Annual Notice of Change (ANOC) and Evidence of Coverage (EOC)

Medicare Advantage and Prescription Drug Program: Final Marketing Provisions CFR 422.111(a)(3) and 423.128(a)(3) (CMS-10260)

OMB: 0938-1051

IC ID: 186438

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Information Collection (IC) Details

View Information Collection (IC)

Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) CM-CPC
 
No Modified
 
Mandatory
 
42 CFR 423.128(a)(3) 42 CFR 422.111(a)(3)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction HPMS User Guide Extract for CMS-10260.docx No   Fillable Fileable
Instruction CY2024_1_HMO_MAPD_ISNP_CSNP_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_2_ PPO_MAPD_ISNP_CSNP_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_3_DE_SNP_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_4_Cost Plan_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_5_PFFS_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_6_MSA_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_7_HMO MA_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_8_PPO MA_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_9_PDP_ANOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_1_HMO_MAPD_ISNP_CSNP_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_2_ PPO_MAPD_ISNP_CSNP_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_3_DE_SNP_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_4_Cost Plan_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_5_PFFS_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_6_MSA_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_7_HMO MA_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_8_PPO MA_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable
Instruction CY2024_9_PDP_EOC_30 day PRA CLEAN.pdf No   Fillable Fileable

Health Health Care Services

 

800 0
   
Private Sector Businesses or other for-profits
 
   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 800 0 5 0 0 795
Annual IC Time Burden (Hours) 9,600 0 60 0 0 9,540
Annual IC Cost Burden (Dollars) 741,888 0 -41,258,112 0 0 42,000,000

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