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Employers - Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment
No Modified
Required to Obtain or Retain Benefits
45 CFR 155 45 CFR 156 45 CFR 157

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Data Elements CMS-10468 - Appendix A - Data Elements.docx Yes Yes Printable Only

Health Health Care Services


13,200 0
State, Local, and Tribal Governments
   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 13,200 0 0 0 0 13,200
Annual IC Time Burden (Hours) 960 0 0 0 0 960
Annual IC Cost Burden (Dollars) 53,196,000 0 0 0 0 53,196,000

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