Information Collection

Qualified Health Plan Minimum Certification Standards

IC 226172 under ICR 202401-0938-015 · OMB 0938-1341.

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IC Title:

Qualified Health Plan Minimum Certification Standards

Agency IC Tracking Number:

CMS-10592

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 156.200

Information Collection Instruments:

table that charts list of 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: 302

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	302	52	250
Annual IC Time Burden (Hours)	12,080	2,080	10,000
Annual IC Cost Burden (Dollars)	1,100,216	1,100,216	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.