Health Insurance and Key Driver Modules - Survey of Veteran Enrollees' Health and Reliance Upon VA

ICR 200610-2900-003

OMB: 2900-0693

Federal Form Document

ICR Details
2900-0693 200610-2900-003
Historical Active
VA
Health Insurance and Key Driver Modules - Survey of Veteran Enrollees' Health and Reliance Upon VA
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/09/2007
Retrieve Notice of Action (NOA) 10/16/2006
Approved consistent with changes to the questionnaire submitted by VA memo and included in the electronic docket. In the next submission of OMB number 2900-0609, VA shall combine this collection and 2900-0609 into a single submission. Additionally, OMB continues to encourage VA to work with their contractor to enhance the coding of case level outcomes to better understand reasons for nonresponse and conduct research that may include tracing veterans with inadequate contact information, increasing the number of call attempts, and testing strategies for identifying and handling veterans in institutions, etc, under 2900-0609. Should VA develop plans for related substudies, the Department should consult with and seek clearance from OMB through administrative change requests (83-Cs).
  Inventory as of this Action Requested Previously Approved
01/31/2010 36 Months From Approved
44,000 0 0
3,168 0 0
0 0 0

These frequently changing modules will be added to the more stable core questions to provide information for planning & policy development for actuarial projections of enrollment, utilization, expenditures, mandated annual enrollment reforms, & quantitative & qualitative research.

US Code: 38 USC 501 Name of Law: Rules and Regulations
   PL: Pub.L. 104 - 262 101-207 Name of Law: Eligibility Reform
  
None

Not associated with rulemaking

  71 FR 118 06/20/2006
71 FR 194 10/06/2006
No

1
IC Title Form No. Form Name
Health Insurance and Key Driver Modules - Survey of Veteran Enrollees' Health and Reliance Upon VA VA Form 10-21034k, VA Form 10-21034j, VA Form 10-21034k, VA Form 10-21034j Key Drivers Module 2 ,   Health Insurance Module 1 ,   Cover Sheet for Health Insurance Module 1 ,   Cover Sheet for Key Drivers Module 2

  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 44,000 0 0 44,000 0 0
Annual Time Burden (Hours) 3,168 0 0 3,168 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
These modules (with a new approval number) will be added to the questions currently approved under 2900-0609. Although questions of this nature have been asked in the past, they are now considered a program increase of 3,168 burden hours

$255,275
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  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.
10/16/2006


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