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Federal Register / Vol. 86, No. 177 / Thursday, September 16, 2021 / Proposed Rules
affected public, including automated collection techniques.
The Departments are soliciting public comment on each of the required issues under section 3506c2A of the PRA
for the following information collection requirements.
A. Wage Estimates To derive wage estimates, HHS
generally used data from the Bureau of
Labor Statistics to derive average labor costs including a 100 percent increase for fringe benefits and overhead for estimating the burden associated with the ICRs.36 Table 1 in these proposed rules presents the mean hourly wage, the cost of fringe benefits and overhead, and the adjusted hourly wage.
As indicated, employee hourly wage estimates have been adjusted by a factor of 100 percent. This is necessarily a
rough adjustment, both because fringe benefits and overhead costs vary significantly across employers, and because methods of estimating these costs vary widely across studies.
Nonetheless, there is no practical alternative, and HHS is of the view that doubling the hourly wage to estimate total cost is a reasonably accurate estimation method.

TABLE 1WAGE ESTIMATES
Occupational code
Occupation title Computer and Information Systems Managers
Computer Programmers
Secretaries and Administrative Assistants, Except Legal, Medical, and Executive
Business Operations Specialist
Database Administrator
Lawyer
Insurance Sales Agents

B. ICRs Regarding Disclosure of Agent and Broker Compensation to Individuals in Individual Health Insurance Coverage and Short-Term, Limited-Duration Insurance 45 CFR
148.410c2i and ii and c3 and 4
As discussed in section III.B of the preamble of these proposed rules, section 2746 of the PHS Act, as added by section 202c of Title II of Division BB of the CAA, requires health insurance issuers offering individual health insurance coverage or short-term, limited-duration insurance to make disclosures to enrollees regarding direct and indirect compensation provided by the issuer to an agent or broker associated with enrolling individuals in such coverage, prior to when the individual finalizes their plan selection, as well as on any documentation confirming the individuals enrollment, including enrollment documentation required in applicable state or Federal law or an initial enrollment package. At new proposed 45 CFR 148.410c, HHS
proposes to codify these disclosure requirements.
HHS assumes that the compensation information to be provided to potential policyholders prior to finalizing enrollment would be provided by agents and brokers on behalf of issuers. As discussed in section III.B of the 36 See May 2020 Bureau of Labor Statistics, Occupational Employment Statistics, National Occupational Employment and Wage Estimates.
Available at https www.bls.gov/oes/current/oes_
nat.htm.

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Mean hourly wage $/hr.

Fringe benefits and overhead $/hr.

Adjusted hourly wage $/hr.

113021
151251

$77.76
45.98

$77.76
45.98

$155.52
91.96

436014
131198
151245
231011
413021

19.43
40.53
48.60
71.59
33.22

19.43
40.53
48.60
71.59
33.22

38.86
81.06
97.20
143.18
66.44

preamble of these proposed rules, HHS
anticipates the required information would be provided in the form of a commission schedule, a similar document satisfying the requirements of 45 CFR 148.410c5, or a supplemental document detailing additional compensation not on the commission schedule, detailing the compensation structure of agents and brokers who assist consumers in enrolling in and purchasing individual health insurance coverage or short-term, limited-duration insurance. HHS anticipates that the burden associated with the disclosure requirement, prior to implementation, would include review by a lawyer. HHS
assumes that a lawyer for each issuer would need 2 hours at an hourly rate of $143.18 to review the regulation, and prepare instructions for issuers to relay to individual agents and brokers to implement the disclosure requirements.
The burden for each issuer would be 2
hours, with an equivalent cost of approximately $286. There are an estimated 1,298 issuers in the individual market 37 and 26 issuers of short-term, limited-duration insurance coverage,38 for a total of 1,324 issuers.
Therefore, the total annual burden to all issuers to implement the disclosure requirement would be 2,648 hours with an equivalent cost of approximately $379,141. The review of the statute, regulation, and issuers implementation
plan would likely occur annually to ensure compliance with any potential changes to the regulation. HHS assumes that each agent or broker would need 30
minutes at an hourly rate of $66.44
annually to review the requirements and the instructions from issuers. The total burden for each agent or broker would be 0.5 hours with an equivalent cost of approximately $33. As of June 10, 2021, there were 55,541 agents or brokers working with issuers and each agent or broker had approximately two appointment arrangements which are mandated by state law and govern the compensation provided to agents and brokers for assisting consumers.39
Therefore, the total burden for all agents and brokers, to review instructions from the issuers with which they have appointment arrangements, would be 27,770.5 hours, with an equivalent cost of approximately $1,845,072.
HHS estimates the cost associated with this disclosure requirement, when provided in situations related to inperson enrollment in coverage, to be limited to only printing and material costs. HHS estimates that each commission schedule would be, on average, 4 pages in length, at a cost of $0.05 per page, for a total of $0.20 per provided schedule. Printing of supplemental documentation disclosing compensation not included on the commission schedule would be, on
37 Based on data from medical loss ratio MLR
annual report for the 2019 MLR reporting year, available at https www.cms.gov/CCIIO/Resources/
Data-Resources/mlr.
38 National Association of Insurance Commissioners, 2019 Accident and Health Policy
Experience Report. https content.naic.org/sites/
default/files/publication-ahp-lr-accident-healthreport.pdf.
39 Based on information found in the National Insurance Producer Registrys Producer Database PDB.

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