Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1210-0053
ICR Reference No:
200611-1210-006
Status:
Historical Active
Previous ICR Reference No:
200401-1210-001
Agency/Subagency:
DOL/EBSA
Agency Tracking No:
Title:
Employee Benefit Plan Claims Procedure Under ERISA
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
04/11/2007
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/22/2007
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
04/30/2010
36 Months From Approved
04/30/2007
Responses
320,999,996
0
18,000,000
Time Burden (Hours)
529,000
0
336,200
Cost Burden (Dollars)
423,051,994
0
90,582,000
Abstract:
ERISA Section 503 and regulations at 29 CFR 2560.503-1 require employee benefit plans to establish procedures for resolving benefit claims under the plan, including initial claims and appeal of denied claims. The regulation requires specific information to be disclosed at different stages of the claims process. It also requires claims denial notices to be provided within specific time frames and to include specific information.
Authorizing Statute(s):
US Code:
29 USC 1133
Name of Law: Employee Retirement Income Security Act of 1974
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
71 FR 63784
10/31/2006
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 8018
02/22/2007
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Employee Benefit Plan Claims Procedure Under ERISA
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
320,999,996
18,000,000
0
0
302,999,996
0
Annual Time Burden (Hours)
529,000
336,200
0
0
192,800
0
Annual Cost Burden (Dollars)
423,051,994
90,582,000
0
0
332,469,994
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
No program changes have been made since the previous submission. The changes in burden estimation are due to the use of updated information concerning the number of respondents and the frequency of claims. While the volume of claims has remained fairly stable over time, new research in health claims indicates that denial rates are much larger (15 percent as compared to 3 percent) and appeal rates are much lower (.2 percent as compared to 10 percent) than our earlier analyses assumed. In addition, new assumptions were made with regard to the share of denied claims appealed for medical versus administrative reasons (28.9 percent for medical versus 35.4 percent) based on new information. Assumptions pertaining to non-health claims made in the original analysis were largely retained, as no new information was available to refine. The exception to this was the share of covered workers filing short-term disability claims, which researchers indicated should be twice the previous assumption (6 percent as compared to 3 percent).
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Susan Lahne 202 693-8500
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
02/22/2007
An official website of the United States government
The .gov means it's official.
The site is secure.
