Information Collection Request

Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)

ICR 202504-0938-012 · OMB 0938-1254 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1254 can be found here:

Forms and Documents

Document Name	Status
Form CMS-10527 Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction	Modified
Form CMS-10527 Product Discontinuance Notice for QHP Issuers Form and Instruction	Modified
Form CMS-10527 Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction	Modified
Form CMS-10527 Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction	Modified
CMS-10527 Summary of Changes (Attachments - Notices)_60-day.docx Supplementary Document	2025-04-17
CMS-10527 - Supporting Statement NPRM.docx Supporting Statement A	2025-04-10
CMS-10527 Summary of Changes.pdf Supplementary Document	2023-04-26
CMS-10527 Comment and Response Summary 30d comment period rev.docx Supplementary Document	2023-06-08

IC Document Collections

IC ID	Document Title	Status
212940	Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction	Modified
212939	Product Discontinuance Notice for QHP Issuers Form and Instruction	Modified
212938	Product Renewal Notice for Issuers Outside the Marketplace (Non-QHP) Form and Instruction	Modified
212937	Product Renewal and Discontinuance Notice for QHP Issuers Form and Instruction	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CMS
OMB Control No	0938-1254
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202304-0938-018
Agency Tracking No	CCIIO
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31