Employee Benefit Plan Claim Procedures under the Employee Retirement Income Security Act of 1974 (ERISA)

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
13348	Employee Benefit Plan Claim Procedures under the Employee Retirement Income Security Act of 1974 (ERISA)	Migrated

ICR Details

OMB Control No: 1210-0053	ICR Reference No: 199809-1210-021
Status: Historical Inactive	Previous ICR Reference No: 199506-1210-021
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Employee Benefit Plan Claim Procedures under the Employee Retirement Income Security Act of 1974 (ERISA)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 12/17/1998
	Date Received in OIRA: 09/30/1998
Terms of Clearance: By this action, the current OMB approval continues but the changes contained in the NPRM of 9-9-98 are not approved at this time. In light of the nature of substantial public commment on all provisions of this NPRM, DOL will be addressing in its final rule issues raised by the rule including those related to information collections. In doing this, DOL should consider how the information collection requirements can minimize burden while maximizing public utility. In making this request for OMB approval, DOL failed to comply with the procedural requirements at 5 CFR 1320.11 which states that submissions of information collections in proposed rules shall be made to OMB not later than the day on which the NPRM is published in the Federal Regiater. DOL should submit the final rule for Paperwork Reduction Act approval upon its development by DOL. In making the submission of the final rule, no further public comment is required by the Paperwork Reduction Act.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1998	12/31/2001	12/31/1998
Responses	23,454	0	23,454
Time Burden (Hours)	7,063	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: ERISA section 503 and regulations at 29 CFR 2560.503-1 require employee benefit plans to establish procedures for notification on claim denials, disclosure of reasons, and notice of opportunity to obtain review of the denial.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Employee Benefit Plan Claim Procedures under the Employee Retirement Income Security Act of 1974 (ERISA)

---

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/30/1998

---