Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Mandatory Insurer Reporting (GHP-Private) Modified 1600000 133333 0 Instruction
Mandatory Insurer Reporting (GHP-Private, Maintenance/Administrative) Modified 1030 22660 0 Instruction
Mandatory Insurer Reporting (NGHP-Private) Modified 3618000 301500 0 Form and Instruction CMS-10625 Interim Non-GHP Record Layout
Mandatory Insurer Reporting (Non-GHP, Private - Maintenance/Administration) Modified 20111 156222 0 Form and Instruction CMS-10265 Interim Non-GHP Record Layout
Mandatory Insurer Reporting for Prescription Drug (GHP RREs-Private, Maintenance/Administrative) New 790 4345 0 Instruction
Total burden requested under this ICR: 5239931 618060 0  
To view an IC, click on IC Title