Information Collection

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

IC 193288 under ICR 201009-1210-003 · OMB 1210-0143.

⚠️ Notice: This information collection may be referencing outdated material.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

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Information Collection (IC) Details

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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:

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 %

	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

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