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View ICR - OIRA Conclusion

OMB Control No: 1210-0114	ICR Reference No: 202107-1210-005
Status: Historical Active	Previous ICR Reference No: 201805-1210-003
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Disclosures by Insurers to General Account Policyholders
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: 11/01/2021
	Date Received in OIRA: 09/27/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2024	36 Months From Approved	11/30/2021
Responses	26,981	0	27,009
Time Burden (Hours)	114,670	0	114,789
Cost Burden (Dollars)	10,792	0	10,128

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	26,981	27,009	-28
Annual Time Burden (Hours)	114,670	114,789	-119
Annual Cost Burden (Dollars)	10,792	10,128	664

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 hour and cost burdens have been adjusted based on updated information about the numbers of existing Transition Policies, and an increase in wage rates. More specifically, Form 5500 data suggest the number of policy holders who would receive these notices has dropped from 27,009 to 26,981.

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]? No

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? No

Agency Contact: James Butikofer 202 693-8434 Butikofer.James@dol.gov

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