REG-120476-07, Employer Comparable Contributions to Health Savings Accounts and Requirement of a Return for filing of the excise taxes under sections 4980B, 4980D, 4980E and 4980G.

Forms and Documents

Document Name	Status
HSA Hope - Supporting Statement for PRA.doc Supporting Statement A	2009-03-23

IC Document Collections

IC ID	Document Title	Status
188460	REG-120476-07, Employer Comparable Contributions to Health Savings Accounts and Requirement of a Return for filing of the excise taxes under sections 4980B, 4980D, 4980E and 4980G.	New

ICR Details

OMB Control No: 1545-2146	ICR Reference No: 200912-1545-019
Status: Historical Active	Previous ICR Reference No: 200903-1545-021
Agency/Subagency: TREAS/IRS	Agency Tracking No: ah-XXXX-021 (ARRA [PL 111-5])
Title: REG-120476-07, Employer Comparable Contributions to Health Savings Accounts and Requirement of a Return for filing of the excise taxes under sections 4980B, 4980D, 4980E and 4980G.
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/23/2009
	Date Received in OIRA: 12/23/2009
Terms of Clearance: Pre-approval contingent upon no substantive changes to this collection after adoption of the final rule. Otherwise this collection should be re-submitted to OMB for review.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2012	36 Months From Approved
Responses	5,000	0	0
Time Burden (Hours)	2,500	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information results from the requirement to file a return for the payment of the excise taxes under section 4980B, 4980D, 4980E, and 4980G of the code.

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Authorizing Statute(s): US Code: 26 USC 4980B Name of Law: Failure to satisfy continuation coverage requirements of group health plans.
   US Code: 26 USC 4980E Name of Law: Failure of employer to make comparable Archer MSA contributions.
   US Code: 26 USC 4980G Name of Law: Failure of employer to make comparable health savings account contributions.
   US Code: 26 USC 4980D Name of Law: Failure to meet certain group health plan requirements.
  

Citations for New Statutory Requirements: PL: Pub.L. 111 - 5 705 Name of Law: The American Recovery and Reinvestment Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1545-BG71	Final or interim final rulemaking	73 FR 40793	07/16/2008

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 40793	07/16/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
REG-120476-07, Employer Comparable Contributions to Health Savings Accounts and Requirement of a Return for filing of the excise taxes under sections 4980B, 4980D, 4980E and 4980G.

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ICR Summary 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	5,000	0	5,000	0	0	0
Annual Time Burden (Hours)	2,500	0	2,500	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This document contains final regulations providing guidance on employer comparable contributions to Health Savings Accounts (HSAs) under section 4980G of the Internal Revenue Code (Code) as amended by sections 302, 305 and 306 of the Tax Relief and Health Care Act of 2006 (the Act). The final regulations also provide guidance relating to the manner and method of reporting and paying the excise tax under sections 4980B, 4980D, 4980E, and 4980G of the Code. The American Recovery and Reinvestment Act (PL 111-5), provides for a premium reduction for COBRA continuation coverage elected by certain individuals as the result of an involuntary termination of employment. These final regulations provide a method and manner for the payment and reporting of the excise tax and also serve as a catalyst for the creation of a new form (Form 8928) that will be used for payment of the section 4980B excise tax (as well as other excise taxes under chapter 43). The total estimated burden is 2,500 hours.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Yes

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/31/2009

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