Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction

ICR 201004-1210-006

OMB: 1210-0135

Federal Form Document

ICR Details
1210-0135 201004-1210-006
Historical Active 201003-1210-001
DOL/EBSA
Request to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 04/23/2010
Retrieve Notice of Action (NOA) 04/21/2010
  Inventory as of this Action Requested Previously Approved
11/30/2012 11/30/2012 11/30/2012
15,400 0 15,400
14,350 0 14,350
8,000 0 8,000

Section 3001 of the American Recovery and Reinvestment Act of 2009 (ARRA) provides "Assistance Eligible Individuals" with the right to pay reduced COBRA premiums for up to 9 months. If individuals request treatment as an assistance eligible individual and are denied such treatment because of their ineligibility for COBRA continuation coverage, ARRA section 3001(a)(5) requires the Secretary of Labor to provide for expedited review of the denial upon application to the Secretary in the form and manner the Secretary provides. The Secretary of Labor is required to act in consultation with the Secretary of the Treasury and must make a determination within 15 business days after receipt of an individual’s application for review. The “Application to the Department of Labor for Expedited Review of Denial of COBRA Premium Reduction” (the "Application") is the form used by individuals to file their expedited review appeals. Such individuals must complete all information requested on the Application in order to file their review requests with the Department’s Employee Benefits Security Administration (EBSA). The ICR relates to the Application.

PL: Pub.L. 111 - 5 3001(a)(5) Name of Law: American Recovery and Reinvestment Act of 2009
  
PL: Pub.L. 111 - 5 3001(a)(5) Name of Law: American Recovery and Reinvestment Act of 2009

Not associated with rulemaking

  74 FR 28279 06/15/2009
74 FR 48780 09/24/2009
Yes

  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 15,400 15,400 0 0 0 0
Annual Time Burden (Hours) 14,350 14,350 0 0 0 0
Annual Cost Burden (Dollars) 8,000 8,000 0 0 0 0
No
No
The hour and cost burden associated with this ICR has been reduced since EBSA made its emergency submission in April 2009. This reduction is due to the fact that of eligible enrollees, EBSA has found that only .12 percent of the eligible population both applied for the COBRA subsidy, were denied, and formally appealed to the U.S. Department of Labor. The Department therefore estimates that only 14,000 individuals (reduced from 95,000) would file an appeal with the Department, and that the costs associated with the ICR would be $7,960 (reduced from $52,000).

$6,858,000
No
No
Uncollected
Uncollected
Yes
Uncollected
Christopher Cosby 202-693-8425 [email protected]

  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.
04/21/2010


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