Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Mandatory Insurer Reporting (GHP-Private) New 3515000 292917 0 Instruction
Mandatory Insurer Reporting (GHP-State, Local, Tribal Gov't) New 185000 15417 0 Instruction
Mandatory Insurer Reporting (Non-GHP, Federal) New 27173 2264 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Federal, System Set-up and Administrative) New 1077 7561 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Private - System Set-up and Administration) New 289227 806715 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Private) New 2898827 241569 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, State, Local, Tribal Govt.) New 100 8 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, State, Local, Tribal Govt., System Set-up and Administration) New 100 27 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Private, Administrative) New 1900 3800 0 Instruction
Mandatory Insurer Reporting (Private, System Set-up) New 1900 712500 0 Instruction
Mandatory Insurer Reporting (State, Local, Tribal Govt, System Set-up) New 100 37500 0 Instruction
Mandatory Insurer Reporting (State, Local, Tribal Govt., Administrative) New 100 200 0 Instruction
Total burden requested under this ICR: 6920504 2120478 0  
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