Federal Employee Health Benefits (FEHB) Open Season Express Interactive Response (IVR) System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FEHB IVR Federal Employee Health Benefits (FEHB) Open Season Express Interactive Response (IVR) System	Form and Instruction	Modified	Available
AHBOSS_PIA_2012_07.pdf	Supplementary Document	Uploaded 2017-09-25	Available
FEHB2017_IVR_WorkFlow.pdf	Supplementary Document	Uploaded 2017-09-25	Repair queued
FEHB2017_IVR_WEB_Pages_Part03.pdf	Supplementary Document	Uploaded 2017-09-25	Available
FEHB2017_IVR_WEB_Pages_Part02.pdf	Supplementary Document	Uploaded 2017-09-25	Available
FEHB2017_IVR_WEB_Pages_Part01.pdf	Supplementary Document	Uploaded 2017-09-25	Available
FEHB2017_IVR_Scripts.pdf	Supplementary Document	Uploaded 2017-09-25	Available
FEHBOSIVR_60DayFRN_Published_2017_05_17.pdf	Supplementary Document	Uploaded 2017-09-25	Available
FEHBOSIVR_30DayFRN_Published_2017_09_21.pdf	Supplementary Document	Uploaded 2017-09-25	Available
FEHB_IVR_OMBSuppStmt_2017.docx	Supporting Statement A	Uploaded 2017-09-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
33690	Federal Employee Health Benefits (FEHB) Open Season Express Interactive Response (IVR) System	Form and Instruction	Modified

ICR Details

OMB Control No: 3206-0201	ICR Reference No: 201709-3206-012
Status: Active	Previous ICR Reference No: 201404-3206-002
Agency/Subagency: OPM	Agency Tracking No:
Title: Federal Employee Health Benefits (FEHB) Open Season Express Interactive Response (IVR) System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/20/2017
	Date Received in OIRA: 09/29/2017
Terms of Clearance: This collection is approved based on the revised materials provided by the Agency.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	11/30/2017
Responses	350,100	0	350,100
Time Burden (Hours)	58,349	0	58,349
Cost Burden (Dollars)	0	0	0

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Abstract: The FEHB Open Season Express IVR System and the Open Season web site, Open Season Online, is used by retirees and survivors; it collects information for changing FEHB enrollments, collecting dependent and other insurance information for self and family enrollments, requesting plan brochures, requesting a change of address, requesting cancellation or suspension of FEHB benefits, asking to making payment to the Office of Personnel Management when the FEHB payment is greater than the monthly annuity amount, or requesting FEHB plan accreditation and Customer Satisfaction Survey information. We have made editorial text changes to this information collection request (ICR).

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Authorizing Statute(s): US Code: 5 USC 8905 Name of Law: null
   US Code: 5 USC 8905A Name of Law: Continued Coverage
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 22679	05/17/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 44221	09/21/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Federal Employee Health Benefits (FEHB) Open Season Express Interactive Response (IVR) System	FEHB IVR, FEHB IVR, FEHB IVR	Open Season Online ,   Open Season Online ,   Open Season Online

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ICR Summary of Burden

table that charts list of burden

	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	350,100	350,100	0	0	0	0
Annual Time Burden (Hours)	58,349	58,349	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $268,500

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/29/2017

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