Model Creditable Coverage Disclosure Notices (CMS-10182)

Model Creditable Coverage Disclosure Notices

OMB: 0938-0990

IC ID: 45715

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Document Name
Document Type
Instruction
Information Collection (IC) Details

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Model Creditable Coverage Disclosure Notices (CMS-10182)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 423.56

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS-10182 09.15.06 CC Guidance Updated Final - 09.12.06.doc Yes Yes Printable Only

Health Health Care Services

 

5,540 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 42,436 0 0 0 0 42,436
Annual IC Time Burden (Hours) 13,580 0 0 0 0 13,580
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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