Form 13560, HCTC Health Plan Administrator (HPA) Return of Funds Form, and Form 13561, HCTC Health Plan Administrators Operations Guide

Form 13560, HCTC Health Plan Administrator (HPA) Return of Funds Form, and Form 13561, HCTC Health Plan Administrators Operations Guide

OMB: 1545-1891

IC ID: 19574

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Form 13560, HCTC Health Plan Administrator (HPA) Return of Funds Form, and Form 13561, HCTC Health Plan Administrators Operations Guide
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 13560 No No
Form 13561 No No


    

200 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 200 0 0 0 0 200
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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