Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)

ICR 202404-0938-009

OMB: 0938-1119

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-10371 SBM Three-year Budget Reports Form and Instruction	Unchanged
Form CMS-10371 SBM Three-year Budget Reports Form and Instruction	Unchanged
Form CMS-10371 SBM Individual Market Reports (weekly) Form and Instruction	Unchanged
Form CMS-10371 SBM Individual Market Reports (weekly) Form and Instruction	Unchanged
SBEBudgetTemplate2024_Redline.xls Supplementary Document	2024-04-11
SBEBudgetTemplate2024_Redline.xls Supplementary Document	2024-04-11
SBEBudgetTemplate2024.xls Supplementary Document	2024-04-11
SBEBudgetTemplate2024.xls Supplementary Document	2024-04-11
0938-1119 Non-sub Change Request Memo_clean.docx Justification for No Material/Nonsubstantive Change	2024-04-11
0938-1119 Non-sub Change Request Memo_clean.docx Justification for No Material/Nonsubstantive Change	2024-04-11
CMS-10371 - Cooperative Agreement Weekly Metrics - Final.docx Supplementary Document	2023-03-06
CMS-10371 - Cooperative Agreement Weekly Metrics - Final.docx Supplementary Document	2023-03-06
CMS-10371 - Cooperative Agreement Weekly Metrics redlined.docx Supplementary Document	2023-03-06
CMS-10371 - Cooperative Agreement Weekly Metrics redlined.docx Supplementary Document	2023-03-06
0938-1119 Change Request - Justification (003).docx Justification for No Material/Nonsubstantive Change	2023-03-10
0938-1119 Change Request - Justification (003).docx Justification for No Material/Nonsubstantive Change	2023-03-10
CMS-10371 - Cooperative Agreement Supporting Statement (F).docx Supporting Statement A	2022-04-08
CMS-10371 - Cooperative Agreement Supporting Statement (F).docx Supporting Statement A	2022-04-08

IC Document Collections

IC ID	Document Title	Status
252604	State Based Marketplace Data Collection Templates for Bi-Annual Reporting Other-Data Template	Unchanged
228022	SBM Three-year Budget Reports Form and Instruction	Unchanged
228022	SBM Three-year Budget Reports Form and Instruction	Unchanged
228019	SBM Individual Market Reports (weekly) Form and Instruction	Unchanged
228019	SBM Individual Market Reports (weekly) Form and Instruction	Unchanged
216248	End of Enrollment Budget Report Other-Data Elements	Unchanged