Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP)

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

OMB: 0938-1254

IC ID: 212938

Information Collection (IC) Details

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Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP)
 
No Modified
 
Mandatory
 
45 CFR 147.106 45 CFR 147.152 45 CFR 148.122

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10527 Renewal Notice CMS-10527 Appendix C - Updated-Federal-Standard-Notices.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

1,805 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 2,503 0 0 -1,426 0 3,929
Annual IC Time Burden (Hours) 50,060 0 0 -28,520 0 78,580
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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