Information Comparision with Insurance Data

Forms and Documents

Document Name	Status
Form 1 Insurance Match File: Quarterly Reporting Electronically Form and Instruction	New
Form 1 Insurance Match File: Daily Reporting Electronically Form and Instruction	Modified
Form 1 Insurance Match File: Weekly Reporting Electronically Form and Instruction	Modified
Form 1 Insurance Match File: Monthly Reporting Electronically Form and Instruction	Modified
0970-0342_Insurance Match_Supporting_Statement_102523.docx Supporting Statement A	2023-11-06

IC Document Collections

IC ID	Document Title	Status
263231	Insurance Match File: Quarterly Reporting Electronically Form and Instruction	New
228579	Insurance Match File: Daily Reporting Manually Other-Daily Reporting Manual Submission	Modified
228578	Insurance Match File: Daily Reporting Electronically Form and Instruction	Modified
228577	Insurance Match File: Weekly Reporting Electronically Form and Instruction	Modified
228576	Insurance Match File: Monthly Reporting Electronically Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0342	ICR Reference No: 202311-0970-003
Status: Received in OIRA	Previous ICR Reference No: 202010-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No: OCSE
Title: Information Comparision with Insurance Data
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/13/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2024
Responses	31,173	28,390
Time Burden (Hours)	3,091	2,818
Cost Burden (Dollars)	0	0

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Abstract: The Information Comparison with Insurance Data Match (“Insurance Match”) program is a cooperative effort between the federal Office of Child Support Services (OCSS), states, insurers, and third-party administrators or agents. The information collected for the Insurance Match is necessary to help state child support agencies (“CSAs”) collect past-due support from noncustodial parents. To facilitate the Insurance Match, OCSS uses a centralized, efficient, secure, and cost-effective automated process that compares information about individuals who may receive a payment from an insurance claim, settlement, or award (“claim”) with information in the OCSS Debtor File (OMB #0970-0161, Federal Tax Refund Offset, Administrative Offset, and Passport Denial) to identify obligors who owe past-due support. State workers’ compensation agencies and the U.S. Department of Labor also provide OCSS with claim information for collecting past-due child support from noncustodial parents. State agency and insurer participation in the Insurance Match program is voluntary; however, 13 states have specific mandates for insurers to report claims. The Insurance Match program assists with meeting these state mandates. The information collection activities associated with the Insurance Match program are authorized by 42 U.S.C. § 652(a)(9) and (m), which authorizes the Secretary of the U.S. Department of Health and Human Services (HHS), through the Federal Parent Locator Service (FPLS), to conduct comparisons of information concerning individuals with a child support debt with information that insurers (or their agents) maintain concerning insurance claims. This approval request is for a revision of a currently approved information collection. An explanation of changes is provided under item #15 of Supporting Statement A.

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Authorizing Statute(s): US Code: 42 USC 652(a)(9) and (m) Name of Law: Information Comparisons with Insurance Data
  

Citations for New Statutory Requirements: None

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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:
	88 FR 43356	07/07/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 77590	11/13/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Insurance Match File: Daily Reporting Electronically	1	OCSE Insurance Match Standard Input File Record
Insurance Match File: Daily Reporting Manually
Insurance Match File: Monthly Reporting Electronically	1	OCSE Insurance Match Standard Input File Record
Insurance Match File: Quarterly Reporting Electronically	1	OCSE Insurance Match Standard Input File Record
Insurance Match File: Weekly Reporting Electronically	1	OCSE Insurance Match Standard Input File Record

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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	31,173	28,390	0	2,783	0	0
Annual Time Burden (Hours)	3,091	2,818	0	273	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The Insurance Match instruments underwent minor edits to replace “Office of Child Support enforcement (OCSE)” with “Office of Child Support Services (OCSS)”. These adjustments constitute a program change but do not impact the burden. The burden hour increased since the previous approval, from 2,817.21 hours to 3,090.86 hours. This adjustment is the result of an increase in the number of new Insurance Match program respondents from 145 to 165 and adding a burden estimate for quarterly reporting respondents. The estimated average amount of time for each response is unchanged.

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Annual Cost to Federal Government: $2,730,382

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.     Yes

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.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

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: 11/13/2023

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