Information Collection

Affordable Care Act Enrollment Opportunity Notice Relating to Lifetime Limits

IC 193312 under ICR 201006-1545-035 · OMB 1545-2179.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2179 can be found here:

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Document Name	Document Type

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IC Title:

Affordable Care Act Enrollment Opportunity Notice Relating to Lifetime Limits

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 54.9815-2711T

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: General Government

Subfunction: Taxation Management

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: 0 %

table that charts list of burden
	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)	0	0

Documents for IC

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