This collection
is cleared based on the revised materials provided by the
agency.
Inventory as of this Action
Requested
Previously Approved
10/31/2014
36 Months From Approved
27,000
0
27,000
20,250
0
20,250
0
0
0
The Direct Pay Remittance System
(DPRS) 2809 is used by enrollees under the Spouse Equity and
Temporary Continuation of Coverage provisions of FEHB law, and by
annuitants who pay their premiums directly to the retirement
system. During the annual FEHB open season, these enrollees use
this form to change their enrollment. Several changes have been
made to this information collection that makes it consistent with
the Affordable Care Act (P. L. 111-48).
US Code:
5 USC
8905 Name of Law: Health Insurance Election of Coverage
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.