OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

REG-114494-10 - Affordable Care Act Enrollment Opportunity Notice Relating to Extended Dependent Coverage

ICR 201203-1545-021 · OMB 1545-2172 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
1545-2172_SS_TD9482.doc Supporting Statement A Uploaded 2012-03-26 Available
IC Document Collections
IC IDCollectionTypeStatusForm
192791 REG-114494-10 - Affordable Care Act Enrollment Opportunity Notice Relating to Extended Dependent Coverage Modified
ICR Details
1545-2172 201203-1545-021
Historical Active 201005-1545-005
TREAS/IRS
REG-114494-10 - Affordable Care Act Enrollment Opportunity Notice Relating to Extended Dependent Coverage
Existing collection in use without an OMB Control Number   No
Regular
Approved without change 07/17/2012
Retrieve Notice of Action (NOA) 03/27/2012
  Inventory as of this Action Requested Previously Approved
07/31/2015 36 Months From Approved
39,786,500 0 0
411,000 0 0
0 0 0
26 CFR 54.9815-2714T requires plans and issuers to provide a notice of enrollment opportunity to individuals whose coverage ended, or who were denied coverage (or not eligible for coverage) under a group health plan or group health insurance coverage because, under the terms of the plan or coverage, the availability of dependent coverage of children ended before the attainment of age 26.
PL: Pub.L. 111 - 148 1001, Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 152 2714 Name of Law: Health Care and Education Reconciliation Act
  
PL: Pub.L. 111 - 148 1001 Name of Law: Patient Protection and Affordable Care Act
PL: Pub.L. 111 - 152 2714 Name of Law: Health Care and Education Reconciliation Act
US Code: 26 USC 9833 Name of Law: Regulations
1545-BJ46 Final or interim final rulemaking 75 FR 27122 05/13/2010
No
1
IC Title Form No. Form Name
REG-114494-10 - Affordable Care Act Enrollment Opportunity Notice Relating to Extended Dependent Coverage
  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 39,786,500 0 39,786,500 0 0 0
Annual Time Burden (Hours) 411,000 0 411,000 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This submission is for clearance of the final rule that received preapproval but was never activated.
$0
No
No
Yes
No
No
Uncollected
Karen Levin 202 622-6080 [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.
03/27/2012