Notice Requirements of the Health Care Continuation Coverage Provisions

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0123 can be found here:

Documents and Forms

Document Name Document Type
Final Rule FedReg.pdf Other-Final Rule
Deliberative_Document_Place_Holder.docx Other-Deliberative Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notice Requirements of the Health Care Continuation Coverage Provisions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 2590

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Final Rule			Final Rule FedReg.pdf		Yes	Yes	Fillable Printable
Other-Deliberative Document			Deliberative_Document_Place_Holder.docx		No		Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 649,000	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	Previously Approved
Annual Number of Responses for this IC	15,662,333	15,662,333
Annual IC Time Burden (Hours)	503,815	503,815
Annual IC Cost Burden (Dollars)	20,217,778	20,217,778

Documents for IC

Title	Document	Date Uploaded
No associated records found

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