Notice of Opportunity to Enroll

ICR 200101-1210-001

OMB: 1210-0120

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
13497
Migrated
ICR Details
1210-0120 200101-1210-001
Historical Active
DOL/EBSA
Notice of Opportunity to Enroll
New collection (Request for a new OMB Control Number)   No
Emergency 01/17/2001
Approved without change 07/27/2001
Retrieve Notice of Action (NOA) 01/08/2001
  Inventory as of this Action Requested Previously Approved
07/31/2001 07/31/2001
2,000,000 0 0
5,950 0 0
5,100,000 0 0

The interim final rules of 29 CFR 2590.702 prohibit discrimination based on a health factor for group health plans and issuers of health insurance coverage offered in connection with a group health plan, and require notice of the opportunity to enroll in a plan where coverage has been denied based on a health factor.

None
None


No

1
IC Title Form No. Form Name
Notice of Opportunity to Enroll

  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 2,000,000 0 0 2,000,000 0 0
Annual Time Burden (Hours) 5,950 0 0 5,950 0 0
Annual Cost Burden (Dollars) 5,100,000 0 0 5,100,000 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.
01/08/2001


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