Information Collection

Notice of Group Health Plan's Use of Transition Period and Posting Thereof

IC 13462 under ICR 199806-1210-005 · OMB 1210-0107.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Notice of Group Health Plan's Use of Transition Period and Posting Thereof

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 286

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	286	286
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	1,000	1,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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