Disclosure of State Rating Requirements and Individual Market Special Enrollment Notice (CMS-10454)

ICR 202212-0938-001

OMB: 0938-1258

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-10454 Disclosure of State Rating Requirements Form and Instruction	Unchanged
CMS-10454 - Non-Sub Change Request 2022.docx Justification for No Material/Nonsubstantive Change	2022-12-01
CMS-10454 Supporting Statementf - Part A -.docx Supporting Statement A	2021-03-18

IC Document Collections

IC ID	Document Title	Status
208568	Disclosure of State Rating Requirements Form and Instruction	Unchanged