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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Annual MLR Report
Modified
2818
179278
0
Form and Instruction
CMS-10418
MLR Reporting Form
Form and Instruction
CMS-10418
MLR Form Instructions
Disbursement of Rebate Checks
Modified
3704400
34375
0
Notice of Rebate to Enrollees
Modified
859760
21494
0
Form and Instruction
CMS-10418
MLR Notice 1 - Individual Market to Subscribers
Form and Instruction
CMS-10418
MLR Notice 2 Group Markets - Rebate to Policyholder
Form and Instruction
CMS-10418
MLR Notice 3 - Group Markets - Rebate to Subscribers
Form and Instruction
CMS-10418
MLR Notice Instructions
Retention of Records
Modified
2798
170
0
Total burden requested under this ICR:
4569776
235317
0
To view an IC, click on IC Title