View Information Collection Request (ICR) Package
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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:
1210-0113
ICR Reference No:
202204-1210-005
Status:
Active
Previous ICR Reference No:
202102-1210-001
Agency/Subagency:
DOL/EBSA
Agency Tracking No:
Title:
National Medical Support Notice-Part B
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
11/23/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/26/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2025
36 Months From Approved
11/30/2022
Responses
19,352,287
0
10,546,371
Time Burden (Hours)
1,215,658
0
878,864
Cost Burden (Dollars)
6,400,769
0
3,322,107
Abstract:
Section 609 of ERISA and 29 CFR 2590.609-2 establish a National Medical Support Notice. Part B of which is used to implement coverage of children under ERISA covered group health plans pursuant to "Qualified Medical Child Support Orders."
Authorizing Statute(s):
US Code:
29 USC 1169(a)
Name of Law: Employee Retirement Income Security Act of 1974
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
87 FR 23570
04/20/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 58376
09/26/2022
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
National Medical Support Notice - Part B
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
19,352,287
10,546,371
0
8,805,916
0
0
Annual Time Burden (Hours)
1,215,658
878,864
0
336,794
0
0
Annual Cost Burden (Dollars)
6,400,769
3,322,107
0
3,078,662
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The Department is proposing to require that the addendum to Part B of the NMSN, previously only for those using e-NMSN, be included for all Part B notices. The increase in hour and cost burden for this submission reflect the change being proposed by the Department that all plan administrators prepare and mail the addendum. The estimates also reflect updated wage rates, health insurance data, postage costs, and plan data. As a result, the number of responses increased by 8,805,916 the hour burden increased by 336,794 hours and cost burden by $3,078,662. The changes to the form itself are generally formatting changes and additional spaces intended to facilitate completion of the notice and conform to similar changes made to Part A.
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
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
09/26/2022
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