OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Notice of rebates to Subscribers and Policyholders

IC 201982 under ICR 202311-0938-016 · OMB 0938-1164.

Documents and Forms
Document Name
Document Type
Other-Template
Other-Template
Other-Template
Other-Template
Other-Template
Other-Template
Information Collection (IC) Details

View Information Collection (IC)

Notice of rebates to Subscribers and Policyholders
 
No Modified
 
Mandatory
 
45 CFR 158

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Template MLR Notice 1 Individual Market- Rebate to Subsribers.pdf Yes No Paper Only
Other-Template MLR Notice 2 Group Markets - Rebate to Policyholder.pdf Yes No Printable Only
Other-Template MLR Notice 3 Group Markets - Rebate to Subscribers.pdf Yes No Printable Only

Health Health Care Services

 

114 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 4,200,368 0 0 -3,050,444 0 7,250,812
Annual IC Time Burden (Hours) 38,824 0 0 -26,281 0 65,105
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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