Information Collection Request

Agent/Broker Data Collection in Federally-facilitated Health Insurance Exchanges (CMS-10464)

ICR 202207-0938-019 · OMB 0938-1204 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10464 Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges Form and Instruction Modified Repair queued
CMS-10464 Agent-Broker Supporting Statement_7-29-22.docx Supporting Statement A Uploaded 2022-07-29 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
207074 Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 07/31/2022
64,000 52,000
15,360 15,600
0 0





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1
table that charts list of burden
IC Title Form No. Form Name
Agents/Broker Data Collection in Federally Facilitated Health Insurance Exchanges CMS-10464 Agent-Broker Appendix A Screenshot_508_07.20.22

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 64,000 52,000 0 12,000 0 0
Annual Time Burden (Hours) 15,360 15,600 0 -240 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No