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

ICR 200204-1545-011

OMB: 1545-1581

Federal Form Document

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Name
Status
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ICR Details
1545-1581 200204-1545-011
Historical Active 199904-1545-005
TREAS/IRS
REG-209485-86 (Final) Continuation Coverage Requirements Applicable to Group Health Plans
Extension without change of a currently approved collection   No
Regular
Approved without change 06/07/2002
Retrieve Notice of Action (NOA) 04/11/2002
The agency is not required to display the expiration date.
  Inventory as of this Action Requested Previously Approved
08/31/2005 08/31/2005 06/30/2002
12,079,600 0 12,079,600
404,640 0 404,640
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
REG-209485-86 (Final) Continuation Coverage Requirements Applicable to Group Health Plans

  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 12,079,600 12,079,600 0 0 0 0
Annual Time Burden (Hours) 404,640 404,640 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
04/11/2002


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