EBSA assists participants in understanding their rights, responsibilities, and benefits under employee benefit law and intervenes informally on their behalf with the plan sponsor in order to assist them in obtaining the health and retirement benefits to which they may have been inappropriately denied, which can avert the necessity for a formal investigation or a civil action. EBSA has made a request for assistance form available on its Web site for those wishing to obtain assistance in this manner.
The burden estimates are lower than during the last submission.
In the case of the hour burden, the Department made projections on the use of the new form that turned out to be too high. Actual usage was lower than projected, and has been adjusted accordingly for this submission.
Further, the Department expected to receive 15 percent of its inquiries through the mail and calculated the cost burden accordingly. In actuality, none of its inquiries were received through the mail, and the Department sees no reason why this will change in the future.
The cost to the government has decreased because the costs included in the last submission reflected one-time start-up costs that are no longer applicable for this renewal.
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.
Form 301 Customer Service Intake Form
Supporting Statement Web Intake Form 2014.doc
Customer Service Intake Form