Notice Requirements of the Health Care Continuation Coverage Provisions

ICR 201609-1210-001

OMB: 1210-0123

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2016-09-22
ICR Details
1210-0123 201609-1210-001
Historical Active 201406-1210-001
DOL/EBSA
Notice Requirements of the Health Care Continuation Coverage Provisions
Extension without change of a currently approved collection   No
Regular
Approved without change 12/20/2016
Retrieve Notice of Action (NOA) 10/07/2016
  Inventory as of this Action Requested Previously Approved
12/31/2019 36 Months From Approved 12/31/2016
16,052,495 0 20,712,556
0 0 0
30,490,898 0 26,554,404

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides that under certain circumstances participants and beneficiaries of group health plans that satisfy the definition of “qualified beneficiaries” under COBRA may elect to continue group health coverage temporarily following events known as “qualifying events” that would otherwise result in loss of coverage. COBRA provides that the Secretary of Labor (the Secretary) has the authority under section 608 of the Employee Retirement Income Security Act of 1974 (ERISA) to carry out the provisions of Part 6 of title I of ERISA. The Conference Report that accompanied COBRA authorized the Secretary to issue regulations implementing the notice and disclosure requirements of COBRA. Under the regulatory guidelines, plan administrators are required to distribute notices as follows: a general notice to be distributed to all participants in group health plans subject to COBRA; an employer notice that must be completed by the employer upon the occurrence of a qualifying event; a notice and election form to be sent to a participant upon the occurrence of a qualifying event that might cause the participant to lose group health coverage; an employee notice that may be completed by a qualified beneficiary upon the occurrence of certain qualifying events such as divorce or disability; and, two other notices, one of early termination and the other a notice of unavailability. Also included in the ICR are two model notices that the Department believes will help reduce costs for service providers in preparing and delivering notices to comply with the regulations.

US Code: 29 USC 1166 Name of Law: Employee Retirement Income Security Act
   US Code: 29 USC 1168 Name of Law: Employee Retirement Income Security Act
  
None

Not associated with rulemaking

  81 FR 33550 05/26/2016
81 FR 69858 10/07/2016
No

1
IC Title Form No. Form Name
Notice Requirements of the Health Care Continuation Coverage Provisions

  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 16,052,495 20,712,556 0 0 -4,660,061 0
Annual Time Burden (Hours) 0 0 0 0 0 0
Annual Cost Burden (Dollars) 30,490,898 26,554,404 0 0 3,936,494 0
No
No

$0
No
No
Yes
No
No
Uncollected
Allan Beckmann 202 693-8429 [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.
10/07/2016


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