Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Submission for the Federally-facilitated Exchange User Fee Adjustment (Fully Insured Issuers) Modified 325 406 0 Form and Instruction CMS-10492
Data Submission for the Federally-facilitated Exchange User Fee Adjustment (Issuer) Modified 48 528 0 Form and Instruction CMS-10492
Form and Instruction CMS-10492
Data Submission for the Federally-facilitated Exchange User Fee Adjustment (TPAs) Modified 488 5612 0 Form and Instruction CMS-10492
Form and Instruction CMS-10492
Total burden requested under this ICR: 861 6546 0  
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