Coverage of Certain Preventive Services Under the Affordable Care Act - Private Sector

ICR 202210-1545-017

OMB: 1545-2307

Federal Form Document

Forms and Documents

Document Name	Status
Supporting Statement IRS.docx Supporting Statement A	2022-11-07

IC Document Collections

IC ID	Document Title	Status
256649	Confirmation of Eligibility for the Individual Contraceptive Arrangement	New
256648	Notice of Availability of Separate Payments for Contraceptive Services	New
256647	Self-Certification or Notification to HHS	New