Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Election Process (Beneficiaries) Modified 11697487 3895263 0 Form and Instruction CMS-10718 Enrollment Form
Form and Instruction CMS-10718 Enrollment Form (Spanish)
Form and Instruction CMS-10718 Enrollment Form (Korean)
Form and Instruction CMS-10718 Enrollment Form (Traditional Chinese)
Form and Instruction CMS-10718 Enrollment Form (Vietnamese)
Election Process (MA organization) Modified 11697487 2339496 0 Form and Instruction CMS-10718 Enrollment Form
Form and Instruction CMS-10718 Enrollment Form (Spanish)
Form and Instruction CMS-10718 Enrollment Form (Korean)
Form and Instruction CMS-10718 Enrollment Form (Traditional Chinese)
Form and Instruction CMS-10718 Enrollment Form (Vietnamese)
Eligibility and Enrollment Eligibility and enrollment (Beneficiaries) Modified 8118410 2703431 0 Form and Instruction CMS-10718 Enrollment Form
Form and Instruction CMS-10718 Enrollment Form (Spanish)
Form and Instruction CMS-10718 Enrollment Form (Korean)
Form and Instruction CMS-10718 Enrollment Form (Traditional Chinese)
Form and Instruction CMS-10718 Enrollment Form (Vietnamese)
Eligibility and Enrollment Eligibility and enrollment (Part D sponsor) Modified 8118410 1623682 0 Form and Instruction CMS-10718 Enrollment Form
Form and Instruction CMS-10718 Enrollment Form (Spanish)
Form and Instruction CMS-10718 Enrollment Form (Korean)
Form and Instruction CMS-10718 Enrollment Form (Traditional Chinese)
Form and Instruction CMS-10718 Enrollment Form (Vietnamese)
Medicare Advantage Communication Requirements Review and Distribution of Marketing Materials Unchanged 740 4440 0
Part D Communication Requirements, Review and Distribution of Marketing Materials Unchanged 63 378 0
Required Notice for Reinstatements Based on Beneficiary Cancellation of New Enrollment Unchanged 225906 3840 0
Total burden requested under this ICR: 39858503 10570530 0  
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