Information Collection Requirements Referenced in HIPAA for Group Health Plans -- 45 CFR 146.111, 115, 117, 150, 152, 160, 180

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0702 can be found here:

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Information Collection (IC) Details

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IC Title:	Information Collection Requirements Referenced in HIPAA for Group Health Plans -- 45 CFR 146.111, 115, 117, 150, 152, 160, 180	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-206				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,430	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	42,500,000	42,500,000
Annual IC Time Burden (Hours)	5,900,000	5,900,000
Annual IC Cost Burden (Dollars)	30,800,000	30,800,000

Documents for IC

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