Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Annual MLR Report Modified 2818 179278 0 Form and Instruction CMS-10418
Form and Instruction CMS-10418
Disbursement of Rebate Checks Modified 3704400 34375 0
Notice of Rebate to Enrollees Modified 859760 21494 0 Form and Instruction CMS-10418
Form and Instruction CMS-10418
Form and Instruction CMS-10418
Form and Instruction CMS-10418
Retention of Records Modified 2798 170 0
Total burden requested under this ICR: 4569776 235317 0  
To view an IC, click on IC Title