Open Season Health Benefits Enrollment Change

OPEN SEASON HEALTH BENEFITS ENROLLMENT CHANGE

OMB: 3206-0200

IC ID: 157092

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Information Collection (IC) Details

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OPEN SEASON HEALTH BENEFITS ENROLLMENT CHANGE
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form OPM 2809-EZ2 No No


    

36,559 0
   
Individuals or Households
 
   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 35,559 0 0 -2,756 0 38,315
Annual IC Time Burden (Hours) 18,280 0 0 -878 0 19,158
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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