Information Collection

Medicare Advantage and Prescription Drug Benefit Program: Final Marketing Provisions referenced in 42 CFR 422.111(a)(3) and 423.128(a)(3)

IC 186438 under ICR 201703-0938-013 · OMB 0938-1051.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1051 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CY2018_4_Cost_Plan_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_3_DE_SNP_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_7_HMO_MA_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_1_HMO_MAPD_ISNP_CSNP_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_6_MSA_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_9_PDP_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_5_PFFS_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_8_PPO_MA_ANOC_EOC_05122017 CLEAN.docx	Instruction
CY2018_2_PPO_MAPD_ISNP_CSNP_ANOC_EOC_05122017 CLEAN.docx	Instruction

IC Title:

Medicare Advantage and Prescription Drug Benefit Program: Final Marketing Provisions referenced in 42 CFR 422.111(a)(3) and 423.128(a)(3)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 423.128(a)(3) 42 CFR 422.111(a)(3)

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	CY2018_1_HMO_MAPD_ISNP_CSNP_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_4_Cost_Plan_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_3_DE_SNP_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_7_HMO_MA_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_6_MSA_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_2_PPO_MAPD_ISNP_CSNP_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_5_PFFS_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_8_PPO_MA_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable
Instruction	CY2018_9_PDP_ANOC_EOC_05122017 CLEAN.docx	Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 805

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	805	35	770
Annual IC Time Burden (Hours)	9,660	420	9,240
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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