Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Glossary Modified 1627758 13565 634826 Other-Uniform Glossary- November 2019
Modifications Modified 1458000 5079 298628
Summary of Benefits and Coverage Modified 77096540 294846 6672534 Other-SBC template-Nov 2019
Instruction
Other-SBC Sample Glossary
Other-SBC Yes Answers -- Why This Matters
Other-SBC - No Answers - Why This Matters
Other-Template
Other-Template
Other-Template
Instruction
Other-Narrative
Other-Narrative
Other-Narrative
Other-Coverage Calculator
Other-AIAN Limited Cost Sharing
Other-AIAN Zero Cost Sharing
Other-Crosswalk of Changes
Instruction
Other-List of Anchors
Other-Sample Completed- SBC Accessible Format
Other-Sample Completed- SBC Standard Format
Other-SBC Template Accessible Format
Total burden requested under this ICR: 80182298 313490 7605988  
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