Information Collection Request

Affordable Care Act Section 2715 Summary Disclosures

ICR 201108-1210-005 · OMB 1210-0147 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form NEW Summary of Benefits and Coverage Form New Available
2011-21192_PI.pdf Supplementary Document Uploaded 2011-08-18 Available
2715_SS_08-18-2011.doc Supporting Statement A Uploaded 2011-08-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
198891 Modifications New
198890 Glossary New
198888 Summary of Benefits and Coverage Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0





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3
table that charts list of burden
IC Title Form No. Form Name
Glossary
Modifications
Summary of Benefits and Coverage NEW Summary of Benefits and Coverage (SBC) Template



Reginfo record details
  No