Navigator Annual Progress Report

Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Exchanges (CMS-10463)

Documents and Forms

Document Name Document Type
CMS-10463 - Navigator Reporting Requirements.pdf Reporting Elements IC Document
CMS-10463 - Navigator Reporting Requirements.pdf Reporting Elements IC Document

Information Collection (IC) Details

IC Title:	Navigator Annual Progress Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 155.210

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	50	50
Annual IC Time Burden (Hours)	200	100	100
Annual IC Cost Burden (Dollars)	84,800	42,400	42,400

Documents for IC

Title	Document	Date Uploaded
Reporting Elements	CMS-10463 - Navigator Reporting Requirements.pdf	02/02/2022

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