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: 1545-2181	ICR Reference No: 201008-1545-022
Status: Historical Active	Previous ICR Reference No: 201006-1545-037
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: REG-120399-10 - Affordable Care Act Notice of Patient Protections
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/12/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/12/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2010	6 Months From Approved
Responses	4,000,000	0	0
Time Burden (Hours)	33,000	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to New Statute
Annual Number of Responses	4,000,000	4,000,000
Annual Time Burden (Hours)	33,000	33,000
Annual Cost Burden (Dollars)	0	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: The Departments estimate that 339,000 ERISA-covered plans will need to notify an estimated 8.0 million policy holders of their plans policy in regards to designating a primary care physician and for obstetrical or gynecological visits. Because the interim final regulations provide model language for this purpose, the Departments estimate that five minutes of clerical time will be required to incorporate the required language into the plan document and ten minutes of a human resource professionals time will be required to review the modified language. These burdens will vary from year to year. Therefore, the Departments estimate that plans will incur an average annual hour burden of 66,000 hours to meet the disclosure requirement (50% to DOL and 50% to IRS).