ANNUAL SURVEY OF INDEPENDENT PREPAID AND SELF-INSURED HEALTH PLANS

ICR 198301-0938-004

OMB: 0938-0249

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0249 198301-0938-004
Historical Active 198202-0938-002
HHS/CMS
ANNUAL SURVEY OF INDEPENDENT PREPAID AND SELF-INSURED HEALTH PLANS
Extension without change of a currently approved collection   No
Regular
Approved without change 03/11/1983
Retrieve Notice of Action (NOA) 01/17/1983
  Inventory as of this Action Requested Previously Approved
06/30/1985 06/30/1985 03/31/1983
200 0 200
200 0 200
0 0 0

THE DATA COLLECTED IN THIS SURVEY ARE ESSENTIAL IN MAKING ACCURATE ANNUAL ESTIMATES OF THE ENROLLMENT COVERAGE AND BENEFIT EXPENDITURES OF INDEPENDENT HEALTH PLANS. THE DATA ARE USED IN THE ANNUAL SERIES OF ARTICLES ON PRIVATE HEALTH INSURANCE, IN HCFA HEALTH NOTES, AND FOR NATIONAL HEALTH EXPENDITURE ESTIMATES, GROSS NATIONAL PRODUCT ESTIMATES, AND CONSUMER PRICE INDEX ESTIMATES.

None
None


No

1
IC Title Form No. Form Name
ANNUAL SURVEY OF INDEPENDENT PREPAID AND SELF-INSURED HEALTH PLANS HCFA-1807

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 200 200 0 0 0 0
Annual Time Burden (Hours) 200 200 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/17/1983


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