Disclosures by Insurers to General Account Policyholders

ICR 199911-1210-004

OMB: 1210-0114

Federal Form Document

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
13477
Migrated
ICR Details
1210-0114 199911-1210-004
Historical Active
DOL/EBSA
Disclosures by Insurers to General Account Policyholders
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/02/1999
Retrieve Notice of Action (NOA) 11/26/1999
  Inventory as of this Action Requested Previously Approved
12/31/2002 12/31/2002
123,500 0 0
1,204,369 0 0
30,000 0 0

Section 1460 of the Small Business Job Protection Act of 1996 (Pub. L. 104-188) amended ERISA by adding new section 401(c), which establishes certain requirements for insurance companies that offer and maintain policies for private sector employee benefit plans where the assets are held in the insurer's general account. The regulation requires certain disclosures to be provided at the outset of the contract and annually and other disclosures to be provided upon request.

None
None


No

1
IC Title Form No. Form Name
Disclosures by Insurers to General Account Policyholders

  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 123,500 0 0 123,500 0 0
Annual Time Burden (Hours) 1,204,369 0 0 1,204,369 0 0
Annual Cost Burden (Dollars) 30,000 0 0 30,000 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.
11/26/1999


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