Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adult Qualified Health Plan Enrollee Experience Survey Unchanged 180010 57610 0 Form and Instruction CMS-10488 Vendor Form
Form and Instruction CMS-10488 QHP Enrollee Survey (Beta Test) - Chinese
Form and Instruction CMS-10488 QHP Enrollee Survey (Beta Test) - English
Form and Instruction CMS-10488 QHP Enrollee Survey (Beta Test) - Spanish
Marketplace Survey Data Collection Modified 52800 12672 0 Form and Instruction CMS-10488 Marketplace Survey for Beta Test English
Form and Instruction CMS-10488 Marketplace Survey for the Beta Test English
Form and Instruction CMS-10488 Marketplace Survey for Beta Test Chinese
Total burden requested under this ICR: 232810 70282 0  
To view an IC, click on IC Title