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Federal forms, ICRs, and supporting documents

Information Collection Request

TD 9575 - Summary of Benefits and Coverage and the Uniform Glossary

ICR 201409-1545-021 · OMB 1545-2229 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Cost Estimates.pdf Supplementary Document Uploaded 2011-09-02 Available
Burden Estimates.pdf Supplementary Document Uploaded 2011-09-02 Repair queued
2014_Supporting_Statement_for_1545-2229.doc Supporting Statement A Uploaded 2015-02-23 Available
IC Document Collections
IC IDCollectionTypeStatusForm
199118 TD 9575 - Summary of Benefits and Coverage and the Uniform Glossary Modified
ICR Details
1545-2229 201409-1545-021
Historical Active 201211-1545-009
TREAS/IRS Ready
TD 9575 - Summary of Benefits and Coverage and the Uniform Glossary
Extension without change of a currently approved collection   No
Regular
Approved without change 01/06/2016
Retrieve Notice of Action (NOA) 02/27/2015
The agency will include the Summary of Benefits Template as an instrument to this collection prior to renewal.
  Inventory as of this Action Requested Previously Approved
01/31/2019 36 Months From Approved 01/31/2016
79,699,998 0 79,699,998
649,500 0 649,500
5,035,021 0 5,035,021
This document contains regulations regarding disclosure of the summary of benefits and coverage and the uniform glossary for group health plans and health insurance coverage in the group and individual markets under the Patient Protection and Affordable Care Act. This document implements the disclosure requirements to help plans and individuals better understand their health coverage, as well as other coverage options. The templates and instructions to be used in making these disclosures are being issued in a separate notice.
PL: Pub.L. 111 - 148 2701- 2719A Name of Law: Affordable Care Act
  
None
Not associated with rulemaking
  79 FR 55074 09/15/2014
80 FR 10566 02/26/2015
No
1
IC Title Form No. Form Name
TD 9575 - Summary of Benefits and Coverage and the Uniform Glossary
  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 79,699,998 79,699,998 0 0 0 0
Annual Time Burden (Hours) 649,500 649,500 0 0 0 0
Annual Cost Burden (Dollars) 5,035,021 5,035,021 0 0 0 0
No
No
No
No
Yes
Yes
Yes
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.
02/27/2015