Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adult Qualified Health Plan Enrollee Experience Survey Modified 120015 39623 0 Form and Instruction CMS-10488 Survey Vendor Application
Form and Instruction CMS-10488 QHP Survey (Chinese)
Form and Instruction CMS-10488 Cover Letter (Chinese)
Form and Instruction CMS-10488 QHP Survey (English)
Form and Instruction CMS-10488 Cover Letter (English)
Form and Instruction CMS-10488 QHP Survey (Spanish)
Form and Instruction CMS-10488 Cover Letter (Spanish)
Marketplace Survey Data Collection Removed 0 0 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: 120015 39623 0  
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