Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)

ICR 201703-3206-010

OMB: 3206-0136

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Supplementary Document
2017-03-23
Supplementary Document
2017-03-23
Supporting Statement A
2017-03-23
ICR Details
3206-0136 201703-3206-010
Historical Active 201401-3206-001
OPM
Designation of Beneficiary - Federal Employees' Group Life Insurance Program (FEGLI)
Extension without change of a currently approved collection   No
Regular
Approved without change 10/02/2017
Retrieve Notice of Action (NOA) 03/27/2017
  Inventory as of this Action Requested Previously Approved
10/31/2020 36 Months From Approved 09/30/2017
48,000 0 48,000
12,000 0 12,000
0 0 0

Standard Form 2823 is used by any Federal employee or retiree covered by the Federal Employees' Group Life Insurance (FEGLI) Program, or an assignee who owns an insured's coverage, to instruct the Office of Federal Employees' Group Life Insurance how to distribute the proceeds of the FEGLI coverage when the statutory order of precedence does not meet his or her needs. OPM is revising the form to clarify its policy regarding the filing of court orders used for the payment of FEGLI benefits. In addition, OPM is making some minor textual changes to explain how and to whom proceeds can be designated, and to emphasize that the insured individual keep the designation updated as needs change.

US Code: 5 USC Section 8705, Subpart G Name of Law: Insurance and Annuities
  
None

Not associated with rulemaking

  81 FR 64958 09/21/2016
82 FR 41 03/03/2017
No

  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 48,000 48,000 0 0 0 0
Annual Time Burden (Hours) 12,000 12,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$12,700
No
    Yes
    Yes
No
No
No
Uncollected
Charles Conyers 202 606-0125 [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.
03/27/2017


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