Subpart C-General Functions of an Exchange

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: 207761

Documents and Forms
Document Name
Document Type
Other-Data elements
Other-Data elements
Information Collection (IC) Details

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Subpart C-General Functions of an Exchange
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 155.227

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

 

4 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 18 0 0 5 0 13
Annual IC Time Burden (Hours) 540 0 0 -98,996 0 99,536
Annual IC Cost Burden (Dollars) 57,024 0 0 -359,291 0 416,315

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