CMS-10527 Federal Standard Notices
Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices (CMS-10527)
CMS-10527 Attachment 5 - Discontinuation Notice without 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⚠️ Notice: This form may be outdated.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: