OMB control number

Early Retiree Reinsurance Program: Survey of Plan Sponsors

OMB 0938-1150 · HHS/CMS.

OMB 0938-1150

Latest forms, documents, and information collections
Document	Type
Form CMS-10408 ERRP Survey	Form and Instruction
Form CMS-10408 Revised_Survey_Screenshots	Form and Instruction
Form CMS-10408 Final Survey	Form
Form CMS-10408 REVISED ERRP Survey of Plan Sponsors 11-17-11	Form
Form CMS-10408 ERRP Survey of Plan Sponsors	Form
Form CMS-10408 Final Survey	Form
Form CMS-10408 REVISED ERRP Survey of Plan Sponsors 11-17-11	Form
Form CMS-10408 ERRP Survey of Plan Sponsors	Form
CMS-10408_Supporting_Statement_Part_B_FINAL.docx	Supporting Statement B
CMS-10408_ERRP_Survey_Crosswalk_of_Changes_FINAL.pdf	Supplementary Document
CMS-10408_Subsequent_Email_Clean_Sponsor_Previously_Responded_FINAL.pdf	Supplementary Document
CMS-10408_Subsequent_Email_Clean_Sponsor_Did_Not_Previously_Respond_FINAL.pdf	Supplementary Document
CMS-10408 SupportingStatement_A_FINAL (Reinstatement).docx	Supporting Statement A
Survey of Plan Sponsors	Form and Instruction
Survey of Plan Sponsors	Form and Instruction
Survey of Plan Sponsors (Private Entities)	Form
Survey of Plan Sponsors (Private Entities)	Form
Survey of Plan Sponsors (Private Entities)	Instruction
Survey of Plan Sponsors (Private Entities)	Form
Survey of Plan Sponsors (Public Entities)	Form
Survey of Plan Sponsors (Public Entities)	Form
Survey of Plan Sponsors (Public Entities)	Instruction
Survey of Plan Sponsors (Public Entities)	Form

Historical document collections
Reference	Filing	Received	Concluded	Action
201301-0938-008	Reinstatement with change of a previously approved collection	2013-01-25		Approved with change
201111-0938-007	New collection (Request for a new OMB Control Number)	2011-11-10		Approved with change