Information Collection Request

Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)

ICR 201910-0938-008 · OMB 0938-1254 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10527 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified Available
Form CMS-10527 Product Discontinuance Notice for QHP Issuers Form and Instruction Modified Available
Form CMS-10527 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified Available
Form CMS-10527 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction Modified Available
CMS-10527 -Supporting Statement 30day.docx Supporting Statement A Uploaded 2020-04-29 Available
CMS-10527 Appendix F - Crosswalk of Changes 30d.pdf Supplementary Document Uploaded 2019-10-29 Available
CMS-10527 Appendix E - Comment Response Summary 30d.pdf Supplementary Document Uploaded 2019-10-29 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
212940 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified
212939 Product Discontinuance Notice for QHP Issuers Form and Instruction Modified
212938 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified
212937 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2023 36 Months From Approved 04/30/2020
7,420 0 11,594
90,331 0 149,188
0 0 0





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 7,420 11,594 0 0 -4,174 0
Annual Time Burden (Hours) 90,331 149,188 0 0 -58,857 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No