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Glossary
Summary of Benefits and Coverage and Uniform Glossary Required Under the Affordable Care Act
OMB: 1210-0147
IC ID: 198890
OMB.report
DOL/EBSA
OMB 1210-0147
ICR 201902-1210-007
IC 198890
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0147 can be found here:
2022-04-07 - Extension without change of a currently approved collection
2020-02-03 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
UG April 2017.doc
Uniform Glossary-April 2016
IC Document
SBCUniformGlossary - 2012.pdf
Uniform Glossary- 2012
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Glossary
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 2590.715-2715
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,327,339
Number of Respondents for Small Entity:
2,160,922
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
56 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,526,350
0
0
276,150
0
1,250,200
Annual IC Time Burden (Hours)
12,720
0
0
2,302
0
10,418
Annual IC Cost Burden (Dollars)
572,381
0
0
141,062
0
431,319
Documents for IC
Title
Document
Date Uploaded
Uniform Glossary-April 2016
UG April 2017.doc
04/04/2016
Uniform Glossary- 2012
SBCUniformGlossary - 2012.pdf
04/04/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.