Start-up Outcomes Metrics - Quarterly Reports

Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges

OMB: 0938-1119

IC ID: 208343

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Start-up Outcomes Metrics - Quarterly Reports
 
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Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10371 Outcome Metric – SBM Exchange Metrics 0938-1119. (Outcome Metric) SBM Exchange Metrics 20130829 pg layout.xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10371 Start-up Outcomes Metrics - Quarterly Reports CMS-10371 - Data Elements Start up Outcomes Metrics Quarter_508 pdf - Adobe Acrobat Pro.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

16 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 64 0 0 64 0 0
Annual IC Time Burden (Hours) 1,152 0 0 1,152 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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