Model Employer Children's Health Insurance Program Notice

ICR 202211-1210-002

OMB: 1210-0137

Federal Form Document

Forms and Documents

Document Name	Status
1210-0137 CHIPRA Model Notice 12-14-2022 Clean.docx Supporting Statement A	2022-12-14

IC Document Collections

IC ID	Document Title	Status
208807	Model Employer CHIP Notice (State, Local, Tribal Governmental Burden) Other-Model Notice	Modified
191695	Model Employer CHIP Notice (Private Sector Burden) Other-Model Notice	Modified