FED VIP (BENFEDS.com)

Federal Employees Dental and Vision Insurance Program (FEDVIP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3206-0272 can be found here:

Documents and Forms

Document Name Document Type
Benefeds Screens - OPM Oct2018.pdf BENFEDS Screens 1 IC Document
Benefeds Screens - OPM Oct2018.pptx BENFEDS Screens 2 IC Document
FEDVIP Privacy Statement.png Privacy Act Statement IC Document
public burden statement.png Public Burden Statement IC Document

Information Collection (IC) Details

IC Title:	FED VIP (BENFEDS.com)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 5 CFR Chapter 89 A 5 CFR Chapter 89B (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: OPM/Central-1, Civil Service Retirement and Insurance Records	FR Citation: 82 FR 32191

Number of Respondents: 332,304	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	332,304	0	332,304
Annual IC Time Burden (Hours)	44,307	0	44,307
Annual IC Cost Burden (Dollars)	158,988	158,988	0

Documents for IC

Title	Document	Date Uploaded
BENFEDS Screens 1	Benefeds Screens - OPM Oct2018.pdf	10/31/2018
BENFEDS Screens 2	Benefeds Screens - OPM Oct2018.pptx	10/31/2018
Privacy Act Statement	FEDVIP Privacy Statement.png	07/30/2019
Public Burden Statement	public burden statement.png	07/30/2019

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