appealssupportingstatement 2OMB

SUPPORTING STATEMENT FOR REQUEST FOR OMB APPROVAL
UNDER THE PAPERWORK REDUCTION ACT AND 5 CFR PART 1320

AGENCY:

Pension Benefit Guaranty Corporation

TITLE:

Administrative Appeals

STATUS:

Request for renewal of a currently approved collection of information (OMB
control no. 1212-0061; expires May 31, 2016)

CONTACT: Deborah C. Murphy (326-4400, ext. 3451) or Donald F. McCabe (326-4223, ext.
3872)
A.

Justification.
1. Need for collection. PBGC’s regulation on Rules for Administrative Review of

Agency Decisions (29 CFR part 4003) prescribes rules governing the issuance of initial
determinations by PBGC and the procedures for requesting and obtaining administrative review
of initial determinations. Certain types of initial determinations are subject to administrative
appeals, which are covered in subpart D of the regulation. Subpart D prescribes regulations on
who may file appeals, when and where to file appeals, contents of appeals, and other matters
relating to appeals.
Under the regulation, an appeal must: (1) be in writing; (2) be clearly designated as an
appeal; (3) contain a statement of the grounds upon which it is brought and the relief sought;
(4) reference all pertinent information already in the possession of PBGC and include any
additional information believed to be relevant; (5) state whether the appellant desires to appear in
person or through a representative before the Appeals Board; and (6) state whether the appellant
desires to present witnesses to testify before the Appeals Board, and, if so, why the presence of
witnesses will further the decision-making process. Under the regulation, where the appellant

believes that another person may be aggrieved if PBGC grants the relief sought, the appeal must
include the name(s) and address(es) (if known) of such other person(s). In addition, PBGC
requires from individual appellants: (1) their Social Security Number; (2) the name of the
pension plan; (3) the PBGC case number assigned to the plan; (4) their daytime telephone
number; (4) the name and Social Security Number of the plan participant, if the appellant is not
the participant; (5) a list of information requests for which the appellant is awaiting PBGC’s
response; (6) and, if possible, a copy of the PBGC formal determination letter and benefit
statement. Further, PBGC requests from appellants: (1) copies of documents that provide
additional information that the Appeals Board should consider, especially if they support the
appellant’s claim; (2) a description of relevant information that the appellant believes is known
by PBGC; and (3) the appellant’s e-mail address.
Most appeals filed with PBGC are filed by individuals (participants, beneficiaries, and
alternate payees) in connection with benefit entitlement or amounts. A small number of appeals
are filed by employers in connection with other matters, such as plan coverage under ERISA
section 4021 or employer liability under ERISA sections 4062(b)(1), 4063, or 4064. Appeals
may be filed by hand, mail, commercial delivery service, fax or e-mail. For appeals of benefit
determinations, PBGC has developed optional forms for filing appeals and requests for
extensions of time to appeal.
2. Use of Information. The purpose of the collection of information is to enable affected
individuals and employers to appeal initial determinations made by PBGC. The information is
used by PBGC’s Appeals Board to resolve matters raised in such appeals.

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3. Reducing the Burden. By creating optional forms for individual appellants, PBGC has
reduced the burden for individuals to furnish the information required for appeals. The optional
forms are available on PBGC’s Web site, www.pbgc.gov.
4. Duplicate or similar information. Most of the information collected is not otherwise
available to the PBGC Appeals Board. Even for those items of information that have otherwise
been provided to other parts of PBGC, the relatively small burden associated with this collection
is far offset by the greater assurance that appeals will be processed correctly.
5. Consequence of reduced collection. This collection of information is necessary for
individuals and employers to file appeals of initial determinations by PBGC. If this collection of
information were required less frequently or not at all, individuals and employers would not be
able to file appeals.
6. Consistency with guidelines. This collection of information is consistent with the
guidelines in 5 CFR § 1320.6.
7. Outside input. PBGC published a Federal Register notice soliciting public comment
on this collection of information on February 29, 2016, at 81 FR 10289. No public comments
were received in response to the notice.
8. Payment to respondents. PBGC provides no payments or gifts to respondents in
connection with this collection of information.
9. Confidentiality. Confidentiality of information is that afforded by the Freedom of
Information Act and the Privacy Act. PBGC's rules that provide and restrict access to its records
are set forth in 29 CFR Part 4901.
10. Sensitive Questions. This collection of information does not call for submission of
information of a sensitive or private nature.
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11. Burden on the public. PBGC based its estimates in items 11 and 12 on its
experience. The burden on the appellant will vary depending on whether the appellant is an
individual or an employer, whether the appellant hires professionals, and whether the appellant
uses the optional forms. In addition, the burden for filing an appeal will differ from the burden
for filing of an extension request.
PBGC estimates that in each of the next three years there will be 700 appeals and 200
extension requests and that 99.5 percent of the filers in each category will be individuals and 0.5
percent will be employers. PBGC further estimates that of the individuals who file appeals and
extension requests, 90 percent in each category will make the filings themselves and 10 percent
will hire professionals, and that all employers filing appeals will hire professionals. PBGC
estimates that 30 percent of individual appellants will use the optional forms for filing appeals
and 60 percent will use the form for filing extension requests, and that no employers filing
appeals or extension requests will use either of the optional forms.
For individual appellants not hiring professionals, the burden estimate takes into account
only the hour burden. For appeals, PBGC estimates that the burden will be one hour if a form is
not used and 45 minutes if a form is used. For extension requests, PBGC estimates that the
burden will be 30 minutes if a form is not used and 15 minutes if a form is used.
Based on these estimates, PBGC estimates that, for each of the next three years, an
average of 696.5 individuals (700 x 0.995) and 3.5 employers (700 x 0.005) will file appeals.
626.85 of the individuals (696.5 x 0.9) will file the appeals themselves, while 69.65 of them
(696.5 x 0.1) will hire professionals. Of the 626.85 individuals filing appeals themselves, 188.06
(626.85 x 0.3) will use the optional forms, while 438.79 (626.85 x 0.7) will not.

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The hour burden for the 188.06 individuals who file appeals themselves (without using
professionals) using the forms is estimated to be 0.75 hours per individual, for a total of 141.05
hours (188.06 x 0.75 hours). The hour burden for the 438.79 individuals who file appeals
themselves without using forms is estimated to be 1 hour per individual, for a total of 438.79
hours (438.79 x 1 hour). Thus the total hour burden for individuals filing appeals themselves is
estimated to be 579.84 hours (141.05 + 438.79).
PBGC estimates that an average of 199 individuals (200 x 0.995) and 1 employer (200 x
0.005) per year will file extension requests. Ninety percent of these 199 individuals (179.1) will
file extension requests themselves (without using professionals), and ten percent (19.9) will hire
professionals. The employer will hire a professional. Of the 179.1 individuals who file appeals
themselves, 107.46 (179.1 x 0.6) will use the optional extension request form, and 71.64 (179.1 x
0.4) will not. The hour burden for the 107.46 individuals who use the optional extension request
form is estimated to be 0.25 hours, for a total burden of 26.87 hours (107.46 x 0.25 hours). The
hour burden for the 71.64 individuals who do not use the optional extension request form is
estimated to be 0.5 hours, for a total burden of 35.82 hours (71.64 x 0.5). Thus, the total burden
for individuals not using professionals to file extension requests is estimated to be 62.69 hours
(26.87 + 35.82).
Thus, the total annual hour burden for filing of appeals and extension requests is
estimated to be 579.84 hours + 62.69 hours = 642.53 hours. For 900 appellants, this is an
average hour burden per appellant of 0.71 hours.
12. Costs. For appellants hiring professionals, PBGC assumes that there is no hour
burden on the appellant and that the cost burden on the appellant will be the same regardless of
whether the optional forms are used. For individuals hiring professionals, PBGC estimates that
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the cost of filing an appeal will be $600 (3 hours x $200/hour) and the cost of filing an extension
request will be $100 (0.5 hours x $200/hour). For employers hiring professionals, PBGC
estimates that the cost of filing an appeal will be $800 (4 hours x $200/hour) and the cost of
filing an extension request will be $100 (0.5 hours x $200/hour).
The cost burden for the 69.65 individuals filing appeals who hire professionals is
estimated to be $41,790 (69.65 x $600). The cost burden for the 3.5 plans filing appeals is
estimated to be $2,800 (3.5 x $800). The total annual cost burden for appeals is estimated to be
$44,590.
The cost burden for the 19.90 individuals filing extension requests who hire professionals
is estimated to be $1,990 (19.9 x $100). The cost burden for the 1.0 employers filing extension
requests is estimated to be $100 (1.0 x $100). The total annual cost burden for extension
requests is estimated to be $2,090.
Thus, the total annual cost burden for all appellants hiring professionals is estimated to be
$44,590 + $2,090 = $46,680. For 900 appellants, this is an average annual cost burden for each
appellant of $51.86.
13. Costs to the Federal government. PBGC estimates that the annual cost to the
government of this collection of information will be $45,000. This estimate is based on an
average cost of $50 per filing multiplied by 900 total filings, including administrative staff time
and prorated cost of equipment for reading the incoming information, sending it for imaging,
adding it to PBGC’s software system, and sending a letter to filing acknowledging receipt.
14. Adjustments. There have been no changes in the figures for numbers of appeals,
costs, and burdens since the last submission.

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15. Publication plans. PBGC does not intend to publish the results of this collection of
information.
16. Display of expiration date. PBGC is not seeking approval to not display the
expiration date for OMB approval of this information collection.
17. Exceptions to certification statement. There are no exceptions to the certification
statement.
B. Collections of Information Employing Statistical Methods.
This collection of information is not intended for statistical analysis or publication.

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