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Federal Register / Vol. 86, No. 177 / Thursday, September 16, 2021 / Proposed Rules average, 2 pages in length, at a cost of $0.05 per page, for a total of $0.10 per provided supplemental document. HHS
assumes, based on experience with the regulation of insurance agents and brokers operating on the Federallyfacilitated Exchanges and State-based Exchanges on the Federal Platform, that for most consumers, the information would be provided electronically or orally at minimal cost. HHS assumes that each agent or broker would provide, on average, ten commission schedules
and ten supplemental documents in print to consumers annually from each arrangement, for a total of 20
commission schedules and 20
supplemental documents provided in print. Each agent or broker would incur an annual printing cost of approximately $6. For all agents and brokers, HHS estimates that a total of 1,110,820 printed commission schedules and 1,110,820 printed supplemental documents would be provided to consumers, for a total
51757

printing cost of $333,246 annually. HHS
assumes that agents and brokers would be compensated by issuers for the printing costs associated with providing the compensation schedules and supplemental documents to consumers.
Therefore, HHS estimates that each issuer, on average, would incur printing costs of approximately $252 annually, starting in 2022. The total costs to all issuers for disclosures provided prior to enrollment, including printing costs, would be approximately $712,387.

TABLE 2PROPOSED ANNUAL ONGOING COSTS REGARDING DISCLOSURE OF AGENT AND BROKER COMPENSATION TO
ENROLLEES PRIOR TO ENROLLMENT
Estimated number of respondents
Respondent Issuer
Agents and Brokers

1,324
55,541

Estimated number of responses
Estimated burden hours
1,110,820
55,541

2,648
27,771.5

Issuers would also be required to provide an agent or broker compensation disclosure to individuals on documentation confirming enrollment, including enrollment documentation required by applicable state or Federal law or an initial enrollment package. HHS assumes that the disclosure and supplemental documentation disclosing compensation not included on the commission schedule provided along with documentation confirming enrollment would be available to all enrollees in the same coverage, in the same household, via the policyholder receiving the disclosure information and informing all enrollees on the plan. There are an estimated 1,298 issuers in the individual market providing approximately 8,639,866 enrollment confirmations annually, and 26 issuers of short-term, limited-duration insurance providing approximately 121,038 enrollment confirmations annually. HHS assumes that 50 percent of policyholders with individual health insurance coverage 40 and all policyholders with short-term, limitedduration insurance are assisted by agents or brokers.
In the individual market, 1,298
issuers would be required to provide commission schedules or similar documentation, and supplemental documentation detailing the structure for compensation not captured on the
commission schedule, along with approximately 4,319,933 enrollment confirmations, 3,328 on average per issuer. HHS estimates that approximately 66 percent of commission schedules and supplemental documents 2,851,156
disclosures would be mailed to individuals 34 percent sent electronically 41 in conjunction with any documents confirming enrollment or renewal notice with no additional mailing costs. Therefore, each issuer would provide approximately 2,197
commission schedules or similar documentation, as well as the supplemental documents by mail annually. HHS assumes that for each issuer, an administrative assistant would need 5 minutes at an hourly rate of $38.86 to print and enclose a commission schedule or similar documentation, as well as the supplemental document, with the enrollment confirmation or renewal notice, for a cost of $3.24 per commission schedule or similar documentation, and the supplemental documentation. The total burden for each issuer would be approximately 183
hours, with an equivalent cost of approximately $7,113 annually. For all issuers, the total annual burden would be 237,596 hours with an equivalent cost of approximately $9,232,993.
Assuming that the cost of printing each commission schedule or similar
40 Agents and brokers accounted for 47.8 percent of all consumers enrolled during the plan year 2020
open enrollment period. Source: CMS, Agents and Brokers in the Marketplace. https www.cms.gov/
CCIIO/Resources/Forms-Reports-and-OtherResources/Downloads/Agents-and-Brokers-in-theMarketplace.pdf.

41 According to data from the National Telecommunications and Information Agency, 34
percent of households in the United States accessed health records or health insurance online. https
www.ntia.doc.gov/blog/2020/more-half-americanhouseholds-used-internet-health-related-activities2019-ntia-data-show.

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Estimated labor costs $
$379,141
1,845,072

Estimated printing costs $333,246
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Estimated total cost $
$712,387
1,845,072

documentation would be $0.20, and the cost of printing each supplemental document would be $0.10, the average cost of printing for each issuer would be approximately $659 annually and the total cost of printing for all issuers would be approximately $855,347. The total annual cost for all issuers, including printing costs, would be $10,088,340.
For short-term, limited-duration insurance, 26 issuers would be required to provide commission schedules or similar documentation, as well as supplemental documentation detailing the structure for compensation not captured on the commission schedule, along with approximately 121,038
enrollment confirmations, 4,655 on average per issuer. HHS estimates that approximately 66 percent of commission schedules or similar documentation, and supplemental documents 79,885 disclosures would be mailed to individuals in conjunction with any documents confirming enrollment or renewal notice with no additional mailing costs. Therefore, each issuer would provide approximately 3,073 commission schedules or similar documentation, and supplemental documentation, by mail annually. HHS assumes that for each issuer, an administrative assistant would need 5 minutes at an hourly rate of $38.86 to print and enclose a commission schedule or similar documentation, and the supplemental documentation, with the enrollment confirmation or renewal notice, for a cost of $3.24 per disclosure. The total burden for each issuer would be approximately 256 hours, with an equivalent cost of approximately $9,950

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