Information Collection Request

Summary of Benefits and Coverage and Uniform Glossary (CMS-10407)

ICR 202210-0938-011 · OMB 0938-1146 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1146 can be found here:

Forms and Documents

Document Name	Status
SBC PRA 30 day supporting statement2_clean.docx Supporting Statement A	2022-11-01
CMS-10407 Non-Substantive Change Request.pdf Justification for No Material/Nonsubstantive Change	2019-11-27
Copy of CMS-10407-SBC PRA-2019 30-day Notice Period-Comments and Responses_OMB.xlsx Supplementary Document	2019-10-24
Crosswalk of Changes.pdf Supplementary Document	2019-10-22

IC Document Collections

IC ID	Document Title	Status
201038	Deemed Compliance Reporting	Modified
199007	SBC Disclosure Other-Maternity Care Narrative	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CMS
OMB Control No	0938-1146
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	201911-0938-018
Agency Tracking No	CCIIO
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31