Notice of Special Enrollment Rights under Group Health Plans

ICR 201904-1210-002

OMB: 1210-0101

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2019-04-09
IC Document Collections
ICR Details
1210-0101 201904-1210-002
Active 201601-1210-002
DOL/EBSA
Notice of Special Enrollment Rights under Group Health Plans
Extension without change of a currently approved collection   No
Regular
Approved without change 08/01/2019
Retrieve Notice of Action (NOA) 06/28/2019
  Inventory as of this Action Requested Previously Approved
08/31/2022 36 Months From Approved 07/31/2019
8,746,897 0 8,600,000
1 0 1
76,536 0 75,000

Under 29 CFR 2590.701-6(c), a group health plan must provide an individual who is offered coverage under the plan a notice describing the plan's special enrollment rights at or before the time coverage is offered. The Departments believe that the special enrollment notice is necessary to ensure that employees understand their enrollment options and will be able to exercise their rights during any 30-day enrollment period following a special enrollment event. The final regulations provide detailed sample language describing special enrollment rights for use in the notice. The sample language is expected to reduce costs for group health plans since it eliminates the need for plans to develop their own language.

US Code: 29 USC 1191c Name of Law: Employee Retirement Income Security Act of 1974
  
None

Not associated with rulemaking

  83 FR 53500 10/23/2018
84 FR 31112 06/28/2019
No

1
IC Title Form No. Form Name
Notice of Special Enrollment Rights under Group Health Plans

  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 8,746,897 8,600,000 0 0 146,897 0
Annual Time Burden (Hours) 1 1 0 0 0 0
Annual Cost Burden (Dollars) 76,536 75,000 0 0 1,536 0
No
No

$0
No
    No
    No
No
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.
06/28/2019


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