EHB Dental Plan Issuers

Essential Health Benefits Benchmark Plans (CMS-10488)

OMB: 0938-1174

IC ID: 203740

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EHB Dental Plan Issuers
 
No Modified
 
Mandatory
 
45 CFR 156.120

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

175 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 175 0 0 155 0 20
Annual IC Time Burden (Hours) 88 0 0 78 0 10
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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