Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adult Qualified Health Plan Enrollee Experience Survey Modified 604240 271930 0 Form and Instruction CMS-10488 Vendor Form
Form and Instruction CMS-10488 English Adult QHP Enrollee Survey
Form and Instruction CMS-10488 Spanish - Qualified Health Plan Enrollee Experience Survey
Form and Instruction CMS-10488 Chinese - Qualified Health Plan Enrollee Experience
Marketplace Survey Data Collection Unchanged 64350 25740 0 Form and Instruction CMS-10488 English - Marketplace Survey
Form and Instruction CMS-10488 Spanish - Marketplace Survey
Form and Instruction CMS-10488 Chinese - Marketplace Survey
Total burden requested under this ICR: 668590 297670 0  
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