OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Early Retiree Reinsurance Program: Survey of Plan Sponsors

OMB 0938-1150 · HHS/CMS.

OMB 0938-1150

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10408 Survey of Plan Sponsors Form and Instruction
Form CMS-10408 Survey of Plan Sponsors (Private Entities) Form
Form CMS-10408 Survey of Plan Sponsors (Public Entities) 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 (Private Entities) Form
Survey of Plan Sponsors (Public Entities) Form

All Historical Document Collections

201301-0938-008 Approved with change	Reinstatement with change of a previously approved collection	2013-01-25
201111-0938-007 Approved with change	New collection (Request for a new OMB Control Number)	2011-11-10