Early Retiree Reinsurance Program Rerimburement Request Materials and Instructions (Cost Documentation) (Private) Program Year 2

Early Retiree Reinsurance Program

OMB: 0938-1087

IC ID: 199543

Information Collection (IC) Details

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Early Retiree Reinsurance Program Rerimburement Request Materials and Instructions (Cost Documentation) (Private) Program Year 2
 
No Removed
 
Required to Obtain or Retain Benefits
 
45 CFR 149 Subpart E

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 0938-1087 Revised_Instrument Collection Instructions.docx Yes No Fillable Fileable
Form CMS-10321 Revised ERRP Collection Instrument 0938-1087 Revised ERRP Collection Instrument-1.docx Yes No Fillable Fileable

Health Health Care Services

Early Retiree Reinsurance Program  75 FR 31440

1,500 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 0 0 -3,000 0 0 3,000
Annual IC Time Burden (Hours) 0 0 -24,000 0 0 24,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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