Portability Requirements - Individual

Pre-Existing Condition Insurance Plan and Supporting Regulations

OMB: 0938-1100

IC ID: 196170

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Portability Requirements - Individual
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10339 PCIP Policy Letter #3 PCIP Policy Letter No 3.pdf Yes No Fillable Fileable

Health Health Care Services

 

80 0
   
Individuals or Households
 
   0 %

  Requested 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 80 0 80 0 0 0
Annual IC Time Burden (Hours) 40 0 40 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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