Notice Relating to Extension of Dependent Coverage - Individual Market

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

OMB: 0938-1089

IC ID: 192839

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Notice Relating to Extension of Dependent Coverage - Individual Market
 
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

 

315 0
   
Private Sector Businesses or other for-profits
 
   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 5,444,000 5,444,000 0 0 0 0
Annual IC Time Burden (Hours) 56,254 56,254 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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