Information Collection Request

Notice Requirements of the Health Care Continuation Coverage Provisions

ICR 200902-1210-004 · OMB 1210-0123 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
1210-0123_ER-FRN(03-05-09).pdf Supplementary Document Uploaded 2009-03-05 Available
SSCOBRA09stimulu.doc Supporting Statement A Uploaded 2009-03-15 Available
Note to Reviewer of 1210-0123.doc Supplementary Document Uploaded 2009-02-27 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
188172 COBRA Notification Requirements--American Recovery and Reinvestment Act of 2009 Other- ARRA Model COBRA Initial Election Notice New
13504 Notice Requirements of the Health Care Continuation Coverage Provisions Other-Final Rule Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2009 6 Months From Approved 08/31/2010
38,114,957 0 15,237,957
0 0 0
34,500,473 0 18,387,739





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Notice Requirements of the Health Care Continuation Coverage Provisions
COBRA Notification Requirements--American Recovery and Reinvestment Act of 2009

table that charts list of burden
  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 38,114,957 15,237,957 22,877,000 0 0 0
Annual Time Burden (Hours) 0 0 0 0 0 0
Annual Cost Burden (Dollars) 34,500,473 18,387,739 16,112,734 0 0 0


Reginfo record details
  No