Information Collection Request
Non-Standardized Plan Option Limit Exception Justification Form (CMS-10878)
ICR 202404-0938-012 · OMB 0938-1461 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10878 Non-Standardized Plan Option Limit Exceptions |
Form and Instruction | Modified | Repair queued |
 CMS-10878 - Supporting Statement FR.docx |
Supporting Statement A | Uploaded 2024-04-16 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 263675 |  Non-Standardized Plan Option Limit Exceptions |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1461 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Previous ICR Reference No | 202311-0938-012 |
| Agency Tracking No | CCIIO |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |