PTE 1990-1; Insurance Company Pooled Separate Accounts

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
PTE 90-1ss15final.docx	Supporting Statement A	Uploaded 2015-10-18	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43796	PTE 90-1; Insurance Company Pooled Separate Accounts	Other-PTE 90-1	Modified

ICR Details

OMB Control No: 1210-0083	ICR Reference No: 201509-1210-001
Status: Historical Active	Previous ICR Reference No: 201205-1210-002
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: PTE 1990-1; Insurance Company Pooled Separate Accounts
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/23/2015
	Date Received in OIRA: 10/23/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2018	36 Months From Approved	12/31/2015
Responses	960	0	640
Time Burden (Hours)	160	0	107
Cost Burden (Dollars)	0	0	0

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Abstract: PTE 90-1 permits parties in interest to an employee benefit plan that invests in an insurance company pooled separate account to engage in transactions with the separate account under specified conditions

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Authorizing Statute(s): US Code: 29 USC 1108 Name of Law: Employee Retirement Income Security Act of 1974
   US Code: 26 USC 4975(c)(2) Name of Law: Internal Revenue Code
  

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:
	80 FR 34696	06/17/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 64451	10/23/2015
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
PTE 90-1; Insurance Company Pooled Separate Accounts

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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	960	640	0	0	320	0
Annual Time Burden (Hours)	160	107	0	0	53	0
Annual Cost Burden (Dollars)	0	0	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 since the last submission. However, the Department has made certain minor adjustments based on new data. First, the number of insurance companies offering pooled separate accounts has increased from 64 companies to 96 companies, based on 2012 Form 5500 data. The result is that the Department's estimate of the annual hour burden for this ICR has increased from 107 hours to 160 hours. Additionally, wage rates have been updated to reflect increased labor costs.

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Annual Cost to Federal Government: $0

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: 10/23/2015

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