Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Mandatory Insurer Reporting (GHP-Private) Modified 2600000 216658 0 Instruction
Mandatory Insurer Reporting (GHP-Private, Maintenance/Administrative) Modified 1134 24948 0 Instruction
Mandatory Insurer Reporting (GHP-State, Local, Tribal Gov't) Removed 0 0 0 Instruction
Mandatory Insurer Reporting (Non-GHP, Federal) Removed 0 0 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Federal, System Set-up and Administrative) Removed 0 0 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Private - Maintenance/Administration) Modified 18114 44228 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Private) Modified 2400000 199992 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, State, Local, Tribal Govt.) Removed 0 0 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, State, Local, Tribal Govt., System Set-up and Administration) Removed 0 0 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Private, System Set-up) Removed 0 0 0 Instruction
Mandatory Insurer Reporting (State, Local, Tribal Govt, System Set-up) Removed 0 0 0 Instruction
Mandatory Insurer Reporting (State, Local, Tribal Govt., Administrative) Removed 0 0 0 Instruction
Total burden requested under this ICR: 5019248 485826 0  
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