Annual Report for Multiple Employer Welfare Arrangements (Form M-1)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form M-1 Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)	Form and Instruction	Modified	Available
Justification for nonmaterial nonsubstantive change--2010 Form M-1final.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2011-01-10	Available
1210-0116-SSPRA-2010_2-18-2010.doc	Supporting Statement A	Uploaded 2010-02-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13484	Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)	Form and Instruction	Modified

ICR Details

OMB Control No: 1210-0116	ICR Reference No: 201101-1210-001
Status: Historical Active	Previous ICR Reference No: 201002-1210-002
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Annual Report for Multiple Employer Welfare Arrangements (Form M-1)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/20/2011
	Date Received in OIRA: 01/10/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2013	03/31/2013	03/31/2013
Responses	464	0	464
Time Burden (Hours)	62	0	62
Cost Burden (Dollars)	44,000	0	44,000

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Abstract: The Health Insurance Portability and Accountability Act of 1996 (HIPAA), codified as Part 7 of Title I of the Employee Retirement Security Act of 1974 (ERISA), was enacted to improve the portability and continuity of health care coverage for participants and beneficiaries of group health plans. To insure compliance with Part 7, section 101(g) of ERISA, HIPAA permits the Secretary of Labor (the Secretary) to require multiple employer welfare arrangements (MEWAs), as defined in section 3(40) of ERISA, to report to the Secretary in such form and manner as the Secretary might determine. The Department of Labor (the Department) published a final rule providing for such reporting on an annual basis, together with a form (Form M-1) to be used by MEWAs for the annual report. See 29 CFR 2520.101-2. Pursuant to section 101(g) of ERISA, the Form M-1 information is used by governmental oversight entities to determine the extent of compliance with the requirements of Part 7 of ERISA by MEWAs and ECEs under section 3(40) of ERISA and to take appropriate compliance assistance and enforcement actions.

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Authorizing Statute(s): US Code: 29 USC 1021(g) Name of Law: Employee Retirement Income Security Act of 1974 (ERISA)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 62350	11/27/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 8750	02/25/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)	M-1	Annual Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception (Form M-1)

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	464	464	0	0	0	0
Annual Time Burden (Hours)	62	62	0	0	0	0
Annual Cost Burden (Dollars)	44,000	44,000	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There have been no program changes to this information collection. The changes in burden estimates derive solely from adjustments. The estimate of respondents is based on actual 2006, 2007 and 2008 Form M-1 filings. The fraction of M-1 filings that are estimated to be originations is .09 instead of .17 based on recent filing data. The wage estimates are now based on the National Occupation Employment Survey instead of the National Compensation Survey. The Department now assumes that filers use Priority Mail from the United States Postal Service instead of basic mail. The estimated clerical time was changed from 1 minute to 5 minutes. In addition, while an earlier ICR assumed the likelihood that a MEWA/ECE would make a separate filing for each ERISA-covered plan for which it provided benefits, this ICR assumes instead, based on the 2009 instructions to the Form M-1, that each MEWA/ECE will file one Form M-1 per year. In the 2007 update, this had significant implications in there being a lower cost burden compared to 2004 figures. Mailing costs are now estimated using Priority Mail to account for a possible desire to monitor receipt of the documents. There is no longer an expectation that processing costs will decline over time for the Federal Government or that reminders will have to be sent at a cost to the Government.

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Annual Cost to Federal Government: $9,600

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/10/2011

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