View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

QHP Certification
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 155.1065 45 CFR 156.200

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMs-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Form and Instruction CMS-10433 Yes Yes Fillable Fileable
Other-Data Elements Yes Yes Fillable Fileable

Health Health Care Services

 

215 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 215 0 0 0 215 0
Annual IC Time Burden (Hours) 42,140 0 0 0 42,140 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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