Information Collection Request

Excepted Benefit Health Reimbursement Arrangements

ICR 202004-0938-004 · OMB 0938-1375 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10727 - Supporting Statement (EBHRA 60-day).docx Supporting Statement A Uploaded 2020-04-16 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
241379 Excepted Benefit Health Reimbursement Arrangements New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Excepted Benefit Health Reimbursement Arrangements



Reginfo record details
  No