Quarterly Reporting

Medical Loss Ratio - Quarterly Reporting for Mini-med Plans and Expatriate Plans

OMB: 0938-1132

IC ID: 197131

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Quarterly Reporting
 
No New
 
Mandatory
 
45 CFR 158.110(b)(2)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10373 Instrument CMS-10373.REVISED Instrument.xls No   Fillable Fileable
Form and Instruction CMS-10373 Instructions CMS-10373.REVISED Instructions.doc No   Fillable Fileable

Health Health Care Services

 

75 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  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 1,125 1,125 0 0 0 0
Annual IC Time Burden (Hours) 69,750 69,750 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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