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Federal forms, ICRs, and supporting documents

Information Collection

COBRA Notification Requirements--American Recovery and Reinvestment Act of 2009 as amended by Department of Defense Appropriations Act, 2010

IC 188172 under ICR 201006-1210-002 · OMB 1210-0123.

Documents and Forms
Document Name
Document Type
Other-Model Notice
Other-Model Notice
Other-Model Notice
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

COBRA Notification Requirements--American Recovery and Reinvestment Act of 2009 as amended by Department of Defense Appropriations Act, 2010
 
No Removed
 
Voluntary
 
29 CFR 2590.606(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Model Notice Updated Model Alternative Notice final.doc Yes No Printable Only
Other-Model Notice Updated Model General Notice - full version final.doc Yes No Printable Only
Other-Model Notice Model Premium Assistance Extension Notice final.doc Yes No Printable Only

Income Security General Retirement and Disability

 

2,700,000 0
   
Private Sector Businesses or other for-profits
 
   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 0 0 -8,500,000 0 0 8,500,000
Annual IC Time Burden (Hours) 0 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 -6,800,000 0 0 6,800,000

Title Document Date Uploaded
ARRA Extension Draft Federal Register Notice ARRA extension model FR notice 12 23 09 final.doc 12/24/2009
ARRA Emergency Federal Register Notice COBRAEmergencyFRN2010.doc 12/24/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.