Issuer - Attest (Individual)

Health Care Reform Insurance Web Portal and Supporting Authority Contained in Sections 1103 and 10102 of The Patient Protection and Affordability Care Act, P.L. 111-148 (PPACA)

OMB: 0938-1086

IC ID: 199283

Information Collection (IC) Details

View Information Collection (IC)

Issuer - Attest (Individual)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments CMS-10320.Issuer - FINAL Instructions and Instruments (5-12-10).pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10320 CMS-10320 Appendix_C_InsuranceIssuers CMS-10320 Appendix_C_InsuranceIssuers.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10320 CMS-10320 Appendix_D_BenefitsPremiumsInformation CMS-10320 Appendix_D_BenefitsPremiumsInformation20120801.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

800 0
   
Private Sector 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 450 0 0 0 450 0
Annual IC Time Burden (Hours) 900 0 0 0 900 0
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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