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QHP Issuers Data Collection for Notices for Plan or Display Errors Special Enrollment Periods
QHP Issuers Data Collection for Notices for Plan or Display Errors Special Enrollment Periods (CMS-10595)
OMB: 0938-1301
IC ID: 219319
OMB.report
HHS/CMS
OMB 0938-1301
ICR 202301-0938-015
IC 219319
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
QHP Issuers Data Collection for Notices for Plan or Display Errors Special Enrollment Periods
Agency IC Tracking Number:
CCIIO-10595
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
45 CFR 155.420(d)(12)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
374
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
374
0
0
-131
0
505
Annual IC Time Burden (Hours)
292
0
0
-1,408
0
1,700
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.