Information Collection

TD 9166, Health plans imposing pre-existing condition notification requirements

IC 18644 under ICR 201401-1545-009 · OMB 1545-1537.

Documents and Forms

Document Name Document Type
TD 9166.pdf TD 9166 IC Document
TD 9491.pdf TD 9491 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	TD 9166, Health plans imposing pre-existing condition notification requirements	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 602 26 CFR 54

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,700,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	2,700,000	2,700,000
Annual IC Time Burden (Hours)	2,289	2,289
Annual IC Cost Burden (Dollars)	272,000	272,000

Documents for IC

Title	Document	Date Uploaded
TD 9166	TD 9166.pdf	01/13/2014
TD 9491	TD 9491.pdf	01/13/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.