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Attachment C
ICR 201706-0938-002 · OMB 0938-1074 · Object 75007101.
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1074 can be found here:
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Attachment C – GHP Data Elements
Note: The list of GHP Data Elements published with the Supporting Statement of 02/28/14 has been superseded by the information available in the Section 111 GHP User Guide. A current User Guide can be found on the Mandatory Insurer Reporting web page at https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Mandatory-Insurer-Reporting-For-Group-Health-Plans/GHP-User-Guide/GHP-User-Guide.html .
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Attachment C – GHP Data Elements |
| Author | CMS |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |