Notice to Employee of Pending Cancellation of Health Benefits (Private Sector)

29 C.F.R. Part 825, The Family and Medical Leave Act of 1993

OMB: 1215-0181

IC ID: 182234

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Notice to Employee of Pending Cancellation of Health Benefits (Private Sector)
 
No Modified
 
Mandatory
 
29 CFR 825.212(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Workforce Management Labor Rights Management

 

105,585 97,062
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 105,585 2,138 0 103,447 0 0
Annual IC Time Burden (Hours) 8,799 1,777 0 7,022 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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