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Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
Annual Report for Multiple Employer Welfare Arrangements
OMB: 1210-0116
IC ID: 13484
OMB.report
DOL/EBSA
OMB 1210-0116
ICR 202206-1210-004
IC 13484
( )
Documents and Forms
Document Name
Document Type
Form Form M-1
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
Form and Instruction
Form M-1 Report for Multiple Employer Welfare Arrangements (MEWAs
Form M-1.pdf
Form and Instruction
Form M-1 Report for Multiple Employer Welfare Arrangements (MEWAs
Form M-1.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 2520.101-2
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Form M-1
Report for Multiple Employer Welfare Arrangements (MEWAs) and Certain Entitiies Claiming Exception (ECEs)
Form M-1.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
719
Number of Respondents for Small Entity:
58
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
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
719
0
0
147
0
572
Annual IC Time Burden (Hours)
1,839
0
0
1,719
0
120
Annual IC Cost Burden (Dollars)
0
0
0
-111,377
0
111,377
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.