Employee Benefit Plan Claims Procedure Under ERISA

Employee Benefit Plan Claims Procedure Under the Employee Retirement Income Security Act

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0053 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	Employee Benefit Plan Claims Procedure Under ERISA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2560.503-1

Information Collection Instruments:

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

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,808,427	Number of Respondents for Small Entity: 5,366,583

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

Percentage of Respondents Reporting Electronically: 70 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	311,790,227	2,321	634,906	311,153,000
Annual IC Time Burden (Hours)	516,227	0	23,727	492,500
Annual IC Cost Burden (Dollars)	814,449,932	15,805,959	79,205,973	719,438,000

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.