Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-Grandfathered Plans

ICR 201203-1210-002

OMB: 1210-0144

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1210-0144 201203-1210-002
Historical Active 201105-1210-001
DOL/EBSA
Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-Grandfathered Plans
Extension without change of a currently approved collection   No
Regular
Approved without change 07/06/2012
Retrieve Notice of Action (NOA) 05/02/2012
  Inventory as of this Action Requested Previously Approved
07/31/2015 36 Months From Approved 07/31/2012
117,864 0 117,864
886 0 886
642,461 0 642,461

This collection of information request includes the information collection and third party notice and disclosure requirements that a plan must satisfy under interim final regulations implementing provisions of the Affordable Care Act pertaining to internal claims and appeals, and the external review process.

PL: Pub.L. 111 - 148 2719 Name of Law: Patient Protection and Affordable Care Act
  
PL: Pub.L. 111 - 148 2719 Name of Law: Patient Protection and Affordable Care Act

Not associated with rulemaking
Other Documents for OIRA Review

  77 FR 10781 02/23/2012
77 FR 26046 05/02/2012
No

  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 117,864 117,864 0 0 0 0
Annual Time Burden (Hours) 886 886 0 0 0 0
Annual Cost Burden (Dollars) 642,461 642,461 0 0 0 0
No
No

$0
No
No
Yes
No
No
Uncollected
Christopher Cosby 202-693-8425 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/02/2012


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