Information Collection

TD 9489- Interim & Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan under the Patient Protection and Affordable Care Act

IC 193151 under ICR 202011-1545-008 · OMB 1545-2178.

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Information Collection (IC) Details

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IC Title:	TD 9489- Interim & Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan under the Patient Protection and Affordable Care Act	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 146.145 26 CFR 54.9831 29 CFR 2590.732 26 CFR 54.9815-1251T

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: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 133,200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 38 %

	Approved	Previously Approved
Annual Number of Responses for this IC	66,600	66,600
Annual IC Time Burden (Hours)	2,220	2,220
Annual IC Cost Burden (Dollars)	366,800	366,800

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