Affordable Care Act Grandfathered Health Plan Disclosure, Recordkeeping Requirement, and Change in Carrier Disclosure

ICR 202412-1210-001

OMB: 1210-0140

Federal Form Document

Forms and Documents

Document Name	Status
1210-0140 Grandfathering SS 3-20-25.docx Supporting Statement A	2025-03-20

IC Document Collections

IC ID	Document Title	Status
195225	Grandfathered Plan Change in Carrier Disclosure	Modified
193127	Grandfathered Plan Disclosure and Recordkeeping Requirement	Modified