Information Collection Request

Information Collection for Transparency in Coverage Reporting by Qualified Health Plan Issuers (CMS-10572)

ICR 201903-0938-009 · OMB 0938-1310 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10572 QHP Issuer Data Collection and Display Form Modified Available
CMS-10572 Supporting Statementd.docx Supporting Statement A Uploaded 2019-04-24 Available
CMS-10572 - Transparency PRA 60 day Comment Chart_508.pdf Supplementary Document Uploaded 2019-03-18 Available
CMS-10572-Transparency PRA Appendix B_508.pdf Supplementary Document Uploaded 2019-03-18 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
221316 QHP Issuer Data Collection and Display Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2022 36 Months From Approved 06/30/2019
470 0 475
42 0 72
0 0 0





Reginfo record details
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table that charts list of burden
IC Title Form No. Form Name
QHP Issuer Data Collection and Display CMS-10572, CMS-10572 QHP Issuer Data Collection and Display ,   Data Submission Template

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 470 475 0 0 -5 0
Annual Time Burden (Hours) 42 72 0 0 -30 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No