Notice Relating to Extension of Dependent Coverage - State and Local gov't plans

Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent Coverage

OMB: 0938-1089

IC ID: 192838

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Notice Relating to Extension of Dependent Coverage - State and Local gov't plans
 
No New
 
Required to Obtain or Retain Benefits
 
45 CFR 147.120

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

Health Health Care Services

 

126,000 0
   
State, Local, and Tribal Governments
 
   38 %

  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 19,627,000 19,627,000 0 0 0 0
Annual IC Time Burden (Hours) 202,812 202,812 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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