Continuation Coverage Requirements Applicable to Group Health Plans -- REG-209485-86 (Final)

ICR 199901-1545-002

OMB: 1545-1581

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
1545-1581 199901-1545-002
Historical Active 199712-1545-035
TREAS/IRS
Continuation Coverage Requirements Applicable to Group Health Plans -- REG-209485-86 (Final)
Revision of a currently approved collection   No
Emergency 01/05/1999
Approved without change 01/14/1999
Retrieve Notice of Action (NOA) 01/05/1999
The agency is not required to display the expiration date.
  Inventory as of this Action Requested Previously Approved
07/31/1999 07/31/1999 02/28/2001
120,797,600 0 26,400
404,640 0 440
0 0 0

The statute and the regulations require group health plans to provide notices to individuals who are entitled to elect COBRA continuation coverage of their election rights. Individuals who wish to obtain the benefits provided under the statute are required to provide plans notices in the cases of divorce from the covered employee, a dependent child's ceasing to be a dependent under the terms of the plan, and disability. Most plans will require that elections of COBRA continuation coverage be made in writing. In cases where qualified beneficiaries are short by an insignificant amount in a payment made to the plan...

None
None


No

1
IC Title Form No. Form Name
Continuation Coverage Requirements Applicable to Group Health Plans -- REG-209485-86 (Final)

  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 120,797,600 26,400 0 120,771,200 0 0
Annual Time Burden (Hours) 404,640 440 0 404,200 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
01/05/1999


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