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OMB Control No: 1210-0123	ICR Reference No: 202508-1210-007
Status: Received in OIRA	Previous ICR Reference No: 202210-1210-001
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Notice Requirements of the Health Care Continuation Coverage Provisions
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 01/12/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2026
Responses	24,351,126	26,890,373
Time Burden (Hours)	524,890	490,857
Cost Burden (Dollars)	19,237,389	16,403,128

Abstract: The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides that under certain circumstances participants and beneficiaries of group health plans that satisfy the definition of “qualified beneficiaries” under COBRA may elect to continue group health coverage temporarily following events known as “qualifying events” that would otherwise result in loss of coverage. Under the regulatory guidelines, plan administrators are required to distribute notices: a general notice to be distributed to all participants in group health plans subject to COBRA; an employer notice that must be completed by the employer upon the occurrence of a qualifying event; a notice and election form to be sent to a participant upon the occurrence of a qualifying event that might cause the participant to lose group health coverage; an employee notice that may be completed by a qualified beneficiary upon the occurrence of certain qualifying events such as divorce or disability; and, two other notices, one of early termination and the other a notice of unavailability. Also included in the ICR are two model notices that the Department believes will help reduce costs for service providers in preparing and delivering notices to comply with the regulations.

Authorizing Statute(s): US Code: 29 USC 1168 Name of Law: Employee Retirement Income Security Act
US Code: 29 USC 1166 Name of Law: Employee Retirement Income Security Act

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:
	90 FR 30984	07/11/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 1199	01/12/2026
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
Notice Requirements of the Health Care Continuation Coverage Provisions

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	24,351,126	26,890,373	-2,539,247
Annual Time Burden (Hours)	524,890	490,857	34,033
Annual Cost Burden (Dollars)	19,237,389	16,403,128	2,834,261

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: There are no program changes for this submission. The increases in the cost burden estimates are due to a decrease in the number of individuals in COBRA eligible plans, labor cost inflation, and increased postage costs resulting from inflation. As a result, the number of responses has decreased 2,539,247 responses, the hour burden has increased by 34,033 hours, and the cost burden has increased by $2,834,261. While the decline in responses is a result of fewer general notices being sent, the hour and cost burdens have increased due to an increase in the number of termination notices and plan administrator election notices, as well as an increase in the cost of postage to mail the notices.

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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