Private Maintenance of Records Year 2_3_4

Early Retiree Reinsurance Program

OMB: 0938-1087

IC ID: 192765

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Private Maintenance of Records Year 2_3_4
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 149.350

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 0938-1087 Revised ERRP Collection Instrument-1.docx Yes No Fillable Fileable
Instruction 0938-1087 Revised_Instrument Collection Instructions.docx Yes No Fillable Fileable

Health Health Care Services

 

3,055 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 3,055 0 0 -1,070 0 4,125
Annual IC Time Burden (Hours) 18,330 0 0 -6,420 0 24,750
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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