TD 9724 - Summary of Benefits and Coverage Disclosures

OMB 1545-2229

Latest Forms, Documents, and Supporting Material

Document Name
1545-2229 Justification for Change 2017-03.docx Justification for No Material/Nonsubstantive Change
Simple fracture.pdf Supplementary Document
SBC Sample Completed 4 4 clean.doc Supplementary Document
SBC Template 4 4 clean.doc Supplementary Document
UG 4-1-16 -12 pm clean.doc Supplementary Document
Yes Answers 4 1 12 pm clean.doc Supplementary Document
No Answers 4 1 12 pm clean.doc Supplementary Document
maternity-narrative.pdf Supplementary Document
Copy of Copy of coverage_examples_calculator 02 07.xlsm Supplementary Document
coverage_examples_calculator instructions FINAL.docx Supplementary Document
Copy of Managing Type 2 Diabetes.xlsx Supplementary Document
Copy of Simple fracture.xlsx Supplementary Document
Copy of Having a baby.xlsx Supplementary Document
SBC Template 4 4 clean.doc Supplementary Document
SBC Response to Comments 4 5 16 clean.docx Supplementary Document
No Answers 4 1 12 pm clean.doc Supplementary Document
Individual Instructions 4 4 clean.docx Supplementary Document
Group Instructions 4 4 clean.docx Supplementary Document
2019-03-19_SS_1545-2229r.doc Supporting Statement A
TD 9724 - Summary of Benefits and Coverage Disclosures

All Historical Document Collections

201810-1545-024 Approved without change	Revision of a currently approved collection	2019-04-30
201703-1545-005 Approved without change	No material or nonsubstantive change to a currently approved collection	2017-03-22
201604-1545-003 Approved without change	Revision of a currently approved collection	2016-04-05
201409-1545-021 Approved without change	Extension without change of a currently approved collection	2015-02-27
201211-1545-009 Approved without change	Revision of a currently approved collection	2012-11-08
201109-1545-001 Preapproved	New collection (Request for a new OMB Control Number)	2012-01-24