(Cycle I) Application re-release

Grants to States for Health Insurance Premium Review - Cycles I and II

OMB: 0938-1121

IC ID: 196342

Documents and Forms
Information Collection (IC) Details

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(Cycle I) Application re-release
 
No Removed
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10380 CMS-10380.Deliberative Document CMS-10380.Deliberative Document.docx Yes Yes Fillable Fileable

Health Health Care Services

 

10 0
   
State, Local, and Tribal Governments
 
   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 0 0 -10 0 0 10
Annual IC Time Burden (Hours) 0 0 -5,200 0 0 5,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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