Mandatory Insurer Reporting (GHP-Private, Maintenance/Administrative)

Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007 (CMS-10265)

OMB: 0938-1074

IC ID: 188578

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Mandatory Insurer Reporting (GHP-Private, Maintenance/Administrative)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 4 GHP User Guide v5.pdf Yes Yes Printable Only

Health Health Care Services

Medicare Advantage Prescription Drug System (MARx)  70 FR 60530

1,030 0
   
State, Local, and Tribal Governments
 
   100 %

  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 1,030 0 0 -104 0 1,134
Annual IC Time Burden (Hours) 22,660 0 0 -2,288 0 24,948
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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