Information Collection Request

Notice for Health Reimbursement Arrangements integrated with Individual Health Insurance Coverage

ICR 201810-1210-001 · OMB 1210-0160 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
SSA 1210-HRA 10-02-2018.docx Supporting Statement A Uploaded 2018-10-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
233410 HRA Notice to Participants and other disclosures New

ICR Details

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table that charts list comparision
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
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table that charts list of burden
IC Title Form No. Form Name
HRA Notice to Participants and other disclosures



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  No