Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
HRA Notice to Participants and other disclosures Modified 2128613 52166 24831 Other-Model
Other-Model
Participant Notification of Individual Coverage HRA of Cancelled or Discontinued Coverage New 11584 965 0
Total burden requested under this ICR: 2140197 53131 24831  
To view an IC, click on IC Title