Information Collection Request

Rate Increase Disclosure and Review Reporting Requirements (CMS-10379)

ICR 201501-0938-004 · OMB 0938-1141 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10379 - Nonsub change request.docx Justification for No Material/Nonsubstantive Change Uploaded 2015-01-08 Available
0938-1141 - Nonsub change request.docx Justification for No Material/Nonsubstantive Change Uploaded 2015-01-06 Available
Comment and Response for CMS.docx Supplementary Document Uploaded 2014-04-04 Available
508_CMS-10379_Rate_Review_Supporting_Statement_Part_A_clean.pdf Supporting Statement A Uploaded 2015-01-06 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
198022 State Unreasonable Rate Increase Determinations Modified
198020 Health Insurance Issuer Submission of Final Justification for Unreasonable Rate Increases Other-Microsoft Word Modified
198019 Health Insurance Issuer Submission of the Preliminary Justification Other-Microsoft Word Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2017 07/31/2017 07/31/2017
9,356 0 359
84,990 0 1,885
0 0 0





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 9,356 359 0 0 8,997 0
Annual Time Burden (Hours) 84,990 1,885 0 0 83,105 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No