Issuer - Attest (Small Group)

Health Care Reform Insurance Web Portal Requirements 45 CFR part 159 (CMS-10320)

OMB: 0938-1086

IC ID: 199284

Information Collection (IC) Details

View Information Collection (IC)

Issuer - Attest (Small Group)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10320 CMS-10320 - Issuer - FINAL Instructions and Instruments CMS 10320 Appendix G_2020 .xlsm Yes Yes Fillable Fileable
Form and Instruction CMS-10320 Appendix C - Insurance Issuer and Product Level Data CMS 10320 Appendix C Issuer and Product Level Data_PRA 2020.pdf Yes No Fillable Fileable
Form and Instruction CMS-10320 Appendix D - Data Collection CMS 10320 Appendix D_Data Collection_PRA2020.pdf Yes No Fillable Fileable

Health Health Care Services

 

500 0
   
Private Sector Businesses or other for-profits
 
   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 500 0 0 -200 700 0
Annual IC Time Burden (Hours) 250 0 0 -1,150 1,400 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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