Information Collection Request

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

ICR 202611-0938-016 · OMB 0938-1254 · Received in OIRA

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 Discontinuation without auto enrollment (QHP) Form and Instruction Modified Available
Form CMS-10527 Discontinuation Notices Form and Instruction Modified Available
Form CMS-10527 Renewal Notice Form and Instruction Modified Available
Form CMS-10527 Renewal and Discontinuance Notice Form and Instruction Modified Available
CMS-10527 Attachment 6 - Discontinuation Notice without Auto Enrollment QHP_60-day_REDLINE_10-13-2026.docx Supplementary Document Uploaded 2026-11-13 Available
CMS-10527 Attachment 5 - Discontinuation Notice without Auto Enrollment Off Exchange_60-day_REDLINE 08-07-2026.docx Supplementary Document Uploaded 2026-11-13 Available
CMS-10527 Attachment 4 - Discontinuation Notice with Auto Enrollment QHP_60-day _REDLINE_10-13-2026.docx Supplementary Document Uploaded 2026-11-13 Available
CMS-10527 Attachment 3 - Discontinuation Notice with Auto Enrollment Off Exchange_60-day_REDLINE 08-07-2026.docx Supplementary Document Uploaded 2026-11-13 Available
CMS-10527 Attachment 2 - Renewal Notice QHP_60-day_REDLINE_10-13-2026.docx Supplementary Document Uploaded 2026-11-13 Available
CMS-10527 Attachment 1 - Renewal Notice Off Exchange_60-day_REDLINE 08-07-2026.docx Supplementary Document Uploaded 2026-11-13 Available
CMS-10527 Supporting Statement_60 dayw91.docx Supporting Statement A Uploaded 2026-11-13 Available

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
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
212938 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction ModifiedRenewal Notice
212937 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction ModifiedRenewal and Discontinuance Notice

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 02/28/2029
5,397 5,397
66,091 66,091
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

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,397 5,397 0 0 0 0
Annual Time Burden (Hours) 66,091 66,091 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No