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Federal Register / Vol. 86, No. 177 / Thursday, September 16, 2021 / Proposed Rules
annually. For all issuers, the total annual burden would be 6,657 hours with an equivalent cost of approximately $258,695. Assuming that the cost of printing each commission schedule or similar 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 $35

annually and the total printing cost for all issuers would be $922. The total annual cost for all issuers, including printing costs would be $259,616.
For issuers of individual health insurance coverage or issuers of shortterm, limited-duration insurance, the total combined burden for providing disclosures and supplemental documents with enrollment materials
would be 244,253 hours, with an equivalent cost of $9,491,687. The total annual printing cost would be $856,268, with an overall annual total cost of $10,347,956. CMS is seeking an OMB
control number and approval for the proposed information collection OMB
control number: 0938NEW Agent and Broker Disclosure and Reporting Requirements CMS10787.

TABLE 3PROPOSED ANNUAL ONGOING COSTS RELATED TO AGENT AND BROKER COMPENSATION DISCLOSURE
PROVIDED WITH ENROLLMENT MATERIALS
Estimated number of respondents
Type of coverage
Estimated number of responses
Total burden hours
Estimated labor cost
Estimated printing cost
Estimated total cost
Individual health insurance coverage
Short-term, limited-duration insurance

1,298
26

4,319,933
121,038

237,596
6,657

$9,232,993
258,695

$855,347
922

$10,088,340
259,616

Total

1,324

4,440,971

244,253

9,491,687

856,268

10,347,956

C. ICRs Regarding Issuer Requirements for Agent and Broker Compensation Reporting to the Secretary of HHS 45
CFR 148.410d As discussed in section III.B of the preamble, 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 submit reports to HHS regarding direct and indirect compensation provided by the issuer to an agent or broker associated with enrolling individuals in such coverage. HHS is proposing to codify these reporting requirements in new proposed 45 CFR 148.410d.

HHS estimates that each issuer would incur an annual ongoing burden and cost to submit the required information annually to HHS, starting in 2023
reporting for calendar year 2022 would be due by July 31, 2023. HHS
acknowledges that the burden associated with this reporting requirement would vary depending on the size of the issuer. HHS estimates that for each issuer, on average, an administrative assistant would need 10
hours at an hourly rate of $38.86 and a database administrator would need 40
hours at an hourly rate of $97.20 to collect and submit the required information, as described in section III.B
of the preamble, electronically. HHS

estimates that each issuer would incur an annual ongoing burden of 50 hours, with an associated equivalent cost of $4,277. For all 1,324 issuers, HHS
estimates a total annual ongoing burden of 66,200 hours and an associated total annual cost of $5,662,218. HHS believes the burden and costs would decrease in subsequent years as issuers become more adept at extracting the data from their systems and submitting it to HHS.
CMS is seeking an OMB control number and approval for the proposed information collection OMB control number: 0938NEW Agent and Broker Disclosure and Reporting Requirements CMS10787.

TABLE 4PROPOSED ANNUAL ONGOING COSTS REGARDING ISSUER REPORTING OF AGENT AND BROKER COMPENSATION
TO HHS
Estimated number of respondents
Estimated number of responses
Burden per response hours
Total estimated annual burden hours
Total estimated labor cost
1,324

1,324

50

66,200

$5,662,218

D. ICRs Regarding Air Ambulance Reporting Requirements for Group Health Plans and Health Insurance Issuers 45 CFR 149.230
As discussed in section II.E of the preamble, section 106b of the No Surprises Act added parallel provisions at section 9823 of the Code, section 723
of ERISA, and section 2799A8 of the PHS Act, requiring plans and issuers to submit certain data related to air ambulance services for dates of service falling within a calendar year and data on claims paid within the calendar year.
In this proposed rule, OPM also proposes to direct FEHB carriers to
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comply with requirements of 45 CFR
149.230 with respect to an FEHB plan in the same manner as such provisions apply to a group health plan or health insurance issuer offering group or individual health insurance coverage.
The proposed time and manner of the reporting are set forth in 45 CFR
149.230a of these proposed rules, and 45 CFR 149.230b includes a list of the data elements the Departments propose to collect on air ambulance services from plans, issuers, and FEHB carriers.
The Departments and OPM assume that TPAs generally would incur the burden to submit the data on behalf of self-

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insured plans and the associated costs would likely be passed on to those plans. The Departments and OPM
acknowledge that some large selfinsured plans may seek to make needed IT changes and report the required information to HHS without the use or assistance of a TPA or other third-party entity. In those instances, the selfinsured plan would directly incur the burden and cost to meet the requirements of these proposed rules.
The Departments and OPM are unable to determine how many self-insured plans may choose to develop their IT
system and report the required
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