Operational Metrics - Monthly Reports

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

OMB: 0938-1119

IC ID: 208345

Information Collection (IC) Details

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Operational Metrics - Monthly Reports
 
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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 Operational Metric – SBM Open Enrollment Weekly Indicators 0938-1119 (Operational Metric) SBM Open Enrollment Weekly Indicators Rev 9_5_2013 Word-508.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10371 Exchange Establishment Grants FOA 2012 Exchange Establishment FOA 02_21_12 clean for PRA posting DRAFT.docx No No Fillable Fileable

Health Health Care Services

 

16 0
   
State, Local, and Tribal Governments
 
   0 %

  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 96 0 0 96 0 0
Annual IC Time Burden (Hours) 2,304 0 0 2,304 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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