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Policies And Practices Of Insurance Carriers Affecting Applicants For Group Insurance

IC 122139 under ICR 198003-1215-002 · OMB 1215-0096.

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POLICIES AND PRACTICES OF INSURANCE CARRIERS AFFECTING APPLICANTS FOR GROUP INSURANCE
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form ESA-80(T) No No


    

150 0
   
Private Sector Businesses or other for-profits
 
   0 %

  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 150 0 0 150 0 0
Annual IC Time Burden (Hours) 50 0 0 50 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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