Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual MLR Report New 5534 352563 0 Form CMS-10418 .MLR_Annual_Form
Instruction
Instruction
Disbursement of Rebate Checks New 2725464 68136 0
Notice of Rebate to Enrollees New 7205139 58897 0 Form CMS-10418 Notice_#1_to_Subscribers_in_Individual_Market
Form CMS-10418 Notice_#2_Group_Markets_Rebate_to_Policyholder
Form CMS-10418 Notice_#3_Group_Markets_Rebate_to_Subscribers
Instruction
Instruction
Instruction
Retention of Records New 527 332 0
Total burden requested under this ICR: 9936664 479928 0  
To view an IC, click on IC Title