Information Collection Request
ICR 201604-0938-001 · OMB 0938-1013 · Public filing
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1013 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10198 Creditable Coverage Disclosure to CMS |
Form and Instruction | Modified | Available |
| Form CMS-10198 Creditable Coverage Disclosure to CMS |
Form and Instruction | Modified | Repair queued |
 Justification for Nonsubstantive Change.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2016-04-04 | Available |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 46153 |  State, Local, or Tribal Governments - Creditable Coverage Disclosure to CMS OnLine Form and Instructions |
Unchanged | ||
| 46152 | Private Sector - Creditable Coverage Disclosure to CMS OnLine Form and Instructions |
Form and Instruction | Modified | Creditable Coverage Disclosure to CMS |
| 46151 | Federal - Creditable Coverage Disclosure to CMS OnLine Form and Instructions |
Form and Instruction | Modified | Creditable Coverage Disclosure to CMS |
ICR Details
| OMB Control No | 0938-1013 |
|---|