Information Collection Request

Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions (CMS-10466)

ICR 202403-0938-005 · OMB 0938-1190 · Received in OIRA

Forms and Documents

Document Name	Status
Form CMS-10466 Exemption Applications - Eligibility for Exemptions Form and Instruction	Modified
CMS-10466 - Supporting Statement 2023_Final.pdf Supporting Statement A	2024-03-13

IC Document Collections

IC ID	Document Title	Status
208103	Agreements	Modified
208102	Periodic Electronic Notifications	Modified
208101	Redeterminations	Modified
205756	Verification of New and Changed Applications	Modified
205755	Eligibility Notices	Modified
205754	Application Development (Edits)	Modified
205753	Exemption Applications - Eligibility for Exemptions Form and Instruction	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CMS
OMB Control No	0938-1190
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202003-0938-013
Agency Tracking No	CCIIO
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31