MSA or Medicare+Choice MSA Information

MSA or Medicare+Choice MSA Information

OMB: 1545-1518

IC ID: 40849

Documents and Forms
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Information Collection (IC) Details

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MSA or Medicare+Choice MSA Information
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 5498-SA Yes Yes


    

16,442 0
   
Private Sector Businesses or other for-profits
 
   95 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 41,105 0 0 0 0 41,105
Annual IC Time Burden (Hours) 6,988 0 0 0 0 6,988
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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