Information Collection Request

REG-132455-11 - Reporting of Minimum Essential Coverage (TD 9660 - final)

ICR 201710-1545-006 · OMB 1545-2252 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1094-B Form 1094-B, Transmittal of Health Coverage Information Returns Form Modified Available
2018-01-18_SS_1545-2252rTP.doc Supporting Statement A Uploaded 2018-01-18 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
213670 Form 1095-B, Health Coverage Instruction Modified
205933 Form 1094-B, Transmittal of Health Coverage Information Returns Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2022 36 Months From Approved 06/30/2019
125,030,000 0 4,600,430
2,088,333 0 86,072
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Form 1094-B, Transmittal of Health Coverage Information Returns 1094-B Transmittal of Health Coverage Information Returns
Form 1095-B, Health Coverage 1095-B Health Coverage

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 125,030,000 4,600,430 0 120,429,570 0 0
Annual Time Burden (Hours) 2,088,333 86,072 0 2,002,261 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No