Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B

ICR 201701-1210-001

OMB: 1210-0149

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2017-01-11
Supplementary Document
2013-11-01
ICR Details
1210-0149 201701-1210-001
Historical Active 201307-1210-003
DOL/EBSA
Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B
Extension without change of a currently approved collection   No
Regular
Approved without change 05/17/2017
Retrieve Notice of Action (NOA) 02/01/2017
  Inventory as of this Action Requested Previously Approved
05/31/2020 36 Months From Approved 05/31/2017
29,165,840 0 72,484,292
117,149 0 374,502
4,709,408 0 12,229,992

Section 18B of the FLSA, as added by section 1512 of the Affordable Care Act, generally provides that, in accordance with regulations promulgated by the Secretary of Labor, an applicable employer must provide each employee at the time of hiring (or with respect to current employees, not later than March 1, 2013), a written notice: 1. Informing the employee of the existence of Exchanges including a description of the services provided by the Exchanges, and the manner in which the employee may contact Exchanges to request assistance; 2. If the employer plan's share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code (the Code) if the employee purchases a qualified health plan through an Exchange; and 3. If the employee purchases a qualified health plan through an Exchange, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes. The model notice is being to provided by the Department to facilitate compliance with FLSA section 18B.

US Code: 29 USC 218a Name of Law: Fair Labor Standards Act (FLSA)
  
None

Not associated with rulemaking

  81 FR 75157 10/28/2016
82 FR 8955 02/01/2017
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 29,165,840 72,484,292 0 0 -43,318,452 0
Annual Time Burden (Hours) 117,149 374,502 0 0 -257,353 0
Annual Cost Burden (Dollars) 4,709,408 12,229,992 0 0 -7,520,584 0
No
No
There are no program changes for this submission. The PRA hour and cost burden estimates decreased in this submission because the previous submission reflected one-time start-up costs, which are no longer applicable. This submission also correctly disaggregates burden across private sector employers and public sector employers in ROCIS. The prior submission accurately reflected total burden, but failed to reflect the disaggregated burden across sectors within the submission's ROCIS entry.

$0
No
No
Yes
No
No
Uncollected
Allan Beckmann 202 693-8429 beckmann.allan@dol.gov

  No

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.
02/01/2017


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