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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:
1210-0103
ICR Reference No:
200911-1210-003
Status:
Historical Active
Previous ICR Reference No:
200609-1210-002
Agency/Subagency:
DOL/EBSA
Agency Tracking No:
Title:
Establishing Creditable Coverage under Group Health Plans
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:
12/31/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/01/2009
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2012
36 Months From Approved
12/31/2009
Responses
19,593,756
0
16,250,284
Time Burden (Hours)
88,066
0
75,306
Cost Burden (Dollars)
13,830,615
0
11,456,011
Abstract:
This ICR covers an information collection requirement imposed under the regulations in connection with the alternative method of crediting coverage established by the regulations. The regulations permit a plan to adopt, as its method of crediting prior health coverage, provisions that impose different preexisting condition exclusion periods with respect to different categories of benefits, depending on prior coverage in that category. In such a case, the regulations require former plans to provide additional information upon request to new plans in order to establish an individuals length of prior creditable coverage within that category of benefits.
Authorizing Statute(s):
US Code:
29 USC 1181
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:
74 FR 49024
09/25/2009
30-day Notice:
Federal Register Citation:
Citation Date:
74 FR 62828
12/01/2009
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
Establishing Creditable Coverage under Group Health Plans
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
19,593,756
16,250,284
0
0
3,343,472
0
Annual Time Burden (Hours)
88,066
75,306
0
0
12,760
0
Annual Cost Burden (Dollars)
13,830,615
11,456,011
0
0
2,374,604
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:
There have been no program changes to this ICR since the last submission in 2006. The Department has updated the estimates of respondents (plans) and responses, as well as the assumptions relating to cost (e.g., labor rates and worker characteristics). These changes have resulted in an increase in the numbers of responses, and a corresponding increase in the overall burden of this information collection.
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)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Chris Cosby 202 693-8540
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:
12/01/2009
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