Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Glossary Modified 1569242 13077 808160 Other-Uniform Glossary- November 2019
Modifications Modified 1426000 4955 335972
Summary of Benefits and Coverage Modified 74798145 285938 6467977 Other-SBC Template
Instruction
Other-SBC Sample Glossary
Other-SBC Yes Answers -- Why This Matters
Other-SBC - No Answers - Why This Matters
Other-Template
Other-Template
Other-Template
Instruction
Other-Narrative
Other-Narrative
Other-Narrative
Other-Coverage Calculator
Other-AIAN Limited Cost Sharing
Other-AIAN Zero Cost Sharing
Other-Crosswalk of Changes
Instruction
Other-List of Anchors
Other-SBC Template (Completed)
Total burden requested under this ICR: 77793387 303970 7612109  
To view an IC, click on IC Title