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Federal forms, ICRs, and supporting documents

Information Collection

Good Cause Processes (Sec. 417.460, 422.74, and 423.44)

IC 215417 under ICR 202205-0938-002 · OMB 0938-1271.

Documents and Forms
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Document Type
IC Document
Information Collection (IC) Details

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Good Cause Processes (Sec. 417.460, 422.74, and 423.44)
 
No Modified
 
Voluntary
 
42 CFR 417.460 42 CFR 422.74 42 CFR 423.44

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

41,289 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved 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 41,289 0 0 31,281 10,008 0
Annual IC Time Burden (Hours) 27,499 0 0 20,834 6,665 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
60.3.4.1- Process for Good Cause Determinations for Nonpayment of Plan Premiums Good_Cause_Section_60.3.4.1_Chapter 2_MMCM _incl_Exhibits.pdf 11/02/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.