Information Collection Request

Cost-Sharing Reduction Reconciliation (CMS-10526)

ICR 202012-0938-014 · OMB 0938-1266 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10526 CSR Reconciliation Data Elements Form and Instruction Removed Available
Form CMS-10526 Simplified Methodology Effective Parameters and Plan and Policy Reports Form and Instruction Removed Repair queued
Form CMS-10526 CSR Reconciliation Data Elements Form and Instruction Removed Available
Form CMS-10526 Standard Methodology Plan and Policy Report Form and Instruction Removed Repair queued
Form CMS-10526 CSR Reconciliation Data Elements Form and Instruction Modified Available
Form CMS-10526 Simplified Actuarial Value Methodology Plan and Policy Report Form and Instruction Modified Repair queued
Form CMS-10526 CSR Reconciliation Data Elements Form and Instruction Modified Available
Form CMS-10526 Issuer Report Form and Instruction Modified Repair queued
CMS-10526 CSR Reconciliation Supporting_Statement 30.docx Supporting Statement A Uploaded 2020-12-18 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
213320 Simplified Methodology Effective Parameters and Plan and Policy Reports Form and Instruction RemovedCSR Reconciliation Data Elements
213320 Simplified Methodology Effective Parameters and Plan and Policy Reports Form and Instruction Removed
213319 Standard Methodology Plan and Policy Report Form and Instruction RemovedCSR Reconciliation Data Elements
213319 Standard Methodology Plan and Policy Report Form and Instruction Removed
213296 Simplified Actuarial Value Methodology Plan and Policy Report Form and Instruction ModifiedCSR Reconciliation Data Elements
213296 Simplified Actuarial Value Methodology Plan and Policy Report Form and Instruction Modified
213295 Issuer Report Form and Instruction ModifiedCSR Reconciliation Data Elements
213295 Issuer Report Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2024 36 Months From Approved
2,030,100 0 0
2,363 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Simplified Actuarial Value Methodology Plan and Policy Report CMS-10526
Issuer Report CMS-10526
Simplified Methodology Effective Parameters and Plan and Policy Reports CMS-10526
Standard Methodology Plan and Policy Report CMS-10526

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,030,100 0 0 0 -1,970,223 4,000,323
Annual Time Burden (Hours) 2,363 0 0 0 -3,233 5,596
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No