Annual Notice of Change (ANOC) and Evidence of Coverage (EOC)

Medicare Advantage and Prescription Drug Program: Final Marketing Provisions CFR 422.111(a)(3) and 423.128(a)(3) (CMS-10260)

OMB: 0938-1051

IC ID: 186438

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Information Collection (IC) Details

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Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) CM-CPC
 
No Modified
 
Mandatory
 
42 CFR 423.128(a)(3) 42 CFR 422.111(a)(3)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CY2021_Clean_1_HMO_MAPD_ISNP_CSNP_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_4_Cost_Plan_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_8_PPO_MA_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_9_PDP_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_2_PPO_MAPD_ISNP_CSNP_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_3_DE_SNP_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_4_Cost_Plan_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_5_PFFS_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_6_MSA_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_7_HMO_MA_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_8_PPO_MA_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_9_PDP_ANOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_1_HMO_MAPD_ISNP_CSNP_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_2_PPO_MAPD_ISNP_CSNP_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_3_DE_SNP_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_5_PFFS_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_6_MSA_EOC_03162020.docx No   Fillable Fileable
Instruction CY2021_Clean_7_HMO_MA_EOC_03162020.docx No   Fillable Fileable
Instruction HPMS User Guide Extract for CMS-10260.docx No   Fillable Fileable

Health Health Care Services

 

795 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 795 0 0 -10 0 805
Annual IC Time Burden (Hours) 9,540 0 0 -120 0 9,660
Annual IC Cost Burden (Dollars) 42,000,000 0 0 -8,026,730,000 0 8,068,730,000

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