Quarterly Reports

Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)

OMB: 0938-1119

IC ID: 208343

Information Collection (IC) Details

View Information Collection (IC)

Quarterly Reports
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10371 Quarterly Template CMS-10371 - Quarterly Template - SBM Data Submission Guide _ 2015 CLEAN_Final_508.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

18 0
   
State, Local, and Tribal Governments
 
   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 72 0 0 0 0 72
Annual IC Time Burden (Hours) 1,656 0 0 -1,433 0 3,089
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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