Product Discontinuance Notice for QHP Issuers

Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)

OMB: 0938-1254

IC ID: 212939

Documents and Forms

Document Name Document Type
Form CMS-10527 Product Discontinuance Notice for QHP Issuers Form and Instruction
CMS-10527 Discontinuation Notices CMS-10527 Attachment 4 - Discontinuation Notice with Auto Enrollment QHP_60-day.pdf Form and Instruction
CMS-10527 Discontinuation without auto enrollment (QHP) CMS-10527 Attachment 6 - Discontinuation Notice without Auto Enrollment QHP_60-day.pdf Form and Instruction