Glossary

Affordable Care Act Section 2715 Summary Disclosures

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0147 can be found here:

Documents and Forms

Document Name Document Type
2715_Deliberative_Document[(20120207).docx Uniform Glossary of Coverage and Medical Terms IC Document

Information Collection (IC) Details

IC Title:	Glossary	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2590.715-2715

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 858	Number of Respondents for Small Entity: 274

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 38 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,750,000	1,199,999	550,001
Annual IC Time Burden (Hours)	15,750	10,500	5,250
Annual IC Cost Burden (Dollars)	535,000	365,004	169,996

Documents for IC

Title	Document	Date Uploaded
Uniform Glossary of Coverage and Medical Terms	2715_Deliberative_Document[(20120207).docx	02/07/2012

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