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Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
OMB: 1210-0116
IC ID: 13483
OMB.report
DOL/EBSA
OMB 1210-0116
ICR 200008-1210-002
IC 13483
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0116 can be found here:
2022-06-28 - Extension without change of a currently approved collection
2021-09-15 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
M-1
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,678
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,678
0
0
0
0
2,678
Annual IC Time Burden (Hours)
874
0
0
0
0
874
Annual IC Cost Burden (Dollars)
394,000
0
0
0
0
394,000
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.