Issuer Report

Cost-Sharing Reduction Reconciliation (CMS-10526)

OMB: 0938-1266

IC ID: 213295

Documents and Forms
Information Collection (IC) Details

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Issuer Report
No Modified
45 CFR 156.430

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10526 CSR Reconciliation Data Elements CMS-10526 - CSR Recon PRA_Collection Elements 30d.docx Yes Yes Fillable Fileable

Health Health Care Services


150 0
Private Sector Businesses or other for-profits, Not-for-profit institutions
   0 %

  Requested 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 150 0 0 0 0 150
Annual IC Time Burden (Hours) 113 0 0 0 0 113
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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