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View ICR - OIRA Conclusion

OMB Control No: 1210-0083	ICR Reference No: 202112-1210-002
Status: Historical Active	Previous ICR Reference No: 201808-1210-004
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: PTE 1990-1; Insurance Company Pooled Separate Accounts
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: 04/11/2022
	Date Received in OIRA: 02/23/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2025	36 Months From Approved	04/30/2022
Responses	1,080	0	1,020
Time Burden (Hours)	180	0	170
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,080	1,020	60
Annual Time Burden (Hours)	180	170	10
Annual Cost Burden (Dollars)	0	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 Department has made certain minor adjustments based on new data. First, the number of insurance companies offering pooled separate accounts has increased from 102 companies to 108 companies, based on 2019 Form 5500 data. The result is that the Department’s estimate of the annual hour burden for this ICR has increased from 170 hours to 180 hours. Additionally, wage rates have been updated to reflect increased labor costs.

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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