Information Collection Request

Annual Report for Multiple Employer Welfare Arrangements

ICR 202108-1210-003 · OMB 1210-0116 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form M-1 Report for Multiple Employer Welfare Arrangements (MEWAs) and Certain Entitiies Claiming Exception (ECEs) Form and Instruction Modified Available
Form Form M-1 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) Form and Instruction Modified Repair queued
1210-0116 ss21 9-15-21.docx Supporting Statement A Uploaded 2021-09-15 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
13484 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) Form and Instruction ModifiedReport for Multiple Employer Welfare Arrangements (MEWAs) and Certain Entitiies Claiming Exception (ECEs)
13484 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) Form and Instruction Modified
13484 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) Other-Proposed Changes To 2022 Form M-1 And Instructions Modified

ICR Details

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table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2022 36 Months From Approved 08/31/2022
572 0 572
120 0 120
111,377 0 111,377





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1
table that charts list of burden
IC Title Form No. Form Name
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1) Form M-1



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