View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1210-0142	ICR Reference No: 202108-1210-006
Status: Historical Active	Previous ICR Reference No: 202106-1210-002
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Patient Protection and Affordable Care Act Patient Protection Notice
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 09/10/2021
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/10/2021
	Date Received in OIRA: 08/24/2021
Terms of Clearance: DOL will expeditiously work to transition this into a standard clearance, considering comments received both from the associated rule and from the 60/30 FRNs

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	6 Months From Approved	05/31/2022
Responses	128,133	0	734,800
Time Burden (Hours)	3,534	0	6,546
Cost Burden (Dollars)	1,602	0	4,005

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute
Annual Number of Responses	128,133	734,800	-606,667
Annual Time Burden (Hours)	3,534	6,546	-3,012
Annual Cost Burden (Dollars)	1,602	4,005	-2,403

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 No Surprises Act added section 2799A-7 of the PHS Act, which contains the patient protections regarding choice of health care professional from section 2719A of the PHS Act. The patient protections under the No Surprises Act apply generally to all group health plans and health insurance coverage, including grandfathered health plans. The Department believes that only plans that relinquish their grandfathered status in 2021 and plans that are still grandfathered in 2022 will become subject to this notice requirement for the first time and incur the one-time costs to prepare the notice. Burden numbers adjusted for the six-month emergency request.

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? No

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

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