OMB control number
Application for Coverage in the Pre-Existing Condition Insurance Plan
OMB 0938-1095 · HHS/CMS.
OMB 0938-1095
Latest Forms, Documents, and Supporting Material
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Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Form and Instruction |
Supporting Statement A |
Form CMS-10334 Premium Payment Burden
CMS-10334 Supporting_Statement_Part_A(CLEAN 1-30-12).docx
Premium Payment Burden All Historical Document Collections
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Approved with change |
Revision of a currently approved collection | 2011-12-19 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2011-11-08 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2011-06-15 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2011-04-08 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2011-02-16 | |
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Approved without change |
Extension without change of a currently approved collection | 2010-12-30 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2010-08-23 | |
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Approved with change |
New collection (Request for a new OMB Control Number) | 2010-06-25 |