Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges

Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges (CMS-10464)

OMB: 0938-1204

IC ID: 207074

Information Collection (IC) Details

View Information Collection (IC)

Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 155.220

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10464 Agent/Broker Registration Collection Tool CMS-10464 - Appendix A - Agent Broker Screenshots.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

52,000 0
   
Private Sector Businesses or other for-profits
 
   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 52,000 0 0 -120,525 172,525 0
Annual IC Time Burden (Hours) 15,600 0 0 -56,861 72,461 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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