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GenIC #28 Health Insurance Literacy Survey
Generic Social Marketing & Consumer Testing Research (CMS-10437)
OMB: 0938-1247
IC ID: 269722
OMB.report
HHS/CMS
OMB 0938-1247
ICR 202407-0938-019
IC 269722
( )
Documents and Forms
Document Name
Document Type
Form CMS-10437.GenIC#28
GenIC #28 Health Insurance Literacy Survey
Form and Instruction
CMS-10437.GenIC#28 Marketplace and Medicare Health Insurance Literacy Surve
CMS-10437.GenIC#28.Survey Instrument - final.docx
Form and Instruction
CMS-10437.GenIC#28 Marketplace and Medicare Health Insurance Literacy Surve
CMS-10437.GenIC#28.Survey Instrument - final.docx
Form and Instruction
CMS-10437.GenIC#28.Supporting Statement - final.docx
CMS-10437.GenIC#28.Supporting Statement - final
IC Document
CMS-10437.GenIC#28.Supporting Statement - final.docx
CMS-10437.GenIC#28.Supporting Statement - final
IC Document
CMS-10437.GenIC#28.Cover Sheet - final.docx
CMS-10437.GenIC#28.Cover Sheet - final
IC Document
CMS-10437.GenIC#28.Cover Sheet - final.docx
CMS-10437.GenIC#28.Cover Sheet - final
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
GenIC #28 Health Insurance Literacy Survey
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
CMS-10437.GenIC#28
Marketplace and Medicare Health Insurance Literacy Survey
CMS-10437.GenIC#28.Survey Instrument - final.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
2,400
0
2,400
0
0
0
Annual IC Time Burden (Hours)
600
0
600
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
CMS-10437.GenIC#28.Supporting Statement - final
CMS-10437.GenIC#28.Supporting Statement - final.docx
08/06/2024
CMS-10437.GenIC#28.Cover Sheet - final
CMS-10437.GenIC#28.Cover Sheet - final.docx
08/06/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.