Document
Special Enrollment Period form
ICR 202207-0938-005 · OMB 0938-1426 · Object 122887200.
This document may belong to an older filing. More recent activity for OMB 0938-1426:
Document Viewer [pdf]
Status: No verified local artifact is currently available. The document remains flagged for repair and upstream re-check.
Queue: Repair is queued and waiting for the next worker pass. (priority 80 · attempts 7 · next 2026-06-06 05:02:48)
Missing: pdf
No local or Spaces-backed artifact is available yet for this document.
Loading document viewer…
Document Metadata
| File Type | application/octet-stream |
|---|---|
| File Title | Special Enrollment Period form |
| Subject | TITLE: Special Enrollment Period COMPLETED:/2022, REQUESTOR NAME: Carla Patterson (CM) External, SEP |
| Author | CMS |
| File Modified | 2022-06-23 |
| File Created | 2022-04-21 |
| Conversion State | failed_conversion |