Performance Reviews

Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges

OMB: 0938-1119

IC ID: 198687

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Performance Reviews
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10371 Revised FOA FOA - IE-HBE-11-004.pdf Yes No Fillable Fileable

Health Health Care Services

 

16 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 16 0 0 -34 0 50
Annual IC Time Burden (Hours) 3,760 0 0 -1,990 0 5,750
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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