exchange web sites to be identical to that
of HealthCare.gov. Instead, HHS requires that the display must have the same level of
differentiation and clarity as is provided on HealthCare.gov.
Furthermore, to permit web-brokers and issuers using the Classic DE and EDE pathways
additional flexibility, HHS allows these entities to submit a request to deviate from the manner in
which standardized plan options are differentially displayed on HealthCare.gov. These requests
are reviewed based on whether the same level of differentiation and clarity is being provided
under the requested deviation that is provided on HealthCare.gov.
Of the 100 total web-brokers and issuers utilizing the Classic DE and EDE pathways, we estimate
that 15 will submit a request to deviate from the manner in which standardized plan options are
differentially displayed on HealthCare.gov. We estimate it will take a compliance officer (at an
hourly rate of $72.76) approximately one hour annually to complete and submit the request to
deviate. We therefore estimate an annual cost burden of $72.76 per applicable entity. This
amounts to an annual burden of 15 hours at a total annual cost of $1,091.40 for all web-brokers
and issuers utilizing a Classic DE and EDE pathway to submit a request to deviate from the
manner in which standardized plan options are differentially displayed on HealthCare.gov.

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Table 3. Burden for Web-Brokers and Issuers Utilizing the Classic DE and EDE
Pathways to Request to Deviate from the Display on HealthCare.gov
Hourly Labor
Burden Total Burden Total Burden
Number of Costs (Hourly
Hours (Per Cost (Per
Costs (All
Labor Category
Respondents rate + 100%
Respondent) Respondent) Respondents)
Fringe Benefits)
Compliance
Officer

15

$72.76

Total - Annual

1

$72.76

$1,091.40

15

$72.76

$1,091.40

Table 4. Summary of Annual Total Burden
Table Number: Name
Table 2. Burden for Web-Brokers
and Issuers Utilizing the Classic
DE and EDE Pathways to
Differentially Display Standardized
Plan Options in a Manner
Consistent with the Display on
HealthCare.gov
Table 3. Burden for Web-Brokers
and Issuers Utilizing the Classic
DE and EDE Pathways to Request
to Deviate from the Display on
HealthCare.gov
Total

CFR Section

Total Annual Total Annual
Burden Hours Burden Costs

45 CFR §§
155.220(c)(3)(i)(H) and
156.265(b)(3)(iv)

200

$18,948.00

45 CFR §§
155.220(c)(3)(i)(H) and
156.265(b)(3)(iv)

15

$1,091.40

215

$20,039.40

13. Capital Costs
There are no anticipated capital costs associated with these information collections.
14. Cost to Federal Government
We estimate that the operations and maintenance costs for the data collection tool and the data
collection support to have a total cost to the Federal government of $3,708.50 per year. The
calculations for CCIIO employees’ hourly salary was obtained from the OPM website.

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Table 5. Administrative Burden Costs for the Federal Government Associated with the
Data Collection
Task
Operations, maintenance, and data collection support
2 GS-13 (step 7): 2 x $138.661 x 10 hours
Managerial review and oversight
1 GS-15 (step 7): $187.061 x 5 hours
Total Costs to Government

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Hourly basic rate + 100% fringe benefit rate.

Estimated Cost
$2,773.20
$935.30
$3,708.50

15. Changes to Burden
There is an overall decrease in the financial burden from the 2022 PRA package because of a
reduction in the burden estimate for web-brokers and issuers utilizing the Classic DE and EDE
pathways to differentially display standardized plan options consistent with the manner in which
they are differentially displayed on HealthCare.gov in the current collection is lower. Specifically,
the annual total burden estimate in the previous PRA package was 275 hours at a cost of
$24,205.50, while the annual total burden estimate in the current iteration of the collection is 215
hours at a cost of $20,039.40, a reduction of 60 hours and $4,166.10, respectively.
This reduction is primarily due to the lower number of entities subject to this requirement in the
current collection. Specifically, in the previous PRA package, we estimated 110 entities would be
subject to the standardized option differential display requirements and we propose 100 entities,
which is a decrease of 10 entities. Additionally, we estimated 55 entities would submit a request
to deviate from the manner in which standardized plan options are differentially displayed on
HealthCare.gov and we propose 15 entities will submit such a request. This reduction of 40
entities is based on the last three years of our experience in this information collection.
16. Publication/Tabulation Dates
There are no plans to publish the outcome of the data collection. This is because the data that
web-brokers and issuers that utilize the Classic DE and EDE pathways will submit as part of this
collection will solely pertain as to whether these entities are requesting to deviate slightly from the
manner in which standardized plan options are differentially displayed on HealthCare.gov on their
own enrollment platforms. Such data is not in a standardized, machine-readable format. Instead, it
has historically been in the form of a brief written request.
17. Expiration Date
The expiration date and OMB control number will appear on the first page of the instrument in
the top, right corner.
18. Certification Statement
There are no exceptions to the certification statement.

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