Subpart H - Exchange Functions: Small Business Health Options Program

Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment (CMS-10468)

OMB: 0938-1207

IC ID: 207760

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Document Type
Other-Data Elements
Other-Data Elements
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Subpart H - Exchange Functions: Small Business Health Options Program
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 155.716

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Data Elements CMS-10468 - Appendix A - Data Elements.pdf Yes Yes Printable Only

Health Health Care Services

 

10 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 40 0 0 -210 0 250
Annual IC Time Burden (Hours) 720 0 0 -1,280 0 2,000
Annual IC Cost Burden (Dollars) 71,240 0 0 -936,260 0 1,007,500

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