Document
Model Notice to Enrollees in a Self-Funded Nonfederal Governmental Group Health Plan For Plan Years Beginning On or After Septem
ICR 202210-0938-005 · OMB 0938-0702 · Object 125786201.
This document may belong to an older filing. More recent activity for OMB 0938-0702:
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 20 · next 2026-06-06 08:55:37)
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 | Model Notice to Enrollees in a Self-Funded Nonfederal Governmental Group Health Plan For Plan Years Beginning On or After Septem |
| Subject | Group Health plans, continued coverage |
| Author | CMS/CCIIO |
| File Modified | 2022-05-03 |
| File Created | 2019-06-21 |
| Conversion State | failed_conversion |