OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Notice to Participants and Beneficiaries and the Federal Government of Electing One Percent Increased Cost Exemption

ICR 200711-1210-003 · OMB 1210-0105 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
SSforonepercent2007-105.doc Supporting Statement A Uploaded 2007-11-28 Available
IC Document Collections
IC IDCollectionTypeStatusForm
13456 Notice to Participants and Beneficiaries and the Federal Government of Electing One Percent Increased Cost Exemption Other-Interim Final Regulation Containing Model Notice Modified
ICR Details
1210-0105 200711-1210-003
Historical Active 200411-1210-001
DOL/EBSA
Notice to Participants and Beneficiaries and the Federal Government of Electing One Percent Increased Cost Exemption
Extension without change of a currently approved collection   No
Regular
Approved without change 01/25/2008
Retrieve Notice of Action (NOA) 12/04/2007
  Inventory as of this Action Requested Previously Approved
01/31/2011 36 Months From Approved 01/31/2008
10,000 0 10,000
300 0 333
7,000 0 5,000
Plans may be exempted from Mental Health Party Act requirements for parity between mental health and medical/surgical benefits if parity would result in cost increase of one percent or more. This ICR covers notice to participants and beneficiaries and the Federal Government that is required in order to make use of the exemption.
US Code: 29 USC 1181 Name of Law: ERISA
  
None
Not associated with rulemaking
  72 FR 54072 09/21/2007
72 FR 68197 12/04/2007
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 10,000 10,000 0 0 0 0
Annual Time Burden (Hours) 300 333 0 0 -33 0
Annual Cost Burden (Dollars) 7,000 5,000 0 0 2,000 0
No
No
The Department has adjusted the wage and postal rates to account for cost increases between 2004 and 2007. This resulted in slightly higher cost burdens. The reduction in burden hours is due to rounding.
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Christopher Cosby 202-693-8425 [email protected]
  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.
12/04/2007