OMB control number
Evidence of Coverage under An Employer Group Health Plan
OMB 3220-0189 · RRB.
OMB 3220-0189
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Evidence of Coverage under An Employer Group Health Plan |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 199709-3220-002 | Revision of a currently approved collection | 1997-09-24 | Approved without change | |
| 199407-3220-003 | New collection (Request for a new OMB Control Number) | 1994-07-26 | Approved without change |