Information Collection Request

Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges

ICR 201407-0938-013 · OMB 0938-1215 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10463 - Navigator FOA Supporting Statement (Final OMB) .docx Supporting Statement A Uploaded 2014-11-14 Available
Appendix A - Response to Comments 071414.docx Supplementary Document Uploaded 2014-07-23 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
212550 Weekly Reporting New
212437 Monthly Progress Report Submissions New
208330 Bi-Annual Prevention Fund Reports Removed
208329 Quarterly Progress Reports Modified
208328 Navigator Annual Progress Report Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2017 36 Months From Approved 09/30/2016
6,831 0 1,848
46,537 0 308,352
3,414,268 0 6,491,232





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Weekly Reporting
Navigator Annual Progress Report
Quarterly Progress Reports
Monthly Progress Report Submissions
Bi-Annual Prevention Fund Reports

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,831 1,848 0 -528 5,511 0
Annual Time Burden (Hours) 46,537 308,352 0 -1,584 -260,231 0
Annual Cost Burden (Dollars) 3,414,268 6,491,232 0 -55,968 -3,020,996 0


Reginfo record details
  No