View Information Collection (IC)

View Information Collection (IC)

Health Insurance Marketplace Consumer Experience Surveys: Enrollee Satisfaction Survey and Marketplace Survey
 
No New
 
Voluntary
 
45 CFR 156.200(b)(5) 45 CFR 155.200(d)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10488 Chinese Cover Letter CMS- 10488 - Cover Letters_Chinese_101413_clean.docx Yes Yes Fillable Printable
Form and Instruction CMS-10488 English/Spanish CMS-10488 - Cover Letters_English and Spanish_ 9-30-13 (clean).doc Yes Yes Fillable Fileable
Form and Instruction CMS-10488 Vendor Participation Form CMS-10488 - Vendor Participation Form_clean.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10488 Chinese Marketplace Survey CMS-10488 - Chinese Marketplace Survey_Sept30_clean.docx Yes Yes Fillable Printable
Form and Instruction CMS-10488 English Marketplace Survey CMS-10488 - English Marketplace Survey_Sept_30_2013_clean.docx Yes Yes Fillable Printable
Form and Instruction CMS-10488 Spanish Marketplace Survey CMS-10488 - Spanish Marketplace Survey_ Sept 30_clean.docx Yes Yes Fillable Printable
Form and Instruction CMS-10488 Chinese QHP Enrollee Survey CMS-10488 - Chinese QHP Enrollee Survey_Sept 30_clean.docx Yes Yes Fillable Printable
Form and Instruction CMS-10488 English QHP Enrollee Survey CMS-10488 - English QHP Enrollee Survey_Sept_30_2013_clean.docx Yes Yes Fillable Printable
Form and Instruction CMS-10488 Spanish QHP Enrollee Survey CMS-10488 - Spanish QHP Enrollee Survey_Sept 30_Clean.docx No No Fillable Printable

Health Health Care Services

 

755,043 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   50 %

  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 755,043 755,043 0 0 0 0
Annual IC Time Burden (Hours) 100,708 100,708 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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