Information Collection

Clearance for Evaluation of Stakeholder Training Health Insurance Marketplace and Market Stabilization Programs

IC 247049 under ICR 202104-0938-015 · OMB 0938-1331.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1331 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10598 Clearance for Evaluation of Stakeholder Training Health Insurance Marketplace and Market Stabilization Programs	Form and Instruction
CMS-10598 Stakeholder CBT Survey CMS-10598 - Stakeholder CBT Survey.docx	Form and Instruction
CMS-10598 Stakeholder CBT Survey CMS-10598 - Stakeholder CBT Survey.docx	Form and Instruction
CMS-10598 Stakeholder Online Evaluation Survey CMS-10598 - Stakeholder Online Evaluation Surveys.docx	Form and Instruction
CMS-10598 Stakeholder Online Evaluation Survey CMS-10598 - Stakeholder Online Evaluation Surveys.docx	Form and Instruction
CMS-10598 Stakeholder Onsite Evaluation Survey CMS-10598 - Stakeholder Onsite Evaluation Surveys.docx	Form and Instruction
CMS-10598 Stakeholder Onsite Evaluation Survey CMS-10598 - Stakeholder Onsite Evaluation Surveys.docx	Form and Instruction

IC Title:

Clearance for Evaluation of Stakeholder Training Health Insurance Marketplace and Market Stabilization Programs

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10598	Stakeholder CBT Survey	CMS-10598 - Stakeholder CBT Survey.docx	Yes	Yes	Fillable Printable
Form and Instruction	CMS-10598	Stakeholder Online Evaluation Survey	CMS-10598 - Stakeholder Online Evaluation Surveys.docx	Yes	Yes	Fillable Fileable
Form and Instruction	CMS-10598	Stakeholder Onsite Evaluation Survey	CMS-10598 - Stakeholder Onsite Evaluation Surveys.docx	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 45,322

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	45,322	45,322
Annual IC Time Burden (Hours)	11,331	11,331
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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