Annual Eligibility
Redetermination, Product Discontinuation and Renewal Notices
(CMS-10527)
Revision of a currently approved collection
No
Regular
07/01/2025
Requested
Previously Approved
36 Months From Approved
06/30/2026
5,397
5,881
66,091
72,002
0
0
The final rule "Patient Protection and
Affordable Care Act; Annual Eligibility Redeterminations for
Exchange Participation and Insurance Affordability Programs; Health
Insurance Issuer Standards Under the Affordable Care Act, Including
Standards Related to Exchanges", provides that a Marketplace may
choose to conduct the annual redetermination process for a plan
year (1) in accordance with the existing procedures described in 45
CFR 155.335; (2) in accordance with procedures described in
guidance issued by the Secretary for the coverage year; or (3)
using an alternative proposed by the Marketplace and approved by
the Secretary. The guidance document "Guidance on Annual
Redeterminations for Coverage for 2015" contains the procedures
that the Secretary is specifying for the 2015 coverage year, as
noted in (2) above. These procedures will be adopted by the
Federally-facilitated Marketplace. Under this option, the
Marketplace will provide three notices. The final rule also amends
the requirements for product renewal and re-enrollment (or
nonrenewal) notices to be sent by Qualified Health Plan (QHP)
issuers in the Exchanges and specifies content for these notices.
The accompanying guidance document "Form and Manner of Notices When
Discontinuing or Renewing a Product in the Group or Individual
Market" provides standard notices for product discontinuation and
renewal to be sent by issuers of QHPs and issuers in the individual
market. Issuers in the small group market may use the draft Federal
standard small group notices released in the June 26, 2014 bulletin
"Draft Standard Notices When Discontinuing or Renewing a Product in
the Small Group or Individual Market", or any forms of the notice
otherwise permitted by applicable laws and regulations. States that
are enforcing the Affordable Care Act may develop their own
standard notices, for product discontinuances, renewals, or both,
provided the State-developed notices are at least as protective as
the Federal standard notices.
The burden for individual
market QHP issuers has increased by approximately 423.5 hours (from
12,820.5 to 13,244) due to an increase in the estimated number of
QHP issuers (from 333 to 344). The burden for issuers in the
individual market outside the Exchange and issuers in the small
group market has decreased by 6,335 hours (from 59,326 to 52,992)
due to a decrease in the estimated number of issuers in those
markets (from 1,340 to 1,206). In total, there is a reduction in
burden by approximately 5,911 hours.
$0
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.