OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Risk Corridors Transitional Policy

IC 214480 under ICR 201501-0938-001 · OMB 0938-1267.

Documents and Forms
Document Name
Document Type
Form
Instruction
Form
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Risk Corridors Transitional Policy
 
No New
 
Mandatory
 
45 CFR 153.530

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10532 Transitional Policy Reporting Form CMS-10532 Copy of 30 day transitional reporting form_Jan clean v2.xlsx Yes Yes Fillable Fileable
Instruction CMS-10532 - Transitional Adjustment Reporting Form Instructions (Final) Jan clean.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

400 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 400 400 0 0 0 0
Annual IC Time Burden (Hours) 400 400 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Modifications to the Updated Version of Transitional Adjustment Data Reporting Form CMS-10532 Memo regarding change to transitional form.docx 02/09/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.