Annual Submission of Transparency in Coverage Data

Information Collection for Transparency in Coverage Reporting by Qualified Health Plan Issuers (CMS-10572)

OMB: 0938-1310

IC ID: 221316

Documents and Forms

Document Name Document Type
Form CMS-10572 Annual Submission of Transparency in Coverage Data Form and Instruction
CMS-10572 QHP Issuer Data Collection - Appendix A2 CMS-10572_Transparency in Coverage_Appendix A2.pdf Form and Instruction
CMS-10572 QHP Issuer Data Collection - Appendix A2 CMS-10572_Transparency in Coverage_Appendix A2.pdf Form and Instruction
CMS-10572 Data Submission Template - Appendix C CMS-10572_Transparency in Coverage_Appendix C.pdf Form and Instruction
CMS-10572 Data Submission Template - Appendix C CMS-10572_Transparency in Coverage_Appendix C.pdf Form and Instruction
CMS-10572 Data Elements - Appendix A1 CMS-10572_Transparency in Coverage_Apppendix A1.pdf Form and Instruction
CMS-10572 Data Elements - Appendix A1 CMS-10572_Transparency in Coverage_Apppendix A1.pdf Form and Instruction
CMS-10572 Data Templates Appendix B CMS-10572_Transparency in Coverage_Appendix B1.pdf Form and Instruction
CMS-10572 Data Templates Appendix B CMS-10572_Transparency in Coverage_Appendix B1.pdf Form and Instruction
CMS-10572 Data Template Appendix B2 CMS-10572_Transparency in Coverage_Appendix B2.pdf Form and Instruction
CMS-10572 Data Template Appendix B2 CMS-10572_Transparency in Coverage_Appendix B2.pdf Form and Instruction
CMS-10572 Data Template - Appendix D CMS-10572_Transparency in Coverage_Appendix D.pdf Form and Instruction
CMS-10572 Data Template - Appendix D CMS-10572_Transparency in Coverage_Appendix D.pdf Form and Instruction