Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
HRA Notice to Participants and Other Disclosures Modified 1407453 31399 16996 Other-Model
Other-Model
Participant Notification of Individual Coverage HRA of Cancelled or Discontinued Coverage Modified 7630 636 0
Total burden requested under this ICR: 1415083 32035 16996  
To view an IC, click on IC Title