Health Insurance Flexibility and Accountability Section 1115 Model Waiver

Health Insurance Flexibility and Accountability Section 1115 Model Waiver

OMB: 0938-0848

IC ID: 8659

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Information Collection (IC) Details

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Health Insurance Flexibility and Accountability Section 1115 Model Waiver
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10048 Yes Yes


    

25 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 25 0 25 0 0 0
Annual IC Time Burden (Hours) 250 0 250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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