Marketplace Operations (CMS-10637)

Forms and Documents

Document Name	Status
Appendix_A_Marketplace_Operations_60-Day_Comment_Response_508.pdf Supplementary Document	2025-12-16
CMS-10637 Marketplace Operations Supporting Statement_10.22.25.docx Supporting Statement A	2025-12-16

IC Document Collections

IC ID	Document Title	Status
230943	Enrollment Process for Qualified Individuals (§ 156.1230)	Modified
230942	Consumer Cases Related to Qualified Health Plans and Qualified Health Plan Issuers	Modified
230941	AV Continuance Tables Other-Template	Unchanged

ICR Details

OMB Control No: 0938-1353	ICR Reference No: 202512-0938-018
Status: Received in OIRA	Previous ICR Reference No: 202206-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Marketplace Operations (CMS-10637)
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: 12/16/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	504	0
Time Burden (Hours)	2,325,340	0
Cost Burden (Dollars)	0	0

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Abstract: The data collections and third-party disclosure requirements will assist HHS in determining Exchange compliance with Federal standards and monitoring QHP issuers in FFEs for compliance with Federal QHP issuer standards. The data collection will assist HHS in monitoring Web-brokers for compliance with Federal Web-broker standards. The data collected by health insurance issuers and Exchanges will help to inform HHS, Exchanges, and health insurance issuers as to the participation of individuals, employers, and employees in the individual Exchange, the SHOP, and the premium stabilization programs.

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Authorizing Statute(s): US Code: 45 USC 156 Name of Law: Health Insurance Issuer Standards under the Affordable Care Act
   PL: Pub.L. 111 - 156 1302 Name of Law: Patient Protection and Affordable Care Act
   US Code: 45 USC 155 Name of Law: Exchange Establishment Standards and Other Related Standards under the Affordable Care Act
  

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:
	90 FR 30940	07/11/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 57473	12/11/2025
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
AV Continuance Tables
Consumer Cases Related to Qualified Health Plans and Qualified Health Plan Issuers
Enrollment Process for Qualified Individuals (§ 156.1230)

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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	504	0	0	0	67	437
Annual Time Burden (Hours)	2,325,340	0	0	0	302,595	2,022,745
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 because of the increase in the number of issuers from 437 to 503, which is an increase of 66 issuers. Regarding the issuer burden in maintaining records of consumer case resolution and inputting into the HHS-developed casework tracking system, there was an increase in the number of respondents from 361 in the previous package to 415 in the current package. Additionally, regarding issuer burden in maintaining a DE web site, there was an increase in the number of respondents from 77 in the previous package to 88 in the current package. The total annual burden increased from 2,022,725 hours to 2,325,340 hours, which is an increase of 302,595 hours.

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Annual Cost to Federal Government: $888,078

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: 12/16/2025

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