Consolidated Omnibus Budget Reconciliation Act Health Benefits Subsidy Under the American Recovery and Reinvestment Act of 2009 Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
COBRA_OMBResponseMemo-Sept13.docx	Supplementary Document	Uploaded 2012-09-25	Available
PART B. App_A_TAA Incentive Experiment Results(kg).pdf	Supplementary Document	Uploaded 2012-04-04	Available
PART A APP_A-FedRegNotice.pdf	Supplementary Document	Uploaded 2012-04-04	Available
BLS Approval.PDF	Supplementary Document	Uploaded 2012-03-27	Available
PART A.rev.pdf	Supporting Statement A	Uploaded 2012-04-04	Available
PART B.docx	Supporting Statement B	Uploaded 2012-04-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
201487	Impact of the ARRA Subsidy on COBRA Take-up Pre-screener	Other-Survey	New
199766	COBRA Subsidy Study	Other-Survey	New

ICR Details

OMB Control No: 1291-0001	ICR Reference No: 201109-1291-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOL/OASAM	Agency Tracking No:
Title: Consolidated Omnibus Budget Reconciliation Act Health Benefits Subsidy Under the American Recovery and Reinvestment Act of 2009 Evaluation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/25/2012
	Date Received in OIRA: 04/10/2012
Terms of Clearance: This information collection request is approved as supplemented by DOL's response memo providing additional information, appended to this record. In addition, DOL agrees to amend the incentives associated with the collection to limit payment to $40 for respondents who call in and $30 to those who wait to be called. DOL will amend its submission to reflect this via a nonsubstantive change request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2015	36 Months From Approved
Responses	31,800	0	0
Time Burden (Hours)	5,217	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This Information Collection Request is needed to conduct an evaluation of the impact of a subsidy for health benefits under the Consolidated Omnibus Budget Reconciliation Act (COBRA) that was provided by the American Recovery and Reinvestment Act (ARRA) of 2009. The subsidy was available to workers who experienced involuntary termination of a job from September 2008 to May 2010, were eligible for COBRA at the time of job loss, and were not eligible for certain other health insurance options. The overall aim of the evaluation is to determine whether and how people who had employer-sponsored health insurance maintained health care coverage after employment termination and whether the COBRA subsidy provided by ARRA led to increased health care coverage. The Department of Labor is requesting Office of Management and Budget clearance for approval to conduct a one-time survey of randomly selected unemployment insurance recipients as part of this evaluation.

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Authorizing Statute(s): None

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:
	76 FR 77263	12/12/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 21586	04/10/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
COBRA Subsidy Study
Impact of the ARRA Subsidy on COBRA Take-up Pre-screener

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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	31,800	0	0	31,800	0	0
Annual Time Burden (Hours)	5,217	0	0	5,217	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new information collection to support a program evaluation.

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Annual Cost to Federal Government: $3,499,443

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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)? Yes

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: 04/10/2012

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