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Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent Coverage

IC 192671 under ICR 201011-1210-003 · OMB 1210-0139.

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Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent Coverage
 
No Modified
 
Required to Obtain or Retain Benefits
 
29 CFR 2590.715-2714(f)

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

Income Security General Retirement and Disability

 

2,800,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   38 %

  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 79,573,000 0 0 0 0 79,573,000
Annual IC Time Burden (Hours) 411,000 0 0 0 0 411,000
Annual IC Cost Burden (Dollars) 1,233,500 0 0 0 0 1,233,500

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