Information Collection

Health Benefits Education Campaign Compliance Assistance Generic IC

IC 235184 under ICR 201701-1225-001 · OMB 1225-0088.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HBEC Survey 2019.pdf	Other-survey
HBEC Survey Supporting Statement 2019.pdf Health Benefits Education Campaign Compliance Assistance Supplemental Statement	IC Document

IC Title:

Health Benefits Education Campaign Compliance Assistance Generic IC

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			HBEC Survey 2019.pdf		No		Printable 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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
Health Benefits Education Campaign Compliance Assistance Supplemental Statement	HBEC Survey Supporting Statement 2019.pdf	03/11/2019

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