Information Collection

Web-broker Website Required QHP Comparative Information and Enrollment Support Disclaimer

IC 263328 under ICR 202311-0938-002 · OMB 0938-1463.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1463 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Web-broker Website Required QHP Comparative Information and Enrollment Support Disclaimer	Agency IC Tracking Number:	CCIIO - 10877

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 155.220(c)(3)(i)(A)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	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 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	40,020	40,020

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.