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Federal forms, ICRs, and supporting documents

Information Collection Request

COMPREHENSIVE MEDICAL PLANS: APPLICATIONS TO PARTICIPATE IN FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB) PROGRAM AND CONTRACTOR RECORDS RETENTION

ICR 199202-3206-002 · OMB 3206-0145 · Historical Active

Forms and Documents
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IC Document Collections
IC IDCollectionTypeStatusForm
156963 COMPREHENSIVE MEDICAL PLANS: APPLICATIONS TO PARTICIPATE IN FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB) PROGRAM AND CONTRACTOR RECORDS RETENTION Migrated
ICR Details
3206-0145 199202-3206-002
Historical Active 198905-3206-003
OPM
COMPREHENSIVE MEDICAL PLANS: APPLICATIONS TO PARTICIPATE IN FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB) PROGRAM AND CONTRACTOR RECORDS RETENTION
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 03/27/1992
Retrieve Notice of Action (NOA) 02/18/1992
  Inventory as of this Action Requested Previously Approved
01/31/1995 01/31/1995
25 0 0
7,050 0 0
0 0 0
THIS INFORMATION COLLECTION IS USED BY OPM TO DETERMINE IF COMPREHENSI MEDICAL PLANS APPLYING FOR PARTICIPATION IN THE FEDERAL EMPLOYEES HEAL BENEFITS PROGRAM MEET THE REQUIREMENTS FOR PARTICIPATION. THE SECOND PART OF THIS CLEARANCE COVERS RECORDKEEPING REQUIREMENTS IMPOSED ON TH PLANS THAT PARTICIPATE IN THE FEHB PROGRAM FOR THE PURPOSE OF CONTRACT
None
None
No
  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 25 0 0 0 25 0
Annual Time Burden (Hours) 7,050 0 0 0 7,050 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
02/18/1992