Annual MLR Report

Medical Loss Ratio Annual Reports, MLR Notices, and Recordkeeping Requirements (CMS-10418)

OMB: 0938-1164

IC ID: 201981

Documents and Forms
Information Collection (IC) Details

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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
Form and Instruction CMS-10418 MLR Reporting Form 2014_MLR_Reporting_Form_4-03-2015.xlsx Yes Yes Fillable Fileable
Form and Instruction CMS-10418 MLR Form Instructions 2014 MLR Form Instructions 4-02-2015.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

522 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 3,394 0 0 0 0 3,394
Annual IC Time Burden (Hours) 212,361 0 0 -4,074 0 216,435
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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