Information Collection Request
Summary of Benefits and Coverage and Uniform Glossary (CMS-10407)
ICR 202210-0938-011 · OMB 0938-1146 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1146 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 SBC PRA 30 day supporting statement2_clean.docx |
Supporting Statement A | Uploaded 2022-11-01 | Repair queued |
 CMS-10407 Non-Substantive Change Request.pdf |
Justification for No Material/Nonsubstantive Change | Uploaded 2019-11-27 | Repair queued |
 Copy of CMS-10407-SBC PRA-2019 30-day Notice Period-Comments and Responses_OMB.xlsx |
Supplementary Document | Uploaded 2019-10-24 | Repair queued |
| Crosswalk of Changes.pdf |
Supplementary Document | Uploaded 2019-10-22 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 201038 |  Deemed Compliance Reporting |
Modified | ||
| 199007 | SBC Disclosure |
Other-Maternity Care Narrative | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1146 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 201911-0938-018 |
| Agency Tracking No | CCIIO |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |