Health Insurance Issuer Submission of Final Justification for Unreasonable Rate Increases

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

OMB: 0938-1141

IC ID: 198020

Documents and Forms
Information Collection (IC) Details

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Health Insurance Issuer Submission of Final Justification for Unreasonable Rate Increases
 
No Modified
 
Mandatory
 
45 CFR 154.200

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Microsoft Word Final Justification Submission Function.docx Yes No Printable Only
Instruction Revised 2017 Unified Rate Review Instructions clean 8.9.16.docx Yes No Paper Only

Health Health Care Services

 

19 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 19 0 0 -394 0 413
Annual IC Time Burden (Hours) 19 0 0 -394 0 413
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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