Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
States - Data submission Modified 50 25 0 Form and Instruction CMS-10320 CMS-10320.FINAL State Instructions and Instrument (5-5-10).
Form and Instruction CMS-10320 Appendix E - State Requirements
States - Training, reviewing regulation, and analyzing data Modified 50 100 0 Form and Instruction CMS-10320 CMS-10320.FINAL State Instructions and Instrument (5-5-10).
Form and Instruction CMS-10320 Appendix E - State Requirements
States - Data Collection Modified 50 400 0 Form and Instruction CMS-10320 Appendix E - State Requirements
Form and Instruction CMS-10320 State Instructions and Application
Issuers Training and Communication Modified 750 22500 0 Form and Instruction CMS-10320 Appendix C Insurance Issuer and Product Level Data
Form and Instruction CMS-10320 Appendix D
Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Issuers - Submission Preparation (Individual) Modified 450 19800 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendix C - Insurance Issurer and Product Level Data
Form and Instruction CMS-10320 Appendix D - Data Collection 2014
Issuers - Submission Preparation (Small Group) Modified 700 30800 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendic C - Insurance Issuer and Product Level Data
Form and Instruction CMS-10320 Data Collection 2014
Issuer - Data Entry (Individual) Modified 450 1800 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendix C - Issurance Issuer and Product Level Data
Form and Instruction CMS-10320 Appendix D - Data Collection 2014
Issuer - Data Entry (Small Group) Modified 700 2800 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendix C - Insurance Issuer and Product Level Data
Form and Instruction CMS-10320 Appendix D - Data Collection 2014
Issuer - Troubleshoot (Individual) Modified 450 3600 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendix C - Insurance Issuer and Product Level Data
Form and Instruction CMS-10320 Appendix D - Data Collection 2014
Issuer - Troubleshoot (Small Group) Modified 700 5600 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendix C - Insurance Issuer and Product Level Data
Form and Instruction CMS-10320 Appendix S - Data Collection 2014
Issuer - Attest (Individual) Modified 450 900 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendix C - Insurance Issuer and Product Level Data
Form and Instruction CMS-10320 Appendix D - Data Collection 2014
Issuer - Attest (Small Group) Modified 700 1400 0 Form and Instruction CMS-10320 CMS-10320.Issuer - FINAL Instructions and Instruments
Form and Instruction CMS-10320 Appendix C - Insurance Issuer and Product Level Data
Form and Instruction CMS-10320 Appendix D - Data Collection 2014
Total burden requested under this ICR: 5500 89725 0  
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