Annual MLR Report

Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements

OMB: 0938-1164

IC ID: 201981

Information Collection (IC) Details

View Information Collection (IC)

Annual MLR Report
 
No Modified
 
Mandatory
 
45 CFR 158

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CMS 10418 2012 MLRA Instructions.pdf Yes Yes Fillable Fileable
Form CMS-10418 MLR_Annual_Form CMS 10418 MLR PRA Package MLR Form Template.xlsx Yes Yes Fillable Fileable
Instruction CMS 10418 MLRA Instructions.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

502 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 3,087 0 0 -2,447 0 5,534
Annual IC Time Burden (Hours) 196,668 0 0 -155,895 0 352,563
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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