COMPREHENSIVE MEDICAL PLANS - APPLICATION TO PARTICIPATE IN FEHB PROGRAM - FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM - CONTRACTOR RECORDS RETENTION

ICR 198905-3206-003

OMB: 3206-0145

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
3206-0145 198905-3206-003
Historical Active 198812-3206-001
OPM
COMPREHENSIVE MEDICAL PLANS - APPLICATION TO PARTICIPATE IN FEHB PROGRAM - FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM - CONTRACTOR RECORDS RETENTION
No material or nonsubstantive change to a currently approved collection   No
Emergency 05/05/1989
Approved with change 05/05/1989
Retrieve Notice of Action (NOA) 05/05/1989
  Inventory as of this Action Requested Previously Approved
01/31/1992 01/31/1992 01/31/1992
75 0 75
22,896 0 22,896
0 0 0

THIS INFORMATION COLLECTION IS USED BY OPM TO DETERMINE IF COMPREHENSI MEDICAL PLANS APPLYING FOR PARTICIPATION IN THE FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM MEET THE REQUIREMENTS FOR PARTICIPATION. THE SECOND PART OF THIS CLEARANCE COVERS RECORDKEEPING REQUIREMENTS IMPOSE ON THE PLANS THAT PARTICIPATE IN THE FEHB PROGRAM FOR THE PURPOSE OF

None
None


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 75 75 0 0 0 0
Annual Time Burden (Hours) 22,896 22,896 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
05/05/1989


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