Information Collection Request
Cooperative Agreement to Support Establishment of State-Operated Health Insurance Exchanges (CMS-10371)
ICR 202404-0938-009 · OMB 0938-1119 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1119 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form and Instruction |
Unchanged |
Form and Instruction |
Unchanged |
Form and Instruction |
Unchanged |
Form and Instruction |
Unchanged |
Supplementary Document | 2024-04-11 |
Supplementary Document | 2024-04-11 |
Supplementary Document | 2024-04-11 |
Supplementary Document | 2024-04-11 |
Justification for No Material/Nonsubstantive Change | 2024-04-11 |
Justification for No Material/Nonsubstantive Change | 2024-04-11 |
Supplementary Document | 2023-03-06 |
Supplementary Document | 2023-03-06 |
Supplementary Document | 2023-03-06 |
Supplementary Document | 2023-03-06 |
Justification for No Material/Nonsubstantive Change | 2023-03-10 |
Justification for No Material/Nonsubstantive Change | 2023-03-10 |
Supporting Statement A | 2022-04-08 |
Supporting Statement A | 2022-04-08 |
Form CMS-10371 SBM Three-year Budget Reports
SBEBudgetTemplate2024_Redline.xls
0938-1119 Non-sub Change Request Memo_clean.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 252604 | Unchanged | ||
| 228022 | Unchanged | ||
| 228022 | Unchanged | ||
| 228019 | Unchanged | ||
| 228019 | Unchanged | ||
| 216248 | Unchanged |
State Based Marketplace Data Collection Templates for Bi-Annual ReportingICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1119 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202302-0938-016 |
| Agency Tracking No | CCIIO |
| Date Submitted to OIRA | 2024-04-11 |
| Requested Expiration Date | 1969-12-31 |