Information Collection Request

Basic Health Program Report for Health Insurance Exchange Premium (CMS-10510)

ICR 202305-0938-007 · OMB 0938-1218 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10510 Enrollment Data Guide Form and Instruction Unchanged Available
Form CMS-10510 State Report for Health Insurance Exchange Premiums Form and Instruction Unchanged Available
Form CMS-10510 Blueprint Form and Instruction Unchanged Available
Form CMS-10510 Annual Report Form and Instruction Unchanged Available
Form CMS-10510 Basic Health Program Supporting Regulations Form and Instruction Unchanged Repair queued
CMS-10510 - Supporting Statement A (2022 version 7).docx Supporting Statement A Uploaded 2022-12-28 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
260184 BHP Enrollment by DACA Recipients New
209843 Basic Health Program Supporting Regulations Form and Instruction UnchangedEnrollment Data Guide
209843 Basic Health Program Supporting Regulations Form and Instruction UnchangedState Report for Health Insurance Exchange Premiums
209843 Basic Health Program Supporting Regulations Form and Instruction UnchangedBlueprint
209843 Basic Health Program Supporting Regulations Form and Instruction UnchangedAnnual Report
209843 Basic Health Program Supporting Regulations Form and Instruction Unchanged
209843 Basic Health Program Supporting Regulations Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2026 36 Months From Approved 01/31/2026
27 0 27
2,568 0 2,568
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
BHP Enrollment by DACA Recipients
Basic Health Program Supporting Regulations CMS-10510, CMS-10510, CMS-10510, CMS-10510 ,   ,   ,  



Reginfo record details
  No