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View ICR - OIRA Conclusion

OMB Control No: 1210-0142	ICR Reference No: 201902-1210-004
Status: Historical Active	Previous ICR Reference No: 201510-1210-004
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: 05/02/2019
	Date Received in OIRA: 04/01/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2022	36 Months From Approved	05/31/2019
Responses	734,800	0	693,007
Time Burden (Hours)	6,546	0	5,173
Cost Burden (Dollars)	4,005	0	5,371

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	734,800	693,007	41,793
Annual Time Burden (Hours)	6,546	5,173	1,373
Annual Cost Burden (Dollars)	4,005	5,371	-1,366

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 ICR contains no program changes. Adjustments to the burden estimates result from updated estimates on the number of plans and policyholders affected by the regulations, an increase in the share of notices assumed to be transmitted electronically, and increases in wage rates. These updated data inputs increase the hour burden by 1,373 hours compared with the prior submission and reduce the cost burden by $1,366 compared with the prior submission.

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: Allan Beckmann 202 693-8429 beckmann.allan@dol.gov

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