OMB Supporting Statement Part A

CUSTOMER SATISFACTION SURVEY AND CONFERENCE EVALUATION CLEARANCE FORM

A. SUPPLEMENTAL SUPPORTING STATEMENT

A.1. Title:	EBSA Participant Assistance Program Customer Survey
A.2. Compliance with 5 CFR 1320.5: Yes X No _____				A.3. Assurances of confidentiality: No confidential data will be collected, however, the interviewer reads the following statement of assurance: “I want to assure you that Gallup and EBSA will protect your privacy. Your voluntary cooperation is requested to make the results of this study complete and accurate. Gallup will not share your individual responses with EBSA and your data will only be used in aggregate with responses of others like you.”
A.4. Federal cost: $731,000 Based on the cost for research contractor, contract oversight and IT contractor for support				A.5. Requested expiration date (Month/Year): 03/2016
A.6. Burden Hour estimates: a. Number of Respondents: 11,000 a.% Received Electronically 0% b. Frequency: Once c. Average Response Time: _8 minutes d. Total Annual Burden Hours: 1,467 hours				A7. Does the collection of information employ statistical methods? __ ____ Yes (Complete Section B and attach BLS review sheet).
A.8. Abstract: This survey will collect customer satisfaction data for a sample of private citizens who call into the participant assistance program to ask about their private sector employer provided benefits such as pensions, retirement savings, and health benefits. Three types of callers will be queried: 1. Those who need benefit claim assistance 2. Those who have a valid benefit claim and 3. Those who have an invalid benefit claim. Changes: This submission is for a revision to finalize the survey previously cleared on 03/31/20015 (OMB Control #1225-0059). At the time of the prior submission, the Department noted that it is testing new questions CE8 – I am proud to have used EBSA’s services and CE10 – EBSA is the perfect federal agency for people with needs like mine, and would remove unneeded questions once testing was completed in order to bring the survey length in line with the approved burden hours. The Department has completed testing and decided to add the two new questions and remove the following three items: Delete CE2 - If you had a similar need for information or assistance in the future, how likely would you be to contact EBSA again? Delete CE4 – EBSA is a name I can always trust? Delete CE7A – If a problem arises, I can always count on EBSA to reach a fair and satisfactory resolution. No other changes have been made to this submission packet.
Program Official MARK B. CONNOR		Date 10/28/2015	Departmental Clearance Officer		Date