Information Collection Request

Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)

ICR 202504-0938-012 · OMB 0938-1254 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10527 Federal Standard Notices Form and Instruction Modified Available
Form CMS-10527 Discontinuation Notices Form and Instruction Modified Available
Form CMS-10527 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified Repair queued
Form CMS-10527 Discontinuation without auto enrollment (QHP) Form and Instruction Modified Available
Form CMS-10527 Discontinuation Notices Form and Instruction Modified Available
Form CMS-10527 Product Discontinuance Notice for QHP Issuers Form and Instruction Modified Repair queued
Form CMS-10527 Renewal Notice Form and Instruction Modified Available
Form CMS-10527 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified Repair queued
Form CMS-10527 Renewal and Discontinuance Notice Form and Instruction Modified Available
Form CMS-10527 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction Modified Available
CMS-10527 Summary of Changes (Attachments - Notices)_60-day.docx Supplementary Document Uploaded 2025-04-17 Available
CMS-10527 Summary of Changes (Attachments - Notices)_60-day.docx Supplementary Document Uploaded 2025-04-17 Repair queued
CMS-10527 - Supporting Statement NPRM.docx Supporting Statement A Uploaded 2025-04-10 Repair queued
CMS-10527 - Supporting Statement NPRM.docx Supporting Statement A Uploaded 2025-04-10 Repair queued
CMS-10527 Summary of Changes.pdf Supplementary Document Uploaded 2023-04-26 Repair queued
CMS-10527 Summary of Changes.pdf Supplementary Document Uploaded 2023-04-26 Repair queued
CMS-10527 Comment and Response Summary 30d comment period rev.docx Supplementary Document Uploaded 2023-06-08 Repair queued
CMS-10527 Comment and Response Summary 30d comment period rev.docx Supplementary Document Uploaded 2023-06-08 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
212940 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction ModifiedFederal Standard Notices
212940 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction ModifiedDiscontinuation Notices
212940 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified
212939 Product Discontinuance Notice for QHP Issuers Form and Instruction ModifiedDiscontinuation without auto enrollment (QHP)
212939 Product Discontinuance Notice for QHP Issuers Form and Instruction ModifiedDiscontinuation Notices
212939 Product Discontinuance Notice for QHP Issuers Form and Instruction Modified
212938 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction ModifiedRenewal Notice
212938 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction Modified
212937 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction ModifiedRenewal and Discontinuance Notice
212937 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2026 36 Months From Approved 06/30/2026
5,881 0 5,881
72,002 0 72,002
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) CMS-10527
Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) CMS-10527, CMS-10527 ,  
Product Discontinuance Notice for QHP Issuers CMS-10527, CMS-10527 ,  
Product Renewal and Discontinuance Notice for QHP Issuers CMS-10527



Reginfo record details
  No