Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual MLR Report Modified 3087 196668 0 Instruction
Form CMS-10418 MLR_Annual_Form
Instruction
Disbursement of Rebate Checks Modified 1540728 38518 0
Notice of Rebate to Enrollees Modified 8324640 68048 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 Modified 502 316 0
Total burden requested under this ICR: 9868957 303550 0  
To view an IC, click on IC Title