Notice for Health Reimbursement Arrangements integrated with Individual Health Insurance Coverage

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SSA 1210-0160 HRA 06-05-2019.docx	Supporting Statement A	Uploaded 2019-06-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
233410	HRA Notice to Participants and other disclosures	Other-Model	Modified

ICR Details

OMB Control No: 1210-0160	ICR Reference No: 201905-1210-001
Status: Active	Previous ICR Reference No: 201810-1210-001
Agency/Subagency: DOL/EBSA	Agency Tracking No:
Title: Notice for Health Reimbursement Arrangements integrated with Individual Health Insurance Coverage
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/26/2019
	Date Received in OIRA: 06/13/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2022	36 Months From Approved
Responses	9,399,428	0	0
Time Burden (Hours)	196,992	0	0
Cost Burden (Dollars)	120,662	0	0

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Abstract: The rules would remove the current prohibition on integrating HRAs with individual health insurance coverage, if certain conditions are met including notice requirements. The rules also set forth conditions under which certain HRAs would be recognized as limited excepted benefits. DOL is providing a safe harbor to provide HRA plan sponsors with assurance that the individual health insurance coverage that is integrated with an HRA would not become part of an ERISA plan if the conditions of the safe harbor are met.

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Authorizing Statute(s): US Code: 29 USC 2510 and 2590 Name of Law: Employee Retirement Income Security Act of 1974 (ERISA)
   EO: EO 13813 Name/Subject of EO: Promoting Healthcare Choice and Competition Across the United States
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1210-AB87	Final or interim final rulemaking	84 FR 28888	06/20/2019

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 57585	11/15/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 57585	11/15/2018
Did the Agency receive public comments on this ICR? Yes

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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
HRA Notice to Participants and other disclosures

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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	9,399,428	0	0	9,399,428	0	0
Annual Time Burden (Hours)	196,992	0	0	196,992	0	0
Annual Cost Burden (Dollars)	120,662	0	0	120,662	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: This is a new information collection in response to Executive Order 13813 , “Promoting Healthcare Choice and Competition Across the United States.” The executive order directed the Agencies to increase usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage. The ICRs are needed to notify the HRA that participants are enrolled in individual health insurance coverage, to help individuals understand the impact of enrolling in an HRA on their eligibility for the PTC, and that coverage is not subject to the rules and consumer protections of the Employee Retirement Income Security Act (ERISA).

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Annual Cost to Federal Government: $0

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.     No

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.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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: 06/13/2019

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