Health Benefits Education Campaign Compliance Assistance Survey

Department of Labor Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0088 can be found here:

Documents and Forms

Document Name Document Type
hbecsurvey1117.pdf Other-Survey
EBSA HBEC Survey Mini SS.pdf EBSA HBEC Survey Mini SS IC Document

Information Collection (IC) Details

IC Title:	Health Benefits Education Campaign Compliance Assistance Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			hbecsurvey1117.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
EBSA HBEC Survey Mini SS	EBSA HBEC Survey Mini SS.pdf	02/01/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.