Document Name Document Type
Form CMS-10882 MPPP Model Notices Programming Form and Instruction
CMS-10882 Likely to Benefit Notice Exhibit 1_Likely to Benefit Notice_2025-.docx Form and Instruction
CMS-10882 Likely to Benefit Notice_ Spanish Exhibit 1.2_SPA_Likely to Benefit Notice_2025-.docx Form and Instruction
CMS-10882 Likely to Benefit Instructions Exhibit 1.3_Likely to Benefit Instructions_2025-.docx Form and Instruction
CMS-10882 Medicare Prescription Payment Plan Participation Request Exhibit 2_Election Request_2025-.docx Form and Instruction
CMS-10882 Part D Sponsor Notice to Acknowledge Acceptance of Elect Exhibit 3_Notice of Election Approval_2025-.docx Form and Instruction
CMS-10882 Part D Sponsor Notice for Failure to Make Payments under Exhibit 4_Notice of Failure to Pay_2025-.docx Form and Instruction
CMS-10882 Part D Sponsor Notice for Failure to Make Payments under Exhibit 5_Notice of Involuntary Termination_2025-.docx Form and Instruction
CMS-10882 Part D Sponsor Notice of Voluntary Removal from the Medi Exhibit 6_Notice of Voluntary Termination_2025-.docx Form and Instruction
CMS-10882 Part D Sponsor Notice of Participation Renewal in the Me Exhibit 7_Notice of Participation Renewal_2025-.docx Form and Instruction
CMS-10882 Likely to Benefit Notice_ Chinese Exhibit 1.4_CH_Likely to Benefit Notice_2025-.docx Form and Instruction
CMS-10882 Likely to Benefit Notice_ Vietnamese Exhibit 1.5_VI_Likely to Benefit Notice_2025-.docx Form and Instruction
CMS-10882 Likely to Benefit Notice_ Korean Exhibit 1.6_KO_Likely to Benefit Notice_2025-.docx Form and Instruction
Exhibit 1_Likely to Benefit Notice_2025_REDLINE.pdf Exhibit 1_Likely to Benefit Notice - Track Change IC Document
Exhibit 2_Election Request_2025-_REDLINE.pdf Exhibit 2_Election Request - Track Change IC Document
Exhibit 3_Notice of Election Approval_2025-_REDLINE.pdf Exhibit 3_Notice of Election Approval - Track Change IC Document
Exhibit 4_Notice of Failure to Pay_2025-_REDLINE.pdf Exhibit 4_Notice of Failure to Pay_2025 - Track Change IC Document
Exhibit 5_Notice of Involuntary Termination_2025_REDLINE.pdf Exhibit 5_Notice of Involuntary Termination - Track Change IC Document
Exhibit 6_Notice of Voluntary Termination_2025_REDLINE.pdf Exhibit 6_Notice of Voluntary Termination - Track Change IC Document

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