Information Collection Request

Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)

ICR 201609-0938-010 · OMB 0938-1254 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10527 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified Available
Form CMS-10527 Product Discontinuance Notice for QHP Issuers Form and Instruction Modified Available
Form CMS-10527 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified Repair queued
Form CMS-10527 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction Modified Available
CMS- 10527 Appendix A - Comment and Response Document.pdf Supplementary Document Uploaded 2016-09-19 Available
CMS-10527 Supporting Statement OMB.pdf Supporting Statement A Uploaded 2016-09-19 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
212940 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified
212939 Product Discontinuance Notice for QHP Issuers Form and Instruction Modified
212938 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified
212937 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2019 36 Months From Approved 05/31/2018
11,594 0 11,594
149,188 0 149,188
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 11,594 11,594 0 0 0 0
Annual Time Burden (Hours) 149,188 149,188 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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