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

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

OMB: 0938-1254

IC ID: 212940

Information Collection (IC) Details

View Information Collection (IC)

Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP)
 
No Modified
 
Mandatory
 
45 CFR 147.106 45 CFR 146.152 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 Discontinuation Notices CMS-10527 Appendix D - Renewal and Discontinuation Notices - Small Group.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10527 Federal Standard Notices CMS-10527 Appendix C - Updated-Federal-Standard-Notices.pdf Yes Yes Paper Only

Health Health Care Services

 

1,805 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 4,185 0 0 -1,755 0 5,940
Annual IC Time Burden (Hours) 30,877 0 0 -17,593 0 48,470
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy