Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
End of Enrollment Budget Report Modified 20 440 0 Other-Data Elements
SBM Individual Market Reports (weekly) Modified 280 6006 0 Form and Instruction CMS-10371 SBM Individual Market Reporting
SBM Three-year Budget Reports Modified 23 368 0 Form and Instruction CMS-10371 SBM Three-Year Budget Template
State Based Marketplace Data Collection Templates for Bi-Annual Reporting Modified 40 492 0 Other-Data Template
Total burden requested under this ICR: 363 7306 0  
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