National Medical Support Notice-Part B

ICR 202102-1210-001

OMB: 1210-0113

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2021-02-11
Supporting Statement A
2020-09-15
IC Document Collections
ICR Details
1210-0113 202102-1210-001
Received in OIRA 202009-1210-001
DOL/EBSA
National Medical Support Notice-Part B
No material or nonsubstantive change to a currently approved collection   No
Regular 02/11/2021
  Requested Previously Approved
10/31/2022 10/31/2022
10,546,371 10,546,371
878,864 878,864
3,322,107 3,322,107

Section 609 of ERISA and 29 CFR 2590.609-2 establish a National Medical Support Notice. Part B of which is used to implement coverage of children under ERISA covered group health plans pursuant to "Qualified Medical Child Support Orders."

US Code: 29 USC 1169(a) Name of Law: Employee Retirement Income Security Act of 1974
  
None

Not associated with rulemaking

  84 FR 11573 03/27/2019
84 FR 44923 08/27/2019
Yes

1
IC Title Form No. Form Name
National Medical Support Notice - Part B

  Total Request 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 10,546,371 10,546,371 0 0 0 0
Annual Time Burden (Hours) 878,864 878,864 0 0 0 0
Annual Cost Burden (Dollars) 3,322,107 3,322,107 0 0 0 0
No
No

$0
No
    No
    No
No
No
No
No
Christopher Cosby 202-693-8425 [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.
02/11/2021


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