Affordable Care Act Internal Claims and Appeals and External Review Procedures for ERISA Plans

ICR 202503-1210-004

OMB: 1210-0144

Federal Form Document

Forms and Documents

Document Name	Status
Justification for No Material or Nonsubstantive Change to Currently Approved Collection (OMB Control 1210-0144).docx Justification for No Material/Nonsubstantive Change	2025-01-17
1210-0144 DOL IFR 2 external review SS 3.20.25.docx Supporting Statement A	2025-03-20

IC Document Collections

IC ID	Document Title	Status
194302	Procedures for Federal External Review and Model Notices Relating to Internal Claims and Appeals and External Review under the Patient Protection and Affordable Care Act Other-Model	Modified
193842	Group Health Plans Internal Claims and Appeals and External Review Processes	Modified