Information Collection

Affordable Care Act Enrollment Opportunity Notice -- Prohibition on Lifetime Limits

IC 193288 under ICR 201006-1210-004 · OMB 1210-0143.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1210-0143 can be found here:

Documents and Forms

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Document Name	Document Type

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IC Title:

Affordable Care Act Enrollment Opportunity Notice -- Prohibition on Lifetime Limits

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2590.2711

Information Collection Instruments:

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

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 315

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 38 %

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	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	29,000	29,000
Annual IC Time Burden (Hours)	1,300	1,300
Annual IC Cost Burden (Dollars)	7,000	7,000

Documents for IC

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Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.