View Information Collection Request (ICR) Package

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: 1210-0142	ICR Reference No: 201401-1210-003
Status: Historical Active	Previous ICR Reference No: 201011-1210-009
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Patient Protection and Affordable Care Act Patient Protection Notice
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: 04/24/2014
	Date Received in OIRA: 02/28/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2017	36 Months From Approved	04/30/2014
Responses	1,700,000	0	6,186,404
Time Burden (Hours)	15,000	0	33,000
Cost Burden (Dollars)	13,000	0	48,000

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,700,000	6,186,404	-4,486,404
Annual Time Burden (Hours)	15,000	33,000	-18,000
Annual Cost Burden (Dollars)	13,000	48,000	-35,000

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: This collection of information reflects a burden reduction due to the reduced number of impacted plans. Although this ICR may still impact plans in the future, the bulk of the burden associated occurred during the initial three year approval because this ICR only impacts plans which relinquish grandfathered status during the first year that they do so. As time goes on, most of the plans that intend to relinquish their grandfathered status will already have done so. The burden associated with continuing to provide this notice is factored into the estimates for the Summary Plan Description ICR (OMB Control Number 1210-0110).

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