Form CMS-10527 Discontinuation Notices
Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)
CMS-10527 Attachment 3 - Discontinuation Notice with auto enrollment Off Exchange 30 -day
Product Discontinuance Notice for Issuers Outside the Marketplace (Non-QHP)
OMB: 0938-1254
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1254 can be found here:
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