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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Additional Information Request to Plan Administrator
New
9500
4750
0
Form and Instruction
EBSA Form 301
Request for Additonal Information from Plan Administrator
Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction
New
95000
95000
52000
Form and Instruction
EBSA Form 300
Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction
Total burden requested under this ICR:
104500
99750
52000
To view an IC, click on IC Title