T.D. 8812 Continuation Coverage Requirements Applicable to Group Health Plans

ICR 201411-1545-052

OMB: 1545-1581

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2014-12-19
IC Document Collections
ICR Details
1545-1581 201411-1545-052
Historical Active 201110-1545-017
TREAS/IRS Ready
T.D. 8812 Continuation Coverage Requirements Applicable to Group Health Plans
Extension without change of a currently approved collection   No
Regular
Approved without change 03/05/2015
Retrieve Notice of Action (NOA) 12/31/2014
  Inventory as of this Action Requested Previously Approved
03/31/2018 36 Months From Approved 03/31/2015
12,079,600 0 12,079,600
404,640 0 404,640
0 0 0

The regulations require group health plans to provide notices to individuals who are entitled to elect COBRA (The Consolidated Omnibus Budget Reconciliation Act of 1985) continuation coverage of their election rights. Individuals who wish to obtain the benefits provided under the statute are required to provide plans notices in the cases of divorce from the covered employee, a dependent child's ceasing to be dependent under the terms of the plan, and disability. Most plans will require that elections of COBRA continuation coverage be made in writing. In cases where qualified beneficiaries are short by an insignificant amount in a payment made to the plan, the regulations require the plan to notify the qualified beneficiary if the plan does not wish to treat the tendered payment as full payment. If a health care provider contacts a plan to confirm coverage of a qualified beneficiary, the regulations require that the plan disclose the qualified beneficiary's complete rights to coverage.

US Code: 26 USC 4980 Name of Law: Tax on reversion of qualified plan assets to employer
   US Code: 26 USC 106 Name of Law: Contributions by employer to accident and health plans
   US Code: 26 USC 162 Name of Law: Itemized Deductions for individuals and Corporations
  
None

Not associated with rulemaking

  79 FR 60893 10/08/2014
79 FR 78566 12/30/2014
No

1
IC Title Form No. Form Name
T.D. 8812 Continuation Coverage Requirements Applicable to Group Health Plans

  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 12,079,600 12,079,600 0 0 0 0
Annual Time Burden (Hours) 404,640 404,640 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
No
No
No
Uncollected
Russell Weinheimer 202 622-6080

  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.
12/31/2014


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