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Minimum Essential Coverage Certification
No Modified
Required to Obtain or Retain Benefits
45 CFR 156.304(a)(3) 45 CFR 156.604(d)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10465 Minimum Essential Coverage Certification CMS-10465 MEC Certification_updatedfinal.pdf Yes Yes Fillable Printable

Health Health Care Services


10 0
Private Sector Not-for-profit institutions, Businesses or other for-profits
   100 %

  Approved 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 10 0 0 10 0 0
Annual IC Time Burden (Hours) 53 0 0 53 0 0
Annual IC Cost Burden (Dollars) 2,200 0 0 2,200 0 0

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